NCLEX exam sample questions

1. A patient arrives at the emergency department complaining of mid-sternal chest pain. Which of the following nursing action should take priority?

A. A complete history with emphasis on preceding events.
B. An electrocardiogram.
C. Careful assessment of vital signs.
D. Chest exam with auscultation.

2. A patient has been hospitalized with pneumonia and is about to be discharged. A nurse provides discharge instructions to a patient and his family. Which misunderstanding by the family indicates the need for more detailed information?

A. The patient may resume normal home activities as tolerated but should avoid physical exertion and get adequate rest.
B. The patient should resume a normal diet with emphasis on nutritious, healthy foods.
C. The patient may discontinue the prescribed course of oral antibiotics once the symptoms have completely resolved.
D. The patient should continue use of the incentive spirometer to keep airways open and free of secretions.

3. A nurse is caring for an elderly Vietnamese patient in the terminal stages of lung cancer. Many family members are in the room around the clock performing unusual rituals and bringing ethnic foods. Which of the following actions should the nurse take?

A. Restrict visiting hours and ask the family to limit visitors to two at a time.
B. Notify visitors with a sign on the door that the patient is limited to clear fluids only with no solid food allowed.
C. If possible, keep the other bed in the room unassigned to provide privacy and comfort to the family.
D. Contact the physician to report the unusual rituals and activities.

4. The charge nurse on the cardiac unit is planning assignments for the day. Which of the following is the most appropriate assignment for the float nurse that has been reassigned from labor and delivery?

A. A one-week postoperative coronary bypass patient, who is being evaluated for placement of a pacemaker prior to discharge.
B. A suspected myocardial infarction patient on telemetry, just admitted from the Emergency Department and scheduled for an angiogram.
C. A patient with unstable angina being closely monitored for pain and medication titration.
D. A post-operative valve replacement patient who was recently admitted to the unit because all surgical beds were filled.

5. A newly diagnosed 8-year-old child with type I diabetes mellitus and his mother are receiving diabetes education prior to discharge. The physician has prescribed Glucagon for emergency use. The mother asks the purpose of this medication. Which of the following statements by the nurse is correct?

A. Glucagon enhances the effect of insulin in case the blood sugar remains high one hour after injection.
B. Glucagon treats hypoglycemia resulting from insulin overdose.
C. Glucagon treats lipoatrophy from insulin injections.
D. Glucagon prolongs the effect of insulin, allowing fewer injections.

6. A patient on the cardiac telemetry unit unexpectedly goes into ventricular fibrillation. The advanced cardiac life support team prepares to defibrillate. Which of the following choices indicates the correct placement of the conductive gel pads?

A. The left clavicle and right lower sternum.
B. Right of midline below the bottom rib and the left shoulder.
C. The upper and lower halves of the sternum.
D. The right side of the sternum just below the clavicle and left of the precordium.

7. The nurse performs an initial abdominal assessment on a patient newly admitted for abdominal pain. The nurse hears what she describes as "clicks and gurgles in all four quadrants" as well as "swishing or buzzing sound heard in one or two quadrants." Which of the following statements is correct?

A. The frequency and intensity of bowel sounds varies depending on the phase of digestion.
B. In the presence of intestinal obstruction, bowel sounds will be louder and higher pitched.
C. A swishing or buzzing sound may represent the turbulent blood flow of a bruit and is not normal.
D. All of the above.

8. A patient arrives in the emergency department and reports splashing concentrated household cleaner in his eye. Which of the following nursing actions is a priority?

A. Irrigate the eye repeatedly with normal saline solution.
B. Place fluorescein drops in the eye.
C. Patch the eye.
D. Test visual acuity.

9. A nurse is caring for a patient who has had hip replacement. The nurse should be most concerned about which of the following findings?

A. Complaints of pain during repositioning.
B. Scant bloody discharge on the surgical dressing.
C. Complaints of pain following physical therapy.
D. Temperature of 101.8 F (38.7 C).

10. A child is admitted to the hospital with an uncontrolled seizure disorder. The admitting physician writes orders for actions to be taken in the event of a seizure. Which of the following actions would NOT be included?

A. Notify the physician.
B. Restrain the patient's limbs.
C. Position the patient on his/her side with the head flexed forward.
D. Administer rectal diazepam.

11. Emergency department triage is an important nursing function. A nurse working the evening shift is presented with four patients at the same time. Which of the following patients should be assigned the highest priority?

A. A patient with low-grade fever, headache, and myalgias for the past 72 hours.
B. A patient who is unable to bear weight on the left foot, with swelling and bruising following a running accident.
C. A patient with abdominal and chest pain following a large, spicy meal.
D. A child with a one-inch bleeding laceration on the chin but otherwise well after falling while jumping on his bed.

12. A patient is admitted to the hospital with a calcium level of 6.0 mg/dL. Which of the following symptoms would you NOT expect to see in this patient?

A. Numbness in hands and feet.
B. Muscle cramping.
C. Hypoactive bowel sounds.
D. Positive Chvostek's sign.

13. A nurse cares for a patient who has a nasogastric tube attached to low suction because of a suspected bowel obstruction. Which of the following arterial blood gas results might be expected in this patient?

