TEXT BOOK ON Strategies for Student Success To the NEXT GENERATION NCLEX(NGN) Test ITEMS-2023 by Linda A.Silvestri and Angela E. Silvestri(2023), NEWEST VERSION AND COMPLETE

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Go to 2019v1.0 Strategies for Student Success on the NEXT GENERATION NCLEX® (NGN) This page intentionally left blank Strategies for Student Success on the NEXT GENERATION NCLEX® (NGN) Linda Anne Silvestri, PhD, RN, FAAN Nursing Instructor University of Nevada, Las Vegas Las Vegas, Nevada; President Nursing Reviews, Inc. and Professional Nursing Seminars, Inc. Henderson, Nevada; Next Generation NCLEX® (NGN) Consultant and Subject Matter Expert Elsevier Inc. Angela Elizabeth Silvestri, PhD, APRN, FNP-BC, CNE Associate Professor and BSN Program Director University of Nevada, Las Vegas Las Vegas, Nevada; President Nurse Prep, LLC Henderson, Nevada; Next Generation NCLEX® (NGN) Subject Matter Expert Elsevier Inc. Donna D. Ignatavicius, MS, RN, CNE, CNEcl, ANEF, FAADN Speaker and Curriculum Consultant for Academic Nursing Programs Founder Boot Camp for Nurse Educators; President DI Associates, Inc. Littleton, Colorado; Next Generation NCLEX® (NGN) Consultant and Subject Matter Expert Elsevier Inc. Elsevier 3251 Riverport Lane St. Louis, Missouri 63043 STRATEGIES FOR STUDENT SUCCESS ON THE NEXT GENERATION NCLEX® (NGN) TEST ITEMS ISBN: 978-0-323-87229-4 Copyright © 2023 by Elsevier Inc. All rights reserved. No part of this publication may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopying, recording, or any information storage and retrieval system, without permission in writing from the publisher. Details on how to seek permission, further information about the Publisher’s permissions policies and our arrangements with organizations such as the Copyright Clearance Center and the Copyright Licensing Agency, can be found at our website: This book and the individual contributions contained in it are protected under copyright by the Publisher (other than as may be noted herein). Notice Practitioners and researchers must always rely on their own experience and knowledge in evaluating and using any information, methods, compounds or experiments described herein. Because of rapid advances in the medical sciences, in particular, independent verication of diagnoses and drug dosages should be made. To the fullest extent of the law, no responsibility is assumed by Elsevier, authors, editors or contributors for any injury and/or damage to persons or property as a matter of products liability, negligence or otherwise, or from any use or operation of any methods, products, instructions, or ideas contained in the material herein. International Standard Book Number: 978-0-323-87229-4 Content Strategist: Heather D. Bays-Petrovic Content Development Manager: Ellen M. Wurm-Cutter Content Development Specialist: Laura Klein; Meredith Madeira Publishing Services Manager: Julie Eddy Senior Project Manager: Jodi Willard Design Direction: Amy Buxton Printed in India Last digit is the print number: 9 8 7 6 5 4 3 2 1 In loving memory of my parents and Angela’s grandparents, Arnold Lawrence and Frances Mary, who opened my door of opportunity to this amazing profession of nursing. My memories of their love, support, and words of encouragement will remain in my heart forever! And, to my husband, Larry, for being my rock of support through all of my life’s journeys. Linda Anne Silvestri To my husband, Brent, who has supported my work since the day we met. I will always remember how he anticipated what I would need to be successful in this journey. To nursing students, you have chosen a wonderful profession that will give back to you what you are putting in now. You can do this! Angela Elizabeth Silvestri To my family, who has supported my work as an author and consultant for many decades. To nursing students, who have chosen the caring profession that can change the lives of so many, and to nurse educators, whose passion and role modeling continues to shape the future of the nursing profession. Donna D. Ignatavicius About the Authors Linda Anne Silvestri, PhD, RN, FAAN Linda is a well-known nurse educator, entrepreneur, and philanthropist whose profes- sional aspirations focus on assisting nursing students to become successful. She has been teaching nursing stu- dents at all levels of nursing education for many years. Dr. Silvestri is currently a nursing instructor at the Uni- versity of Nevada, Las Vegas (UNLV). She earned her PhD in Nursing from UNLV and conducted research on self-ecacy and the predictors of NCLEX® success. Her research ndings