You might be reading this because you’ve failed the NCLEX. (If you haven’t, skip down to get to the study tips).
There’s nothing quite like the moment you find out and read it on the screen or in your mail. It’s shocking.
Then it gets heartbreaking. You spent all that time reviewing and studying for the NCLEX.
You won’t be able to help the self-doubt and negativity from dominating your thinking for a while.
But you need to know this:
Your nursing journey is not over until you give up. You can recover from this!
You can become a nurse – just a little bit later than you were planning. There’s a clear path to where you’re wanting to be.
I know it sounds far off right now, but I’m telling you there are clear steps to get there.
Here’s what this guide will show you:
- I’ll first prove to you that you’re far from being alone in this situation.
- I will also prove that you CAN pass the NCLEX and bounce back from this.
- At the same time, you need to understand what you’re up against and how the statistics look for you.
- Then, I’m going to go back to basics: how to study for the NCLEX correctly (also, what NOT to study).
- Next, I’m going to teach you how to tell if the NCLEX study source you’re using is too easy.
- Finally, I’ll review some very simple AND actionable ways to eliminate test anxiety.
This Should Make You Feel Much Better About Failing the NCLEX
Before I start telling you what to do and all that, there’s something you HAVE to know.
Failing the NCLEX happens to SO MANY PEOPLE!
Let me show you:
Here are the pass rates released by the NCSBN for 2016.
You can click on that link if you want, but here’s what you need to see:
In 2016, 81.43% of First Time Test Takers taking the NCLEX-RN passed – which means the rest (18.57%) failed. See below:
That’s 31,316 people who failed the NCLEX in just a single year.
And if you add the NCLEX-PN (which had similar pass-fail percentages), that’s another 7693 students who failed, for a total of 39,009 students who failed in one year!
How big was your nursing class? 50 students? 39,009 equals more than 780 whole 50-person nursing classes who failed.
If your nursing class was closer to 25 students, that’s over fifteen hundred whole nursing classes who failed the NCLEX that year alone!
Here’s another way to think about it:
About 15% of people failed (100% minus 84.57%). That’s 1 person per every 6 to 7 people.
How big was your nursing class? If it had at least 14 people, about 2 people would have failed. If it was 21 or more, 3 people should have failed. And so on.
So already you’re not alone, despite all the Facebook posts and celebration messages from the people who passed.
Chances are, two or even more of your classmates have failed too – they’re just keeping quiet.
Remember, the people who’ve failed aren’t going to be broadcasting it. There is a silent minority of people like you, even amongst your classmates.
So remember this:
Thousands of people fail the NCLEX every year. Many thousands. You’re far from alone.
Here’s How I Prove You Can Pass The NCLEX
Thousands and thousands of people have failed, but then passed when they tried again. How do I know?
You guessed it:
Let’s look at the NCSBN Pass Rates again!
Look closely at that screenshot. To sum it up, in 2016, over 30,000 repeat test takers passed the NCLEX. 31,204 to be exact.
That’s a familiar number…it’s close to the number of people who failed (39,009, remember?)!
Here’s what that means:
About 39,000 students failed the NCLEX for the first time in 2016. Yet another 30,000 students passed the NCLEX in 2016 after already failing in the past!
That’s amazing news! That’s a humongous amount of people who turn around and pass after a failed attempt.
So could you end up being one of those 30,000 people who recovered from failing the NCLEX? YES, you can!
Here’s the Bad News…
Statistics do not apply to individual outcomes. Just because so many people statistically pass or fail, the only thing that decides whether YOU pass or fail is completely dependent on your actions.
You have a lot of work ahead of you. If you look at the screenshots, you’ll notice that only about 30-40% of repeat test takers actually passed. That’s not a really high number.
Statistics have no bearings on individual outcomes. What you do now and up until your next attempt will ultimately decide whether
What You Have To Do to Pass the NCLEX The Next Time
I’ll get straight to it.
Number One: Do Something Different.
As I mention in my About page, I work as a nurse manager. What I don’t mention is that I manage a chemical dependency unit (a detox unit).
Patients come to my unit to safely withdraw from Alcohol, Benzodiazepene, and Opiate addictions.
