How I Conquered the NCLEX in 76 Questions

Hola.

I was busy the past months preparing for the NCLEX-RN. Late last year (2015), I was offered a job in the US as a registered nurse in one of their prestigious hospitals. In order for me to be hired by them, I had to pass the NCLEX-RN, which is the equivalent of the Nurse Licensure Exam here in the Philippines. I took the NLE 4 years ago and most of my nursing knowledge are a little outdated, so I had to review.

Last Sept. 26, 2016, I took the NCLEX and passed it in 76 items, 1 hour and 30 minutes. The NCLEX consists of a maximum of 265 questions and 6 hours. You have a minimum of 75 questions to answer for the computer to decide whether you pass or fail. It was the most nerve-wracking experience of my life.

I am writing this post to help my fellow nurses who would like to face this scary examination. These are all just personal experiences and tips that worked for me, so please take it with a grain of salt.

BEFORE: Part 1

Before the exam I enrolled in a review course under KAPLAN. My review started November 2015, one month after my job offer. During that time I was on vacation leave from my current full-time job in the hospital so I had time. I purchased their books (2 course books and one workbook for international nurses) and their 4-month online materials (videos and qbanks).

All was well until my vacation leave ended and I had to go back to work. Aside from working I was also finishing the first semester of my Master’s degree, so you can say that I wasn’t fully focused on my NCLEX review. A lot of things occupied me and I was tired and stressed all the time to actually learn anything. I was barely answering the online question banks, I missed all the live lectures and I was barely past 1/3 of the book.

One day, the agency managing my application called me and asked why I hadn’t accessed my online account for a long time. That’s when I realized that my online review with KAPLAN had already ended without me even learning anything. It was a sort of wake up call for me. To cut the long story short, I had decided to postpone my master’s degree for now, resign from my job and focus solely on passing the NCLEX. I made arrangements with my university, my employer and finally with KAPLAN. I resigned May 2016.

BEFORE: Part 2

Kaplan allowed me to have a one month extension. They also provided me with a study schedule so that I would be on track and not miss out on reading and answering the question bank. Unlike the 4 months review, mine was compressed and I had to catch up on reading the content. Although I’m a bedside nurse, most of my knowledge were not up to date with the nursing standards of the US. Also, practice here in the Philippines differ greatly to that in the United States because the culture there is different. I had to make sure not to think of the practice here whenever I answer the post-tests.

I often reviewed in the afternoons, starting at 1PM to 6-7PM. I do it in my room, sometimes I go to the nearby milk tea place when our house is a little noisy. I first read the content before answering the post-tests. Depending on the length of the content, the questions range from 30-50.

My day starts at 11 AM: I eat brunch, take a shower, do some light facebook browsing before studying from 1PM to 6PM. I take bladder breaks and 20minute breaks in between. Sundays are my days off, which I spend reading manga or watching anime shows. I rarely go out (I’m an indoor-type of person anyway) and I just eat out as stress-reliever. I also ate whatever I want, I had no special diet whatsoever, I drank a lot of coffee, tea, water, milk tea… No wonder I gained weight. 🙂

After dinner I relax a little while before reading again. Then by 10-12midnight, I go to sleep.

I do it all over again the next day.

I also attended live lectures, meaning classroom setting kind of review. What we do is we answer a looong test with questions NCLEX-style and the next day the lecturer rationalizes the answers, helping us develop test-taking strategies that are unique to the NCLEX. The NCLEX loves to ask about delegation and prioritization questions, so these live classes really helped me (since in the Philippines, the nurses do everything and you don’t have anyone to delegate to LOL).

For one month, all I did was read then answer the post test. To be honest, I don’t remember all that I read. But what I did religiously was learn the rationale behind each and every question even if I got the question right. I made sure that I understood why this patient has to be seen before the other, why this intervention is correct and why an elderly patient must not be given Cimetidine.

Others would say that you don’t have to study content and just read rationales–doing just one or the other did not work for me. I found out that I learned better when I read and then answer the post test and then study the rationales.

I also focused on my weak spots: Maternity and Child nursing, pharmacology, cardio and therapeutic procedures. As I said, nursing practice in the Philippines differ greatly with American nursing practice, so I also encountered new equipment (Sengstaken-Blakemore tubes, Hickman and Groshong central catheters…).

After one month I took the readiness test by Kaplan and I scored 73%, well above the 65% that they require. Kaplan provided me with a breakdown of my performance and I found that I made significant improvement in the areas of Maternity, Child, Pharma and Adult Nursing care.

After my one month review with Kaplan though, my ATT–Authority to Test– sort of permit that you need in order to take the NCLEX. This is issued to you by the Board of Nursing of your state. Mine is Texas, and their requirements include school records and passing the Nursing Jurisprudence Exam– is still ways away. Therefore, I still can’t take the NCLEX.

Okay, while we’re in the topic of ATT, let me just share to you the process of taking the NCLEX.

