2019_RN_NCLEX TestPlan

Table of Contents I. Background . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 II. 2019 NCLEX-RN® Test Plan . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 Beliefs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 Classification of Cognitive Levels . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4 Test Plan Structure . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4 ƒClient Needs. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4 ƒIntegrated Processes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5 Distribution of Content. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5 Overview of Content. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6 Safe and Effective Care Environment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8 ƒManagement of Care. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8 ƒSafety and Infection Control . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13 Health Promotion and Maintenance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17 Psychosocial Integrity. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21 Physiological Integrity. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26 ƒBasic Care and Comfort. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26 ƒPharmacological and Parenteral Therapies. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 30 ƒReduction of Risk Potential . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 34 ƒPhysiological Adaptation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 38 III. Administration of the NCLEX-RN® Examination . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 42 Examination Length . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 42 The Passing Standard . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 42 Similar Items. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 43 Reviewing Answers and Guessing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 43 Scoring the NCLEX® Examination . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 43 ƒComputerized Adaptive Testing (CAT) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 43 ƒPretest Items . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 44 ƒPassing and Failing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 44 ƒScoring Items . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 45 ƒTypes of Items on the NCLEX-RN® . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 45 ƒNCLEX® Terminology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 45 ƒExamination Security and Confidentiality . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 45 ƒTutorial . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 45 IV. Item Writing Exercises . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .54 V. References. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 57 VI. Appendix A . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .58 iii 2019 NCLEX-RN® Test Plan critical thinking to integrate increasingly complex knowledge, skills, technologies, and client care activities into evidence-based nursing practice. The goal of nursing for client care is preventing illness and potential complications; protecting, promoting, restoring, and facilitating comfort, health and dignity in dying. The RN provides a unique, comprehensive assessment of the health status of the client. The RN applies principles of ethics, client safety, health promotion and the nursing process to develop and implement an explicit plan of care that reflects unique cultural and spiritual client preferences, the applicable standard of care and legal considerations. The nurse assists clients to promote health, cope with health problems, adapt to and/or recover from the effects of disease or injury, and support the right to a dignified death. The RN is accountable for abiding by all applicable member board jurisdiction statutes and regulations/rules related to nursing practice. Classification of Cognitive Levels Bloom’s taxonomy for the cognitive domain is used as a basis for writing and coding items for the examination (Bloom, et al., 1956; Anderson & Krathwohl, 2001). Since the practice of nursing requires application of knowledge, skills and abilities, the majority of items are written at the application or higher levels of cognitive ability, which requires more complex thought processing. Test Plan Structure The framework of Client Needs was selected for the examination because it provides a universal structure for defining entry-level nursing actions and competencies, and focuses on clients in all settings. Client Needs The content of the NCLEX-RN Test Plan is organized into four major Client Needs categories. Two of the four categories are divided into subcategories: Safe and Effective Care Environment ƒ Management of Care ƒ Safety and Infection Control Health Promotion and Maintenance Psychosocial Integrity Physiological Integrity ƒ Basic Care and Comfort ƒ Pharmacological and Parenteral Therapies ƒ Reduction of Risk Potential ƒ Physiological Adaptation 5 2019 NCLEX-RN® Test Plan Integrated Processes The following processes are fundamental to the practice of nursing and are integrated throughout the Client Needs categories and subcategories: ƒ Nursing Process – a scientific, clinical reasoning approach to client care that includes assessment, analysis, planning, implementation and evaluation. ƒ Caring – interaction of the nurse and client in an atmosphere of mutual respect and trust. In this collaborative environment, the nurse provides encouragement, hope, support and compassion to help achieve desired outcomes. ƒ Communication and Documentation – verbal and nonverbal interactions between the nurse and the client, the client’s significant others, and the other members of the health care team. Events and activities associated with client care are recorded in written and/or electronic records that demonstrate adherence to the standards of practice and accountability in the provision of care. ƒ Teaching/Learning – facilitation of the acquisition of knowledge, skills and abilities promoting a change in behavior. ƒ Culture and Spirituality – interaction of the nurse and the client (individual, family or group, including significant others and populations) which recognizes and considers the client-reported, self- identified, unique and individual preferences to client care, the applicable standard of care and legal considerations. Distribution of Content The percentage of test questions assigned to each Client Needs category and subcategory of the NCLEX-RN Test Plan is based on the results of the Report of Findings from the 2017 RN Practice Analysis: Linking the NCLEX-RN ® Examination to Practice (NCSBN, 2018) and expert judgment provided by members of the NCLEX Examination Committee. Client Needs Safe and Effective Care Environment Percentage of Items from Each Category/Subcategory  Management of Care 17–23%  Safety and Infection Control 9–15% Health Promotion and Maintenance 6–12% Psychosocial Integrity 6–12% Physiological Integrity  Basic Care and Comfort 6–12%  Pharmacological and Parenteral Therapies 12–18%  Reduction of Risk Potential 9–15%  Physiological Adaptation 11–17% 6 2019 NCLEX-RN® Test Plan Distribution of Content for the NCLEX-RN® Test Plan Reduction of Risk Potential 12% Physiological Adaptation 14% Management of Care 20% Safety and Infection Control 12% Pharmacological and Parenteral Therapies 15% Health Promotion and Maintenance 9% Basic Care and Comfort 9% Psychosocial Integrity 9% NCLEX-RN examinations are administrated adaptively in variable length format to target candidate-specific ability. To accommodate possible variations in examination length, content area distributions of the individual examinations may differ up to ±3% in each category. Overview of Content The activity statements used in the 2017 RN Practice Analysis: Linking the NCLEX-RN ® Examination to Practice (NCSBN, 2018) preface each of the eight content categories and are identified throughout the test plan by an asterisk(*). NCSBN performs an analysis of those activities used frequently and identified as important by entrylevel nurses to ensure client safety. This is called a practice analysis; it provides data to support the NCLEX as a reliable, valid measure of competent, entry-level nursing practice. The practice analysis is conducted every three years. In addition to the practice analysis, NCSBN conducts a knowledge, skills and abilities (KSA) survey. The primary purpose of this study is to identify the knowledge needed by newly licensed registered nurses (RNs) in order to practice safe and effective care. Findings from both the 2017 RN Practice Analysis and the 2017 RN KSA survey can be found at NCLEX-RN Test Plan as well as to inform item development. All task statements in the 2019 NCLEX-RN ® Test Plan require the nurse to apply the fundamental principles of clinical decision-making and critical thinking to nursing practice. The test plan also assumes that the nurse integrates concepts from the following bodies of knowledge: ƒ Social Sciences (psychology and sociology); ƒ Biological Sciences (anatomy, physiology, biology and microbiology); and ƒ Physical Sciences (chemistry and physics)