A. pH 7.52, PCO2 54 mm Hg.
B. pH 7.42, PCO2 40 mm Hg.
C. pH 7.25, PCO2 25 mm Hg.
D. pH 7.38, PCO2 36 mm Hg.

14. A patient is admitted to the hospital for routine elective surgery. Included in the list of current medications is Coumadin (warfarin) at a high dose. Concerned about the possible effects of the drug, particularly in a patient scheduled for surgery, the nurse anticipates which of the following actions?

A. Draw a blood sample for prothrombin (PT) and international normalized ratio (INR) level.
B. Administer vitamin K.
C. Draw a blood sample for type and crossmatch and request blood from the blood bank.
D. Cancel the surgery after the patient reports stopping the Coumadin one week previously.

15. The follow lab results are received for a patient. Which of the following results are abnormal? Note: More than one answer may be correct.

A. Hemoglobin 10.4 g/dL.
B. Total cholesterol 340 mg/dL.
C. Total serum protein 7.0 g/dL.
D. Glycosylated hemoglobin A1C 5.4%.

16. A nurse is performing routine assessment of an IV site in a patient receiving both IV fluids and medications through the line. Which of the following would indicate the need for discontinuation of the IV line as the next nursing action?

A. The patient complains of pain on movement.
B. The area proximal to the insertion site is reddened, warm, and painful.
C. The IV solution is infusing too slowly, particularly when the limb is elevated.
D. A hematoma is visible in the area of the IV insertion site.

17. A hospitalized patient has received transfusions of 2 units of blood over the past few hours. A nurse enters the room to find the patient sitting up in bed, dyspneic and uncomfortable. On assessment, crackles are heard in the bases of both lungs, probably indicating that the patient is experiencing a complication of transfusion. Which of the following complications is most likely the cause of the patient's symptoms?

A. Febrile non-hemolytic reaction.
B. Allergic transfusion reaction.
C. Acute hemolytic reaction.
D. Fluid overload.

18. A patient in labor and delivery has just received an amniotomy. Which of the following is correct? Note: More than one answer may be correct.

A. Frequent checks for cervical dilation will be needed after the procedure.
B. Contractions may rapidly become stronger and closer together after the procedure.
C. The FHR (fetal heart rate) will be followed closely after the procedure due to the possibility of cord compression.
D. The procedure is usually painless and is followed by a gush of amniotic fluid.

19. A nurse is counseling the mother of a newborn infant with hyperbilirubinemia. Which of the following instructions by the nurse is NOT correct?

A. Continue to breastfeed frequently, at least every 2-4 hours.
B. Follow up with the infant's physician within 72 hours of discharge for a recheck of the serum bilirubin and exam.
C. Watch for signs of dehydration, including decreased urinary output and changes in skin turgor.
D. Keep the baby quiet and swaddled, and place the bassinet in a dimly lit area.

20. A nurse is giving discharge instructions to the parents of a healthy newborn. Which of the following instructions should the nurse provide regarding car safety and the trip home from the hospital?

A. The infant should be restrained in an infant car seat, properly secured in the back seat in a rear-facing position.
B. The infant should be restrained in an infant car seat, properly secured in the front passenger seat.
C. The infant should be restrained in an infant car seat facing forward or rearward in the back seat.
D. For the trip home from the hospital, the parent may sit in the back seat and hold the newborn.

Answer Key

1. Answer: C

The priority nursing action for a patient arriving at the ED in distress is always assessment of vital signs. This indicates the extent of physical compromise and provides a baseline by which to plan further assessment and treatment. A thorough medical history, including onset of symptoms, will be necessary and it is likely that an electrocardiogram will be performed as well, but these are not the first priority. Similarly, chest exam with auscultation may offer useful information after vital signs are assessed.

2. Answer: C

It is always critical that patients being discharged from the hospital take prescribed medications as instructed. In the case of antibiotics, a full course must be completed even after symptoms have resolved to prevent incomplete eradication of the organism and recurrence of infection. The patient should resume normal activities as tolerated, as well as a nutritious diet. Continued use of the incentive spirometer after discharge will speed recovery and improve lung function.

3. Answer: C

When a family member is dying, it is most helpful for nursing staff to provide a culturally sensitive environment to the degree possible within the hospital routine. In the Vietnamese culture, it is important that the dying be surrounded by loved ones and not left alone. Traditional rituals and foods are thought to ease the transition to the next life. When possible, allowing the family privacy for this traditional behavior is best for them and the patient. Answers A, B, and D are incorrect because they create unnecessary conflict with the patient and family.

4. Answer: A

The charge nurse planning assignments must consider the skills of the staff and the needs of the patients. The labor and delivery nurse who is not experienced with the needs of cardiac patients should be assigned to those with the least acute needs. The patient who is one-week post-operative and nearing discharge is likely to require routine care. A new patient admitted with suspected MI and scheduled for angiography would require continuous assessment as well as coordination of care that is best carried out by experienced staff. The unstable patient requires staff that can immediately identify symptoms and respond appropriately. A post-operative patient also requires close monitoring and cardiac experience.

5. Answer: B

Glucagon is given to treat insulin overdose in an unresponsive patient. Following Glucagon administration, the patient should respond within 15-20 minutes at which time oral carbohydrates should be given. Glucagon reverses rather than enhances or prolongs the effects of insulin. Lipoatrophy refers to the effect of repeated insulin injections on subcutaneous fat.

