The Key to Passing the NCLEX? Critical Thinking

The NCLEX is one of the most stressful standardized exams around. While the ACT, SAT, GRE, or GMAT are extremely important exams that heavily influence one’s chances of admission to college or graduate school, they are one of many factors that are considered in the admissions process. The NCLEX is different. It functions as a true gatekeeper. If you don’t pass, there are no other factors that can help you move forward with your career as a nurse. Being a nurse requires passing the NCLEX. Failure means you must take a deep breath, return to your studies, and try again at some point soon. This is, of course, a stressful proposition that all future nurses would like to avoid.

There are only two real keys to passing the NCLEX.

First and obviously, you must know the content and understand the concepts you’ll be tested on and secondly, you must sharpen your critical thinking skills to apply your knowledge effectively, so you answer NCLEX questions correctly. I find that most students generally have much less trouble with the former than the latter. They also sometimes incorrectly assume that if they are learning and understanding nursing concepts in their degree program, they are naturally building the skills required to pass the NCLEX. But this is not completely true. There is a different between understanding the concepts and building the critical thinking skills required to apply them when you are taking the NCLEX.

For example, the National Council of the State Boards of Nursing published what is tested on the NCLEX in its Basic Test Plan. So, it’s straight forward to understand what will be on the exam and ensure you study the appropriate topics, which are:

• Safe and Effective Care Environment
  • Management of Care 17-23%
  • Safety and Infection Control 9-15%
• Health Promotion and Maintenance 6-12%
• Psychosocial Integrity 6-12%
• Physiological Integrity
  • Basic Care and Comfort 6-12%
  • Pharmacological and Parenteral Therapies 12-18%
  • Reduction of Risk Potential 9-15%
  • Physiological Adaptation 11-17%

The NCSBN also tells you that, across these content areas, a series of processes fundamental to effective nursing will be tested: Clinical nursing processes, caring, communication and documentation, teaching/learning, and culture.

This content is what you’ve studied in nursing school and if you’ve been successfully able to earn As and Bs in nursing classes, you’ll probably have a very good handle on this material.  But so many NCLEX takers fail one or more times and start to really have trouble understanding what is going on and why they aren’t passing.

The fact is, the NCLEX is not a test of your ability to remember facts. It requires understanding facts, but then going beyond that to determine what’s important and making the most informed choice possible about what to do next given the available facts.

The real key to passing the NCLEX is sharpening your critical thinking skills to successfully apply what you know to fluid, complex, and sometimes confusing nursing situations presented to you during the NCLEX exam.

What does critical thinking mean in the context of functioning as a nurse? Well, it covers the ability to, for example:

• Decide what’s important
• Look for important patterns
• Find linkages across situations such that knowledge gained in one area can be applied to another
• Choose the best course of action amongst several feasible alternatives
• Evaluate situations using the right set of criteria
• Communicate using appropriate methods for the situation

The above are the same types of skills and capabilities required to successfully answer NCLEX questions. Here is a super simple formula for “thinking critically” on the NCLEX:

• First, make sure you understand exactly what the question is asking. Many NCLEX questions provide more facts than you need, and it can be easy to get confused about what is being asked.
• Second, eliminate obviously incorrect answers. This is a time-tested test taking strategy that’s just as important for the NCLEX as it is for the ACT or SAT. Even if you don’t know what the right answer is, randomly choosing between two potentially correct answers gives you a much better chance of answering correctly than choosing between all four or five given answers.
• Last, prioritize and choose. There will be many NCLEX questions where the elimination of incorrect answers will lead you directly to the correct answer. However, in most cases, you’ll be left with 2 or maybe 3 choices that seem correct. So, you are left needing to think about what’s most important or identify a linkage that helps you prioritize the possible answers and choose the one that much be “more correct.” For example, you might be analyzing a situation involving a child in the emergency room, where you know you must address he fact that the child is having trouble breathing (that’s one answer), and you know there are critical follow up questions to ask the parent about what lead to this trouble breathing (that’s another answer). It might pop into your mind how important it is to understand what caused this situation to avoid it in the future. But, thinking critically, you realize what’s most important is ensuring the child begins breathing normally again so the situation doesn’t get worse or life threatening right now.

Summary

The NCLEX tests your ability to think through and manipulate facts, not your ability to memorize them. You must embrace the idea of building critical thinking skills to be successful on your next NCLEX attempt. This will serve you well on the NCLEX and as a nurse.