NCLEX-RN (Registered Nurse Licensure Exam)

What you will practice:

Cross-cutting nursing processes and professional behaviours that are tested throughout the exam, regardless of clinical setting.

• Build and maintain a therapeutic nurse–client relationship grounded in respect, trust, compassion, and client-centred goals.
• Use clear verbal and nonverbal communication with clients, families, and the interprofessional team to prevent errors and support continuity of care.
• Document assessments, interventions, and evaluation outcomes accurately and promptly to reflect standards of practice and accountability.
• Incorporate culture and spirituality by integrating client-reported preferences, values, and beliefs into the plan of care within legal and ethical boundaries.
• Apply teaching and learning principles: assess readiness, barriers, and preferred learning methods; reinforce skills to support behaviour change.
• Apply the nursing process end-to-end (assessment, analysis, planning, implementation, evaluation) to make safe care decisions.
• Use clinical reasoning to connect assessment findings with pathophysiology and risk, and to anticipate complications.
• Demonstrate professional judgement when resources are limited (time, staffing, equipment) while keeping safety and priorities central.

Tip: After topic practice, do mixed sets under time pressure and review missed questions immediately.

What you will practice:

Clinical judgment measured via NGN case studies and stand-alone items, aligned to the NCSBN Clinical Judgment Measurement Model (NCJMM).

• Recognize cues by identifying the most relevant information from history, vital signs, assessments, labs, diagnostics, and client statements.
• Analyze cues by clustering and linking findings to the clinical presentation, including risk factors, trends, and red flags.
• Prioritize hypotheses by ranking likely explanations and urgent problems based on risk, time sensitivity, and likelihood.
• Generate solutions by selecting expected outcomes and evidence-based interventions that address the prioritized hypotheses.
• Take action safely: implement the highest-priority intervention(s) first and adapt actions to client response and constraints.
• Evaluate outcomes by comparing actual results to expected outcomes, determining effectiveness, and revising the plan of care.
• Interpret multiple data sources in a single scenario (e.g., evolving vitals, new symptoms, response to treatment) and adjust priorities.
• Handle NGN item formats such as case studies (six items), bow-tie, matrix/grid, highlight, drag-and-drop, and multiple-response reasoning.

Tip: After topic practice, do mixed sets under time pressure and review missed questions immediately.

What you will practice:

Coordination, prioritization, delegation, legal/ethical practice, and systems-based safe care delivery across settings.

• Coordinate safe transitions of care including admission, transfer, discharge, and follow-up planning.
• Give and receive handoff reports using structured communication to ensure continuity and reduce omissions.
• Prioritize care for multiple clients based on acuity, instability, time-critical interventions, and expected outcomes.
• Delegate tasks appropriately to LPN/VN and assistive personnel, and supervise and evaluate delegated care.
• Collaborate with interprofessional team members (e.g., PT, dietitian, social work) to address client needs holistically.
• Implement and verify provider orders correctly, using facility policies and evidence-based resources when clarifying orders.
• Protect confidentiality and information security, including appropriate handling of social media and privacy breaches.
• Practice within ethical and legal boundaries, including refusal of treatment, handling valuables per policy, and use of interpreter services.
• Support informed consent by verifying client understanding, capacity, and proper completion of required components.

Tip: After topic practice, do mixed sets under time pressure and review missed questions immediately.

What you will practice:

Infection control, environmental safety, emergency preparedness, equipment safety, and incident escalation to protect clients and staff.

• Apply standard and transmission-based precautions correctly (contact, droplet, airborne) and educate clients and staff on adherence.
• Perform hand hygiene and aseptic technique; set up, maintain, and troubleshoot a sterile field.
• Identify communicable disease transmission risks and implement appropriate isolation, PPE, and cohorting strategies.
• Determine appropriateness of restraints and safety devices, follow legal and facility requirements, and monitor client response.
• Inspect equipment for hazards, remove malfunctioning equipment from service, and report issues per policy.
• Assess home and environmental safety needs (lighting, rails, kitchen and bathroom safety) and teach risk-reduction strategies.
• Handle hazardous, flammable, infectious, and biohazard materials safely; implement required procedures for disposal and exposure.
• Follow security plans and emergency procedures, including triage, evacuation protocols, disaster drills, and controlled access procedures.
• Recognize when incident/variance reporting is required; document errors/near misses and escalate unsafe practice appropriately.

Tip: After topic practice, do mixed sets under time pressure and review missed questions immediately.

What you will practice:

Growth and development, prevention and screening, lifestyle risk reduction, reproductive health, and client education for optimal health.

• Assess growth and development across the lifespan; tailor communication and education to developmental stage and cognitive ability.
• Teach expected milestones and age-related changes; identify deviations that warrant follow-up or referral.
• Perform risk assessments based on personal, family, genetic, lifestyle, and community factors and integrate findings into care.
• Educate on preventive health behaviours including nutrition, physical activity, sleep hygiene, and smoking cessation strategies.
• Support screening and early detection decisions (e.g., vision, depression, nutrition risks) and link screening rationale to pathophysiology.
• Provide sexuality and reproductive health education including contraception needs, contraindications, safer sex practices, and menopause-related changes.
• Provide maternal-newborn education and care concepts across prenatal, intrapartum, and postpartum periods.
• Assess self-care capacity and home management needs; plan teaching and supports to enable safe self-management.

Tip: After topic practice, do mixed sets under time pressure and review missed questions immediately.

What you will practice:

Mental health, coping and adaptation, crisis intervention, abuse and violence, substance misuse, grief, and end-of-life psychosocial support.

