By Studying for the NCLEX? Passing your state boards is the final step to becoming a licensed nursing professional. As you prepare to sit for your exam, it’s helpful to learn to “speak NCLEX.”
The National Council of State Boards of Nursing (NCSBN) uses consistent language and terms throughout the test. You’ll want to become familiar with them, so you’re more confident about the questions.
NCSBN states, “The exam is developed to ensure that no candidate is afforded an unfair advantage when testing. The language and terminology selected for exam items must be universal and support the assessment of one construct—entry-level nursing knowledge while eliminating the inadvertent assessment of other factors.”
NCLEX Terminology: Each term has only one meaning
Nursing schools use different textbooks and resources. To be consistent and to make sure each candidate’s knowledge and ability are measured accurately, NCSBN uses exact terminology.
Each term can have only one meaning. No matter where you studied or what words were used to identify someone, when you take the NCLEX, you’ll be expected to know its terminology. This eliminates any bias and gives every candidate the same opportunity.
Here is the healthcare-specific vocabulary for the NCLEX:
Client: An individual, family or group which includes significant others and populations. A client, or clients, receives services from healthcare professionals, including assessments, care, treatments, and education. You may have learned to call them “patients,” “residents,” “victims,” or “outpatients,” often to explain the setting where they receive care.
There’s a general movement to replacing “patient” with another term. The word “patient” comes from the Latin “patiens,” from “patior,” to suffer or bear; it implies passivity and inequality between the person who is sick and the person who provides treatment. Today’s healthcare climate encourages people to be actively involved in their care; they are consumers and participants who want to establish relationships based on trust and mutual respect.
Although you may encounter other terms during your studies, and on practice tests, you will only see “client” when you sit for the NCLEX.
Example:
The nurse is educating a client with chronic kidney disease (CKD) about the need to restrict potassium in their diet. Which of the following statements by the client indicates a need for further instruction?
- “I will have an apple instead of a banana.”
- “I’ll cook with onions instead of tomatoes.”
- “I will choose sherbet instead of ice cream.”
- “I can eat peanuts instead of popcorn.”
(Answer: 4)
Primary Health Care Provider: A member of the healthcare team who is licensed and authorized to formulate prescriptions on behalf of the client. The Primary Health Care Provider (PHCP) is usually a medical physician; it can also be a specialist, such as a surgeon, endocrinologist, nephrologist, etc. A Nurse Practitioner can also be a PHCP.
You may also encounter Health Care Provider (HCP) during the examination. A test item may include, “Notify the appropriate HCP,” to indicate that another specialist on the healthcare team, such as an anesthesiologist or pulmonologist, should be contacted.
Example:
The Primary Health Care Provider (PHCP) has ordered hyperbaric oxygen therapy (HBOT) for a diabetic client with a chronic non-healing wound. During the therapy, what is the nurse’s priority?
- Administer medication to decrease anxiety.
- Ensure the client has a patent intravenous access.
- Monitor that adequate oxygen level is being delivered.
- Provide emotional support to the client during HBOT.
(Answer: 3)
Unlicensed Assistive Personnel (UAP): Any unlicensed personnel trained to function in a supportive role, regardless of title, to whom a nursing responsibility may be delegated. Healthcare organizations and facilities use a variety of titles for UAP: You may be familiar with “Certified Nursing Assistant (CNA)” or “Nurse Aide.” Hospitals often use “Patient Care Assistant” or “Nurse Assistant.” UAPs who work in client’s homes can be called “Home Health Aides.”
The UAP has taken a course in basic care and passed a certification examination. Their scope of practice is limited to hands-on assistance with Activities of Daily Living (ADL) and simple non-invasive procedures, such as obtaining urine or sputum samples.
Example:
Which of the following should never be delegated to unlicensed assistive personnel (UAP)?
- Checking to see if blood is still infusing.
- Performing a linen change for an occupied bed.
- Ambulating a client who is two days post-op.
- Emptying a Foley catheter and recording output.
