how to answer critical thinking questions in nursing

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Critical Thinking Nursing Interview Questions

Critical thinking nursing interview questions feature prominently in any interview. They aren’t supposed to trip you up, but they will do just that if you aren’t ready.

Along with your nursing school application cover letter and your nursing school letter of intent , your nursing school interview questions give you an opportunity to show an admissions board, in your own words, how perfect you are for nursing school.

This article will show you how to take that opportunity and maximally utilize it to your advantage. We will go through what exactly a critical thinking question is, why they are being asked, and what types of responses you can give. Finally, we will cover several sample answers so that you can prepare your own answers for your upcoming interview.

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Article Contents 7 min read

Why are critical thinking questions asked.

While critical thinking questions may relate to aspects of healthcare and nursing, including patient care, working as part of a team, and response to emergencies, they may also deal with dilemmas that have nothing to do with healthcare. For example, you may be faced with a conflict of interest scenario, or an ethical dilemma with a close friend.

Essentially, you’re being tested on your decision-making processes and how you solve problems, whether they are healthcare related or not. Your interviewer is trying to find out if you think logically, quickly, and in ways that provide good solutions in real-world scenarios.

Critical thinking is important to any job, but is of particular importance to nursing. Any healthcare professional deals with immense challenges on a daily basis. These challenges come up with little warning and require clearheaded responses.

Because the question is looking for your decision-making processes, you need to make sure that your responses put those processes in the limelight. Therefore, your answers should focus on the steps of how you made your decision and the why behind those steps: in other words, how you arrived at that response. You should show off how you evaluate situations and respond, but also how you concluded that your response was the most logical course of action.

Even if the question you are asked is hypothetical or situational, as we like to call it, you can definitely use your personal experiences to answer. Make sure to demonstrate non-judgmental attitude and objectivity when making your decision.

With nursing school interview questions, expert responses are required.

Let’s look at a sample critical thinking question and an expert response.

Prompt: Describe the most stressful event of your life. Why was it stressful, and how did you handle the situation?

Example: I\u2019m not saying it was easy, but that organization made things much more straightforward, and it helped to keep my mind calm and disciplined in all that chaos. I learned how to not only balance all of these disparate elements of my life, but that I could use the very act of balancing as a calming influence. "}]'>

Nurses often have to deal with hostile patients. Can you recall a time you had to deal with hostility? What did you do and what were the results?

Sample answer:

I was working in a supporting role at a psychiatric institution, and one of the patients was a very angry person. He had a very quick temper and would often be physically violent, in addition to uncooperative or verbally abusive. The nurses said that giving meds felt like playing Russian roulette.

So, I would always make sure that I was around for that patient’s med time, ready to call security if he became violent.

He didn’t like taking his pills, either. One day, I was speaking with him and I discovered that his anger over medication was coming from a lack of understanding; he didn’t fully know what the pills did. So, I talked to his nurse about it, and she went over the reasons for his particular drugs and their side-effects. I also let his physician know about his concerns so that the doctor could have a conversation about it at her next visit in.

Once those issues had been dealt with, medication was much easier to distribute. It didn’t solve all the problems, but it helped make his days a lot smoother.

Critical thinking questions can be daunting and difficult, but they can also show some of your best talents and establish your abilities in a very concrete way. These aren’t abstract. These are demonstrations of actual actions taken. Use these questions to show off your impressive side with a committee.

The focus is the main difference, and with a critical thinking question, that focus is on how you use problem-solving and decision-making in different scenarios. They are to get a sense of how you deal with challenges and obstacles on a day-to-day basis.

Contrast this to more open-ended questions like “Tell us a little bit about yourself,” or “ Why do you want to be a nurse? ”

Fairly compact; you should answer in less than a minute.

Use just enough language to set up the problem you faced, your thought processes on how to deal with those problems, the actions you took, and the outcomes that those actions produced. This can be done in a fairly swift amount of time.

That doesn’t mean you should skimp on detail. While the interviewers don’t need every small thing that happened, they shouldn’t be confused or feel like they’re missing anything. Remember to showcase your abilities – don't brush past them: highlight!

Use mock interviews as part of your nursing school interview preparation to hone your answers for time and detail.

The most important reason is that you will wind up sounding robotic and insincere.

Additionally, the critical thinking questions might be slight variants, so a memorized answer could (or will) end up not quite fitting the question.

Better to memorize scenarios than words so that you can apply those examples to any question that comes up.

You can, and sometimes are directly asked to provide an example of failure.

If an interviewer asks you to describe a time you failed at implementing critical thinking, of course you must supply them with something, and should prepare for such questions in their own right.

Remember that they are looking for your decision-making processes and skills, so the outcome might have been bad, but if your processes were excellent, the interviewer will make note of that. Sometimes even good decisions lead to negative outcomes – sometimes that’s inevitable.

