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Exam Number : NCLEX-PN
Exam Name : National Council Licensure Exam(NCLEX-PN) 2023
Vendor Name : NCLEX
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NCLEX-PN Exam Format | NCLEX-PN Course Contents | NCLEX-PN Course Outline | NCLEX-PN Exam Syllabus | NCLEX-PN Exam Objectives


The test plan is reviewed and approved by the NCLEX®

Exam Committee (NEC) every three years.

Multiple resources are used, including the recent practice analysis of licensed practical/vocational nurses
(LPN/VNs), and expert opinions of the NEC, NCSBN staff and nursing regulatory bodies (NRBs) to ensure that
the test plan is consistent with nurse practice acts. Following the endorsement of proposed revisions by
the NEC, the test plan document is presented for approval to the Delegate Assembly, which is the decisionmaking body of NCSBN.
The test plan serves a variety of purposes. It is used to guide candidates preparing for the examination, to
direct item writers in the development of items, and to facilitate the classification of examination items. This
document offers a comprehensive listing of content for each client needs category and subcategory outlined
in the test plan. Sample items are provided at the end of each category, which are specific to the client needs
category in that section. There is an item writing guide along with sample case scenarios, which provide
nurse educators with hands-on experience in writing NCLEX-style test items.



Entry into the practice of nursing is regulated by the licensing authorities within each of the NCSBN nursing
regulatory bodies (state, commonwealth and territorial boards of nursing). To ensure public protection, each
jurisdiction requires candidates for licensure to meet set requirements that include passing an examination
that measures the competencies needed to perform safely and effectively as a licensed practical/vocational
nurse (LPN/VN). NCSBN develops a licensure examination, the National Council Licensure Exam for
Practical Nurses (NCLEX-PN®), which is used by U.S. members to assist in making licensure decisions.

Several steps occur in the development of the NCLEX-PN Test Plan. The first step is conducting a practice
analysis that is used to collect data on the current practice of entry-level LPN/VNs (Report of Findings from
the 2018 LPN/VN Practice Analysis: Linking the NCLEX-PN® Exam to Practice, NCSBN, 2019). Twelve
thousand newly licensed practical/vocational nurses are asked about the frequency and priority of performing nursing care activities. Nursing care activities are then analyzed in relation to the frequency of performance, impact on maintaining client safety and client care settings where the activities are performed. This
analysis guides the development of a framework for entry-level nursing practice that incorporates specific
client needs, as well as processes that are fundamental to the practice of nursing. The next step is the
development of the NCLEX-PN Test Plan, which guides the selection of content and behaviors to be tested.
Variations in jurisdiction laws and regulations are considered in the development of the test plan.
The NCLEX-PN Test Plan provides a concise summary of the content and scope of the licensure examination.
It serves as a guide for examination development as well as candidate preparation. The NCLEX® assesses the knowledge, skills and abilities that are essential for the entry-level LPN/VN to use in order to meet the needs
of clients requiring the promotion, maintenance and restoration of health. The following sections describe
beliefs about people and nursing that are integral to the examination, cognitive abilities that will be tested in
the examination and specific components of the NCLEX-PN Test Plan.



Client Needs

Percentage of Items from Each

Category/Subcategory

Safe and Effective Care Environment

„ Coordinated Care 18–24%

„ Safety and Infection Control 10–16%

Health Promotion and Maintenance 6–12%

Psychosocial Integrity 9–15%

Physiological Integrity

„ Basic Care and Comfort 7–13%

„ Pharmacological Therapies 10–16%

„ Reduction of Risk Potential 9–15%

„ Physiological Adaptation 7–13%



The activity statements used in the 2018 LPN/VN Practice Analysis: Linking the NCLEX-PN®
Exam to
Practice (NCSBN, 2019) 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 entry-level 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 LPN/VN 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 practical/vocational nurses
in order to provide safe and effective care. Findings from both the 2018 LPN/VN Practice Analysis: Linking
the NCLEX-PN®
Exam to Practice (NCSBN, 2019) and the 2018 LPN/VN Nursing Knowledge Survey
(NCSBN, 2019) can be found at www.ncsbn.org/1235.htm. Both documents are used in the development of
the NCLEX-PN Test Plan as well as to inform item development.
All task statements in the 2020 NCLEX-PN®
Test Plan require the nurse to apply the fundamental principles
of clinical decision making and critical thinking to nursing practice. The test plan also makes the assumption
that the nurse integrates concepts from the following bodies of knowledge:

„ Social Sciences (psychology and sociology); and

„ Biological Sciences (anatomy, physiology, biology and microbiology) Collaboration with Interdisciplinary Team

„ Identify roles/responsibilities of health care team members

„ Identify need for nursing or interdisciplinary client care conference

„ Contribute to the development of and/or update the client plan of care

„ Contribute to planning interdisciplinary client care conferences

„ Participate as a member of an interdisciplinary team Concepts of Management and Supervision

„ Recognize and report staff conflict

„ Verify abilities of staff members to perform assigned tasks (e.g., job description, scope of practice, training, experience)

„ Provide input for performance evaluation of other staff

„ Participate in staff education (e.g., inservices, continued competency)

„ Use data from various credible sources in making clinical decisions

„ Serve as resource person to other staff

„ Monitor activities of assistive personnel

Confidentiality/Information Security

„ Identify staff actions that impact client confidentiality and intervene as needed (e.g., access to medical records, discussions at nurses station, change-of-shift reports)

„ Recognize staff member and client understanding of confidentiality requirements

„ Apply knowledge of facility regulations when accessing client records

„ Maintain client confidentiality*

„ Provide for privacy needs Continuity of Care

„ Follow up with client after discharge*

„ Participate in client discharge or transfer*

„ Provide follow-up for unresolved client care issues

„ Provide and receive report*

„ Record client information (e.g., medical record, referral/transfer form)

„ Use agency guidelines to guide client care (e.g., clinical pathways, care maps, care plans)

Establishing Priorities

„ Organize and prioritize care based on client needs*

„ Participate in planning client care based upon client needs (e.g., diagnosis, abilities, prescribed treatment)

„ Use effective time management skills

Ethical Practice

„ Identify ethical issues affecting staff or client

„ Inform client of ethical issues affecting client care

„ Intervene to promote ethical practice

„ Practice in a manner consistent with code of ethics for nurses*

„ Review client and staff member knowledge of ethical issues affecting client care Informed Consent

„ Identify appropriate person to provide informed consent for client (e.g., client, parent, legal guardian)

„ Participate in client consent process*

„ Describe informed consent requirements (e.g., purpose for procedure, risks of procedure)

„ Recognize that informed consent was obtained (e.g., completed consent form, client understanding of procedure)

Information Technology

„ Use information technology in client care*

„ Access data for client or staff through online databases and journals

„ Enter computer documentation accurately, completely and in a timely manner

Legal Responsibilities

„ Identify legal issues affecting staff and client (e.g., refusing treatment)

„ Verify and process health care provider orders*

„ Recognize self-limitations of task/assignments and seek assistance when needed*

„ Respond to the unsafe practice of a health care provider (e.g., intervene, report)*

„ Follow regulation/policy for reporting specific issues (e.g., abuse, neglect, gunshot wound,
communicable disease)*

„ Document client care

„ Provide care within the legal scope of practice*

Performance Improvement (Quality Improvement)

„ Identify impact of performance improvement/quality improvement activities on client care
outcomes

„ Participate in quality improvement (QI) activity (e.g., collecting data, serving on QI committee)*

„ Document performance improvement/quality improvement activities

„ Report identified performance improvement/quality improvement concerns to appropriate

personnel (e.g., nurse manager, risk manager)

„ Apply evidence-based practice when providing care*



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NCLEX Council PDF Questions

 

How To Ask More Powerful Questions

“I got this.”

This was my go-to line when I knew what I was doing and wanted to get my boss off my back. What I couldn’t see was how it highlighted a major mistake. I wasn’t evaluating the situation, I wasn’t asking questions. I assumed I knew all the answers, and I was usually wrong.

I didn’t realize the error in my ways until a major client rollout flopped and I had no one to blame but myself — my own stubborn belief that “I got this,” even though I clearly didn’t.

In a debrief with my boss, he said, “Aaron, when you say 'I got this' and have no concerns about a situation, that is when I get concerned.”

What he meant was that as soon as I stop asking compelling questions, I assume I know what’s going to work and stop evaluating potential outcomes and solutions. It’s a tendency we all have when we want to take the quick route. It’s what holds us back from being powerful leaders.

Why is asking powerful questions an essential leadership habit?

It provides leaders with a means to mitigate their confirmation biases and dive deep into the evaluation of a situation, a person or their team as a whole.

I had biases for how the rollout was going to play out. I’d done this before; I knew what was going to happen, so why should I look further into it? I wish I could say this was unique to me, but we all do this. Our brains are wired to jump to outcomes, to look for shortcuts.

