What Does NCLEX Style Mean?

I remember being in nursing school and facing one particularly tough exam.  To me, the questions were confusing, detailed, and there seemed to be more than one right answer! My instructor made it a point to tell me that these were NCLEX style questions.  NCLEX style? What did that mean? I knew that NCLEX was the National Council Licensure Exam.  I knew that when I completed nursing school I would have to take and pass this exam to earn my license and the right to call myself RN. But, what I didn’t know was what it meant to have an NCLEX style question. What about you? Are you familiar with what it means when someone says an NCLEX style question? Well, if not, here is the breakdown.

Bloom’s Taxonomy

NCLEX item writers use Bloom’s Taxonomy to structure exam questions. In short, Bloom’s Taxonomy describes different levels of cognitive functioning.  Bloom’s Taxonomy differentiates between being able to recognize a concept and being able to use that concept at a higher level. The Bloom’s levels of cognitive functioning are: Knowledge, Comprehension, Application, Analysis, Synthesis, and Evaluation.  When questions are being written for the NCLEX-RN, the nurse writers decide what level of cognitive functioning they want to test and use appropriate words and prompts to ask questions at that level. What does this mean to the test-taker? It means that not all questions will be straight-forward, from the book type questions.  It means that candidates will have to use their knowledge to not only recognize correct answers but also to critically think how the knowledge of a concept can be used in more complex situations.

Bloom_taxonomy pyramid

Photo by NBC CFF Coach


Next up, are the distractors.  A distractor is just a fancy word for all the answer selections that are not the right answer.  Distractors are not meant to trick or confuse a test taker but to measure how well a test candidate knows a concept.  In many cases, you have already seen these kinds of distractors in other multiple choice tests. Distractors are written so that they are usually plausible, logical answers or common mistakes that are made in the situation being described. In CPR, for example, you might know that you should call 911 and do chest compressions but the question might ask what you should do first. Can you pick the best answer when two possible answers are closely related?  These kinds of distractors help to measure if the candidates really know their stuff! Which, of course, is very important to nursing.

choosing the right answer

So, the next time you hear an instructor mention NCLEX style questions, don’t be too nervous. All this really means is that the questions will use a variety of words to measure cognitive ability and the test-taker’s ability to find the best answer to the given question. The important take-away for a student preparing for the NCLEX-RN  is to carefully read the question and determine exactly what is being asked.  Are you being asked to identify a particular lab value or know what to do when you see something abnormal?  With a little bit of practice and test preparation, answering NCLEX style questions becomes just like any other skill.  Happy Studying!