6. Answer: D

One gel pad should be placed to the right of the sternum, just below the clavicle and the other just left of the precordium, as indicated by the anatomic location of the heart. To defibrillate, the paddles are placed over the pads. Options A, B, and C are not consistent with the position of the heart and are therefore incorrect responses.

7. Answer: D

All of the statements are true. The gurgles and clicks described in the question represent normal bowel sounds, which vary with the phase of digestion. Intestinal obstruction causes the sounds to intensify as the normal flow is blocked by the obstruction. The swishing and buzzing sound of turbulent blood flow may be heard in the abdomen in the presence of abdominal aortic aneurism, for example, and should always be considered abnormal.

8. Answer: A

Emergency treatment following a chemical splash to the eye includes immediate irrigation with normal saline. The irrigation should be continued for at least 10 minutes. Fluorescein drops are used to check for scratches on the cornea due to their fluorescent properties and are not part of the initial care of a chemical splash, nor is patching the eye. Following irrigation, visual acuity will be assessed.

9. Answer: D

Post-surgical nursing assessment after hip replacement should be principally concerned with the risk of neurovascular complications and the development of infection. A temperature of 101.8 F (38.7 C) postoperatively is higher than the low grade that is to be expected and should raise concern. Some pain during repositioning and following physical therapy is to be expected and can be managed with analgesics. A small amount of bloody drainage on the surgical dressing is a result of normal healing.

10. Answer: B

During a witnessed seizure, nursing actions should focus on securing the patient's safely and curtailing the seizure. Restraining the limbs is not indicated because strong muscle contractions could cause injury. A side-lying position with head flexed forward allows for drainage of secretions and prevents the tongue from falling back, blocking the airway. Rectal diazepam may be a treatment ordered by the physician, who should be notified of the seizure.

11. Answer: C

Emergency triage involves quick patient assessment to prioritize the need for further evaluation and care. Patients with trauma, chest pain, respiratory distress, or acute neurological changes are always classified number one priority. Though the patient with chest pain presented in the question recently ate a spicy meal and may be suffering from heartburn, he also may be having an acute myocardial infarction and require urgent attention. The patient with fever, headache and muscle aches (classic flu symptoms) should be classified as non-urgent. The patient with the foot injury may have sustained a sprain or fracture, and the limb should be x-rayed as soon as is practical, but the damage is unlikely to worsen if there is a delay. The child's chin laceration may need to be sutured but is also non-urgent.

12. Answer: C

Normal serum calcium is 8.5 - 10 mg/dL. The patient is hypocalcemic. Increased gastric motility, resulting in hyperactive (not hypoactive) bowel sounds, abdominal cramping and diarrhea is an indication of hypocalcemia. Numbness in hands and feet and muscle cramps are also signs of hypocalcemia. Positive Chvostek's sign refers to the sustained twitching of facial muscles following tapping in the area of the cheekbone and is a hallmark of hypocalcemia.

13. Answer: A

A patient on nasogastric suction is at risk of metabolic alkalosis as a result of loss of hydrochloric acid in gastric fluid. Of the answers given, only answer A (pH 7.52, PCO2 54 mm Hg) represents alkalosis. Answer B is a normal blood gas. Answer C represents respiratory acidosis. Answer D is borderline normal with slightly low PCO2.

14. Answer: A

The effect of Coumadin is to inhibit clotting. The next step is to check the PT and INR to determine the patient's anticoagulation status and risk of bleeding. Vitamin K is an antidote to Coumadin and may be used in a patient who is at imminent risk of dangerous bleeding. Preparation for transfusion, as described in option C, is only indicated in the case of significant blood loss. If lab results indicate an anticoagulation level that would place the patient at risk of excessive bleeding, the surgeon may choose to delay surgery and discontinue the medication.

15. Answer: A and B

Normal hemoglobin in adults is 12 - 16 g/dL. Total cholesterol levels of 200 mg/dL or below are considered normal. Total serum protein of 7.0-g/dL and glycosylated hemoglobin A1c of 5.4% are both normal levels.

16. Answer: B

An IV site that is red, warm, painful and swollen indicates that phlebitis has developed and the line should be discontinued and restarted at another site. Pain on movement should be managed by maneuvers such as splinting the limb with an IV board or gently shifting the position of the catheter before making a decision to remove the line. An IV line that is running slowly may simply need flushing or repositioning. A hematoma at the site is likely a result of minor bleeding at the time of insertion and does not require discontinuation of the line.

17. Answer: D

Fluid overload occurs when then the fluid volume infused over a short period is too great for the vascular system, causing fluid leak into the lungs. Symptoms include dyspnea, rapid respirations, and discomfort as in the patient described. Febrile non-hemolytic reaction results in fever. Symptoms of allergic transfusion reaction would include flushing, itching, and a generalized rash. Acute hemolytic reaction may occur when a patient receives blood that is incompatible with his blood type. It is the most serious adverse transfusion reaction and can cause shock and death.

18. Answer: B, C, and D

Uterine contractions typically become stronger and occur more closely together following amniotomy. The FHR is assessed immediately after the procedure and followed closely to detect changes that may indicate cord compression. The procedure itself is painless and results in the quick expulsion of amniotic fluid. Following amniotomy, cervical checks are minimized because of the risk of infection

19. Answer: D

An infant discharged home with hyperbilirubinemia (newborn jaundice) should be placed in a sunny rather than dimly lit area with skin exposed to help process the bilirubin. Frequent feedings will help to metabolize the bilirubin. A recheck of the serum bilirubin and a physical exam within 72 hours will confirm that the level is falling and the infant is thriving and is well hydrated. Signs of dehydration, including decreased urine output and skin changes, indicate inadequate fluid intake and will worsen the hyperbilirubinemia.