are published in the Journal of Nursing Education and Practice. Dr. Silvestri has received several awards and honors. In 2019 she was inducted as a Fellow in the American Academy of Nursing. In 2012 she received the UNLV School of Nursing Alumna of the Year Award. In 2010 she received the School of Nursing Certicate of Recognition for the Outstanding PhD Student. Dr. Silves- tri is a member of several national nursing organizations, some of which include the Honor Society of Nursing, Sigma Theta Tau International, the National League for Nursing, the American Nurses Association, and the American Acad- emy of Nursing. Dr. Silvestri is a successful Elsevier author of numerous best-selling NCLEX® preparation resources on national and international levels. She also serves as an Elsevier Consultant and Subject Matter Expert for the Next Generation NCLEX® (NGN) and has presented numerous webinars on NCLEX® preparation and success. Dr. Silvestri is the President and Owner of Nursing Reviews, Inc. and Professional Nursing Seminars, Inc. Both companies are dedicated to helping nursing graduates achieve their goals of becoming licensed nurses. Angela E. Silvestri, PhD, APRN, FNP-BC, CNE Angela Silvestri is a well-known nurse educator, researcher, and author. She has been teaching and working in university administra- tive roles for the last 10 years at all levels of nursing education. She has experience teaching across the program and in both classroom and clinical settings and working with graduate students on their culminating projects and research dissertations. She is cur- rently serving in a leadership role as the Program Director for the undergraduate BSN program at the University of Nevada, Las Vegas (UNLV). Angela earned a bachelor’s in Nursing and in Sociology from Salve Regina University in Newport, RI, and her master’s—with a focus in nursing education—and PhD from the University of Nevada, Las Vegas. She also has a post-master’s graduate certicate in Advanced Practice and is a board-certied Family Nurse Practitioner. She is a Scholar in Sigma Theta Tau’s New Academic Leadership Academy. Angela is passionate about college student success. She works as a Family Nurse Practitioner with faculty, sta, and stu- dents on managing primary and episodic health care needs at UNLV’s Student Wellness Center and Faculty and Sta Treatment Center. Dr. Silvestri is a successful Elsevier author of numerous best-selling NCLEX® preparation resources on national and international levels. She also serves as an Else- vier Subject Matter Expert for the Next Generation NCLEX® (NGN). This passion also comes through in her work at the School of Nursing teaching leadership and licensure exam preparation, as well as in publishing research and best-selling licensure exam review resources on national and international levels. Donna D. Ignatavicius, MS, RN, CNE, CNEcl, ANEF, FAADN Nationally recognized as an expert in nursing education and medical-surgical nurs- ing, Donna, better known as “Iggy,” has a wealth of expe- rience in education, clinical nursing, and administra- tion. Through her company, DI Associates, Inc., Iggy speaks at national and state conferences and provides consultation on such topics as curriculum transformation and NGN prep- aration. In addition, she is the author of a number of articles, chapters, and books, including the tenth edition of her lead- ing textbook, Medical-Surgical Nursing: Concepts for Interpro- fessional Collaborative Care. In 2007 Iggy was inducted as a fellow into the very prestigious Academy of Nursing Educa- tion for her national contributions to nursing education. In 2021 she was also inducted as a fellow into the Academy of Associate Degree Nursing for her national inuence and con- tributions to programs preparing students for nursing prac- tice. Iggy obtained her Certied Nurse Educator® credential in 2016 and her Certied Academic Clinical Educator® cre- dential in 2020. vi We want to acknowledge the many people from Elsevier who were such a signicant part of our journey as we prepared this resource for nursing students. First and foremost, we extend our deepest appreciation to Heather Bays-Petrovic, Content Strategist, for accepting our proposal and promot- ing our vision for this project and for supporting us every step of the way from start to nish. Thank you, Heather! Jodi Willard, Senior Project Manager, has been instrumental in moving this publication forward. Jodi’s work and attention to detail has been signicant in the design and nal prod- uct. Thank you, Jodi! We also extend our sincere gratitude to Laura Klein, Senior