If you failed to apply good critical thinking in a situation, you can highlight what you learned from the experience and how it has improved subsequent actions and decision-making processes.

Failure is only truly failure if no lessons were learned.

You can take a short pause to think, and give yourself enough time to recall an appropriate event or incident. It’s important to research the different types of nursing school interview questions and prepare a relevant story for a variety of scenarios.

While it is unlikely that you will be asked about something that you can’t relate to at all (most of the questions are broad enough to allow some sort of connection) it might happen that you just haven’t had a given experience yet.

You can’t just say, “That’s never happened to me,” and leave it at that.

However, you might want to acknowledge this by saying, “That exact thing has never happened to me, but I have had a similar experience,” and speak of the closest thing you have to what was asked. Perhaps it wasn’t a work or healthcare setting, but maybe something that happened with family members or friends in a social setting, for instance – that will do.

Get as close as you can to the question, acknowledge the discrepancy, and answer to the best of your ability.

Expect anything, because depending on the interview, almost anything can be covered.

Even the type of interview can change, depending on the school. Some will use a traditional panel-style interview, but others will use the multiple mini-interview (MMI) format. If the latter, you might want to learn more about how to prepare for your multiple mini interview .

What exactly is in the interview depends on the school and panel, so be ready for anything.

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How to Break Down NCLEX Questions

The NCLEX is different from most tests you’ve taken during school. Instead of measuring your basic nursing knowledge, the NCLEX assumes you know your stuff, then tests how well you can apply it to real-world nursing scenarios. NCLEX questions can feel complicated, and answering them correctly requires careful reading, critical thinking, and strategy. You’ll want to break them down and analyze them before leaping to an answer.

That’s where we come in. This guide will equip you with specific strategies to teach you how to break down NCLEX questions, analyze them, and answer them confidently.

Read on to learn how to understand all aspects of an NCLEX question, apply nursing knowledge and theory, and successfully qualify as an RN.

9 NCLEX Question Analysis Tips

• Understand NCLEX Question Format
• Identify Key Information
• Analyze Patient Scenario
• Rule Out Incorrect Options
• Apply Critical Thinking Skills
• Prioritize Safety & Care
• Select the Best Answer
• Review Answer Rationales
• Practice, Practice, Practice

1. Understanding the NCLEX Question Format

There’s no point in denying it — NCLEX questions can be confusing. Many test takers with great nursing knowledge and instincts slip up by misreading the exam. Avoid this pitfall by breaking down NCLEX questions to understand their format and phrasing. When you get to the core of what they’re asking, you can let your nursing knowledge shine.

Multiple Choice NCLEX Questions

The majority of NCLEX questions are multiple choice and formatted with a stem and several answers. The stem lays out the nursing scenario and asks a question. It can be a short sentence or more detailed, with up to a paragraph of information. The answers are the multiple choice options. When you’re reading a multiple choice NCLEX question, read through the stem and pay close attention to whether it is a positive, negative, or priority question.

A. Positive questions ask you to identify the one correct answer. Positive questions are the most straightforward and often include keywords like the following:

• appropriate

B. Negative questions ask you to identify a false answer. The wording on negative questions can be hard to catch because the test rarely says something as clear as “the following are true except…” Keep an eye out for words and phrases that indicate that a qualified nurse would step in, stop a student from performing certain actions, or would teach a student more. Some words to look out for in the question stem are:

• contraindicated
• further education

C. Priority questions ask you to choose which answer from several correct options is the most important, most correct, or should occur first. Keywords that indicate a priority question include:

• most appropriate

Read more about how to answer NCLEX priority questions , and check out this blog post for more multiple choice tips and strategies .

Alternate Format NCLEX Questions

The NCLEX uses an adaptive learning model to administer the exam which means everyone gets a slightly different mix of NCLEX questions, but you can expect that you’ll encounter some that aren’t formatted as multiple choice. These are called alternate format NCLEX questions. Below are a few of the different types of alternate-format questions you can expect to encounter:

• Audio Questions — You’ll listen to an audio clip and answer a question about it. Be familiar with normal heart, lung, and bowel sounds to prepare for audio format NCLEX questions.
• Chart/Exhibit Questions — You’ll be presented with a medical chart or exhibit that provides context for anything from one multiple choice question to six alternate format questions. Pay attention to all the details and look for clues that will help you answer correctly.
• Graphic Questions — Graphic questions consist of a question with images as the answers. You’ll click an image instead of selecting from written options. For example, you may see four heart rhythm images and have to click on the image that would be shockable.
• Hot Spot Questions — These questions often show an image of a body part or a scan. You’ll click on an area of the image or scan that’s indicated in the question’s scenario. For example, you may be presented with an image of a lung scan and asked to identify the location of an abnormality by clicking on that part of the image.
• Multiple Response Questions (aka Select all that apply or SATA)— Unlike multiple choice questions where you only select the single best answer, on multiple response questions, you’ll be asked to select every answer that applies. One way you can assess this kind of question is to consider each option independently and evaluate each option as a true or false question.
• Ordered Response Questions — Ordered response questions require you to drag and drop answer options into the correct sequence. These can also be used to rank options by priority. For example, would you first give oxygen to a client who has shortness of breath or sit them up in bed.
• Fill In the Blank Questions — Fill in the blank questions are usually reserved for calculations, and don’t worry, you will have a calculator available to you during the NCLEX. You’ll type an answer directly into the answer box.
• Bowtie Questions — The Bowtie Question on the NCLEX-RN is a type of multiple-choice question that presents a clinical scenario and asks test takers to identify the most critical nursing intervention to prevent a potential adverse event while also considering the possible consequences of various choices.