20. Answer: A

All infants under 1 year of age weighing less than 20 lbs. should be placed in a rear-facing infant car seat secured properly in the back seat. Infant car seats should never be placed in the front passenger seat. Infants should always be placed in an approved car seat during travel, even on that first ride home from the hospital.

NCLEX exam preparation

Before the exam

Before you are able to take the NCLEX-RN, you must obtain an Authorization to Test or ATT. In order to get this, you'll have apply to the nursing board and then complete registration with Pearson VUE, which will cost approximately $200. Plan to start this process well before your planned testing date. Don't schedule your exam until you have obtained the Pearson Registration and ATT as well as an eligibility letter from the nursing board.

As a portion of the preparation process, review the NCLEX-RN Candidate Bulletin and become familiar with the testing format. Keep in mind that many testing centers fill up their testing dates quickly. Don't wait until your ATT is about to expire before you plan to schedule your exam. You may end up having to re-register and re-pay if this happens. Once you have your testing date and location, familiarize yourself with this location.

Exam day

Pearson Professional Centers provide candidate exam day process and rules information. Make sure to review it fully before your exam day. Here are a few key points to keep in mind for the exam.

• Be prepared. When you arrive for the NCLEX-RN, you'll need to present a photo ID and the ATT.
• Dress comfortably. You'll have to leave all outerwear (coats, hats, gloves, etc.) outside of the room where the test will be administered.
• Arrive early. Plan to arrive at the testing center a half an hour before the exam will start.
• Provide biometrics. The following biometrics will be collected before the exam: palm vein scan, fingerprints and signature.
• Obtain materials. This exam is administered on the computer. You will not need any paper or writing implements. Your computer screen will include a calculator and erasable note board.
• Pace yourself appropriately. You'll have six hours to complete the NCLEX-RN. This time frame includes a brief tutorial and two optional breaks, one after two hours of testing and another after three and a half hours of testing. Read each question carefully, as you cannot return to previous questions after you have moved on in the test.
• Finish up. The test concludes with a brief computerized survey. When you have completed it, raise your hand and wait to be dismissed.

After the exam

Remember that while the exam is graded as you complete it, all scores will be reviewed with Pearson VUE afterward and will not be available for test takers until a later date. You will receive your score in the mail appropriately one month after you took the NCLEX-RN.

NCLEX exam questions online

Pharmacological and Parenteral Therapies is a subsection of the Physiological Integrity part of your NCLEX-RN® exam. The Pharmacological and Parenteral Therapies represent 15% of your test score. Therefore, be sure you allocate roughly this amount of your preparation to this area of the NCSBN® test.

Here are some free NCLEX-RN exam practice questions for the Pharmacology and Parenteral Nutrition to help you prepare.

1.) Your patient has a new prescription for zolpidem, also known as Ambien. She should report which possible effect while taking this medication? 

A. Discolored urine
B. Irregular heart beat
C. Sudden headache
D. Sleepiness during the day 

2.) Drug toxicity is a serious problem associated with which diagnosis? 

A. Acute renal failure
B. Diverticulitis
C. Pancreatic cancer
D. Stomach ulcers 

3.) A patient has an order for SL Nitro prn chest pain. Standard protocol allows that: 

A. One nitro may be administered under the tongue. If chest pain continues, begin CPR. 
B. One nitro may be administered every 5 minutes, up to 3 total doses, or until chest pain subsides. 
C. Vitals must be checked after administration since BP will rise. 
D. Up to 3 nitro tablets may be administered sub lingual at the same time. 

4.) An oral medication is to be administered based on a child’s weight. You are to give 2 mg’s per kg. There are 10 mg per five cc’s. The child weighs 45 pounds. You will give: 

A. 20 ml
B. 30 cc
C. 22 cc
D. 40 ml

5.) When preparing to change a right subclavian vein TPN bag and tubing, the patient instructions must include: 

A. Inhale deeply, hold it, and bear down
B. Breathe normally
C. Exhale slowly and hold it
D. Turning the head to the left

6.) Total Parenteral Nutrition (TPN) may not have any medications added to it except: 

A. Xanax
B. Phenergan
C. Insulin
D. Demerol 

7.) A patient receiving parenteral nutrition may have it administered via the following routes except: 

A. PICC (Peripherally inserted central catheter) line
B. Peg tube
C. Subclavian line
D. Central Venous Catheter 

8.) Parenteral nutrition differs from enteral nutrition because: 

A. Parenteral nutrition can be given through the digestive system
B. Either type of nutrition can be given through an IV
C. Parenteral nutrition bypasses the digestive system
D. Enteral nutrition bypasses the digestive system

Free NCLEX-RN Practice Test And Review Questions Online: Answers and Rationals
Use the answers to these NCLEX preparation questions to improve your mastery of exam content.

1.) Correct answer: D If daytime sleepiness is a problem, the physician should be consulted. The medication dose may need to be decreased, or is not being properly metabolized which could signal kidney or liver problems. 

