A nursing student should know better than to underestimate the NCLEX.

It is the single test that gives them license to practice nursing in that specific state in the U.S. Since the test is aimed at protecting the public from the incompetence of would-be practitioners, the National Council of State Boards of Nursing (NCSBN) has deemed it necessary to make passing the licensure test more difficult by raising the standards of passing.

There have been many things that have been said about the test.

This article aims to elaborate on the contents and categories in the exam that have been the cause of so much anxiety in the nursing world and give some degree of perspective.

Simply put, the NCLEX is a smorgasbord of four categories and they are: Safe and Effective Care Environment; Health and Promotions Maintenance; Psychosocial Integrity; and Physiological Integrity. It is made up of multiple-choice questions which present the examinee with four options. You need to answer at least 75 of the posed questions up to a possible maximum of 265 questions.

If you are taking the NCLEX and wish to pass it, you have to answer about half of the more difficult questions correctly.

Not all the questions are multiple-choice types of questions. The NCSBN has developed and introduced an alternate item style of question to the actual format of the questions that includes a fill in the spaces, "hot spot" items and multiple-choice types of questions that involve more than one answer.

Fill-in-the-blanks types of questions usually require pharmacology calculations like computation of medication doses and flow rates. This is different from another set of questions that require short answers or an essay. A "hot spot" question means a candidate is asked to identify a portion of a photo or graphic item.

Multiple-choice types of questions that require more than just one possible answer are best illustrated in the example below:

1. The indicators of bacterial meningitis could be -

A. Ear pain
B. Red body rash
C. Fever
D. Headache
E. Leg cramps
F. Neck stiffness

In this specific example, C,D & F are the correct answers. (Small pat on the back if you got that right!) Choosing only one correct answer or the wrong one will be counted as a wrong answer.

There are also pretest questions that have no bearing on your score but are there for possible inclusion in future exams. They are reviewed by the board for suitability in future exams based on how you and your fellow examinees handle them in their current form. Candidates are not be able to tell the pretest questions from the scored ones when he or she takes the NCLEX.