The same close reading and critical thinking skills you’ll use for multiple choice apply to alternate format questions. Check out t his blog post for more information on alternate format NCLEX questions .

2. Identify the Key Information

After you’re comfortable with the question format, the next step in breaking down NCLEX questions is to look for key information. Keep a sharp eye out for:

• Client data: age, weight, gender, etc.
• Relevant clinical details: any diagnoses, if they are post-op, or other details
• Vital signs and lab results
• Medications and doses
• Numbers included in the question stem

Pay close attention to keywords that indicate what each NCLEX question is asking for. For example, a question may provide client details and a scenario, then ask you how you might educate the client on home care. The word “educate” is key here, and offers a huge clue to which answer is correct. If one of the options explains the correct medical treatment for the patient, it could distract you from the correct answer about appropriate patient education.

Expert tip! If the primary focus of the question is “ client education,” eliminate distraction answers by honing in on education-only responses.

3. Analyze the Client Scenario

You know the NCLEX question’s format and you’ve pulled all the data to help you answer it. Now, let’s get a handle on the overarching client scenario.

Say it Your Own Way

Rephrasing the question in your own words will help you get to the core of the question. You’ll prove to yourself that you have a good handle on what the question is asking, which may also give you crucial insights into the client’s condition that will help you answer the question correctly.

Take the Holistic Approach

When you break down NCLEX questions, remember that every detail is relevant. Don’t assume anything about the patient scenario that isn’t explicitly stated, but don’t throw out any information they do give you. If you ever ask “but what if…” you’ve changed the question. Look for these clues when establishing the patient’s scenario and context:

• Social and cultural background
• Health history
• Emotional state
• Any other factor that contributes to their care

In Joyce’s nursing programs, students learn about holistic nursing practices a that knowledge can be applied here. Consider Maslow’s Hierarchy of Needs and look at the question with insight into a whole person with physiological and psychosocial needs. This is especially important when encountering questions about therapeutic communication, which you can read more about in this article .

4. Rule Out Incorrect Options

Multiple choice NCLEX questions will have one correct answer and three decoy answers. These strategies can help you rule out incorrect options and eliminate the distractors :

If there are three answers with similar meaning and one is different, the different answer is likely correct.

Life, health, and nursing rarely deal with certainties. You can usually eliminate answers with absolute wording, including:

• Unrelated Answers

Beware of red herrings! Sometimes an option will bring in an approach or body system that is unrelated to the question stem, and is very likely incorrect. For example, if the question asks about laboratory work but the answer explains correct client education for the disease process, you have to remember what the question is actually asking. If an answer seems random, it probably is.

The NCLEX is focused on textbook answers more than the sometimes messy realities of nursing life. Unless otherwise indicated, your answers should reflect thorough nursing practice under ideal conditions with ample time, staff, and resources.

The Process of Elimination

If you’re really stuck on an NCLEX question, the process of elimination can increase your odds of making a more educated guess. Rule out obviously false answers before you close your eyes and click at random.

5. Apply Critical Thinking Skills

On the NCLEX, you will need to use critical thinking and clinical judgment to understand situations, apply your knowledge, and make decisions that align with nursing best practices. Because this exam is designed to measure the way you apply knowledge in realistic nursing problems, memorization is not the most effective technique for passing this exam.

Break down NCLEX questions to help you analyze and prioritize information and arrive at the best possible answers. Here are some specific critical thinking skills that will help you pass the NCLEX.

Read NCLEX Questions Closely

Misreading the question is one of the most common NCLEX pitfalls. Pay attention to the question’s wording and be clear on its intent before you even look at the answers. Then, pay close attention to each of the answers and their phrasing. It can also help to read through each NCLEX question more than once.

Look for Patterns

Finding patterns in NCLEX questions and answers can help you build mental connections and answer correctly. Look out for patterns, like groups of possible answers that mean the same or similar things, answers that address physiological versus psychosocial needs, or answers about assessing a situation versus implementing action.

Finding connections between situations is another critical thinking skill that will serve you on the NCLEX and during your nursing career. Successful nurses apply the knowledge they gain from one situation to other relevant circumstances, both during the NCLEX and in clinical practice.