As you might imagine, we have patients who frequently relapse – in other words, fail.
HOWEVER – recovery is always a possibility, no matter how difficult it seems.
And do you know what we tell our patients they need to do to recover?
Do something different!
Whether it’s going to a higher level of care after their detox, starting some relapse prevention medications, choosing a different support system, or picking new group therapy options, the main thing is not to do the same thing that didn’t help the first time.
You need to use the same principle. Analyze what you did to prepare for the NCLEX the first time.
The 4 Common Pitfalls That Will Ruin Your NCLEX Prep
- Did you mainly just study your nursing school notes? Did you maybe even go into too much detail in your studying, like you would in nursing school? Because the NCLEX isn’t like that.
- Did you study in a passive way versus an active way?
- Did you control your study environment?
- Did you practice NCLEX questions that were free, too easy, outdated, unorganized, or from an unreputable source?
These are common pitfalls that make up the main reason students fail the NCLEX. Let’s review each in more detail.
1. Why Studying Notes from Nursing School Is a Bad Idea
Have you noticed that nursing school can be kind of…random?
Teachers and instructors will kind of just choose chapters and subjects to test you on, and sometimes things that aren’t even in the book!
Not only that:
How well did your school cover the strategies that the NCLEX tests you on? Unless they had you use an NCLEX simulator of some kind, like the one that Platinum Tests offers, there’s really no way to know.
(Pro tip: You can find out more about Platinum Tests here. They are actually the only company that I know of that has a true Computerized Adaptive Test system).
Well, the NCLEX is not random. They tell you specifically what they’ll test you on, and then they do it.
When you’re studying some obscure subject that your nursing school thought it was important to test you on, and the NCLEX doesn’t ask about that stuff, you’re wasting your time.
Plus, consider this:
Your textbooks and school material go into a lot of detail. Too much detail. I’ve never once seen an NCLEX question asking about pharmacokinetics, mechanisms of actions, and detailed pathophysiology of diseases.
Yet, that’s what you’re tested on and what you study in nursing school. Not that that’s bad. It’s good and essential to know that.
But the NCLEX is not there to test your knowledge on science and biology.
To steal the words from Marlene Hurst’s review, the NCLEX really just wants to know that they can safely send you out to work in a hospital and you won’t kill anyone! (By the way, Hurst Review is one of our most recommended NCLEX reviews.)
It’s a licensure test. And what are licenses for? Licenses are to protect the public.
For example, think of a driver’s license: what is it for? To protect the public from people in cars who haven’t learned to drive!
The NCLEX is like the driving test of nursing.
Driving instructors don’t care if you know how the fuel injectors in the car works. They just want to make sure you can drive it without killing people on the road.
Knowing that, you can see why relying on your nursing school material could have been study overkill.
Using an NCLEX Review resource that is specifically purposed to teach NCLEX will better target the specific concepts and skills you need.
Or, if you would like to continue to self-study, please read my post about using the NCLEX Test Plan as your guide so you don’t get overwhelmed.
2. Changing How You Study can Make All The Difference
What do you imagine when you hear the word “studying?”
I know what came to my mind: somebody sitting in front of a desk with their face buried in a book.
Yes, that’s studying…but it’s the WRONG way to study. That’s passive studying.
There’s a better way. It’s called ACTIVE studying.
How Retrieval Practice can Turn the Tables
One of the best ways to actively study is by using active recall, or retrieval practice.
Both of those mean the same thing. Instead of just “soaking in” information, active recall forces you to bring up answers and concepts from your own memory.
In fact, here’s a scientific study that says retrieval practice works better than making detailed concept maps (which nursing school loves to make you do).
Here are ways to actively study using retrieval practice:
- Reading from a book…then teaching the subject to someone else who knows nothing about it in your own words, and making sure they understand.
- Reading an outline…then re-writing the outline in your own words, avoiding looking at the original as much as possible.
- Writing down notes…then coming back to them later…then quizzing yourself to remember them without looking at them.
- Revisiting your notes…then covering up the right half the page with a piece of paper, then reading the left half out loud,
then completing the right side from memory.
- Watching a video…then pausing it every time something important is coming up and trying to predict what they’ll say using an educated guess.