Not sure if this relates to you? Watch this quick video to test yourself.

Daniel Kahneman, Nobel Prize-winning behavioral economist who was the first to highlight these biases, states, “Confirmation bias comes from when you have an interpretation, and you adopt it, and then, top down, you force everything to fit that interpretation.”

This bias can be disastrous for leaders; it can hinder their decision making ability and blindside them completely. Asking powerful questions is our way around it. It can help us avoid this common miscalculation.

What does a powerful question look like?

I’m going to share a definition of and the criteria for a powerful question, but I also want to be clear there is no script for asking a powerful question. Powerful questions evoke clarity, create greater possibility, reveal new learning and generate action. Here are a few ways to determine if a question is powerful or not.

A powerful question …

• Is open-ended: Ask what, when or how instead of asking a yes or no question.

• Comes from a beginner’s mindset: Start by telling yourself, “I don’t know the answer.”

• Is clear and succinct: Keep it simple, don’t use too many words.

• Is impactful: It’s important to remember that not every question in a conversation should be powerful. In a 30-minute conversation, aim for 2-3 powerful questions.

• Happens in the moment: Here is probably the most crucial point to remember about powerful questioning. You can’t plan it! Formulaic questions outlined before the conversation won’t work. You have to be in the moment.

There is no script for asking powerful questions. There is, however, an often-overlooked trait that will set you up to ask powerful questions in any situation.

What’s the trait?

Curiosity. Want to discover a master of curiosity? Find any 3-year old and watch them for an hour. They ask what, why and how to nearly everything they see in the world around them. They want to know more and do not limit themselves to the societal expectations of what’s right or wrong. They just ask.

As we get older, we are trained to lose our curiosity when it becomes clear it’s not acceptable to ask all the questions that come to mind. Instead, we go about our days having surface-level conversations, rarely digging more in-depth with a co-worker, client or even a friend.

The secret to asking more powerful questions is digging deeper. It’s triggering our 3-year old selves and reconnecting with our curiosity.

I found it hard to come up with a way to share this concept with you. I realized it’s so hard to explain because, as adults, there are very few situations where we are curious. Then I remembered riddles. They are a great way to bring the curiosity right back. Try this one out.

“What has a head, a tail, is brown and has no legs?”

As you are reading this, trying to figure out the answer, your mind is swirling with questions and possibilities.

What kind of animal has no legs?

Is it an animal?

What else could it be?

What sorts of things have tails?

The series of questions running through your head is your curiosity showing up. It’s the little kid inside of you wanting to understand, to know. Curiosity is the genuine desire to learn more -- to explore.

To be able to evaluate people, teams or situations with greater fidelity, go back to the curious part of you that wants to explore. Instead of restricting yourself, open yourself up and allow your mind to ask any question.

Allow yourself to ask the powerful questions. You already have them in you.

Sometimes it may take priming yourself with a riddle to get you there.

“What has a head, a tail, is brown and has no legs?”

A penny.


A Look Ahead: Five Questions for Durham’s New City Council

December 4 marked the end of a tumultuous era for Durham City Council. 

Elaine O’Neal, who served just a single two-year term, officially retired as mayor of Durham. Her council colleagues Jillian Johnson and Monique Holsey-Hyman also had their last evening on the dais. Each of them gave final remarks before walking out of city hall to raucous applause and back into life as private citizens. Moments later, hundreds of people watched as mayor-elect Leonardo Williams and three of his future city council colleagues—Nate Baker, Javiera Caballero, and Carl Rist—were sworn into public office, ushering in the next chapter in Durham politics.

“We are officially writing our new story together because we are greater together,” Williams said during opening remarks after taking the city’s top seat.

]]>

The winning slate of candidates shared overlapping endorsements, including from the INDY, but their policy priorities are considerably varied, says former council member Johnson.

“Endorsements play an important role in cutting through some of the noise,” Johnson says. “What was tricky about this election was that two of the major endorsement processes, both the INDY and the Durham Committee [on the Affairs of Black People], endorsed people with highly opposing political ideologies.”

Williams ran on a platform of “peacemaking” and pragmatic governance. As one of the four council members who often votes yes on new development projects, he is seen as more friendly to the industry by his constituents. Williams is also a restaurant owner along with his wife, Zweli, giving him unique insight into the business community in Durham.