6. Prioritize Safety and Basic Cares

There is another tool that can help you prioritize safety. When in doubt about how to help a client, remember to check their Airway, Breathing, and Circulation. Prioritizing safety and basic cares is another strategy to break down NCLEX questions. Client safety comes first. Here are some things to consider when choosing the safest course of action:

• Meet the client’s most basic physiological needs: oxygen, food, elimination, and fluids
• Prevent injury, including worsening physical condition
• Decrease the risk of disease

Keep an eye out for potential risks and complications that may arise from a client’s condition. The answer that best addresses risk and improves outcomes is likely correct.

Remember your Nursing ABCs.

7. Select the Best Answer

You’ve taken the time to read, reread, and break down an NCLEX question. You understand its format, have identified key information, and analyzed the client scenario. You ruled out decoy answers, then used critical thinking and prioritized safety to come up with the best options. At some point you have to click on an answer.

Because the NCLEX is formatted to make you think, lots of candidates find themselves overthinking. It’s important that you make a decision, then don’t look back. Most of the time when you change your answer, you move from a correct to an incorrect answer.

Choose your answer, take a deep breath, and move onto the next question.

Read more about how to avoid overthinking the NCLEX .

8. Review Answer Rationales on Practice Tests

The point of NCLEX practice tests isn’t to prove to yourself that you already know how to pass the exam. The point of practice tests is to learn how to take the NCLEX. Wrong answers on NCLEX practice questions can teach you just as much as correct ones if you review the answer rationales.

Because this exam is different from pretty much every other test you’ve taken, you need to learn to think like the NCLEX. Studying answer rationales on NCLEX practice questions will help you understand why the correct answer is right and why the incorrect options are wrong. This is one of the best ways to get NCLEX logic deep in your brain. Then, when it comes to test day, you won’t be blindsided by question formats or thinking exercises.

9. Practice, Practice, Practice

Nursing knowledge, great notes, and strategy only go so far. To pass the NCLEX, you’ll have to consistently practice breaking down NCLEX questions. Here are some NCLEX preparation tips:

• Make yourself a study schedule that includes both full NCLEX practice tests and short study sessions. This gets your brain used to sitting down and focusing on the NCLEX for an extended time, but also makes casual practice part of your routine.
• Get familiar with NCLEX practice questions and their phrasing. This blog has examples of the different kinds of questions you can expect to answer on exam day.
• Find and use high quality study materials. You can find four of our favorite NCLEX study guides on this blog .
• Take note of your strengths and weaknesses so you can target your practice. The NCLEX Mastery RN app can help you track this.

You can find more NCLEX study tips in this blog post .

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How to Answer Nursing School Exam Questions (TOP HACKS!)

Test Taking Tips

Nursing exams are totally different than anything you’ve ever taken before. They are worded completely differently, and they really test your critical thinking skills to the max.

But most nursing students I talk with don’t know that there are some super cool test taking tips and strategies that you can use to pick the correct answer, even if you’re not totally sure what the correct answer is.

In this video, we’re diving into some AWESOME nursing school exam hacks that you can use to choose the right answer, even if you’re not totally sure what the correct answer is.

So if you’re struggling with taking your nursing school exams and aren’t doing as well as you want, then this video is for you!

HERE’S A BREAKDOWN OF WHAT WE’LL TALK ABOUT:

• Test Taking Strategy #1: How to answer “Select all that apply” questions (1:34)
• Test Taking Strategy #2: How to answer questions with 2 conflicting or opposite answers (3:33)
• Test Taking Strategy #3: Patient safety is ALWAYS your number one priority (5:33)

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VIDEO TRANSCRIPT

Hey there, friend! In this video, we’re diving into some AWESOME nursing school exam hacks that you can use to choose the right answer, even if you’re not totally sure what the correct answer is. So if you’re struggling with taking your nursing school exams and aren’t doing as well as you want, then this video is for you! So hit that subscribe button and click the notification bell and let’s dive in.

So you already know that nursing exams are totally different than anything you’ve ever taken before. They are worded completely differently, and they really test your critical thinking skills to the max.

That’s why I highly recommend watching THIS video to help you deepen your critical thinking skills and develop them faster, because you’ll do better on your exams and at clinical that way.

So let’s walk through some of them here.

Now if you’re a NursingSOS Member , be sure to check out the bonus video we have for you on how to answer nursing exam questions. You’ll find it inside the bonus section of your dashboard, and I got through a lot more test taking hacks than I have time to cover here today. So definitely check that out after you watch this video.

The first nursing school test taking strategy is the one on everyone’s mind: how to answer those dreaded “Select All That Apply” questions.

Students message me about these all the time because they are some of the hardest questions you’ll see on your nursing school exams.

With these questions, you’ll see a check-box next to each answer, instead of a circle, and it will allow you to choose multiple answers.