- Practicing NCLEX Questions…and making sure they are at the application level of examination to force you to make inferences and remember key concepts.
- Listening to a lecture…and raising your hand first every time the teacher asks a question. Even if you don’t know the answer, try your best guess. Whether it’s right or wrong, you’ll learn more because you were actively involved, you got a little bit of adrenaline, and you just did retrieval practice.
- The SIMPLEST way to use retrieval practice is to simply look away from your materials, and teach yourself the concept in your head. Step by step, example by example. Do it until you know without a doubt that you understand the concept.
But that’s not the only study strategy you need to know.
This is the Ace Student’s Secret Key To Success
You know those students who barely study, yet ace exams?
Those students who always seem to know the right answers during the lectures, who are just annoying because it looks so damn easy for them?
I have a confession:
I’m one of those students. In high school, I aced all the to advanced classes.
In nursing school, I skipped most of the lectures for Anatomy and Physiology and just read the book.
Even now, I’m taking an online college level statistics course in my graduate nursing program, but I’m cutting corners big time.
The reason I’m telling you this is to show you that I know what I’m talking about when it comes to studying.
You know the cliche, “work smart, not hard?” That’s exactly what I’m getting at here.
Just because it looks easy, though, doesn’t mean I “just do it” like magic.
There’s a very important process that I use.
Scaffolding Will Supercharge Your Learning
Have you ever seen scaffolding in real life? It’s a structure of smaller parts, basically, connected to each other from various angles or on top of one another to make strong support system:
To learn properly, you need to structure your learning the same way.
This is so important:
When you learn, you absolutely must connect what you’re hearing or reading to what you’ve previously learned.
You have to make time to do this. If you read or hear something new, and you’re not 110 percent sure you understand, then STOP.
Go back to the last paragraph, go back a slide, stop the teacher, or rewind the video.
Learn it until you are absolutely sure you can connect the concept to what you already knew.
A lot of students don’t do this!
Think of a time during a lecture where you reached a point where you didn’t quite connect with the concept the teacher just told you.
But, instead of speaking up, you (and other students) let it pass and the teacher moved on.
What happened for the rest of the lecture? You were lost!
Some of the rest of the lecture was wasted, because while you can partially keep up, you were still missing part of the puzzle piece.
In that situation, you stopped scaffolding correctly.
Self-studying is the same way: one thing built on top of another, connecting to each other until you have a full understanding.
So if you miss even one part of the scaffolding, you undermine your full understanding.
A lot of students will make this mistake when self-studying:
They’ll read something, and they don’t fully understand or connect with it. But instead of STOPPING, going back, and making connections, they keep reading, hoping it’ll come clear later. That does not happen!
Suddenly, you’re halfway through a chapter of your textbook and you feel like you understand nothing.
That’s because you lost your scaffolding the first page in and didn’t even realize it.
Now, here’s another important concept:
Combining Scaffolding with Retrieval Practice Double Supercharges Your Learning
Remember how I said you have to know the material 110 percent before moving on? But how do you know you know it 110%? Using retrieval practice!
As you learn, or scaffold, new things, you can do retrieval practice on-the-go.
To do it really quickly: pause, look away from the textbook, or whatever you’re learning from. Now, teach yourself the information in your head.
If you can walk through it and understand step by step without reading or referencing anything, you’re good to move on!
STOP RIGHT NOW. Look away from the screen.
Ask yourself now: Do I really remember what retrieval practice is?
In your head, walk through how it works and examples of using it.
If you can’t do it, but you keep reading this article anyways, then you’re not scaffolding the right way. Go back, read, and understand retrieval practice before reading on.
Get the process now?
Okay, continuing on: combining scaffolding with retrieval practice. It’s so easy, yet so rarely done.
STOP RIGHT NOW AGAIN. Do you even understand scaffolding 110%?
Because just now, I mentioned combining scaffolding with retrieval practice. If you don’t understand scaffolding, you won’t be able to understand what I’m about to say.
So look away, and see if you can walk yourself through what scaffolding is (and situations where people fail to do it) in your head. Once you’re done, continue.
Congratulate yourself. You just combined scaffolding with retrieval practice!
You first learned about retrieval practice. You then moved on to learning about scaffolding.