A – Ambien induces sleep and does not discolor urine. 
B – This medication has no adverse effect on heart rate or regularity. 
C – Ambien has not been shown to cause headache. 

2.) Correct answer: A Drugs are carried out of the body via urine. In the case of renal failure, the kidneys do not filter. Therefore, medications can build up to toxic levels. 

B – Diverticulitis is an inflammation of the intestine that does not cause a buildup of medication in the body. 
C – Drug toxicity is not caused by pancreatic cancer; however, drugs and alcohol can contribute to the development of this cancer. 
D – Though many drugs can cause stomach ulcers, this condition does not cause drug toxicity. 

3.) Correct answer: B When a patient is having chest pain, one nitroglycerin tablet is placed under the tongue to dissolve. If the pain is not completely gone in 5 minutes, another may be given. Once 5 more minutes pass, if pain has not significantly subsided, another may be administered. 

A – This is not the protocol for sub lingual nitro use. CPR is never begun on a patient whose heart is beating. 
C – Vitals must be checked, but blood pressure is lowered by nitro. 
D – No more than one nitro tablet is given at a time. This is a powerful drug that can dangerously lower the blood pressure in a matter of minutes, slow the heart, and cause death. 

4.) Correct answer: A Pounds are changed to kilograms. (45/2.2=20.4kg or 20kg) There are 2mg per cc of medication. One cc per kg = 20 cc’s. One cc is equal to one ml. 

B – Poor calculation – you have overdosed the child. 
C – Calculation is off a small amount – but you are still headed for an incident report. 
D – Double dose – the damage done will depend on the medication. 

5.) Correct answer: A This procedure helps build pressure to keep air from entering the vein. 

B – Normal breathing will increase the risk of a dangerous amount of air entering the vein. 
C – This procedure will not produce the positive pressure needed to repel outside air. 
D – Turning the head is not necessary, though the patient may prefer it. 

6.) Correct answer: C Insulin is an acceptable additive for patients who need it with their TPN or PPN. No other additive or component is acceptable through the parenteral line. 

A - Xanax cannot be given via a PN line, as it must pass through the digestive system. 
B - Phenergan, and many other drugs, can cause precipitation in the TPN formulation. 
D – Demerol cannot be administered with TPN. 

7.) Correct answer: B A peg tube empties formula directly into the stomach to be digested. Parenteral nutrition bypasses the digestive system by administration to the bloodstream. 

A – A PICC line is inserted into a peripheral vein, but is long enough to empty into the large veins going directly into the heart. 
C – A subclavian line empties directly into the large vein of the heart, reducing risk of damage to smaller veins. 
D – A CVC also empties just above the heart muscle to be distributed. 

8.) Correct answer C: Parenteral nutrition is formulated to be administered directly into the bloodstream of patients whose digestive system is non-functional. 

A – Parenteral nutrition goes directly into the bloodstream, bypassing the digestive system. 
B – Enteral nutrition cannot be given IV as it must go through the digestive system to be processed. 
D – Enteral nutrition is processed through the digestive system, usually through a tube that empties into the stomach. 

Want more NCLEX review questions, classes, books and prep courses to pass your NCLEX Pharmacological and Parenteral Therapies and other sections of your registered nurse test? 

nclex exam top 5 facts to achieve RN Score

“NCLEX Exam Questions To Ask Yourself To Pass Your NCSBN Nursing Test”

NCLEX exam success and a registered nursing career you can be proud of begins with understanding basic facts of your nursing test. That is, how to register, the format and categories of this test. In this way your test preparation and test taking experience will be much easier and more successful. You can avoid common NCLEX-RN exam prep frustrations and wasting precious time. 

The biggest waste of time in preparing for the NCLEX exam is getting a failing score and having to start all over again from scratch. Therefore, the purpose of the information below is for you to pass on the first try. 

NCSBN NCLEX-RN Exam Facts You Must Know
The National Council Licensure Examination For Registered Nurses® (NCLEX-RN®) exam is developed and administered by the National Council Of State Boards of Nursing® (NCSBN®). It’s purpose is to ensure that each entry level nurse has the knowledge needed to perform in a safe and effective manner. The NCLEX exam is administered across fifty states, four U.S. territories and the District of Columbia. 

How To Register For Your Registered Nurse Exam
In order to register for this assessment, a registered nursing candidate should apply to the National Council of State Boards of Nursing for licensure eligibility. Once your eligibility has been confirmed the board will provide an Authorization to Test (ATT) number. At the same time the candidate should register with Pearson VUE, the contracted test provider. 

There are three ways to register with Pearson VUE: online, by telephone, or by mail. The cost of the exam is $200 and can be paid using a credit or debit card (VISA, MasterCard, or American Express). It is also possible to pay using a money order, cashier’s check, or certified check. 

Scheduling Your NCLEX-RN Exam Date
NCLEX test centers are available throughout the United States and can be scheduled throughPearson Vue. Upon arrival at the testing center, you’ll be asked for your ATT number and valid identification. It’s important to arrive on time, if you are more than 30 minutes late you may have to forfeit your examination. Paper or writing instruments are not permitted in the test center however an on screen calculator and notepad are provided. 