And in order to get the question correct, you need to select all of the correct answers. There is no partial credit given if you only select a few correct one’s. You need to choose ALL of the correct answers.

So here’s the best strategy I’ve found to help with this: Look at every individual answer and treat it as a true or false question in and of itself.

So here’s what you’ll do: read the question, and then look at the first answer and ask yourself, “is it true or false” (as it relates to the question being asked). And then decide if it’s correct or not. And then repeat this process for each answer: re-read the question, and look at the second answer, and so on.

And you MUST treat each answer individually. Some answers may be VERY similar, and that’s okay. You can select both of them if you think they are both correct (even though they are very similar to each other). With SATA or “select all that apply” questions, all answers should be treated individually, and you shouldn’t compare them with any of the other answers.

So that’s why we take it one answer at a time. Read the question, and read the first answer, and decide if it’s true or false. So you need to treat all answers like true or false questions, and take each one individually. Don’t compare answers to each other.

The second nursing school exam hack is that when you see 2 conflicting or opposite answers, one of them is most likely to correct one.

So for example, if you get a question that asks about the side effects of a particular medication, and they give you 4 answers:

• Decreased heart rate
• Low blood pressure
• Tachycardia

2 of those answers are opposite of each other: decrease heart rate and tachycardia (which means a high heart rate). So more than likely, one of those 2 answers would be the correct one.

They’re trying to see if you know the difference between those 2 terms, along with critically thinking about what the side effects of that medication would be.

So if you see 2 answers that are opposite or conflicting, one of them is most likely the correct one.

Now the third nursing school test taking strategy is SUPER important for you to know. But before we dive into it, I want to give a shout out to Maha for our YouTube comment of the week, which says,

“OMG I love her! I spend close to 2 hours trying to understand the relationship between potassium, glucose and insulin. I finally understand now. Thank you.”

That is so sweet, Maha. I’m so glad our videos have helped you out. I really don’t want it to take you 2 hours to learn anything, that’s just crazy land. So I’m glad I can break things down simple and easy for you and help you learn it faster. I’m super happy it helped you out!

I just love reading your comments every week. We are blessed to have the most supportive nursing students here. You are the BEST , my friend. Thank you for your support, and keep your comments coming. I really enjoy reading them and getting to know you.

Now let’s get back to those test taking tips.

The third nursing school exam hack you need to know about is that patient safety is ALWAYS your number one priority.

The best thing to keep in mind during your exam is the ABCs, which stands for airway, breathing and circulation. Make sure your patient’s airway is open, they are breathing, their blood is circulating. If one of those things isn’t happening in the exam question they give you, that is what you need to fix.

We have a whole video on the ABCs and what they mean HERE for you to check out.

Often times, nursing school exams will present you with a case scenario question and have you decide what you would do FIRST to help that patient. So they may ask you what your “priority” nursing action would be, or what your “initial” action would be.

So when you get one of these questions where you’re asked to prioritize, your first thought should be the ABCs:

• Circulation

In a few weeks, I’m going to do a video on how I was able to take an entire day off from studying every single week during nursing school. So if you feel like you’re drowning in nursing school right now and just can’t catch a break, make sure you’ve clicked on the notification bell so you get notified when that video goes up. Seriously, you don’t want to miss it.

Now make sure to like, comment, subscribe and share this video with a friend.

And click on one of these videos here so you can keep rocking nursing school, and go become the nurse that God created only YOU to be. And I’ll catch you in the next video.

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What is Critical Thinking in Nursing? (With Examples, Importance, & How to Improve)

Successful nursing requires learning several skills used to communicate with patients, families, and healthcare teams. One of the most essential skills nurses must develop is the ability to demonstrate critical thinking. If you are a nurse, perhaps you have asked if there is a way to know how to improve critical thinking in nursing? As you read this article, you will learn what critical thinking in nursing is and why it is important. You will also find 18 simple tips to improve critical thinking in nursing and sample scenarios about how to apply critical thinking in your nursing career.

What Is Critical Thinking In Nursing?

