Previous Item Writers Linda Ann Aubrey, MSN, RN, CMSRN, CNE Martha Barry, RN, CNM, MS Jacqueline Rosenjack Burchum, DNSc, FNP-BC, CNE Reitha Cabaniss, MSN Mary C. Carrico, MS, RN Mary L. Dowell, PhD, RN, BC Kimberly R. Foisy, RN, MSN, CMSRN Lena R. Greene, MSN, RN Rebecca Russo Hill, DNP, FNP-C Tiffany Jakubowski, RN Christina Keller, RN, MSN Lynn M. Korvick, PhD, RN, CNE Terri Peterson, RN, BSN, MSNEd Donna Russo, RN, MSN, CCRN, CNE Julie S. Snyder, MSN, RN-BC Bethany Hawes Sykes, EdD, RN, CEN, CCRN Linda Turchin, MSN, RN, CNE Koni J. Utley, MSN, RN Polly Gerber Zimmermann, RN, MS, MBA, CEN, FAEN xi Previous Reviewers Rita R. Armstrong, DNP, MSN Ed, RN Professor Dallas Nursing Institute Dallas, Texas Anna M. Bruch, RN, MSN Nursing Professor Illinois Valley Community College Oglesby, Illinois Lisa Hollett, RN, BSN, MA, MICN, TCRN, CFN, DABFN Trauma Performance Improvement Coordinator MedPartners Ennis, Texas Peter D. Smith, BA, MSN, RN Instructor & Clinical Lead/Critical Care Nurse Otolaryngology/Plastics & Cardio-Thoracic Acute Care Goldfarb School of Nursing at Barnes-Jewish College Barnes-Jewish Hospital St. Louis, Missouri Elaine Kay Strouss, MSN, RN, CNE Professor—Nursing Community College of Beaver County Monaca, Pennsylvania Elizabeth Wright, MSN, RN, CNE Assistant Professor of Nursing Indiana Wesleyan University Marian, Indiana xiii Welcome to Saunders Pyramid to Success! Saunders 2022-2023 Clinical Judgment and Test-Taking Strategies: Passing Nursing School and the NCLEX® Exam is one in a series of products designed to assist you in achieving your goal of passing your nursing courses and becoming a licensed nurse. This product provides you with test-taking strategies that will help you pass your nursing examinations and the NCLEX examination. Organization Saunders 2022-2023 Clinical Judgment and Test-Taking Strategies: Passing Nursing School and the NCLEX® Exam contains three parts and 20 chapters. The chapters in Part I include information on test preparation and the NCLEX exam. The chapters in Part II describe the test-taking strategies and include several sample questions that illustrate how to use each test-taking strategy. The sample questions represent all types of question formats, including multiple choice and alternate item formats. The Next Generation NCLEX® (NGN) Item Types are described; samples of these item types can be located both in the book and on the accompanying Evolve site. In Part III of the book, there are practice questions, and the accompanying Evolve site contains the practice questions from the book along with additional practice questions for a total of 1200 practice questions. All of the practice questions reflect the framework and the content identified in the most current NCLEX test plans. The practice questions in this resource relate to each Client Needs category, each Integrated Process of the NCLEX exam, and the Cognitive Skills identified in the National Council of State Boards of Nursing (NCSBN) Clinical Judgment Measurement Model (NCJMM). The Client Needs categories include Safe and Effective Care Environment, Health Promotion and Maintenance, Psychosocial Integrity, and Physiological Integrity. The Integrated Processes include Caring, Communication and Documentation, Culture and Spirituality, Nursing Process (Clinical Problem-Solving Process), and Teaching and Learning. The Cognitive Skills include Recognize Cues, Analyze Cues, Prioritize Hypotheses, Generate Solutions, Take Action, and Evaluate Outcomes. Part I: Study and Test Preparation Chapter �: Clinical Judgment and Nursing Examinations The information in this chapter describes Clinical Judgment, the NCJMM and the Cognitive Skills of the Model, case studies and the NGN Item Types. The chapter also focuses on the exams that you will take during your nursing program and provides you with information on how to prepare for these exams. Topics include the purpose of nursing exams, what you can expect on nursing exams, how nursing exams are different from other exams, and the types of questions on nursing exams. Additional Preface xiv Preface topics include preparing for a nursing exam using your syllabus, textbook, classroom notes, flash cards, study guides, and study groups. Chapter �: Developing Study Skills This chapter discusses several topics related to study skills and study habits. It pro - vides you with information on how to develop or refine study skills and how to de - velop good study habits so that you will be well prepared for your nursing exams. Included are the top 10 Pyramid Points and study habits. Also, study skills such as listening, note-taking, reading, remembering content, and critical thinking skills are discussed. Chapter �: Reducing Test Anxiety This chapter focuses on the important points related to test anxiety. In this chap - ter, you are provided with self-assessment points to determine if you experience test anxiety. Additionally, the causes of test anxiety, how to prevent test anxiety, and how to control test anxiety before and during an exam are discussed. Points about maintaining a positive attitude and what you can do when you experience test anxiety are presented in this chapter. Chapter �: NCLEX® Preparation This chapter focuses on preparing for the NCLEX exam—the exam that you must take and pass after you graduate from nursing school in order to become a li - censed nurse. This chapter emphasizes the important point that NCLEX prepara - tion begins the moment you enter your nursing program. Specific to the NCLEX, it provides you with the steps for preparing for the NCLEX, self-assessment points to determine your readiness, and a plan for preparation. Part II: Strategies for Success Chapter �: Alternate Item Formats and the Next Generation NCLEX® (NGN) Item Types Alternate item format questions and NGN items are designed to test competency in nursing skills and clinical judgment abilities. This chapter describes the various types of alternate item format questions that you may encounter on the NCLEX examination and on nursing school examinations and provides you with testtaking strategies to answer them correctly. Additionally, strategies for answering NGN item types are presented. Sample alternate item formats and NGN items are illustrated. Chapter �: How to Avoid “Reading into the Question” One of the pitfalls that can cause a problem when answering a question is “read - ing into the question.” This means that you are considering issues beyond the information presented in the question. This chapter describes the strategies to use when answering test questions to prevent this from happening and includes top - ics such as how to read a question, using strategic words, identifying the subject of the question, recognizing and analyzing cues and determining if an abnormality exists, focusing on the client of the question, considering available resources, and using nursing knowledge and the process of elimination. Chapter �: Positive and Negative Event Queries This chapter describes the differences between a positive and a negative event query in a question. Reading the question carefully and noting the type of query used are important to assist in answering a question correctly. This chapter also identifies the strategic words or phrases that indicate whether the question con - tains a positive or negative event query