Content Development Specialist; Amy Buxton, Senior Book Designer; and Julie Eddy, Publishing Services Manager. We thank all of you for your willingness and exibility to design this resource ensuring that our ideas and vision were executed and for your consistent attention to the many details in our manuscript. Finally, we want to thank Bruce Seibert, Senior Digital Media Producer, and Bala Cherukumilli, Digital Media Producer, for all of your patience and assistance in implementing our requests for the electronic platform that accompanies this resource. A very grateful and appreciative “Thank You” from us to all of you— we could not have achieved our aspirations for this resource without you! vii Preface Welcome to the Strategies for Student Success on the Next Gen- eration NCLEX® (NGN) Test Items! This book is focused on providing you with information about the Next Generation NCLEX® (NGN) and practice questions to prepare you to successfully answer the new test item types expected on the NGN.a This book highlights gen- eral NGN Tips and unique test-taking strategies. Chapter 1 introduces the clinical judgment (CJ) cognitive skills upon which the new test items will be based. Chapter 2 presents examples of the new NGN test item types. Chapters 3 through 8 describe the CJ cognitive skills and present unique test- taking strategies on how to answer practice items that measure each skill. Chapter 9 demonstrates how Stand-alone items and Unfolding Case Studies will be presented on the NGN, and Chapter 10 provides an NGN Practice Test to apply what was learned throughout the book. The answers, rationales, test- taking strategies, content area, and CJ cognitive skill(s) for each practice question throughout the book are presented at the end of the book. In addition, the priority concept is identi- ed. The specic focus of each chapter is summarized below. Organization of the Book ■ Chapter 1, Introduction to the Cognitive Skills of Clinical Judgment, describes how clinical judgment builds on the nursing process and introduces you to the six essen- tial cognitive skills of the NCSBN Clinical Judgment Measurement Model (NCJMM). These cognitive skills are the basis for the new NGN test item types. ■ Chapter 2, Introduction to the NGN and the New NGN Item Types, explains the purpose and design of the NGN and presents the new test item types. An example of each item type is presented, and the correct responses are provided with brief rationales. ■ Chapter 3, Strategies for Answering NGN Questions: Recognize Cues, describes the CJ cognitive skill, Recognize Cues, which requires you to identify relevant clinical find- ings and decide which findings are of immediate con- cern and most important based on the clinical scenario. This chapter also identifies test items and enhanced test- taking strategies that you can use when answering items that measure this skill. Examples of these test items allow you the opportunity to practice applying these strategies within the chapter and in the practice test at the end of the chapter. a Please note: The NGN content provided in this book and on the Evolve site reects the information available at the time of production of this resource. The NCSBN research about NGN is ongoing, and changes in the items to measure each cognitive skill may be forthcoming. The NCSBN website at provides you with the latest updates. viii ■ Chapter 4, Strategies for Answering NGN Questions: Analyze Cues, describes the CJ cognitive skill, Analyze Cues, which requires you to connect or link relevant cues to the clinical scenario, interpret these cues, and establish their significance. This chapter also identifies test items and enhanced test-taking strategies that you can use when answering items that measure this skill. Examples of these test items allow you the opportunity to practice applying these strategies within the chapter and in the practice test at the end of the chapter. ■ Chapter 5, Strategies for Answering NGN Questions: Prioritize Hypotheses, describes the CJ cognitive skill, Prioritize Hypotheses, which requires you to establish and rank client needs or hypotheses in order of priority. This chapter also identifies test items and enhanced test- taking strategies that you can use when answering items that measure this skill. Examples of these test items allow you the opportunity to practice applying these strategies within the chapter and in the practice test at the end of the chapter. ■ Chapter 6, Strategies for Answering NGN Questions: Generate Solutions, describes the CJ cognitive skill, Generate Solutions, which requires you