NCLEX Review Course: 4 Major Categories Of The NCSBN Exam

Prepare for your NCLEX RN exam with a clear understanding of the purpose of this assessment. It is determine how well a registered nurse candidate can use their critical thinking skills when making professional judgments in real life nurse practice. Don’t just memorize in the course of your RN review sessions. You must be able to apply the knowledge you learned in 4 years of college to scenarios a professional registered nurse will likely face. 

Before signing-up for any NCLEX exam review class, make sure it covers the four major categories which are The Safe and Effective Care Environment, Health Promotion and Maintenance, Psychosocial Integrity, and Physiological Integrity. The categories are meant to encompass patient needs throughout a human life span. 

• The Safe and Effective Care Environment section represents 17-23 percent of the NCLEX-RN exam. 

It includes both Management and Care, Safety and Infection control. Some of the categories covered in Management and Care are Advocacy, Client Rights, and Ethical practice. Various categories covered in Safety and Control include Accident Prevention, Hazardous Materials and the Use of Restraints. Be sure your NCLEX review books have a lot of practice questions for this section.


• Health Promotion and Maintenance represent 6-12 percent of the test. Some of the concepts covered in this section include the Aging Process, Disease Prevention, and High Risk Behaviors.

Discipline yourself in your NCLEX exam preparation to review areas of the exam you dislike and are probably weak in. By doing that you’ll get the maximum amount of test score improvements output with the least amount of time input.


• The Psychology Integrity section accounts for 6-12 percent of the test.

Your NCLEX exam review must include: Coping Mechanisms, Mental Health Concepts and Stress Management.


• The last section is Physiological Integrity. It’s the largest part of the exam and accounts for 38-62 percent of the questions.

Be sure to cover these 4 sections in your NCLEX practice: Basic Care and Comfort, Pharmacological and Parenteral Therapies, Reduction of Risk Potential, and Physiological Adaptation. If you feel overwhelmed and frustrated, take a NCLEX review course online or a local prep class to sort out the overwhelming amount of medications you’re required to know. 

How The NCLEX Results And Pass Rates Are Determined

The NCLEX-RN is a pass/fail exam. NCSBN exam questions are tailored to each candidate’s competencies calculated in real time by computer during testing. The interactive computer adaptive system (CAT) selects the next question for the test taker based on the skill level demonstrated in previous answers and alternates between easy and difficult to establish an accurate range of professional competency. 

As you do NCLEX exam practice questions, keep in mind the length of the real exam is six hours and contains 265 questions. NCSBN test questions are offered in a multiple choice format with four possible answers. Some versions of the examination also include multiple responses, hot spots, fill-in-the-blank, drag and drop, and charts. Fifteen questions will not be scored as they are for statistical purposes. 

NCLEX-RN testing concludes when at least 75 questions have been answered and a minimum competency is demonstrated, at least 75 questions have been answered and a lack of competency is demonstrated, all 265 questions have been answered, or the six hours have passed. 

The best NCLEX RN exam practice means understanding how your test is scored. A numerical score is not provided. The test results will be available through the State Board of Nursing approximately 4 weeks after the test has been completed. If your nursing board participates in the Quick Results Service, unofficial results may be available within 48 hours. In the event of a fail, a diagnostic evaluation will be sent that will highlight problem areas. If you failed, then use to focus exactly where you need to spend your time in your NCLEX -RN exam study guide. 

Unfortunately, the pass rate on the first attempt is low as most candidates fail the first time. However, while paying continuous testing fees is expensive, it’s possible to retake the test after a 45-90 day waiting period. 

How To Pass The NCLEX-RN Exam

The best way a registered nurse candidate can reduce anxiety and worry in test taking is start reviewing for 2-3 months before the exam date. Overconfidence, procrastination and squandering limited preparation time are leading cause of testing failure. Choosing the best RN review books, practice exams and possibly a tutor (preferably a registered nurse who passed) can make all difference between pass or fail. If you’re not sure what are the best NCLEX-RN books then ask someone who already took the exam and passed or click on the links on this page for more prep help. 

You should create a test study plan starting at least 6-8 weeks before your exam date. If you have more time between now and your test date then leverage that to your advantage and begin preparing now without delay.

Don’t take any chances. 

This is the nursing career you’ve been dedicating your life and a small fortune in college tuition to achieve. You may very well need a few extra weeks of solid review time in order to pass. 

Schedule review time for the NCLEX exam at least 5 days per week and at least 1-2 hours each preparation session. It’s more productive if you take at least one day off each week to clear your mind and recharge your mental batteries. 

Review areas of NCLEX-RN test where you’re the weakest in the first 3 weeks. An investment of time in your weaker areas will often help boost your score two or three times faster than going over areas you’re more comfortable with. 

2 NCLEX Practice Tips For The Most Productive Review Sessions
A candidate who can maintain focus and motivation during preparation for the NCLEX exam is more likely to succeed. Constantly visualize your ultimate goal of passing during your NCLEX-RN review. Create a peak performance mindset and program your mind for success. To do this continuously seeing yourself taking your test with confidence, competence and getting a passing score. 

Don’t think negative. Don’t doubt yourself and don’t dwell on the anxiety or you’ll end up conditioning your mind for failure. 

Visualize living your dream life helping others. See yourself achieving personal success in your own life with your registered nurse license. Feel how good it feels to be working to improve your life during your review for the NCLEX-RN exam. Be willing to pay the price of success and study. Use this to discipline you to study even when you don’t feel like it. See the bigger picture. 