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Baker is now the youngest member of the city council, at the age of 35. He was able to unify a large coalition of voters around a platform focused on labor rights, affordable housing, and environmental justice. Progressive organizations like the Triangle Democratic Socialists of America and the Sunrise Movement rewarded Baker with their endorsements, but he says the major political institutions like the People’s Alliance and the Durham Committee still wield outsized influence during elections.

“PACs are still really important endorsements in this city,” Baker says. “Whether you like that or not, this election showed that those endorsements hold true in their value.”

The new-look city council may have different groups of supporters, and varying political ideologies, but they will have to find common ground to address key issues that will impact the city in this upcoming term. Here are five questions for the council as we look ahead to 2024.

Will the city council raise taxes during the next budget cycle?

Salary raises for city employees including firefighters and sanitation workers became a hot-button issue during campaign season, pitting council members who voted to pass the 2023-24 fiscal budget back in June against others who wanted more money allocated to employee pay. City workers did receive onetime bonuses in October but are still holding out for permanent raises in nextyear’s budget.

Other city departments have echoed the need for more resources. Sean Egan, the director of the City of Durham’s transportation department, told the INDY in October that “funding has not kept up with the level of need from the city’s public works department.” Public works is in charge of implementing infrastructure improvements such as sidewalks and bike lanes, features that community members have been clamoring for.

]]>

Meeting these needs requires the city council to raise more revenue. Rist says the jury is still out on whether a property tax increase is necessary to meet demand.

“There’s critical needs coming up,” Rist says. “The [planned city employee] pay study is one. We already have things on the books like the fare-free buses. But I don’t know if we can assume we need a tax increase.”

North Carolina state statute prohibits flexible property tax rates. So whether you just bought a new million-dollar McMansion or have lived in your modest home for years, you pay the same rate in Durham: roughly 55¢ per $100 of assessed value. Raising taxes would be a hard sell to a community already struggling with affordability. To mitigate the burden on lower-income households, the city offers property tax assistance, a program Rist says he’s proud to have worked on.

“By creating the property tax assistance, we actually have a safety belt,” Rist says. “So we can raise taxes without harming lower-income folks the worst.”

How will the city council address development and housing?

The battle over housing has made some council members the targets of ire from residents who have repeatedly aired their grievances at council meetings. Folks who live in the outskirts of Durham are concerned that large housing developments are causing irreparable damage to the environment by clear-cutting trees and allowing sediment to run off into some of the area’s main water sources. Urban residents worry about ongoing gentrification and rising housing costs across Durham neighborhoods.

No one seems satisfied with the current state of housing, and the city council has limited options to fix the problems.

“There’s literally nothing that we can do to mitigate the burden,” Johnson says. “Building is going to happen. What we can do is change what kind of building happens.”

City council took steps this fall toward bolstering the tools it has to solve these issues. The council passed a new Comprehensive Plan in October, which includes the Urban Growth Boundary, a marker that signals to residents and developers where the city plans to limit future projects in an effort to protect the environment and create more incentives for building density in the urban core.

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But the Comprehensive Plan is not a legally binding document. It’s a framework through which the city says it intends to approach growth based on feedback from residents. To enforce its vision, the city will have to revise its Unified Development Ordinance (UDO), the rules for building in Durham.

“There was a lot of conversation on the campaign trail about development. The truth is, our UDO allows it,” Rist says. “So, if we really don’t want certain types of development, we need to change it altogether to not allow it.”

After months of meetings, op-eds, and task forces, the city council voted in November to adopt a number of changes to the UDO proposed in SCAD (Simplifying Codes for Affordable Development), a series of privately initiated text amendments. The reforms that council chose to approve, such as eliminating parking mandates, had wide consensus. Other proposals were sent back to the city planning department for further review as it prepares for a full examination and rewrite of the entire UDO, which is already under way.

Durham is not alone in facing these housing and development challenges. Cities across the United States are struggling to meet housing demand. Rist points to places like Minneapolis, which recently eliminated single-family zoning in an attempt to increase housing stock, as a model for Durham. He says we should learn from other communities whenever possible instead of trying to reinvent the wheel.

“Durham is special but not that different,” Rist says. “Every community is wrestling with these same issues.”

How will the city council address public safety?

In 2021, Durham voted overwhelmingly to elect former judge Elaine O’Neal as its next mayor largely on the belief that she was the right person to address the issues of crime and public safety. During her tenure, city staff introduced the HEART (Holistic Empathetic Assistance Response Teams) program, a new unit within community safety that supports residents dealing with nonviolent quality-of-life issues. The city council also included a Vision Zero coordinator in this year’s budget, aimed at reducing traffic violence.