to use knowledge of evidence-based solutions about treatments and inter- ventions that would address identified client needs and modify them to meet priorities of care. This chapter also identifies test items and enhanced test-taking strategies that you can use when answering items that measure this skill. Examples of these test items allow you the opportu- nity to practice applying these strategies within the chapter and in the practice test at the end of the chapter. ■ Chapter 7, Strategies for Answering NGN Questions: Take Action, describes the CJ cognitive skill, Take Action, which requires that you perform appropriate and necessary inter- ventions based on the client’s situation and generated solu- tions. This chapter also identifies test items and enhanced test-taking strategies that you can use when answering items that measure this skill. Examples of these test items allow you the opportunity to practice applying these strat- egies within the chapter and in the practice test at the end of the chapter. ■ Chapter 8, Strategies for Answering NGN Questions: Evaluate Outcomes, describes the CJ cognitive skill, Evaluate Outcomes, which requires that you examine out- comes and measure client progress towards meeting those outcomes in the plan of care. This chapter also identifies test items and enhanced test-taking strategies that you can use when answering items that measure this skill. Examples of these test items allow you the opportunity to practice applying these strategies within the chapter and in the practice test at the end of the chapter. Preface ix ■ Chapter 9, Strategies for Answering NGN Stand-alone Items and Unfolding Case Studies, describes the differences between Stand-alone items and Unfolding Case Studies. Samples of Stand-alone items (including the bow-tie and trend) are illustrated, as well as Unfolding Case Studies. This chapter also identifies test items and enhanced test- taking strategies that you can use when answering ques- tions accompanying each type of case study. Examples of these test items allow you the opportunity to practice applying these strategies within the chapter. This chapter also points out external factors to consider in NGN cases, such as the environmental and individual factors. ■ Chapter 10, NGN Practice Test: Putting It All Together, pro- vides you with the opportunity to practice all of the new types of test items expected on the NGN, starting with Unfolding Cases Studies and ending with Stand-alone Bow-tie and Trend items. Special Features of the Book ■ NGN tips within each chapter. These unique tips provide the student with key points to remember, such as the NGN item type or cognitive skill (CS) features. ■ In-chapter sample questions are presented within Chapters 3 through 9 to provide examples of the new NGN test item types that best measure the clinical judgment cogni- tive skill presented in the chapter. Each question within the chapter specifies the priority concept and content area being tested. The answer, rationale, enhanced test-taking strategy, and references are also presented to help students learn the thinking process needed to select the correct test ■ Thinking Space. The Thinking Spaces located in the margins of the book is a place for personal note-taking. The student can use these spaces to write down new and important information they want to remember. To become most famil- iar with the cognitive skills and to build clinical judgment skills, using the Thinking Space to make important linkages between clinical scenario information and the cognitive skill will reinforce the aspects of the NCJMM model as the stu- dent is studying and preparing for the NGN. Special Features Found on Evolve The Evolve site accompanying this resource provides the stu- dent with all of the case studies and practice test questions in the book plus an additional 30 unfolding case studies, each with 6 NGN items. The book includes 60 single cases (each with 1 NGN item), 10 Stand-alone items (5 Bow-tie and 5 Trend), and 5 Unfolding Case Studies (items with 6 NGN items). This equals a total of 100 NGN items. Then there are an additional 30 unfolding cases, each with 6 NGN items, and 4 additional Stand-alone items (2 Bow-tie and 2 Trend) total- ing 184 NGN items. Altogether, there are a total of 284 NGN items on Evolve. The Evolve site lists various category selections. You can select by type of question—either single case, Stand-alone items (either bow-tie or trend), or Unfolding Case Study. You can also select by the specic cognitive skill, content area, or priority concept. The table below illustrates