Schedule blocks of uninterrupted time when reviewing for your NCLEX test date. The reason avoiding interruptions is so important is that once your concentration is broken, it can take you up to 30 minutes to get your brain warmed up again and get into the same flow of concentration you need for highly effective test prep. If you get interrupted often you’re productivity will be cut in half. It could take you twice as long to study in order to pass your registered nursing test. More over, you don’t want to risk not being prepared because your NCLEX review was subpar. 

Get the support of family and friends. Explain what you’re trying to accomplish and get them to work with you, not against you. Explain you can’t be disturbed during these schedule blocks of time and how important this to you. Ask them in advance for their support. 

Retrain yourself not to react to short-term urgencies of the moment like a ringing cellphone, a text message, checking your emails, Facebook or turning on the TV. Do this to avoid losing your limited NCLEX exam review time due to interruptions. 

Next time you’re struggling to block out interruptions, ask yourself, “Is this text message, Facebook update, TV show, phone call worth failing my nursing test and delaying the career?” 

Make your NCLEX-RN review easier and more productive. Turn off your phone and computer so you won’t be tempted with Facebook, phone calls, text messages, email alerts and anything else in your world that could drag your practice for the NCLEX to failure. Again force yourself to think long-term on your goal of getting a passing score and all the success you’ll have once your a registered nurse. 

Once infertile, woman gives birth after surgery

A 30-year-old infertile woman gave birth after surgeons removed her ovaries and re-implanted tissue they treated in a lab, researchers report.

The experimental technique was only tried in a small group of Japanese women with a specific kind of infertility problem, but scientists hope it can also help women in their early 40s who have trouble getting pregnant because of their age.

The new mother gave birth to a son in Tokyo last December, and she and the child continue to be healthy, said Dr. Kazuhiro Kawamura of the St. Marianna University School of Medicine in Kawasaki, Japan. He and others describe the technique in a report published online Monday by the Proceedings of the National Academy of Sciences.

The mother, who was not identified, had been diagnosed with primary ovarian insufficiency, an uncommon form of infertility sometimes called premature menopause. It appears in about 1 percent of women of childbearing age. The cause of most cases is unknown, but the outcome is that the ovary has trouble producing eggs.

That leaves women with only a 5 percent to 10 percent chance of having a baby unless they get treated. The standard treatment is using donor eggs.

After the experimental procedure, Kawamura and colleagues were able to recover eggs from five of their 27 patients. One woman went on to have a miscarriage, one did not get pregnant, and two more have not yet attempted pregnancy, Kawamura said in an email.

The approach differs from what has been done to preserve fertility in some cancer patients, who had normal ovarian tissue removed and stored while they underwent cancer treatments, and then put back. The new work involved ovaries that were failing to function normally.

In the ovary, eggs mature in structures called follicles. For women with the condition the new study targeted, the follicles are either missing or failing to produce eggs. The experimental treatment was designed to stimulate dormant follicles.

First, the women’s ovaries were removed and cut into strips, which were frozen. Later the strips were thawed and cut into tiny cubes, a step intended to stimulate maturation of the follicles. Then the cubes were treated with drugs to stimulate further development of the follicles. Cubes were then transplanted just under the surface of the women’s fallopian tubes.

Within six months, eight women showed signs of follicle maturation, and five of them produced eggs for fertilization in the lab with their husbands’ sperm. The fertilized eggs were grown into early embryos, which were frozen for preservation. In the three attempts at pregnancy, one or two embryos were implanted in the women.

The researchers found that half the 27 patients had no follicles at all, which meant the treatment could not help them, said Aaron Hsueh of Stanford University, senior author of the study. He also said researchers hope to find a way to stimulate follicles without removing the ovaries.

Dr. Sherman Silber of the Infertility Centre of St. Louis criticized the approach, saying he has had success by using drugs rather than surgery to treat the condition. He also disagreed with the researchers’ explanation for why their treatment worked.

Some other experts said treatment with drugs often does not work. The new results, experts cautioned, must be viewed as preliminary.

“It shows a lot of promise (but) I don’t think it’s even close to being ready” for routine use, said Dr. Mark Sauer of the Columbia University Medical Center in New York. Dr. Amber Cooper of Washington University in St. Louis called the technique “very much an experimental method.”

The reported efficiency is very low, and the possible health risk to babies born from the method is unknown, said David Albertini of the University of Kansas Medical Centre.

“One success does not mean we have a treatment.... Stay tuned,” he said.

He and others were also skeptical of the researcher’s suggestion that the procedure would help women between ages 40 and 45. Eggs from women of that age often show genetic abnormalities, many of which would prevent a live birth, said Dr. Marcelle Cedars of the University of California, San Francisco Medical Centre. Stimulating egg production wouldn’t overcome that problem, she said.

  Kawamura released a photo of himself holding the newborn shortly after he delivered him. He said the mother hopes to have another child with one of the frozen embryos in storage from her treatment.

SUGAR - Toxin

Everybody loves a good villain. Diets that focus on one clear bad guy have gotten traction even as the bad guy has changed: fat, carbohydrates, animal products, cooked food, gluten. And now Robert Lustig, a paediatric endocrinologist at the University of California at San Francisco, is adding sugar to the list.