Each state has different requirements. As I said, I want to practice in Texas so I had to comply with Texas BON’s requirements. So what I did, while I was reviewing, I passed original copies of my diploma, transcript, license, board exam rating to the CGFNS for credentials evaluation. Basically, they want to make sure that I graduated from a reputable school and actually completed BSN and got licensed by the Philippines to practice nursing.

I also filled out application for NCLEX forms that the Texas BON required. I suggest that you do all this before you start reviewing so that you’ll be totally focused on your exam, and not be bothered by the paperwork.

When CGFNS received my documents, they evaluated it and forwarded it to the BON for review. But before the BON could give me an ATT, I have to finish the Nursing Jurisprudence Exam.

I am not sure if other states have the NJE but Texas requires it so I took it (it’s an open-book exam, you can open the internet to look up the answers), passed it and finally, my ATT is on the way.

Before my ATT could arrive though, my one month review with KAPLAN ended, and I don’t want to just sit around while waiting for the ATT to arrive. So what I did, I bought the NCSBN review plan for 5 weeks. NCSBN is the council that makes the NCLEX, so it just made sense to make use of their review program, right? Like Kaplan, they provided me with a study schedule which I religiously followed for 6 hours a day, 6 days a week. But because I already reviewed with Kaplan, I just focused on my weak points, looked up the topics in my book and wrote down the things I do not know. I also made it a point to answer questions every day. And not just answer questions but understand the rationale behind the answers. NCSBN actually gives better rationales than Kaplan, but that’s just my opinion.

Everyday, I jot down notes on my books and notebooks, I listened to audio recordings of breath sounds. I watched videos and googled terms and equipment that I did not understand. I visualized how each condition would look like. I devoured my course book and notes.

I divided my study time into one hour blocks with 15 minutes breaks in between. I realized that this actually helped me retain more and leaves me less fatigued. I did not have any special diet–I ate what I want but I ate more banana and drank a lot of coffee.

Finally, my NCLEX was scheduled by Sept 26 at 9am. I scheduled it a bit later because I felt that I wasn’t ready. I was growing anxious and nervous by the minute and I extended my study hours from 6hrs to 8hrs a day until the week before the test. I answered Lippincott and read Saunders, along with Kaplan and NCSBN. Three weeks before the exam, I crammed my head with as much knowledge as I can.

And then one week prior, I started modifying my routine. I’d wake up early (8am), do my review, take a shower, review again, take lunch and then review until dinner time. After dinner, I bathe and then get to bed.

Okay, so to sum up the Before the NCLEX part of my journey:

  1. I did 4 months of serious review. (let’s exclude the initial 4 months that i did not take seriously)
  2. I used KAPLAN, NCSBN, LIPPINCOTT, and SAUNDERS.
  3. I reviewed for 6-8hrs a day, 6days a week.
  4. I focused on rationales and on my weak points.
  5. I prayed for divine intervention.

DURING: Part 1

Three days before the exam, I went to the shrine of St. Jude Thaddeus to ask for divine intervention and guidance. Days prior I also went to pray for intervention from St. Clare of Assisi. Two days before my NCLEX, I visited my testing center (there’s only one testing center in the Philippines and its in Makati City–more info later) and then on the day before, I tried to relax. I watched a movie with my siblings, I browsed facebook, read fanfiction.

The night before…okay, I will be honest. I did not sleep. I was too anxious and too nervous to sleep. I dare not take a sleeping pill, lest I be late for the exam! By the time I was sleepy, it was already 3 am. Wow.

I woke up at 4:45 am (super early I know but that’s just the way I am) and left home at 5:30am. My house is a two-hour travel away from Makati so I had to hustle. I was in Makati at around 7 and I took the time to chill and relax…though I failed and I just drank coffee, trying not to think about the exam too much. I also chat with my aunt in the US and she gave me encouragement which helped a lot.

Then at 7:45Am, I walked over to my testing area which was located in Trident Tower, 27th floor (Pearson Professional Center). I arrived at exactly 8AM.

DURING: Part 2

When I arrived at the testing area I was asked to remove my watch, all jewelries and to turn off my phone. Shorts and slippers were not allowed. Girls with long hair were asked to tie their hair away from their faces. Good thing I wore my hair up in a bun that day.

We were asked to read the guidelines. After that we had our palms scanned and our identities verified. Bring your passport. Only your passport will be accepted as legit identification.

Okay, tips:

  1. Bring your passport.
  2. No slippers, no shorts.
  3. Girls, keep your hair away from your face.
  4. No jewelries. They will ask you to remove them.
  5. Do not bring any reviewers.
  6. Turn off your phone.
  7. You may bring snacks.
  8. Be at the testing area at least 30 minutes before your scheduled time.

After the palm scan and shizz, we were given lockers where we kept all our belongings. The staff are strict so don’t attempt any idiotic maneuvers. Really. Just do what they say. Don’t bother wearing anything fancy. My pockets were turned inside out so better not carry anything in your pockets. Even money. Leave everything in the locker.

DURING: Part 2

OHMAYGAAAHHDD. It’s got to be the most nerve-wracking exam of my life! The moment I sat down in front of the computer, I felt like my heart had stopped beating.