But you also had to connect (or scaffold) the two together into a combined concept: using both together. Before you could do that, though, you HAD to use retrieval practice twice to make sure you understood both concepts 110%.
After you finish learning an advanced concept, it’s good stop right at the end, and retrieval practice the whole thing once over again.
So, STOP RIGHT NOW ONE LAST TIME.
Walk yourself through what retrieval practice means, and examples of how to do it.
Then walk yourself through scaffolding and what that means.
Finally, review how you would combine scaffolding with retrieval practice.
That was one last set of nails to keep your scaffolding together.
You can make it even better using the other retrieval practice methods I gave you examples of in that section.
Congratulate yourself again. You just learned how to learn properly.
I hope you were able to keep up! But if you couldn’t, just stop and go back. It’s as easy as that.
By doing this, you can avoid rote memorization, which is the worst way to learn things.
It might all seem very weird and unnatural, but once you get used to it, you will avoid wasting your time learning without understanding and
you’ll do it faster and faster.
The whole point of this process is to learn things right the first time.
That’s how those annoyingly “smart” students do it. They don’t waste time because they do it right the first time.
3. Successful Students Optimize Their Study Environment by Doing This
Remember the ace student again?
There’s another thing they do.
They know where and when they learn best, and they make it happen.
Note that I said “where” and “when.” Both are important.
But how do you find your ideal study environment? How do you know when you have the sweet spot?
It’s easy: your sweet spot is wherever and whenever you can keep your focused 100% for one hour of quality study.
One hour. Of quality study. One hour? That’s it? Yes.
There is such a thing as overstudying.
If you’re doing real, quality studying (with scaffolding and retrieval practice), one hour is
pushing most people’s limit without a break.
In fact, if you find that you’re getting too scattered to focus even in less than an hour,
just take a break.
You never want to do poor quality studying.
Remember, if you do it right the first time, you’ll save time in the end.
Now you just need to do some trial and error.
Think of a location you used to study. Were you able to do it without getting distracted for a full hour?
Whether it involves turning off your phone, disconnecting from the internet, holing up at the library, staying away from your study group, or locking yourself in a room, if you can’t focus for a full hour, you need to change your environment.
Know also that people have different levels of focus. Some people can sit in a busy Starbucks and focus for an hour. Good for them – that’s their
If you’re bad at focusing, though, you’ll need to do more than them to control your environment.
Once you’ve found somewhere, sometime, or some condition where you were able to focus for a whole hour, REPEAT it.
That’s how you optimize your study environment. Find your sweet spot, then repeat until you have everything completely understood.
However, simply studying won’t get you completely past the NCLEX. There’s one more step.
4. Using The Right NCLEX Practice Questions Will Help You Learn Judgement
We’re going to move away from general study practices now and focus on the NCLEX again.
When it comes to NCLEX resources, you get what you pay for.
So if you pay nothing, what do you get? Pretty much nothing.
You will never find a complete, well-packaged NCLEX practice bank for free.
Free material is usually offered to people to upsell them. They want to get you in the door with a sample, then sell you their complete product.
The exception to this is free material that is outdated, but that’s not very good either.
There are also websites that publish free NCLEX materials and make money from ad revenue.
However, the quality of their content is questionable. Most I’ve seen have way too many “easy” NCLEX questions.
The Problem with A Lot of NCLEX Resources You’ve Probably Used
Remember Bloom’s Taxonomy? Basically, it says that there are increasingly more difficult levels of testing understanding.
Vanderbilt University has a good description of bloom’s taxonomy here.
To sum it up, though, the levels are:
Studying for the NCLEX requires you to be learning at the application level or above.
Just take a look at page 2 of the 2016 NCLEX Test Plan for proof…
Bloom’s taxonomy for the cognitive domain is used as a basis for writing and coding items for the examination (Bloom, et al., 1956; Anderson & Krathwohl, 2001). Since the practice of nursing requires application of knowledge, skills and abilities, the majority of items are written at the application or higher levels of cognitive ability, which requires more complex thought processing.
Knowing that, let’s return to my original point.
How many free NCLEX Practice Questions out there are going to be fully application level or above? Zero.
Even some less reputable paid resources don’t go as far to do this. So be careful what you buy and use for your NCLEX study.