Unfortunately, public safety remains a serious concern, particularly in Durham’s most vulnerable communities, where young people are repeatedly the victims of gun violence. The city council needs to continue exploring proactive alternatives to direct police enforcement that help them limit pathways to crime before they become the last resort. One method is to connect residents to education resources and meaningful employment opportunities.

Rist has spent much of his career educating residents on the importance of financial literacy and working with community organizations to support working-class families through programs like the Durham Living Wage Project. He says Durham has some of the best jobs in growing, dynamic sectors such as life sciences and that all residents should have access to Durham’s economy to discourage folks from turning to crime to meet basic needs.

“We need job training to make sure kids in Durham schools, no matter what high school you go to or zip code you grew up in, are connected with opportunities to actually get training beyond high school,” Rist says. “Whether it’s a two-year degree at a community college or a certificate, we need to help students develop skills beyond high school education to be able to compete for these good jobs that are here.”

Youth opportunities have been a consistent call to action from Williams. He is a vocal advocate for mentorship programs and recreational activities, especially for young Black men. Those opportunities took a hit during the COVID-19 lockdown when gathering in person was dangerous. Time spent at home on screens went up, and so did teen mental health challenges.

On the campaign trail, Baker says a recurring issue for residents is reinvesting in Durham’s parks and recreational activities, and providing outdoor and community spaces is another way to reduce crime.

“It’s a unifying topic that cities are particularly well positioned to be great at,” Baker says.

The city plans to make significant improvements to park facilities in 2024, highlighted by the redevelopment of Wheels Fun Park, which the city bought two years ago. Accessible, equitable recreation is emphasized throughout Durham’s new Comprehensive Plan as part of the vision for “complete” neighborhoods, a design approach that brings essential amenities like health care, schools, and parks within close proximity to residents regardless of where they live. Baker says he plans to make youth recreation a priority.

“We need to make sure that young people never have a moment where they don’t have any options for things to do,” Baker says. “They need real, legitimate choices for fun and stimulating activities that are close to where they live all year long. We can make sure that’s a goal.”

Will the new council members get along?

The last year for Durham City Council left more than a few scars. 

“The road to where we are tonight was not easy at all,” Williams said at the December 4 council meeting. “It was physically taxing, psychologically taxing, emotionally taxing, and yet, here we are.”

During a campaign speech back in November, Williams told the crowd that his car windows had been smashed multiple times, a problem he attributed to the escalating rhetoric and personalized verbal attacks that became customary during city council meetings andcandidate forums.

An alleged physical altercation back in March put council members DeDreana Freeman and Mark-Anthony Middleton at odds on more than just policy. When Williams made a motion to retain Middleton as his mayor pro tem earlier this month, Freeman was the sole dissenting vote.

Baker, one of two newcomers, believes introducing a handful of new members could be a fresh start and an opportunity to rebuild trust among his colleagues.

“I’m willing to sit down at the table with every single one of the council members,” Baker says. “My hope is that we can find common ground and work in good faith. I’m going to remain optimistic until proven otherwise.”

How will city council fill the vacant Ward 3 seat?

The six current city council members still have to fill the Ward 3 seat that Williams left vacant. Policy expertise will be important for candidates interested in the position, but temperament and the ability to work with a team, Johnson says, are characteristics she thinks the council will give serious attention to when voting.

“There’s not really any sort of ideological majority on the council anymore. It’s more about attitudes toward governance than politics,” Johnson says. “I feel like someone who’s got a collaborative approach and a strong work ethic who wants the government to function regardless of their ideology is going to be attractive to the majority of the council members.”

The rules set forth by the City of Durham’s charter gives the council 60 days from the time the seat was officially vacated, December 4, to vote on a replacement. If the council cannot come to an agreement within that time frame, the city will hold a special election on March 5, and Durham voters will decide who fills the final council seat.

Possible candidates include Shelia Ann Huggins, who ran for city council in 2017 and 2023. Huggins finished fifth in this year’s primary and suspended her campaign soon after, though she said at the time that she would be interested in applying for the Ward 3 seat should Williams become mayor.

Applications for the position are open until December 21. Candidates are verified by the city clerk’s office to ensure their eligibility before having to complete a questionnaire and in-person interview with the other six city council members. The council plans to vote on the position at the January 16 council meeting.

Follow Reporter Justin Laidlaw on Twitter or send an email to jlaidlaw@indyweek.com. Comment on this story at backtalk@indyweek.com. 

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Michigan growth council leaves questions about what's next

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