the various cat- egories for selection. Priority item response. Type Cognitive Skill Content Area Concept ■ End-of-chapter practice questions are presented at the end of Chapters 3 through 8 to provide the opportunity for stu- dents to apply what they learned in each chapter and expe- rience answering selected test items that measure each of the NCSBN’s clinical judgment cognitive skills. Chapter 9 presents Stand-alone items, both Bow-tie and Trend items, and Unfolding Case Studies. ■ A comprehensive practice test is presented in Chapter 10 to allow students to apply what they learned in Chapters 1 through 9. Students have the opportunity to answer mul- tiple Unfolding Case Studies and Stand-alone items rep- resenting all clinical specialty areas. The priority concept, content area, answer, rationale, enhanced test-taking strat- egy, and reference for each test item are provided at the end of the book. ■ Enhanced test-taking strategies for the NGN. This unique feature walks students through the thinking process needed to navigate complex NGN cases. Each strategy explains how to apply the cognitive skill when considering the information presented in the clinical scenario. Each question is accompanied by test-taking strategies that are Single Stand- alone Unfolding Recognize Cues Analyze Cues Prioritize Hypotheses Generate Solutions Take Action Evaluate Outcomes Foundations of Nursing Maternal- Newborn Nursing Medical- Surgical Nursing Mental Health Nursing Pediatric Nursing Pharmacology Clotting Cognition Elimination Fluid and Electrolyte Balance Gas Exchange Glucose Regulation Immunity Mobility Mood and Aect Perfusion Stress and Coping Tissue Integrity presented both narratively and in a table format to guide the student through a logical thinking process and to suit multiple learning styles. This thinking process with test- taking strategies will also help on current NCLEX-style (Stand-alone) items and nursing course exams. How to Use This Book For Students As implied in the title, this book was written to help you be successful when taking the new test item types that will be x Preface part of the Next Generation NCLEX® (NGN). The rst two book chapters present a review of clinical judgment and the NGN item types. All new item types are based on the six cog- nitive (thinking) skills needed for safe, appropriate clinical judgment. Be sure that you are very familiar with this infor- mation before beginning to practice answering the test ques- tions later in the book. Chapters 3 through 8 describe each clinical judgment cog- nitive skill and provide general NGN Tips on how to answer test items that measure each skill. Sample NGN test items are then presented with the Rationale and Test-Taking Strategy for the correct and incorrect responses, followed by six end- of-chapter practice questions for you to answer. The practice questions in each chapter represent all content specialties. The rationale and test-taking strategy that you can use for each question to determine the correct answers are described in detail, with tables to help organize the information in each question. In addition, each test item is labeled by priority nursing concept and content specialty. References are also provided to help you review the content associated with each test item if needed. When working through Chapters 3 through 8, start with Chapters 3 and 4 early in your program so that you can learn how to determine the most important client ndings in a clinical scenario and what they mean (Recognize Cues and Analyze Cues). When you feel you have mastered these cogni- tive skills, work through Chapter 5, which will help you learn to prioritize client needs and the care required to meet them. Chapters 6 and 7 are focused on helping you learn to plan and implement nursing actions to meet the client’s needs. Finally, Chapter 8 will assist you in determining whether the client’s condition has improved after care has been implemented. After working through Chapters 3 through 8 and when you feel ready to put all the cognitive skills together, Chapter 9 pro- vides examples for NGN Unfolding Case Studies and Stand- alone items. Chapter 10 presents a comprehensive practice test that simulates what you can expect on the NGN. The rationale and test-taking strategy for each practice test item in these chapters are described in detail. Many additional practice NGN test items are available on the Evolve site with rationale, test- taking strategy, content specialty, priority nursing concept, and reference for each Unfolding Case Study or Stand-alone item. For Faculty This book is