To help demonstrate, here are examples of what NCLEX questions would look like in each category of Bloom’s Taxonomy.
Which of these is the normal range for a given patient’s White Blood Cell levels (in units of x 10^9/L)?
- 3.5 to 5.0
- 4.5 to 11.0
- 8.5 to 11.0
- 5.0 to 12.0
- .05 to 2.0
This one is purely asking you to retrieve information (either facts or basic concepts).
Yet, I’ve actually seen questions like these on some poorly written NCLEX prep sources.
The correct answer is “2,” but you could have googled that easily.
A patient presenting with new-onset congestive heart failure who is placed on a fluid restriction asks you “what does this have to do with my heart condition?” What is your best response?
- “The reduced fluid intake will help improve your breathing.”
- “The reduced fluid intake will help lower your blood pressure.”
- “The lower the amount of fluid you have in your system, the lower your daily weight will be.”
- “The fluid restriction assists the diuretics to lower the amount of fluid in your system.”
- “The less fluid you have in your system, the easier it is for your heart to pump it.”
This one is a lot harder than the first one, but not hard enough!
You can still find the right answer after reading a Wikipedia article about Congestive Heart Failure.
The correct answer is “5.”
Answers “1,” “2,” and “3” describe specific measures of outcomes, but don’t actually describe the rationale behind fluid restrictions. Answer “4” merely repeats the effects of fluid restriction but does not describe the rationale.
Only “5” pinpoints the main problem that it helps solve and properly describes how fluid restrictions help with CHF.
A patient that police brought into the emergency room today for alcohol intoxication for the third time in the last month has the following lab results. Which one would signal that this patient requires immediate intervention?
- Sodium: 130 mEq/L
- WBC: 3.5 x10^9/mcL
- Potassium: 2.3 mEq/dl
- Albumin: 3.2 g/dL
- Blood Alcohol Level: 350 mg/dL
This question requires more thought. Simply knowing and understanding any one thing isn’t enough.
You have to decide which of these lab results would be the biggest safety concern. You not only have to understand them, you have to compare them.
The correct answer is “3” because a low potassium is the most life-threatening imbalance listed. The rest are all abnormal, but not as significant.
The biggest distractor is “5” because of the high level, but the question tells you that the patient is there for repeated alcohol abuse, and therefore will have built a tolerance to alcohol.
A level of 350 mg/dL is not uncommon for these types of patients.
As you administer morning medications to one of your patients, he tells you that he is having palpitations that gradually worsened since yesterday. You know that this patient started taking furosemide 3 days ago to reduce leg swelling. What is your best immediate response?
- Raise the head of the patient’s bed
- Notify the healthcare provider about the patient’s complaint
- Obtain the EKG machine
- Obtain a copy of his latest Comprehensive Metabolic Panel.
- Hold this administration of furosemide.
This question takes it one step up. You have to connect multiple dots to arrive at the correct answer, which is “5.”
You have to know and understand that furosemide is a potassium-wasting medication.
You also have to know that palpitations can be a sign of low potassium. You then ALSO have to choose the best first action. Even though all of the other answers are correct, you have to choose the highest priority intervention.
In order to not cause additional harm to the patient, you have to hold the next dose of this medication that could potentially be threatening the patient’s safety.
Remember the purpose of the NCLEX. They want to make sure you know how to keep the public safe. The first step in keeping them safe is by not harming patients further.
Do you see the difference in difficulty and critical thinking to answer the Apply and Analyze questions? NCLEX questions are at this level.
All too often, I see questions like the first and second one that merely test for knowledge and understanding.
Here’s a cheater’s way of making sure an NCLEX question is good enough:
- If you can Google it to find the answer right away, it’s a “Remember” question.
- If you can Google it and have to read an article to know the answer, it’s an “Understand” question.
- If you can’t Google it to find the answer at all, you’ve got a good NCLEX question!
Hopefully those examples will help you learn to judge NCLEX practice materials so you can avoid the pitfall of practicing questions that are too easy.
Learn This Skill To Help With Test Anxiety
You get to 75 questions, and the test’s not over. You’re nervous.
You get to 100. Still not over. Now you’re in panic mode.
