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Breaking Down of The NCLEX-PN Test Plan | Test Taking

Written by Best Hendricks, MSN, RN, PCCN-K | 4-Apr

In nursing school, the thought of taking the NCLEX exam was exciting and nerve-wracking. I had heard so many stories about how difficult the test was, and I wasn't sure if I was prepared enough to pass it. However, as I delved deeper into studying the NCLEX test plan, I began to understand what the exam was really about and what kind of questions to expect. 

In this blog post, I want to share my experience and insights about the NCLEX-PN test plan and help demystify this important exam for aspiring practical nurses.

Ready to start your journey to becoming an LPN?  Read our article "Is LPN School Hard? (not if you do this)" to learn what to expect and how to succeed.

Test Plan Structure

So your LPN NCLEX is broken down in THREE different ways, and I'd like to highlight the significant framework so that when we break these down, these words will be familiar to you and help reduce your anxiety. Knowing is half the battle. 

Content

The content of the NCLEX is broken down into 8 different Client Needs.  (These are things like Basic care and comfort, safety and infection) .   

The NCLEX is also broken down into SIX Integrated processes and these processes are fundamental to the practice of an LPN, and you'll see them through every test question type. 

Fortunately, you'll see that you're probably very familiar with five of these already. Lastly, the test is broken down into Clinical Judgment steps.  This is basically the nursing process but through a finer lens and different vocabulary.

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We're gonna get to know these words. So you can decode any NCLEX question.

Time

Now I should probably talk about time, right?  That's huge. 

You'll have five hours and that's going to include all of your breaks.  And in that five hours, since it's an adaptive test, you can have a minimum of 85 questions up to 150 questions. To learn more about the adaptive testing visit: the National Council of State Boards of Nursing.

Client Needs

So there are a few categories and subcategories of client needs, and we are going to walk through these.

As you can see from the above graph, the largest category is known as Coordinated Care. The next two largest categories are Pharmacological and Safety & Infection.

Why is it so important to know the largest categories tested? 

Well, you need to know your own strengths and areas to grow for this test, correct? But also you want to know where the biggest chunks of these questions are in the NCLEX.   And as you can see above Coordinated care, Pharmacological, and Safety and Infection are about 50% of my test. 

Let's break this down just a tad more.  We are going to cover these in ORDER of the biggest chunk of your test. 

Coordinated Care

About 21% of your test.   This is going to represent you working with other healthcare team members.  So that whole interdisciplinary staff.  Think respiratory therapy,  PT, OT, ST, or maybe even a chaplain.  

Pharmacological Therapies

About 13% of your test.

You don't just administer medications, you have to have a spectrum of skills. This can be dosage calc, blood transfusion, could even be labs that you're going to monitor with medications. 

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Safety and Infection Control

About 13% of your test.

This is going to involve protecting yourself, but also protecting the patient from environmental hazards.  So think what patient identifiers before you give a med all the way to is there an internal disaster like a fire?  Also PPE, and isolation. 


Physiological Integrity

About 12% of your test.

This is going to be the well-being of your patient's family, all the way to maybe something like identifying a patient that has a substance abuse disorder.

Reduction of Risk

About 12% of your test.

This is going to deal with complications.  You'll be looking for those complications, whether it is from treatment, a procedure, or even maybe the patient has a comorbidity.  So they're in the hospital with heart failure, but they have diabetes. This can be as simple as taking a patient's vital signs all the way to maybe even placing a central line

Physiological Adaptation

About 10% of your test.  

This is going to have to do with patients that have a presentation of chronic acute or even life-threatening conditions. So you're going to have to do those acute skills. So you're thinking maybe Tele strips, maybe you have to work with chest tubes, maybe even you have a patient in respiratory distress.

Basic Care and Comfort

About 10% of your test.

This is assisting patients in ADLs. So this could be something like irrigating a Foley, so the patient can void.  Think elimination, mobility, and skin integrity.

Health Promotion

About 8% of your test.

This is going to be the care of all populations, all the way from newborns, toddlers,  adults, and the elderly. This could include also prevention of high-risk behavior like substance abuse or smoking.  So if you're weaker in peds or maternal, know that it is about 8% of your test.  So that's comforting!

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Integrated Process

I really do not even need to list these off to you because you already do these naturally.  But I will share all 6 of them!

  1. Caring
  2. Clinical problem solving
  3. Communication and documentation
  4. Culture and Spirituality
  5. Teaching & Learning
  6. Clinical Judgement

Caring

You're going to be a nurse, you're a caring individual, and you're going to give support and compassion. 

Clinical Problem-Solving

That is the nursing process. You've heard this semester by semester by now, right? Collecting data, planning, implementing, and evaluating.

Communication

We already talked about it, you're going to have to talk to all these interdisciplinary departments and you're going to have to document that.

Culture and Spirituality

You're going to have patients from different cultures, whether it's a family culture or a geographical one. You're going to have people with different spiritual needs, right? For instance, Jehovah's Witness may not want a blood transfusion. 

Teaching and Learning

We know that we facilitate our patients, their knowledge, their skills, and even their attitude toward promoting those changes in behaviors.  So they don't keep coming back to the hospital.

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Clinical Judgement

This is the BIG ONE!  

This is where most students need a little help.  Let's take a deeper look at this one.

 Clinical judgment takes the nursing process and it basically divides that into smaller steps. It's going to measure your knowledge to observe, assess, prioritize your concerns, and then come up with solutions. Boil that down.

Will you be a safe nurse?

That's what it is going to measure.  And it's measured by NextGen NCLEX questions.

Now, these can be presented as a case study or an individual standalone item.  No matter how many questions you take, whether you take 85 questions or up to 150, in those five hours, you will have a minimum of three unfolding case studies and each one of those case studies will have six different questions that are going to relate to the case study in that patient. 

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You're going to watch that patient as their presentation unfolds. 

The other 10% of your questions are going to be standalone, meaning not attached to a case study. 

Summarization: LPN NCLEX Test Plan

  • Time and Number of Questions: 5 hours and 85-150 Questions
  • Client Needs: 50% = Coordination, Pharmacology, Safty/Infection
  • Integrated Processes: Clinical Judgement = MOST challenging
  • Clinical Judgement: 3 Case Studies and 10% "stand-alone" questions

Preparing for the NCLEX-PN exam can be overwhelming, but with the right information and resources, you can confidently approach the test and pass on your first try.

If you're looking for more helpful tips and tools to help you succeed on the NCLEX-PN exam, visit NURSING.com

NURSING.com offers a comprehensive review course, practice questions, and expert support to help you succeed. Don't let the NCLEX-PN stand in the way of your nursing career.

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If you enjoyed this blog check out our other article on what is the difference between RN and LPN:

What Actually is the Difference Between RN and LPN