Chances are if you are reading this, you are getting ready to tackle the NCLEX, ATI, HESI, etc. The first thing you NEED to remember to pass is that if you are at this point, it means you have either finished nursing school (CONGRATS) or are getting ready to take your exit exam (HESI/ATI).
Anyway… Here are some of the tips that I received throughout nursing school – through study guides, test prep books, etc.

    This is the biggest piece of advice that I can give any nursing student preparing for a big exam. In order to answer NCLEX-style questions correctly, you must be familiar with them. Practice, practice, practice. Practice multiple-choice, select all that apply, ordering questions, medication math questions. Whatever you do PRACTICE questions. 

    – If you are taking ATI use ATI questions (ATI has an app… download it NOW), or using the online practice exams provided by your school… Same goes for HESI. Now if you are looking for NCLEX questions there are many resources available. I used the Saunder’s comprehensive NCLEX guide: NCLEX Saunder’sNewest Version – NCLEX Saunder’s

    There are many NCLEX apps as well; I used the NCLEX-RN Mastery one.

  1. Test taking strategies
    Saunder’s Test Taking Strategies

** Some strategies that have stuck with me:

  • See prioritization & delegation strategies below.
  • If two answers are complete opposites, one is a probable answer.
  • If an answer has an intervention (giving a medication, placing oxygen, raising HOB, etc.) give that answer some thought before crossing it out. [I was always told that if an answer is telling you to give a medication, assume you have an order – do not rule it out if because you assume you don’t have one. Especially if it is a medical emergency]
  • If a question is asking the best nursing intervention, calling the physician is most likely NOT the answer. Remember it is asking for a nursing intervention that means there is likely something you should be doing prior to calling the physician.
  • When answering select all that apply à take each answer individually and write TRUE or FALSE next to it. Then after you got through each answer circle all of the correct responses.
  1. Prioritization of Care:
    is a HUGE topic on both NCLEX. Sample questions may go as follows… You have 4 patients to care for, which should you see first? Your patient has the following condition what should you do first… etc.

*** Remember ABC (airway, breathing, circulation) always come first. If a patient does not have a patent airway, they cannot breath… and you don’t even worry about circulation if they are not breathing. If there is no immediate threat to the patient’s airway or breathing status, circulation comes next (bleeding, hemorrhage, MI, acute swelling, etc.)

*** Read carefully into prioritization-type questions because they may not point to the obvious symptoms. Example: a woman who has indigestion and fatigue… before disregarding this woman, remember that these could be signs of an MI (study typical & atypical symptoms of your major diseases… remember elderly often present with atypical symptoms).
So unless another patient is having an airway or breathing problem, this is likely your answer.

** Next should come mental status changes, renal changes (oliguria, etc.)…

  1. Delegation questions
    Know the training of each member of your team. Remember that the NCLEX is a national exam and things you see in clinical may not always be the case.
    For example, if a nurses assistant (assistive personal, etc.) is assigned a specific task and it states it in the question that they have the training, do not question it based on your clinical experience.

*** As a rule of thumb, the RN is assigned to the difficult, unstable patients, new admissions, those who need to be assessed or taught something.

*** Remember do not delegate what you can EAT (Evaluate, Assess, Teach) as only an RN can do those tasks.

** Always assess unless in distress.

    Rather than trying to memorize everything you have learned throughout nursing school, learn to study smart.
  • When studying medications, learn the common suffixes & key facts about that class of drugs (example: -olol = beta blocker à beta blockers are contraindicated in asthma patients because they cause bronchoconstriction).
  • Memorize the key disorders that you see on a daily basis in clinical (diabetes, hypertension, heart failure, etc.) and also the key medical emergencies (MI, stroke, asthma attack, etc.).
  • Most of the questions you will be able to figure out using the nursing process, ABC’s, Maslow’s hierarchy of needs, etc.
  • If you come across a question that you simply don’t know
    – it will happen – try your best to rule out answers and simply guess.


*** You may feel like you are failing the NCLEX but this is because you are supposed to… to pass the NCLEX you really only need to get ~60% of the questions right. Don’t believe me? – Look up the NCLEX algorithm, it is supposed to feel like the hardest exam you’ve ever taken.

How the NCLEX works

Passing NCLEX 58% correct

*** If you are sitting for these exams you are prepared. Try to stay calm, take a deep breath and do your best. While we all would love to, if you don’t pass on your first try remember that you can take it again.


XO Ty, the overachieving RN