His book “Fat Chance: Beating the Odds Against Sugar, Processed Food, Obesity, and Disease” makes the case that sugar is almost single-handedly responsible for Americans’ excess weight and the illnesses that go with it.

“Sugar is the biggest perpetrator of our present health crisis,” Lustig says, blaming it for not just obesity and diabetes but also for insulin resistance, cardiovascular disease, stroke and even cancer. “Sugar is a toxin,” he says. “Pure and simple.”

His target is one particular sugar: fructose, familiar for its role in making fruit sweet. Fruit, though, is not the problem; the natural sugar in whole foods, which generally comes in small quantities, is blameless. The fructose in question is in sweeteners — table sugar, high-fructose corn syrup, maple syrup, honey and others — which are all composed of the simple sugars fructose and glucose, in about equal proportions.

Although glucose can be metabolised by every cell in the body, fructose is metabolised almost entirely by the liver. There it can result in the generation of free radicals (damaged cells that can damage other cells) and uric acid (which can lead to kidney disease or gout), and it can kick off a process called “de novo lipogenesis”, which generates fats that can find their way into the bloodstream or be deposited on the liver itself.

These by-products are linked to obesity, insulin resistance and the group of risk factors linked to diabetes, heart disease and stroke. (Lustig gives a detailed explanation of fructose metabolism in a well-viewed YouTube video called “Sugar: The Bitter Truth”.)

Everyone agrees that fructose can be metabolised that way, but not that it always is metabolised that way when people consume it in moderate amounts. In rats, the link between fructose and metabolic diseases is so well established that researchers who want to study insulin-resistant rats feed them fructose to get them to that state.

Fructose metabolism research in people, though, is limited by scientists’ inability to kill their human subjects in order to dissect their livers and is further complicated by variation from human to human: Race, gender, exercise, melatonin, probiotics and antioxidants, among other things, affect how our bodies deal with fructose.

In some human studies, large doses of fructose have certainly been shown to do harm, and alarmingly quickly. One 2009 study fed 16 men a controlled diet, then that same diet plus a fructose supplement that added 35 per cent to their calorie consumption, and found fat deposits on their livers, increased triglycerides and insulin sensitivity after just one week.

But as the fructose dose decreases, so does the strength of the link to disease. Luc Tappy of the University of Lausanne in Switzerland concluded in a recent paper that, although large doses of fructose undoubtedly cause problems, “there is no solid evidence that fructose, when consumed in moderate amounts, has deleterious effects”.

Tappy, one of the prominent participants in the fructose debate that Lustig ignited, gives voice to the position that many doctors and scientists share: Sugar is a bad guy, but not the one, overarching bad guy.

“Telling people the problem is all fructose is completely wrong,” says Walter Willett, chair of the nutrition department at the Harvard School of Public Health. “In the amounts being consumed, sugar can lead to serious damage and premature death. I think it’s fair to say that’s toxic,” he says. “But it doesn’t mean everything else is good”.

Read Lustig’s book carefully, and it is clear that his position isn’t as radical as his sound bite implies: He believes that moderate consumption of fructose is safe. The “likely” safe threshold, he says, is 50 grams per day — which translates to 100 grams, or a quarter-cup, of sugar that is half fructose. Average daily American consumption of added sweeteners, according to the USDA, is 95 grams — just under Lustig’s threshold. And our consumption is decreasing, down from a peak of 111 grams in 1999.

Lustig’s colleagues may be less frustrated by his assessment of fructose than they are by his campaign to vilify it. He chooses not to emphasise his position that the average American intake of fructose is safe: He mentions it once in his book and not at all in his 90-minute video. He is also familiar with all the fructose research and concedes that the evidence for its toxicity isn’t ironclad.

Yet he is willing to call it a poison because he believes that waiting for a fuller understanding is not a responsible option.

Lustig works with obese children; he is deeply concerned about their health and their prospects, and he wants to tackle head-on the problem he believes is at the root of their suffering. “The only thing that matters is fixing it,” he says. “The fact is that everyone, whether they believe the mechanism or not, is saying we need to reduce our sugar intake.”

Asked whether he uses words such as “poison” and “toxin” to attract attention to the problem of sugar, he says, “In part, of course.” And it is a strategy that is working. The fructose controversy has been featured in prominent media outlets, including the “New York Times Magazine”, “Scientific American” and “National Geographic”, which put the story on its cover.

But there is a downside to Lustig’s tactics. A recent editorial in the journal “Nature” acknowledged the resonance of simple messages and addressed the problem of sacrificing nuance to get attention: “It is risky to oversimplify science for the sake of a clear public-health message ... [S]imple messages and themes are seductive ... Black-and-white messages can cause confusion of their own.”

Frank Hu, an epidemiologist at the Harvard School of Public Health who studies the link between sugar and health, gives Lustig credit “for raising awareness about sugar”, but he shares other scientists’ concerns: “People think if they take care of fructose, their diet is healthy.”

Tappy believes that, given the complexities of how foods interact with each other and with the human body, focusing on any single nutrient is a mistake: “An approach to fight obesity has to be targeted at multiple components of our diet and lifestyle.” Willett agrees, saying, “We have to find a way to say something is a big problem, a serious problem, but only part of the bigger picture.”

Until we do, we will have to be content with the idea that sugar is a big problem, a serious problem, but only part of the bigger picture.