You feel like you’re reading through tunnel vision. You feel like your brain is pressing in on itself. There’s a little running dialogue in the back of your mind telling you things you don’t want to hear.
That’s test anxiety. Have you had this problem?
Here’s what you need to know.
Choose ONE simple breathing technique.
Here’s a good one (credit to anxieties.com).
- Take a long, slow breath in through your nose, first filling your lower lungs, then your upper lungs.
- Hold your breath to the count of “three.”
- Exhale slowly through pursed lips, while you relax the muscles in your face, jaw, shoulders, and stomach.
It’s going to be very likely that when you get over 75 questions, you’ll start to worry. That’s okay. It’s normal to feel that way. Don’t fight it or get panicked because you’re having those thoughts.
They’re there for a good reason (your mind and body are built that way to protect you), but you just don’t want to allow it to affect your performance.
So, breathe until you are ready to answer the next question.
It’s better to take time and relax before even looking at a question than to rush through questions while you’re in an anxious state (you know you can’t think straight when you’re panicky!).
Between sets of breathing, reinforce yourself with simple, realistic, positive thoughts.
“I can still pass. It’s not too late. Just need to think clearly. I can still pass. It’s not too late. Just need to think clearly.”
That would be a good one to use.
If any other thoughts enter your mind during the exercise, briefly acknowledge them, then put them aside. They aren’t bad. Anxious thoughts are natural. But right now it’s just time for them to go.
Just follow the process: breathing, then the positive realistic thoughts, all the while acknowledging and putting away the anxious thoughts.
Do this until you are calm enough to read the next question objectively.
Continue to do this throughout the test so anxiety will not affect your performance.
…But The BEST Cure for Test Anxiety?
I’m talking about thorough, slow, methodical preparation using some of the methods I told you about in this article.
Only you know how much preparation you need.
How anxious are you when you get ready to do something you KNOW you’re good at, or you’ve been really well-prepared for?
Not very anxious, right?
That’s how well you need to prepare for this.
The more anxious you are, the more it might be an indication that deep down you know you’re not ready yet.
Just in case, here are some indicators that might mean you need to be even more prepared:
- Graduation Date: Graduated from nursing school more than 6 months ago.
- School Location: Educated outside of the U.S.
- School Quality: Graduated from a low-performing nursing school (NCLEX pass rate less than 85%)
- Repeat Test Taker: If this is not your first NCLEX attempt.
- Confidence Level: If you feel you haven’t retained enough information from nursing school.
Remember: slow, methodical, preparation.
Depending on your situation, you might need to completely rebuild your education from the ground up – almost like re-doing nursing school on your own.
Can you do that with a question bank and a 3-5 day course, like a lot of students try to do?
Unfortunately there are just no shortcuts around the NCLEX.
So that is my last piece of advice. Give yourself the time, and make a long term commitment to rebuild your nursing foundation.
I’ll post links at the end of this article that can help you on that journey.
Summary: Here are the Must-Haves for a Solid NCLEX Prep
Whether you choose to do your own NCLEX Review or seek professional help, here are the most important things you have to know and do.
- There is Hope If You’ve Failed. This is for those of you who’ve failed the nclex. I’ve not only shown you how many people fail, but how many people bounce back and pass.
- Learn the Right Things. The NCLEX wants to make sure you’re safe to practice nursing in public. No more, no less. Knowing this will guide your study choices and prevent you from overlearning.
- Use Smart Study Skills. Scaffolding and Retrieval Practice are two advanced learning strategies that you should use for the rest of your life.
- Control Your Study Environment. You can do all of the above right, but if you can’t create a focused study environment, you’ll fail.
- Study NCLEX At Application Level or Higher If you don’t, you’re not studying for the NCLEX, because that’s how the NCLEX tests you.
I really hope these guidelines elevate your understanding and equip you with the skills to prepare for your next pass at the NCLEX!
I hope this is helpful to you. PLEASE – if you have any suggestions on more ways to recover from failing the NCLEX, share in the comments.
Please also share your personal experience with failing (or passing) the NCLEX. I would love to hear it.
Also, if you feel you need more guidance, this article about leveraging the NCLEX Test Plan could really help.
Until next time!