Introduction

The National Council Licensure Examination for Registered Nurses (NCLEX-RN) is administered by the National Council of State Boards of Nursing (NCSBN). It uses Computerized Adaptive Testing (CAT) format with a minimum of 85 questions and a maximum of 150 questions, with a 5-hour time limit. The exam tests the knowledge, skills, and abilities essential for safe, entry-level nursing practice.

The NCLEX-RN Test Plan is organized into 4 major Client Needs categories:

1. Safe and Effective Care Environment
2. •Management of Care (17–23%)
3. •Safety and Infection Control (9–15%)
4. Health Promotion and Maintenance (6–12%)
5. Psychosocial Integrity (6–12%)
6. Physiological Integrity
7. •Basic Care and Comfort (6–12%)
8. •Pharmacological and Parenteral Therapies (12–18%)
9. •Reduction of Risk Potential (9–15%)
10. •Physiological Adaptation (11–17%)

Source: NCSBN NCLEX-RN Test Plan (current edition) — ncsbn.org

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Recommended Resources

• •NCSBN Learning Extension — Official NCLEX review course from the exam makers
• •Saunders Comprehensive Review for the NCLEX-RN (Silvestri) — The gold standard review book
• •UWorld NCLEX-RN QBank — Widely regarded as the most representative practice questions
• •Kaplan NCLEX-RN Prep — Strong on test-taking strategies and decision tree method
• •Hurst Review — Focuses on core content and critical thinking
• •Mark Klimek Audio Lectures — Free audio lectures covering high-yield topics
• •NCSBN Practice Exams — Official practice tests from the exam body
• •La Charity: Prioritization, Delegation, and Assignment — Essential for management of care questions

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10-Week Study Plan

Phase 1: Foundation & Content Review (Weeks 1–4)

Daily Study Time: 4–6 hours

#### Week 1: Fundamentals & Management of Care

• •Topics: Nursing process, delegation, prioritization, legal/ethical issues, informed consent, advance directives, HIPAA, patient rights, advocacy, continuity of care
• •Key Focus: Learn the framework of “who to see first” (ABCs, Maslow’s, acute vs. chronic)
• •Daily Schedule:
• •2 hours: Content review (Saunders Ch. 1–5)
• •1.5 hours: 50 practice questions (UWorld or Saunders) with rationales
• •1 hour: Review incorrect answers and make flashcards
• •30 min: Pharmacology flashcards (start medication review early)

#### Week 2: Safety, Infection Control & Basic Care

• •Topics: Standard precautions, transmission-based precautions, sterile technique, falls prevention, fire safety, disaster planning, restraints, patient positioning, comfort measures, nutrition, elimination, assistive devices
• •Key Focus: Know isolation precautions cold; practice safety priority questions
• •Daily Schedule:
• •2 hours: Content review (Saunders Ch. 6–12)
• •1.5 hours: 50 practice questions with rationales
• •1 hour: Review incorrect answers; update flashcards
• •30 min: Pharmacology review (cardiac medications)

#### Week 3: Pharmacology & Parenteral Therapies

• •Topics: Drug classifications, dosage calculations, IV therapy, blood administration, TPN, central venous access, pain management, epidural analgesia, medication administration routes, drug interactions, adverse effects
• •Key Focus: High-alert medications (insulin, heparin, warfarin, digoxin, opioids); know antidotes
• •Daily Schedule:
• •2.5 hours: Pharmacology deep dive (organized by drug class)
• •1.5 hours: 50 practice questions (pharm-heavy sets)
• •1 hour: Dosage calculation practice (20 problems daily)
• •30 min: Review drug flashcards

#### Week 4: Health Promotion & Psychosocial Integrity

• •Topics: Growth and development (Erikson, Piaget), prenatal/postpartum care, newborn care, pediatric milestones, mental health disorders, therapeutic communication, abuse/neglect, grief and loss, cultural considerations, health screening
• •Key Focus: Developmental stages, therapeutic communication techniques, psychiatric medications
• •Daily Schedule:
• •2 hours: Content review (Saunders OB/Peds/Psych chapters)
• •1.5 hours: 50 practice questions with rationales
• •1 hour: Review incorrect answers
• •30 min: Psych pharmacology and OB medications

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Phase 2: Systems-Based Deep Dive (Weeks 5–7)

Daily Study Time: 5–7 hours

#### Week 5: Cardiovascular & Respiratory Systems

• •Topics: MI, heart failure, dysrhythmias, CABG, chest tubes, mechanical ventilation, COPD, pneumonia, pulmonary embolism, ABGs, hemodynamic monitoring, oxygen therapy
• •Key Focus: Pre- and post-operative care, emergency interventions, lab values (troponin, BNP, ABGs)
• •Daily Schedule:
• •2 hours: System review (Saunders or Hurst)
• •2 hours: 75 practice questions (system-specific + mixed)
• •1 hour: Review rationales, update weak-area list
• •1 hour: Prioritization/delegation practice (La Charity)

