1. Brewer, Sharon MSN, RN

Article Content

If you're preparing to graduate from nursing school, congratulations! You're about to complete all of the requirements for a nursing degree. But one big obstacle remains in your path to becoming a licensed RN-the National Council Licensure Examination (NCLEX). Passing the NCLEX is the goal of every nursing school graduate; with the right preparation, you'll be successful.

Figure. No caption a... - Click to enlarge in new windowFigure. No caption available.

You've actually been preparing for the NCLEX since your first day of nursing school. However, as your graduation date gets closer, there are specific things you can do to enhance your success. Studies have shown that positive lifestyle management, effective study techniques, and stress management can help you be successful on the NCLEX. Let's take a closer look.


Positive lifestyle management

Feeling your best, both physically and mentally, is important not only for nursing school performance and a happy life, but also for NCLEX success. You must prioritize the things that are most important for the time you have. A few high-priority things that may maximize your success include adequate sleep, good nutrition, and exercise.


Adequate sleep. You may tell yourself that 3 hours of sleep is sufficient when you're staying up late to study for a major exam; however, inadequate sleep comes with a price. Nursing students commonly prioritize study time over sleep, but when sleep suffers, cognitive ability also suffers. Many people get insufficient sleep across the school/work week and use the weekend to catch up on sleep. One weekend of recovery sleep may not be sufficient to fully reverse the impairments observed with chronic sleep loss, particularly alertness and thought. A 2014 study demonstrated that newly learned material and skills are consolidated during rapid eye movement (REM) sleep; insufficient sleep may impact our ability to think, perceive, remember, imagine, and plan. The National Sleep Foundation recommends 7 to 9 hours of sleep on a regular basis to be at peak performance.


Good nutrition. As nurses, we all know the importance of good nutrition and healthy eating, but sometimes it's easier and quicker to buy fast food than prepare a nutritious meal at home. One study showed that the gut influences our capacity for acquiring new memories, overall mental function, and cognitive ability. In another study, fifth grade students who ate more fast food performed worse on math and reading scores. So consider bringing a healthy lunch instead of hitting the vending machines. Eating nourishing food supports your body's immune system and can help you deal with stress. In addition, you may find that you feel better and perform better in school, as well as in other areas of your life.


Exercise. Physical activity helps us counteract the negative effects of stress on our memory and cognition, as well as improve our mood. Studies have shown that exercise increases our learning ability and memory under a variety of conditions. A 2008 study showed that exercise can enhance the mental capacity of young adults and even improve functional recovery after brain injury or disease. Many people enjoy going to the gym after work or school to destress. Working out can be a time for focusing on the exercise you're doing and forgetting about the stresses of the day. Exercise improves our breathing and relieves the tension in our muscles. Movement therapies, such as yoga, tai chi, and qigong, combine fluid movements with deep breathing and mental focus-all of which can induce calm. As healthcare professionals, we all have to deal with stress, fatigue, deadlines, and a schedule that's overfull. Although exercise can't change our deadlines, it can make the process of meeting them a lot easier by decreasing our stress and increasing our cognition.


Sleep, diet, and exercise are the pillars of a healthy lifestyle. To maximize your performance during the NCLEX, aim for a minimum of 6 to 7 hours of sleep each night, eat a nutritious meal consisting of lean protein and vegetables at least once a day, and exercise for better overall physical and mental health.


Effective study techniques

Many nursing students assume that any kind of studying is worthwhile, but that isn't really true. Instead, make the best use of your time by studying what you don't know even though you may feel more comfortable studying the material that's more familiar to you.


There are practice exams that can help you identify the content areas in which you're weak. Your school may provide standardized practice tests or you may use an NCLEX review book to see where you stand. The detailed NCLEX test plan found at lists the content areas covered in the exam. You can use these lists to map out your study plan.


Also remember that your exam may require as few as 75 or as many as 265 questions, so be prepared by taking longer practice exams of over 200 questions, as well as shorter exams. This will help you handle the stress and fatigue of a longer exam.


There are many ideas about quality studying, but one proven method is to use active studying. First, skim the material, noticing graphs and major headings, then reread for depth and underline or highlight key concepts. Ask yourself questions about each section of material as you read. Can you answer the questions? If not, review again briefly, reciting key points aloud. This is especially helpful if you're an auditory learner. Visual learners may want to draw pictures as part of their notes or write key words in the text margins. Highlighting text using different colored markers is another good technique, especially for visual learners.


Quickly review the material again at bedtime because new memories are consolidated during REM sleep.


Stress management

Stress is a physiologic event. Good stress, known as eustress, gets us motivated and productive as opposed to some of the stress you probably experience in nursing school, which may be excessive at times, and is known as distress. Stress-related health problems are responsible for up to 80% of healthcare provider visits. Long-term stress can depress the immune system and cause chronic issues such as hypertension, cardiovascular disease, anxiety, and depression. It's important to develop habits that help you overcome the effects of stress. For example, yoga is proven to improve heart health and help decrease depression and anxiety. Breathing is an excellent way to experience relaxation.


