What Are Considered Higher-Level Questions on the NCLEX?


How Does the National Council Licensure Examination Work?

Referred to as the NCLEX, this exam is administered by the National Council of State Boards of Nursing. There is a version for registered nurses and one for practical nurses.

The NCLEX utilizes a technique called Bloom's taxonomy via computerized adaptive testing. As you progress through the test, you will be given multiple choice questions that require a knowledge level higher than what is considered minimum competence. The more questions you answer correctly, the more difficult questions you will receive. This process will continue until you answer a question incorrectly. The following questions will then be less difficult until you answer correctly again.

The RN version requires that you answer at least 75 questions and no more than 265. In contrast, you will need to answer a minimum of 85 questions on the PN exam, with a maximum of 205 questions. In addition to achieving the minimum number of questions, your answers must indicate your skills are above the basic competence level.

What Are Higher-Level NCLEX Questions?

Bloom's taxonomy is a process that categorizes questions into six levels of thinking: knowledge, comprehension, application, analysis, synthesis, and evaluation. Each category of questions requires an increasing level of critical thinking skills. Analysis, synthesis and evaluation questions would be considered higher-level NCLEX questions.

Synthesis questions are based on creating or proposing solutions, such as a plan of care. In contrast, evaluation questions are based on analysis, such as debating the merits of differing plans of care and analysis questions may ask you to compare and contrast an item or evaluate info that you've read in a question.

Both versions of the NCLEX contain four primary areas of client needs. Two of those areas contain sub groups:

  • Health Promotion and Maintenance
  • Psychosocial Integrity
  • Physiological Integrity: Includes the sub groups of reducing risk, physiological adaptation, basic care, and parenteral and pharmacological therapies
  • Safe and Effective Care Environment: Includes the sub groups of safety and infection control and care management

Examples of Higher-Level Questions

Higher-level questions that you'll encounter on the NCLEX will expect you to take the info presented and analyze or evaluate the info in order to make a decision or form a connection. For example, a question may ask you to make a connection between a person's diet and their specific health symptoms or issues. You might also be asked to determine what you would do in a certain medical situation or emergency or what approach would work best for communicating with a patient about specific concerns.

How Can You Prepare for the NCLEX?

One way to prepare for the NCLEX is to utilize the resources provided by the National Council of State Boards of Nursing. The council provides a basic and detailed test plan for each version of the exam, both of which are offered at no cost. The plans will provide a general overview of the exam, including content examples and explaining the client needs groups and sub groups.


Another option to prepare for the exam is to utilize test prep materials available on Study.com. You can access a study guide and sample questions for either the RN or PN version of the test. Both of these study guides can be viewed from your cell phone, tablet, or computer and allow you the freedom to study on your own time.

Continue reading: How to Study for the NCLEX

The NCLEX is an exam for aspiring nurses looking to prove their skills and knowledge. Students must pass this standardized exam in order to receive their nursing license.

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