#### Week 6: Neurological, Musculoskeletal & Endocrine Systems

• •Topics: Stroke, TBI, spinal cord injury, seizure disorders, diabetes mellitus (DKA, HHNS), thyroid disorders, Addison’s/Cushing’s, fractures, traction, amputation, post-op neuro assessment
• •Key Focus: Neurological assessments (Glasgow Coma Scale), diabetic emergencies, insulin types
• •Daily Schedule:
• •2 hours: System review
• •2 hours: 75 practice questions with rationales
• •1 hour: Review rationales; practice drag-and-drop/ordered-response questions
• •1 hour: Pharmacology — endocrine and neuro meds

#### Week 7: GI, Renal, Reproductive & Immune Systems

• •Topics: Liver disorders (cirrhosis, hepatitis), pancreatitis, IBD, dialysis (hemodialysis/peritoneal), AKI/CKD, UTI, reproductive cancers, HIV/AIDS, autoimmune disorders, burns, wound care, transfusion reactions
• •Key Focus: Dialysis care, ostomy management, fluid and electrolyte imbalances, infection signs
• •Daily Schedule:
• •2 hours: System review
• •2 hours: 75 practice questions (mixed content)
• •1 hour: Fluid/electrolyte/acid-base review
• •1 hour: Lab values review (CBC, BMP, LFTs, coagulation studies)

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Phase 3: Practice Exams & Weak Areas (Weeks 8–10)

Daily Study Time: 5–6 hours

#### Week 8: Full-Length Practice Exams & Analysis

• •Day 1: Take full 150-question practice exam (UWorld or NCSBN) — timed, test conditions
• •Day 2: Deep-dive review of entire practice exam; categorize incorrect answers by topic
• •Day 3: Study weakest 2 content areas identified
• •Day 4: 75-question practice set (mixed); continue weak-area review
• •Day 5: Take second full-length practice exam
• •Day 6: Review second exam; update weak-area list
• •Day 7: Rest / light review of flashcards only

#### Week 9: Targeted Remediation

• •Focus on your 3 weakest content areas identified from practice exams
• •Daily Schedule:
• •1.5 hours: Content review of weak areas
• •2 hours: 75 practice questions (targeted to weak areas)
• •1.5 hours: Review all rationales (correct and incorrect)
• •1 hour: Prioritization/delegation/drug review
• •End of Week: Take third full-length practice exam

#### Week 10: Final Review & Confidence Building

• •Day 1–2: Review missed questions from all practice exams; re-study weak spots
• •Day 3: Light content review of highest-yield topics (meds, lab values, isolation)
• •Day 4: Timed 85-question practice test (simulate exam conditions)
• •Day 5: Review only flashcards and high-yield notes
• •Day 6: Rest — no studying; exercise, sleep well, prepare logistics for exam day
• •Day 7: EXAM DAY — Arrive early, bring required ID, stay calm

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Daily Schedule Template

Total: 5–6 hours/day (take 10-min breaks every 50 minutes)

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Key Topics — High-Yield Summary

• •Priority Frameworks: ABCs, Maslow’s Hierarchy, Acute before Chronic, Safety First
• •Delegation: RN tasks vs. LPN tasks vs. CNA tasks (know scope of practice)
• •Isolation Precautions: Airborne, Droplet, Contact — know which diseases go where
• •Lab Values: Know critical values and what to report immediately
• •Drug Classes: Cardiac, respiratory, endocrine, psychiatric — know prototypes, side effects, nursing considerations
• •Emergency Situations: Anaphylaxis, cardiac arrest, malignant hyperthermia, eclampsia, DIC
• •Growth & Development: Erikson’s stages, Piaget’s stages, expected milestones by age

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Test-Taking Tips

1. Read the question completely before looking at answer choices
2. Identify what the question is asking — look for keywords like “priority,” “first,” “best,” “most important”
3. Use the ABCs and nursing process to prioritize when multiple answers seem correct
4. Never leave a question blank — there is no penalty for guessing on the NCLEX
5. Don’t change answers unless you have a clear reason — your first instinct is usually correct
6. Manage your time — don’t spend more than 90 seconds on any single question
7. If you don’t know, eliminate — remove obviously wrong answers first
8. Remember: safety is always the priority — the safest answer is usually correct
9. Trust your CAT — the computer adapts to your ability; getting hard questions means you’re doing well
10. Stay calm — the exam ends when the computer determines with 95% confidence whether you passed or failed

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Sources

• •NCSBN. “NCLEX-RN Test Plan.” ncsbn.org/exams/nclex-rn-test-plan.page
• •NCSBN. “Preparing for the NCLEX Examination.” ncsbn.org
• •National Council of State Boards of Nursing. “NCLEX Examination Candidate Bulletin.”
• •Silvestri, L.A. Saunders Comprehensive Review for the NCLEX-RN Examination. Elsevier.
• •La Charity, P. Prioritization, Delegation, and Assignment. Elsevier.
• •UWorld NCLEX-RN. uworld.com
• •Kaplan NCLEX Prep. kaptest.com
• •Hurst Review. hurstreview.com