designed for you to use as it is organized, begin- focus on assessing the client, discerning how to determine which client ndings are the most important, and deciding what those ndings mean. End-of-chapter practice ques- tions can be used during class, online, simulation pre- or post-brieng, or clinical post-conference. The test items can be assigned to students as individuals or in groups to answer. Regardless of where or how practice test items are used, such as in the classroom, online, lab sessions, or clinical setting, be sure to review the answers, rationales, and strategies for arriving at the correct response(s) to identify and improve students’ thinking process as needed. As students progress to the next course, they should begin to learn how to prioritize care to determine what nursing actions they would plan and implement. Part of this thinking process includes an assessment to decide if the actions were eective and the client’s condition has improved. Therefore students in this semester would focus on Chapters 5 through 8. Again, you can assign the practice items to students as indi- viduals or in groups and review the items to help students improve their thinking as needed. Chapters 9 and 10 puts together all the cognitive skill steps and new NGN test item types—both Stand-alone items and Unfolding Case Studies. These chapters can be used when- ever students are applying the individual CJ cognitive skills to successfully answer the new test items in preparation for the NGN. Assign these practice Unfolding Case Studies and Stand-alone items as individual student practice to determine any skill areas where improvement is needed. Students need- ing improvement can then review any of the six earlier chap- ters (Chapters 3 through 8) to hone their thinking skills. Faculty Tool Kit The Faculty Tool Kit was created to guide faculty in using this book with their students at any stage in the program to pre- pare them for the NGN. The Tool Kit: ■ Furnishes a guide for how to use this book, Strategies for Student Success on the Next Generation NCLEX® (NGN) Test Items, to prepare students for the NGN ■ Provides chapter-to-chapter strategic points to empha- size to students and ways to prepare students for an- swering NGN items ■ Provides suggestions for using the Evolve site accompa- nying this book ■ Presents step-by-step guides for writing Stand-alone items and Unfolding Case Studies ning with helping students learn what CJ is and gain an understanding of each of the essential CJ cognitive skills as described in Chapter 1. Students in their rst nursing course should learn how to use these skills to make safe, appropri- ate clinical judgments to ensure client safety. If students are already making clinical judgments using these skills, Chap- ter 1 could be used for review. Then students should become familiar with the NGN test design and new item types as pre- sented in Chapter 2. Finally, by the end of the rst semester (or other term), students should learn how to Recognize Cues and Analyze Cues (Chapters 3 and 4). These cognitive skills ■ Presents step-by-step guides for writing NGN items ■ Species NCSBN resources that focus on NGN for stu- dents and faculty ■ Provides Elsevier resources and references for prepar- ing students for the NGN Additional Resources for Students ■ Ignatavicius, D.D. (2021). Developing Clinical Judgment for Professional Nursing and the Next-Generation NCLEX-RN® Examination. St. Louis: Elsevier. This workbook helps students preparing to become RNs learn how to develop NCSBN’s six clinical judg- ment cognitive skills through practice in answering new NGN test item types embedded in unfolding and single-episode cases throughout the entire curriculum. Clinical scenarios are presented from more basic care to complex, multisystem care of clients in multiple spe- cialty areas. ■ Ignatavicius, D.D. (2022). Developing Clinical Judgment for Practical-Vocational Nursing and the Next-Generation NCLEX-PN® Examination. St. Louis: Elsevier. This workbook helps students preparing to become LPNs or LVNs learn how to develop NCSBN’s six clinical judg- ment cognitive skills through practice in answering new NGN test item types embedded in unfolding and single- episode cases. Clinical scenarios in multiple specialty areas are included, with a primary emphasis on the care of older adults in a variety of health care settings, and can be used throughout the entire curriculum. ■ Silvestri, L., & Silvestri, A. (2023). Saunders Comprehensive Review for the NCLEX-RN® Examination (9th ed.). St. Louis: Elsevier. This is an excellent resource