(Answer: 1)
Prescription: Orders, interventions, remedies or treatments ordered or directed by an authorized Primary Health Care Provider (PHCP). This is an important term; you may be accustomed to thinking of a “prescription” as an order for a medication, to be filled by a pharmacist.
NCLEX test items will include “prescription” or “prescribe” for medications, blood products, and IV infusions. You will also see them used for any type of treatment: activity, diet, diagnostic testing, or referrals. If you’re familiar with “orders” for a client, now’s the time to make the mental switch to “prescriptions.”
Example:
Following surgery with several complications, a client has now developed paralytic ileus. The provider has prescribed insertion of a nasogastric tube (NGT) to suction. As the nurse prepares to insert the NGT, the client says, “Is this really necessary? I just don’t think I can handle any more.” Which of the following is the nurse’s BEST response?
- “It’s up to you. You can just continue to vomit.”
- “You’re discouraged about your recovery.”
- “I’ll tell your surgeon that you’ve refused his order.”
- “Let’s do this so you can start to feel better.”
(Answer: 2)
“Non-biased” terminology to know for the NCLEX
Although you won’t encounter the following terms on every question, it’s wise to be prepared. These are ways to acknowledge that there are people and situations outside traditional roles or labels. You may still read “husband/wife” or “father/mother,” but many questions are meant to be impartial and unbiased regarding the candidate’s background or experience.
“They” is a singular pronoun. You won’t find any “he or she” on the examination. NCSBN has adopted “they” as a non-binary way to refer to clients. Since the word “client” doesn’t specify gender, test items that don’t specify a client’s gender, or where the gender isn’t essential to the question, will use “they.”
Example:
A client who has been receiving a transfusion of packed red blood cells (PRBC) for 3 hours tells the nurse they are experiencing shortness of breath and an itchy, raised rash. The nurse also notes that the client is anxious and restless. Which type of transfusion reaction does the nurse suspect?
- Hemolytic transfusion reaction
- Febrile transfusion reaction
- Delayed transfusion reaction
- Allergic transfusion reaction
(Answer: 4)
“Caregiver” as a parent, spouse, partner, or someone else who cares for a client. Although you will see traditional titles, such as “parent” or “spouse,” be aware that NCSBN also uses other words to describe someone who provides some type of care for a client. In today’s society, a caregiver can be a family member, as well as someone outside the family unit, whether paid or unpaid.
Example:
The nurse should include caregivers in client teaching because (Select all that apply):
- Caregivers are responsible for all care decisions.
- Caregivers can feel disregarded if not included.
- Clients have better outcomes.
- Clients can be too ill to understand.
- Clients can’t take care of themselves.
(Answers: 3, 4)
“Partner” in addition to “spouse.” Given the various ways people enter or describe their primary relationships, NCSBN often chooses the word “partner” to avoid stereotypes or judgmental references to legal marriage.
Example:
A client with a diagnosis of COPD tells the nurse they have trouble sleeping at night. Which question is MOST important for the nurse to ask?
- “What time do you eat before you go to bed?”
- “Have you always been a light sleeper?”
- “How many pillows are you using at night?”
- “Does your partner’s snoring keep you awake?”
(Answer: 3)
Learn to speak NCLEX: What about drug names and calculations?
During nursing school and clinical rotations, you may have learned either—or both—generic and brand names of medications. Which will be used on the NCLEX?
NCSBN understands that candidates have a mixed background in drug names. To ensure that everyone comes to the exam equally prepared, you will need to focus on generic names. NCSBN states, “We take into account that the use of the medication generic name is more consistent while a brand/trade medication name may vary. Some items may refer to general classifications of medications.”
This position makes sense, when you think of a common antibiotic like ampicillin; brand/trade names include Ampi, Omnipen, Penglobe, and Principen. Or the medication that lowers cholesterol, lovastatin, sold as Mevacor or Altoprev.