• Assess for abuse, neglect, and violence (child, intimate partner, elder, sexual) and initiate reporting and safety interventions.
• Screen for substance misuse, withdrawal, and toxicity; implement nursing safety measures and referrals as appropriate.
• Support coping and stress management during life transitions, chronic illness, disability, and role changes.
• Use crisis intervention techniques to ensure immediate safety and connect clients to recovery and community resources.
• Deliver culturally congruent care by incorporating the client’s self-identified culture, documenting language needs, and using interpreters.
• Provide psychosocial support at end of life including fear, loss of control, financial concerns, and caregiver needs.
• Recognize and respond to grief and loss (anticipatory grief, expected grief reactions) and facilitate support systems.
• Use therapeutic communication, assess cognition/mood/judgement, support treatment adherence, and maintain a therapeutic milieu.

Tip: After topic practice, do mixed sets under time pressure and review missed questions immediately.

What you will practice:

Foundational bedside care focusing on comfort, ADLs, nutrition, elimination, mobility, skin integrity, rest, and nonpharmacologic pain management.

• Assess and support activities of daily living (ADLs) while preserving dignity, privacy, and client preferences.
• Provide hygiene care and adapt routines using assistive devices; perform postmortem care when indicated.
• Assess nutrition and hydration status, swallowing safety, and cultural preferences; monitor intake and output and related indicators.
• Manage enteral feeding basics: verify placement per policy, administer feeding, monitor tolerance, and respond to complications.
• Support bowel and bladder elimination; implement skin protection strategies for incontinence and teach methods to promote voiding.
• Assess mobility, gait, and strength; prevent complications of immobility; implement ROM, positioning, and circulation promotion.
• Maintain skin integrity through risk assessment, repositioning, pressure injury prevention, and wound/skin care basics.
• Apply and maintain orthopedic devices and traction principles; ensure alignment and neurovascular monitoring.
• Use nonpharmacologic comfort interventions and palliative approaches; assess pain and evaluate response.
• Promote rest and sleep by assessing sleep patterns and coordinating care to minimise interruptions.

Tip: After topic practice, do mixed sets under time pressure and review missed questions immediately.

What you will practice:

Medication safety, dosage calculation, adverse effects, IV and central line care, blood products, TPN, and therapeutic monitoring.

• Apply the rights of medication administration and verify orders, allergies, contraindications, and relevant labs before giving medications.
• Perform accurate dosage calculations and infusion rate calculations; double-check high-alert medications per policy.
• Identify and manage adverse effects, side effects, interactions, and incompatibilities across prescribed, OTC, and herbal products.
• Educate clients on medication purpose, expected effects, key side effects, and when to seek urgent help; evaluate learning and response.
• Complete medication reconciliation during transitions of care to prevent omissions, duplications, and interactions.
• Handle controlled substances safely in accordance with regulatory and facility requirements.
• Maintain peripheral IV therapy (site assessment, patency, infiltration/extravasation recognition) and monitor infusion pumps.
• Perform central venous access device care within scope and policy, including infection prevention and line complication monitoring.
• Administer blood products safely and monitor for transfusion reactions and response.
• Administer and monitor TPN, recognizing risks such as hyperglycaemia, infection, and fluid imbalance, and evaluate outcomes.

Tip: After topic practice, do mixed sets under time pressure and review missed questions immediately.

What you will practice:

Early detection and prevention of complications related to diagnostics, procedures, treatments, and evolving clinical changes.

• Recognize abnormal vital signs and trends, link findings to pathophysiology, and initiate appropriate nursing responses.
• Prepare and support clients for diagnostic tests; compare current findings to baseline and pre-test data.
• Collect blood and non-blood specimens correctly; teach clients about tests and interpret results within nursing scope.
• Monitor laboratory trends (e.g., glucose, electrolytes) and notify providers of critical changes per policy.
• Identify aspiration, skin breakdown, and perfusion risks and implement preventive interventions (positioning, skin care, safety strategies).
• Manage common tubes and lines safely (urinary catheters, GI tubes, peripheral IVs) including insertion/maintenance/removal per policy.
• Use devices to promote venous return (SCDs, antiembolism stockings) and monitor for complications.
• Monitor clients receiving moderate sedation during and after procedures and prevent procedure-related injury.

Tip: After topic practice, do mixed sets under time pressure and review missed questions immediately.

What you will practice:

Management of acute, chronic, and life-threatening conditions, including emergency response, hemodynamic stability, and invasive therapies.

• Implement emergency care priorities and recognise deterioration requiring rapid response or escalation.
• Provide respiratory support concepts including ventilator monitoring basics, suctioning, pulmonary hygiene, and oxygenation strategies.
• Monitor telemetry clients and recognise rhythm-related instability; provide basic pacing device care and monitoring considerations.
• Identify and manage hemodynamic alterations affecting perfusion and hemostasis; monitor arterial line concepts when applicable.
• Manage fluid and electrolyte imbalances and temperature regulation to maintain physiologic stability.
• Care for drains and wound systems (chest tubes, wound drains, negative pressure wound therapy) and perform dressing changes safely.
• Assist with invasive procedures (e.g., bronchoscopy, thoracentesis) and monitor for complications post-procedure.
• Provide ostomy and airway-related care and education as indicated, and evaluate client response to interventions.
• Support renal replacement concepts such as peritoneal dialysis care and monitor for complications.

Tip: After topic practice, do mixed sets under time pressure and review missed questions immediately.