4 reasons why critical thinking is so important in nursing, 1. critical thinking skills will help you anticipate and understand changes in your patient’s condition., 2. with strong critical thinking skills, you can make decisions about patient care that is most favorable for the patient and intended outcomes., 3. strong critical thinking skills in nursing can contribute to innovative improvements and professional development., 4. critical thinking skills in nursing contribute to rational decision-making, which improves patient outcomes., what are the 8 important attributes of excellent critical thinking in nursing, 1. the ability to interpret information:, 2. independent thought:, 3. impartiality:, 4. intuition:, 5. problem solving:, 6. flexibility:, 7. perseverance:, 8. integrity:, examples of poor critical thinking vs excellent critical thinking in nursing, 1. scenario: patient/caregiver interactions, poor critical thinking:, excellent critical thinking:, 2. scenario: improving patient care quality, 3. scenario: interdisciplinary collaboration, 4. scenario: precepting nursing students and other nurses, how to improve critical thinking in nursing, 1. demonstrate open-mindedness., 2. practice self-awareness., 3. avoid judgment., 4. eliminate personal biases., 5. do not be afraid to ask questions., 6. find an experienced mentor., 7. join professional nursing organizations., 8. establish a routine of self-reflection., 9. utilize the chain of command., 10. determine the significance of data and decide if it is sufficient for decision-making., 11. volunteer for leadership positions or opportunities., 12. use previous facts and experiences to help develop stronger critical thinking skills in nursing., 13. establish priorities., 14. trust your knowledge and be confident in your abilities., 15. be curious about everything., 16. practice fair-mindedness., 17. learn the value of intellectual humility., 18. never stop learning., 4 consequences of poor critical thinking in nursing, 1. the most significant risk associated with poor critical thinking in nursing is inadequate patient care., 2. failure to recognize changes in patient status:, 3. lack of effective critical thinking in nursing can impact the cost of healthcare., 4. lack of critical thinking skills in nursing can cause a breakdown in communication within the interdisciplinary team., useful resources to improve critical thinking in nursing, youtube videos, my final thoughts, frequently asked questions answered by our expert, 1. will lack of critical thinking impact my nursing career, 2. usually, how long does it take for a nurse to improve their critical thinking skills, 3. do all types of nurses require excellent critical thinking skills, 4. how can i assess my critical thinking skills in nursing.

• Ask relevant questions • Justify opinions • Address and evaluate multiple points of view • Explain assumptions and reasons related to your choice of patient care options

5. Can I Be a Nurse If I Cannot Think Critically?

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The Key to Passing the NCLEX? Critical Thinking

Posted by Mark Skoskiewicz on February 6, 2019 8:00:00 AM CST

There are only two real keys to passing the NCLEX.

First and obviously, you must know the content and understand the concepts you’ll be tested on and secondly, you must sharpen your critical thinking skills to apply your knowledge effectively, so you answer NCLEX questions correctly. I find that most students generally have much less trouble with the former than the latter. They also sometimes incorrectly assume that if they are learning and understanding nursing concepts in their degree program, they are naturally building the skills required to pass the NCLEX. But this is not completely true. There is a different between understanding the concepts and building the critical thinking skills required to apply them when you are taking the NCLEX.

For example, the National Council of the State Boards of Nursing published what is tested on the NCLEX in its Basic Test Plan . So, it’s straight forward to understand what will be on the exam and ensure you study the appropriate topics, which are:

• Management of Care 17-23%
• Safety and Infection Control 9-15%
• Health Promotion and Maintenance 6-12%
• Psychosocial Integrity 6-12%
• Basic Care and Comfort 6-12%
• Pharmacological and Parenteral Therapies 12-18%
• Reduction of Risk Potential 9-15%
• Physiological Adaptation 11-17%

The NCSBN also tells you that, across these content areas, a series of processes fundamental to effective nursing will be tested: Clinical nursing processes, caring, communication and documentation, teaching/learning, and culture.

This content is what you’ve studied in nursing school and if you’ve been successfully able to earn As and Bs in nursing classes, you’ll probably have a very good handle on this material.   But so many NCLEX takers fail one or more times and start to really have trouble understanding what is going on and why they aren’t passing.

The fact is, the NCLEX is not a test of your ability to remember facts. It requires understanding facts, but then going beyond that to determine what’s important and making the most informed choice possible about what to do next given the available facts.

The real key to passing the NCLEX is sharpening your critical thinking skills to successfully apply what you know to fluid, complex, and sometimes confusing nursing situations presented to you during the NCLEX exam.

What does critical thinking mean in the context of functioning as a nurse? Well, it covers the ability to, for example:

• Decide what’s important
• Look for important patterns
• Find linkages across situations such that knowledge gained in one area can be applied to another
• Choose the best course of action amongst several feasible alternatives
• Evaluate situations using the right set of criteria
• Communicate using appropriate methods for the situation

The above are the same types of skills and capabilities required to successfully answer NCLEX questions. Here is a super simple formula for “thinking critically” on the NCLEX:

• First, make sure you understand exactly what the question is asking. Many NCLEX questions provide more facts than you need, and it can be easy to get confused about what is being asked.
• Second, eliminate obviously incorrect answers. This is a time-tested test taking strategy that’s just as important for the NCLEX as it is for the ACT or SAT. Even if you don’t know what the right answer is, randomly choosing between two potentially correct answers gives you a much better chance of answering correctly than choosing between all four or five given answers.
• Last, prioritize and choose. There will be many NCLEX questions where the elimination of incorrect answers will lead you directly to the correct answer. However, in most cases, you’ll be left with 2 or maybe 3 choices that seem correct. So, you are left needing to think about what’s most important or identify a linkage that helps you prioritize the possible answers and choose the one that much be “more correct.” For example, you might be analyzing a situation involving a child in the emergency room, where you know you must address he fact that the child is having trouble breathing (that’s one answer), and you know there are critical follow up questions to ask the parent about what lead to this trouble breathing (that’s another answer). It might pop into your mind how important it is to understand what caused this situation to avoid it in the future. But, thinking critically, you realize what’s most important is ensuring the child begins breathing normally again so the situation doesn’t get worse or life threatening right now.