NCSBN does not have an official list of drugs that might be included on your NCLEX. Pharmacological and Parenteral Therapies will be 12-18% of the NCLEX-RN and 10-16% of the NCLEX-PN. You may want to make flash cards for common drugs and drug classifications. You’ll need to learn how the drugs work, what the adverse/side effects are, and client teaching. Take the Nurse Plus practice tests as many times as you want to become familiar with drugs and the question formats.
Example of how drugs work (action):
A female client comes to the OB/GYN clinic with a complaint of repeated vaginal infections. An assessment shows that she has candidiasis, caused by Candida albicans. What does the nurse anticipate as the treatment for this client?
- An over-the-counter (OTC) vaginal douche product
- A prescription for a broad-spectrum antibiotic
- A prescription for a penicillin suppository
- A nonprescription antifungal medication
(Answer: 4)
Example of adverse/side effects:
Anticholinergics are drugs that block the action of the neurotransmitter acetylcholine. What are some of the side effects of these medications? Select all that apply.
- Blurred vision
- Urinary retention
- Bronchoconstriction
- Dry mouth
- Constipation
- Intense hunger
(Answers: 1,2,4,5)
Example of client teaching:
The nurse is educating a client who is starting on fluoxetine (Prozac) therapy for a diagnosis of depression. Which of the following statements should the nurse include?
- “You will need to monitor your blood pressure. Prozac can cause a hypertensive crisis.”
- “Foods such as yogurt, soy sauce, aged cheese, and salami must be avoided from now on.”
- “Don’t expect to feel any different right away. It takes up to 4 weeks for therapeutic effects.”
- “You can continue to take your MAO inhibitor prescription with this medication.”
(Answer: 3)
Drug calculations: They must be exact to be correct!
Decimal places: All calculation test items have a decimal place, unless the item requests the answer using a whole number. If asked to record to one (or two) decimal places, the candidate must enter the decimal point for the answer to be correct.
Example:
The Health Care Provider (HCP) prescribes penicillin G potassium, 450,000 units IM. Directions on the label of the vial read: “Contains 1,000,000 units of penicillin G potassium. Reconstitute with 9.6 mL sterile water for a concentration of 100,000 units/mL. How many mL of the reconstituted medication will the nurse administer? Calculate to one decimal point.
- 6 mL
- 4 mL
- 5 mL
- 5 mL
(Answer: 3) Calculation: To calculate the correct dose: Divide the desired dose by the amount on hand, multiplied by the volume. (D/H x V) For this question: 450,000 units / 100,000 units x 1 mL= 4.5 mL.
Rounding a calculation: Answers to calculation items should be rounded at the end of the calculation.
Example:
The Health Care Provider (HCP) prescribes total parenteral nutrition (TPN) for a client who weighs 147.6 pounds. The client is to receive 2 grams of protein per kilogram of body weight, daily. How many grams of protein will the client receive each day?
- 8 grams
- 2 grams
- 4 grams
- 1 grams
(Answer: 2) Calculation: To calculate the provider’s prescription of 2 gm protein per kg of client weight, first convert 147.6 pounds to kilograms: 147.6/2.2 = 67.1 kg. Then multiply by 2 to find the daily total grams of protein: 67.1 x 2 = 134.18, round up to 134.2.
How to get more practice “speaking NCLEX”
- Take as many practice tests as possible. Nurse Plus Premier includes the NCSBN terminology, and also offers questions that have alternate wording, to help you transition to what you will find on your NCLEX.
- Make notes or flashcards for generic drug names and classifications. You can find printed resources at your school’s bookstore or online at Amazon.com.
- Be sure to download and study the Test Plan for NCLEX-RN or NCLEX-PN. There are sample questions at the end of each category and sub-category.
- Make a Personal Study Plan to ensure you cover all the Client Needs before you sit for your NCLEX. Our NCLEX Study Guide provides a comprehensive way to prepare.
- Learn more about NCLEX: Anatomy of an NCLEX Question and Types of NCLEX Questions and How They Are Written will help you understand the test items.
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