Okay so you have the option to wear or not to wear the noise cancelling headset. I did so I could focus on the test. Before the test there is a tutorial. Pay attention so that you do not click the wrong button or whatever. The tutorial takes up a part of your 6hrs exam time so do not waste too much time on it.

After the tutorial, the NCLEX officially started and bam! My heart had not stopped beating so hard since then.

As I mentioned earlier, I got all sorts of alternate-type questions: SATA, ECG, Drag and drop. I did not get any pharma computations but there were questions about meds. Everything under the sun was asked, I got a fair amount of psych, MS, infection control and Maternity. I’m not allowed to divulge content or questions, but you can bet that you really should study well because you never know what question you’re gonna get.

So then as I neared the 75th question, I was beginning to have more SATA and management questions that I was already convinced that I will fail. Many times I had to stop and pray because I literally didn’t know the correct answer. By the 75th question, I was ready to sit through all the 265 items and finish the exam. To my utter surprise, the computer shut off at 76!

My first reaction was, “No! No! I want to answer more! Please let me prove myself!” But then the survey came on and I was just clicking yes yes yes…my mind was blank. I was convinced that I was gonna fail. I walked out of the testing area in a daze.

After I collected my stuff, I opened my phone and started the Pearson Vue Trick. However, mobile data was crappy so I settled inside a japanese resto to collect my thoughts and calm my heart.

I started the exam around 8:15AM and finished at 10AM. I was not hungry, I was only worried. I didn’t know what to think or what to feel. It was the most surreal day of my life.

AFTER

After the exam I rushed home and on the way I had migraine headache so bad I puked in the cab. I was still in disbelief but my headache won over and I slept the day away.

The next day, I tried the Pearson Vue Trick and I got the good pop up.

The pearson vue trick is when you try to register for the NCLEX again. If Pearson Vue takes your money, it is a bad pop up and that means you failed. But if it says “Sorry, our records indicate that you have scheduled for blahblahblah….” then it is a good pop up and an indication that you passed.

More info here: http://caring4you.net/pvt.html

NCLEX results are usually available via Quick Results, depending on your state. Quick Results post your “unofficial” results after 48 hours. Official results are sent by snail mail. Some states do not have quick results (ie California). You have to pay a certain amount to be able to avail Quick Results. You could also look up your results at your state’s BON’s website.

So on the 24th hour after my NCLEX I looked up my result at Pearson Vue website but it said that it wasn’t available. I was really nervous and as a result, my migraine headache occurred again. Haha! I stayed in bed all day, miserable.

The next day, at 5AM, I looked in the Pearson Vue website and my results are still unavailable. I tried looking up my name in the Texas BON Website and voila! My name was already listed as an RN! I passed the NCLEX!!

I shared the news with my aunts who validated the result. Now we are all thanking God for His divine intervention. I sent out my thanks to all my friends and relatives and lecturers who helped me pass this difficult exam. Now I am proud to say that I am a USRN.

🙂

LAST

Okay so last words/tips/whatever:

  1. Find a state where you want to practice. The requirements for each state are different so it’s important to know those first.
  2. Preferably find an employer first. But if you’d rather not, you can skip this step.
  3. Visit the website of your preferred state and look up the requirements.
  4. Comply with the said requirements.
  5. Apply for the ATT. The ATT has a validity of 75 days, meaning you should take the NCLEX within 75 days or else you need to re-apply.
  6. Review.
  7. Schedule the NCLEX at Pearson Vue. Pearson Vue is the agency that administers the test. You have to pay 200USD for the NCLEX so find a schedule that really suits you. http://pearsonvue.com/nclex/
  8. Take the NCLEX. Congratulations in advance for passing! 🙂

Okay now, study tips:

1.Memorize lab values, especially ABGs, electrolytes, CBCs and PTT, PT.

2. Pharmacology is the bomb. No, you don’t have to memorize the whole drug guide but you have to be familiar with what medication goes with what food, which meds are contraindicated against each other, side effects…oh and also drug computations.

3.ECG strips! Yes! They’re the bane of our existence but we have to learn them! And you have to identify what condition is reflected in the strip, along with the appropriate intervention.

4. Delegation and prioritization. We do not have that in the Philippines but it’s a big deal in the NCLEX. Majority of my exam was on management, delegation and prioritization.

5. Forget the real world! The NCLEX is a textbook-based exam.It doesn’t matter if you’ve been a nurse for 20 years, it will not test your tenure or real world experience. What it will test however, is what is written in the book. So forget what you see in your hospital experience!

6. Master alternate-type of questions. My exam had 1 ECG strip, 10-15 SATA (select all that apply),  and drag and drop. Know how to attack these type of questions.

7. Have a set schedule and follow it. It pays to have a study schedule so that you do not waste time on subjects that you already know. Focus on your weak points.

8. Pray and ask for support from your friends, family and your god.

9. Take your review seriously. Do not waste time like me. Focus and you will pass!

Well that’s it. I hope I was able to help you guys. Good luck!

 

 

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