The NCLEX tests your ability to think through and manipulate facts, not your ability to memorize them. You must embrace the idea of building critical thinking skills to be successful on your next NCLEX attempt. This will serve you well on the NCLEX and as a nurse.

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10 05.07 Critical Thinking NCLEX Questions

Question 1 of 10.

The nurse is caring for an elderly client who had an unwitnessed fall out of bed and is complaining of hip pain. What is the nurse’s priority?

Question 2 of 10

A client has been brought into the recovery room after undergoing abdominal surgery. Several minutes after arrival, the nurse notes that the client’s hands and feet are cool, capillary refill is 6 seconds, and the client’s blood pressure is dropping. Which response from the nurse is most appropriate?

Question 3 of 10

A nurse manager who works on the medical-surgical unit makes decisions several times a day to ensure that the appropriate staff members on the unit care for clients based on their skill mix, number, and experience level. This is best described as:

Question 4 of 10

The nurse is caring for a newly admitted client with an NSTEMI. The client is on heparin and has blood pressure medications and a coagulation blood draw due. The client is asking for a blanket and pain medication for the chest pain that just started. What is the priority task?

Question 5 of 10

A nurse is caring for a client complaining of pain. Which of the following critical thinking steps would the nurse utilize to respond to this situation? Select all that apply .

Question 6 of 10

A nurse who works at a large, metropolitan hospital answers the phone on a unit and is told by an unidentified caller that there is a bomb in the building. Which actions are the highest priority while the nurse is still on the phone with this caller? Select all that apply .

Question 7 of 10

A nurse is preparing to administer medication to a client who is recovering from surgery. Which of the following demonstrates that the nurse is using critical thinking skills when administering this drug? Select all that apply .

Question 8 of 10

A worker in the laboratory notes that a nurse on the surgical unit of the hospital failed to report a client’s critical lab value to the provider. Which of the following actions should the healthcare staff member perform in response? Select all the apply.

Question 9 of 10

A nurse is preparing to give the first dose of an oral medication to a client. Which answer best describes how the nurse would utilize critical thinking when administering this drug?

Question 10 of 10

A nurse must make a decision about whether to give a PRN medication based on a client’s condition. The nurse utilizes the steps of the decision making process in order to decide. Which concept is the best example of establishing client needs when making a decision?

Lastly, what email should we send your results to?

Test-taking tips

Use your critical thinking skills to ace your next exam..

• The key to successful test taking is accurately identifying what the question is asking.
• Carefully read the entire question.
• Nursing test questions give you all the information you need to know to find the answer the question.

By Debra A. Hrelic, PhD, RNC

Group work in higher education

Generational learning preferences

Teach-back: An underutilized tool

Test taking is a skill, whether you’re a student currently enrolled in a nursing program or have just recently returned to school after several years in the workforce. In either case, these tips will help you build your test-taking muscles.

Put on your critical-thinking cap

The key to successful test taking is accurately identifying what the question is asking. Don’t focus on the background information; think through the problem or situation as identified in the question. Wheth­er it’s a knowledge, application, delegation, or medication question, most questions are designed to test critical thinking. Several strategies will help you problem-solve your way to a correct answer.

Reword the question

Carefully read the entire question. Don’t rush through it or stop half­way through because you assume that you know what’s being asked. Reword the stem to make it easier to understand, and answer the question. Look for hints or key words, such as most , all , first , best , primary , initial , always, and never . On a paper exam, underline or circle those words so that you don’t forget them when seeking your answer; on a computer exam, write them on scrap paper.

Questions with phrases in the stem stating “ further teaching is needed ” may indicate that the answer contains incorrect information or has a negative connotation. For example:

The nurse has completed discharge teaching with the parents of a child suffering from atopic dermatitis. The nurse determines that further teaching is needed when the mother states it is most important upon discharge to:

a. Maintain a high-humidified environment to keep her child’s skin moist.

b. Keep her child’s fingernails trimmed short and with no rough edges.

c. Wrap her child’s hands in soft cotton gloves.

d. Dress her child in loose soft clothing.

The correct answer is “a.” Since “ further teaching is needed ,” you’re looking for an answer that shows what the patient got wrong. In this case, a humid environment would increase bacterial growth and cause clothing to rub and irritate the child’s skin.