to use both while you are in nursing school and in preparation for the NCLEX® examination. This book contains 20 units with 70 chap- ters, and each chapter is designed to identify specic components of nursing content. The book and accom- panying software contain more than 5200 practice ques- tions and include alternate item format questions. The software also contains a 75-question preassessment test that generates an individualized study calendar. A pos- tassessment test is included, as well as case studies and accompanying NGN item type practice questions. ■ Silvestri, L., & Silvestri, A. (2021). Saunders Q&A Review for the NCLEX-RN® Examination (8th ed.). St. Louis: Elsevier. This book and accompanying Evolve site provide you with more than 6000 practice questions based on the NCLEX-RN® test plan. Each practice question includes a priority nursing tip that provides you with a piece of important information to remember that will help you answer questions on nursing exams and on the NCLEX® examination. The chapters in this book are uniquely designed and are based on the NCLEX-RN® examina- tion test plan framework, including Client Needs and Integrated Processes. Alternate item format questions and accompanying NGN item type practice questions are included. With practice questions focused on the Client Needs, Integrated Processes, and Clinical Judg- ment/Cognitive Skills, you can assess your level of competence. ■ Silvestri, L., & Silvestri, A. (2020). HESI/Saunders Online Review Course for the NCLEX-RN® Examination. (3rd ed.) St. Louis: Elsevier. The online NCLEX-RN® review course provides a sys- tematic and individualized approach and addresses all areas of the test plan identied by the National Council of State Boards of Nursing, Inc. This self-paced online review contains 10 interactive, multimedia-rich mod- ules featuring animations and videos, practice ques- tions, end-of-lesson case studies, and much more! A diagnostic pretest generates a study calendar to guide your review. NCLEX®-style questions—including every type of alternate item format question—are provided, concluding with a comprehensive examination that will sharpen your test-taking skills. In addition, case studies and accompanying NGN practice questions are included. Unique videos that simulate a live review course focus on dicult subjects such as dysrhythmias and make them easier to understand. ■ Silvestri, L., & Silvestri, A. (2021). Saunders Clinical Judgment and Test-Taking Strategies (7th ed.) St. Louis: Elsevier. This book is designed for both RN and PN nursing stu- dents and provides a foundation for understanding and unpacking the complexities of NCLEX® exam ques- tions, including alternate item formats. Saunders Clinical Judgment and Test-Taking Strategies takes a detailed look at all the test-taking strategies you will need to know in order to pass any nursing examination, including the NCLEX® examination. Special nursing content tips are integrated along with other tips, such as clinical preparation tips and life-planning tips. There are 1200 practice questions included so you can apply the testing strategies. NGN items and practice test ques- tions are also included on the Evolve site accompanying this resource. ■ Silvestri, L., & Silvestri, A. (2022). Saunders Comprehensive Review for the NCLEX-PN® Examination (8th ed.). St. Louis: Elsevier. This is an excellent resource to use both while you are in nursing school and in preparation for the NCLEX® exam- ination. This book contains 19 units and 65 chapters, and each chapter is designed to identify specic components of nursing content. The book and accompanying Evolve site contain more than 4500 practice questions and include alternate item format questions. The software also contains a 75-question preassessment test that generates an individualized study calendar. A post-assessment test is also included, as well as case studies and accompanying NGN item type practice questions. ■ Silvestri, L., & Silvestri, A. (2020). Saunders Q&A Review for the NCLEX-PN® Examination (6th ed.). St. Louis: Elsevier. This book and accompanying Evolve site provide you with more than 5900 practice questions based on the NCLEX-PN test plan. Each practice question includes a priority nursing tip that provides you with a piece of important information to remember that will help you answer questions on nursing exams and on the NCLEX® examination. The chapters in this book are uniquely designed and are based on the NCLEX-PN® examina- tion test plan framework, including Client Needs and Integrated Processes. Alternate item format questions