Intentional breathing can help turn off the sympathetic (fight or flight) nervous system and turn on the parasympathetic (rest and digest) system. Inhale. Exhale. The most important thing to do is sit quietly and focus on something, such as breathing in and out. In a few minutes, you may find yourself relaxing a little. There are several apps that can help you get started with the practice of relaxation. We'll always have stress in our lives, but humor and laughter, along with relaxation, can help us develop a sense of control and increase our stress tolerance.


Other helpful practices include maintaining a positive attitude, setting goals, and approaching tasks with confidence. Seek out friends and family for support when needed.


If you find yourself getting stressed during the NCLEX, take a moment to consciously inhale and exhale several times. It doesn't matter how many questions you get. Whether you pass with 75 questions or 265 questions, you'll be ready to begin your profession as a licensed RN.


Conquering the exam

You want to be at peak performance when taking the NCLEX. Positive lifestyle management can have a major impact on your mental and physical health, so get sufficient sleep, eat nutritious meals, and exercise on a regular basis. Make the most of your study time by using active learning techniques. Finally, implement stress management and relaxation practices to help you decrease the inevitable stress associated with such an important exam. As you implement these strategies, you can maximize your potential for success and conquer the NCLEX.


cheat sheet

Test-taking tips

You already know that test taking requires certain skills. Here are a few tips to help you be more successful.

Figure. No caption a... - Click to enlarge in new windowFigure. No caption available.

1. Read the question carefully because it may contain insignificant information known as distractors. Keep your focus on the significant issues. Use your clinical reasoning skills to prioritize important data.


2. Don't read into the question. If you find yourself thinking you need more information, you're reading into the question. Keep in mind that all of the information you need to answer the question has been provided.


3. Make sure you understand what the question is asking. You can't select a correct answer if you don't know what the question is.


4. If you don't know the answer to a multiple-choice question, narrow down the answer choices to the best two, then reread the question for information that will show one answer is better than the other or one answer is clearly wrong.


5. One word can make a difference. Look for key words, such as best, initial, early, or except.


6. When asked to prioritize your nursing actions, consider the following:-In general, you should "do" something. Don't simply call the physician. Use your nursing knowledge and skills to take action that will help your patient.-When prioritizing which patient to see first, remember Maslow's hierarchy of needs, urgent versus nonurgent, acute versus chronic, and the ABCs.-Use the steps of the nursing process; for example, assess before doing.



cheat sheet

Steps to take the NCLEX


1. Learn about eligibility and then apply for licensure/registration with a board of nursing/regulatory body.


2. Register with and pay the exam fee to Pearson VUE.


3. Wait to schedule your test date until you receive the acknowledgment of receipt of registration and authorization to test (usually valid for 90 days) from Pearson VUE.


4. Schedule your exam with Pearson VUE.


5. Don't wait until you know your test date to begin studying. You probably had a calendar with due dates in red to help you stay on target during nursing school. Preparing for the NCLEX requires the same planning. Think about where you need to be by certain dates and set goals. Be sure to give these goals a deadline and put them in writing.


6. Check out the National Council of State Boards of Nursing website at You can download the detailed test plan, which contains all of the information you need to get started.


7. On the day before your exam, locate the address of the test location and drive by so that you know where you're going.


8. Leave early on exam day in case traffic is a problem. If you're late, you may be denied entrance to the exam. Bring appropriate identification. Be sure that the first and last name on your picture ID exactly match the name on your authorization to test.




Aberg MA, Pedersen NL, Toren K, et al Cardiovascular fitness is associated with cognition in young adulthood. Proc Natl Acad Sci U S A. 2009;106(49):20906-20911.


Denninger J. Now and zen: how mindfulness can change your brain and improve your health.


Gomez-Pinilla F. Brain foods: the effects of nutrients on brain function. Nat Rev Neurosci. 2008;9(7):568-578.


Harvard Health: understanding the stress response. https://


King B. The Laughing Cure. New York, NY: Skyhorse Publishing; 2016.


Li J, O'Connell AA. Obesity, high-calorie/ food intake, and academic achievement trends among U.S. school children. J Educ Res. 2012;105(6):391-403.


Miller MA, Wright H, Hough J, Cappuccio FP. Sleep and cognition. In: Idzikowski C, ed. Sleep and Its Disorders Affect Society. 2014. https://


National Sleep Foundation. National Sleep Foundation recommends new sleep times.


Silvestri LA. Saunders Comprehensive Review for the NCLEX-RN Exam. 7th ed. Philadelphia, PA: Saunders; 2016.


Silvestri LA, Silvestri A. Saunders 2016-2017 Strategies for Test Success: Passing Nursing School and the NCLEX Exam. 4th ed. Philadelphia, PA: Saunders; 2015.


Zhao Z, Zhao X, Veasey SC. Neural consequences of chronic short sleep: reversible or lasting. Front Neurol. 2017;8:235.