The stem of an answer that holds positive or correct information might be worded like this: “ the patient demonstrates knowledge and understanding .” For example:

When a nurse is providing education to a patient newly diagnosed with diabetes, which action demonstrates learning has occurred?

a. The nurse presented information to the patient about diabetes.

b. The patient demonstrates how to inject insulin.

c. The patient watches a film on diabetes.

d. A primary care provider gives the patient a pamphlet on diabetes.

The correct answer is “b.” “ Learning has occurred ” is a positive statement, so you’re looking for a statement that demonstrates a learned action. “B” is the only answer where the patient demonstrates a learned behavior that’s related to what has been taught.

Choosing the correct answer may mean choosing among several answers that have some degree of correct information. This is where critical thinking especially comes into play. Go back to your interpretation of what the question was really asking, and the correct answer should be apparent.

Answer the question first

Try answering the question before looking at the choices. Decide what the question is asking, what you believe the answer is, and then go to the choices and look for it. If your answer is there, you can choose it and move on. If not, either reword the question or look for patterns and relationships in the answers. Do you see information in the choices related to what you thought was the correct answer? If not, go back to the question, reread it, and be sure you understand what’s being asked.

If you have an idea what the answer is, use that to eliminate incorrect answers. Read remaining choices to obtain clues. Reread the question and try to narrow down the answers by applying knowledge. Is the question asking for a course of action or a demonstration of knowledge? Look for clues in the question and in the remaining answers. Remember not to assume information. Nursing questions give you all the information you need to know. Don’t read into them, wondering, for example, whether the patient is or isn’t febrile. If it isn’t mentioned in the stem, then it isn’t relevant to the answer.

Eliminate wrong answers

After reading and rewording the question, read only the first answer choice. Does it answer your reworded question? If it doesn’t, eliminate it from consideration. If it does or if you’re not sure, keep it as a possibility. Follow this method with each of the remaining three choices, eliminating those that don’t answer the question. This technique eventually will leave you with only one choice.

Time is of the essence

You may be wondering if you’ll have time to follow these steps with each question. The answer is almost always yes. Most students waste time staring at and rereading questions they don’t understand rather than following these simple steps and using their critical-thinking skills. (See Don’t panic, strategize .)

If you have concerns about any questions and you’re taking a paper exam, mark them to come back to after completing everything else. However, keep these caveats in mind: If you’re filling out a form where you fill in circles with your answers, you may forget to leave a circle blank for the skipped question you want to revisit. The grading of your entire test may be thrown off, resulting in failure. Also, skipping a question on a computerized test to return to later may not be an option.

NCLEX-RN® preparation

The computerized National Council Licensure Examination for Registered Nurses (NCLEX-RN), the entry-to-practice examination for RNs in the United States, is organized into four categories of patient need to define nursing actions and competencies: safe and effective care environment, health promotion and maintenance, psychosocial integrity, and physiological integrity. (See NCLEX-RN categories .)

Most of the questions on the NCLEX-RN exam are multiple choice. You’ll also encounter alternative-format questions such as multiple response, fill-in-the-blank, ordered response, and hot spots (which require you to identify and click on a specific area of the body [hot spot] on a graphic with your mouse). Questions may include charts, tables, graphics, sound, or video. The National Council of State Boards of Nursing (NCSBN) website has information about item formats with examples.

Every nursing class and every exam you take in school helps prepare you for taking your NCLEX-RN. And studies show that nursing students who complete between 400 to 500 NCLEX-style review questions for each class they take are better prepared for nursing class exams and are more likely to pass their NCLEX-RN examination.

The more you practice taking NCLEX-type exams, the better you do on them and the less anxious you’ll feel while taking them. You can find practice questions relevant to all areas of nursing in NCLEX-RN preparation books and online. You also can use smartphone, computer, and tablet apps. Check with faculty and local and school libraries for additional resources and recommendations. Some students share preparation books, trading them from class to class.

Ace your next test

Whether you’re a practicing nurse or a student, use your critical-thinking skills and these tips to ace your next test. (See Strategies for success .)

Debra A. Hrelic is the RN-BSN program coordinator at the University of North Carolina in Wilmington.

Selected reference

National Council of State Boards of Nursing. NCLEX-RN® Examination: Detailed Test Plan . April 2016.

NCLEX strategies: Critical thinking & rewording questions . Kaplan Test Prep.

NCLEX-RN® question types . Kaplan Test Prep.

3 Comments .

What would you reccomend if a child can’t concentrate while doing a test?

Knowing and understanding the contents of the exam by heart is important but most people overlook preparing for “how” they’re gonna take the exam and what approach would they take in answering it. Knowing how to go through questions and answering them efficiently would help increase your chances of scoring high.

I’m going to be taking some summer classes next year as I’m saving up for tuition now. Anyways, I know that there will be tests and quizzes so I’ll for sure have to study hard for them. As you said, there will probably be some multiple-choice questions which of course, I’ll have to pay extra attention to as they make you think outside the box quite a bit.

Comments are closed.

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