Top 10 NCLEX Tips Every Nursing Student Must Know in 2026

The NCLEX (National Council Licensure Examination) is the final hurdle between nursing school graduation and becoming a licensed registered nurse or practical/vocational nurse. With the Next Generation NCLEX (NGN) format now standard, the exam is more complex and clinical than ever before. Here are the 10 most important strategies every nursing student needs to know.

Tip 1: Understand the Clinical Judgment Measurement Model (CJMM)

The CJMM is the framework behind NGN questions. It has six cognitive skills:

• Recognize cues: What client findings matter?
• Analyze cues: What do these findings mean clinically?
• Prioritize hypotheses: What are the most likely/urgent problems?
• Generate solutions: What interventions would address each hypothesis?
• Take action: What specific actions should the nurse take?
• Evaluate outcomes: Was the intervention effective? What would indicate improvement or deterioration?

When answering NGN questions, consciously run through these steps. Ask yourself: "What am I recognizing? What does it mean? What do I do?"

Tip 2: Master the ABCs, Maslow's, and SATA Questions

Classic NCLEX prioritization still matters alongside the new NGN format:

• ABCs (Airway, Breathing, Circulation): Any question involving respiratory or cardiovascular compromise is almost always the highest priority.
• Maslow's Hierarchy: Physical needs come before psychological needs. Safety comes before esteem or self-actualization.
• SATA (Select All That Apply): Treat each option as an independent true/false question. Don't look for a "pattern" — evaluate each option on its own merits.

Tip 3: Focus on Priority Setting and Delegation

Multiple NCLEX questions will ask you to prioritize clients, assessments, or interventions. Remember:

• Unstable clients are always seen before stable ones.
• Clients who just returned from surgery, procedures, or who have new/changed symptoms get priority.
• Delegation: RNs can only delegate tasks (not nursing judgment) to UAPs (unlicensed assistive personnel). Complex assessments, new medications, and care planning stay with the RN.
• LPN/LVN scope: Can perform delegated tasks for stable clients, but not assessments of unstable clients or IV push medications.

Tip 4: Know Your Top NCLEX Drug Categories

Pharmacology questions are a major component of NCLEX. Focus on these high-yield drug categories:

• Cardiac: Digoxin (check apical pulse), beta-blockers, ACE inhibitors, anticoagulants (warfarin, heparin)
• Respiratory: Bronchodilators (albuterol), corticosteroids, oxygen therapy
• Psychiatric: Lithium (monitor levels), antipsychotics (check for extrapyramidal effects), SSRIs, MAOIs (tyramine diet restriction)
• Antibiotics: Aminoglycosides (nephrotoxic, ototoxic), penicillins (allergy cross-reaction)
• Insulin: Rapid, short, intermediate, long-acting types; hypoglycemia signs and treatment

Tip 5: Master Infection Control and Safety

Infection control questions appear frequently. Know your isolation precautions cold:

• Contact Precautions: MRSA, VRE, C. diff, scabies — gown and gloves
• Droplet Precautions: Influenza, meningitis, pertussis, mumps — surgical mask within 3 feet
• Airborne Precautions: TB, measles, chickenpox, SARS — N95 respirator, negative pressure room
• Fall Prevention: Bed lowest position, call light in reach, non-slip socks, side rails up as appropriate

Tip 6: Create a Strategic Study Schedule

Most nurses need 6–12 weeks of dedicated NCLEX prep. Here's what works:

• Week 1–2: Review all major body systems. Identify your weakest areas.
• Week 3–4: Deep review of pharmacology and priority/delegation concepts.
• Week 5–6: NGN question practice daily (at least 75 questions per day). Review rationales thoroughly.
• Week 7–8: Full-length practice exams. Target any persistent weak areas.
• Final Week: Light review, adequate rest, and confidence-building.

Tip 7: Use Quality NCLEX Prep Resources

• UWorld NCLEX Qbank: The gold standard for NCLEX practice questions. Highly realistic with detailed rationales.
• ATI Comprehensive Review: Excellent for content review with practice tests.
• Saunders Comprehensive Review Book: Great reference for content with practice questions.
• Mark Klimek Audio Lectures: Free on YouTube — excellent for high-yield review and mnemonics.
• Simple Nursing (YouTube): Excellent visual explanations of complex concepts.

Tip 8: Understand "Nursing Actions" vs. "Medical Actions"

The NCLEX tests nursing judgment, not medical diagnosis. Always select answers from the nurse's perspective:

• Always assess before intervening (unless it's a life-threatening emergency requiring immediate action).
• Notify the physician after completing an assessment, not before assessing the client.
• Position a client appropriately before reporting a concern.
• Document after completing care, not instead of providing care.

Tip 9: Practice NGN Question Types

The NGN introduces several new question formats. Familiarize yourself with each:

• Extended Multiple Response: Select multiple correct answers from a list (like SATA but may involve prioritizing from a larger set)
• Drop-Down: Fill in blanks within a sentence or table with dropdown selections
• Drag-and-Drop Cloze: Drag answers to correct locations in a paragraph
• Matrix/Grid: Check yes/no or condition/action boxes for multiple parameters
• Bow-Tie Questions: Analyze a clinical scenario to identify priority conditions and interventions

Practice these formats specifically — they cannot be mastered by simply knowing content.

Tip 10: Mental Preparation and Exam-Day Strategy

• The NCLEX uses Computer Adaptive Testing (CAT) — questions get harder as you do better. Hard questions are a good sign.
• The exam stops when the computer is 95% confident in your competence level (or you run out of time/questions).
• Don't panic if your exam doesn't stop early — some students pass with 145+ questions.
• Answer every question as if it's the most important one — don't rush near the end.
• Take the built-in optional break — a 10-minute rest can significantly improve performance.
• Trust your nursing education and clinical experience — you know more than you think.