The NCLEX exam is one of the most important tests a nursing student will take. Passing the NCLEX is required to receive a nursing license and begin working as a registered nurse. Many nursing students use UWorld to study for the NCLEX. But is the NCLEX actually harder than UWorld? Let’s take a closer look.
What is the NCLEX?
NCLEX stands for National Council Licensure Examination. It is a nationwide examination for nurses developed by the National Council of State Boards of Nursing (NCSBN). There are two versions of the exam:
- NCLEX-RN for registered nursing candidates
- NCLEX-PN for practical/vocational nursing candidates
The purpose of the NCLEX is to test the competency of nursing graduates to ensure they are ready to provide safe and effective nursing care. The exam covers topics like:
- Management of care
- Safety and infection control
- Health promotion and maintenance
- Psychosocial integrity
- Basic care and comfort
- Pharmacological therapies
- Reduction of risk potential
- Physiological adaptation
The exam is computer adaptive, meaning the difficulty level changes based on the candidate’s responses. For most candidates, the exam is between 75-265 questions. Candidates have a maximum of 6 hours to complete the exam.
What is UWorld?
UWorld is an online self-assessment website that offers practice questions for various standardized exams, including the NCLEX. It contains over 2,000 NCLEX style questions with detailed explanations for each question. The question bank uses an algorithm to identify strengths and weaknesses and provide customized practice. Key features of UWorld for NCLEX prep include:
- Over 2,000 challenging NCLEX-style practice questions
- Detailed rationales explain both correct and incorrect answers
- Questions are written by nurses and expert nurse educators
- Exam simulator mimics the real NCLEX exam environment
- Self-assessments identify areas for focused review
- Track performance with dashboards and progress graphs
- 24/7 access allows flexible studying online or via mobile
Many nursing students use UWorld as one of their primary study resources when preparing for the NCLEX exam. The practice questions expose students to the style and difficulty of NCLEX questions.
Comparing Question Types
Both the NCLEX exam and UWorld practice questions include a variety of alternate format question types beyond just multiple choice questions. Some of the common question types include:
| Question Type | Description |
|---|---|
| Multiple Choice | Choose one correct answer from several options |
| Multiple Response | Select all answers that apply from a list of options |
| Hot Spot | Click an area on a graphic or image for the correct response |
| Fill in the Blank | Type a short answer to complete a sentence or question |
| Ordered Response | Click and drag options into correct sequence |
| Graphic Options | Select answer options from a graphic representation |
These alternate format questions assess critical thinking abilities and readiness for real-world nursing situations.
Question Difficulty
Both the NCLEX exam and UWorld are considered to be quite difficult in terms of question style, content, and critical thinking required. However, the consensus from nursing students is that the NCLEX is more difficult and challenging than UWorld practice questions. Some key differences in difficulty level include:
- NCLEX questions are written in a vague, confusing way requiring careful analysis.
- NCLEX covers a wide range of nursing concepts, often requiring obscure knowledge.
- NCLEX emphasizes critical thinking and application of nursing judgement.
- NCLEX includes unfamiliar case studies and situations.
- NCLEX uses complex wording and sentence structure.
- NCLEX answer choices are nuanced and subtly different.
In comparison, UWorld questions tend to be more clear, direct, and cover a smaller scope of content and situations. The explanations provide a learning opportunity for students to understand why answers are correct or incorrect. On the actual NCLEX, no explanations are provided.
Analysis of Sample Questions
Looking at some sample questions can help illustrate the difference in difficulty between NCLEX exam questions and UWorld practice questions.
UWorld Sample Question
A nurse is assessing a client who has a new prescription for spironolactone 25mg PO daily. Which of the following findings should the nurse report to the provider before giving the first dose?
A. Blood pressure 132/78 mm Hg
B. Potassium level 3.8 mEq/L
C. Sodium level 141 mEq/L
D. Heart rate 68 bpm
Explanation: Spironolactone can cause hyperkalemia. A potassium level above 5 mEq/L should be reported before starting the medication.
This UWorld question provides relevant context about a client and medication. The question stem clearly identifies what the nurse should assess before giving the first dose. The answer choices list straightforward lab values. The explanation clearly states why a potassium level above 5 mEq/L relates to the safe administration of spironolactone.
NCLEX Sample Question
A 62 year-old client comes to the emergency department complaining of sudden onset chest pain that began 30 minutes ago. The pain is described as pressure located substernally and radiating to the left arm. It is unrelieved by rest. The client rates the pain as 8/10. Which of the following actions ordered for this client requires clarification?
A. Chest x-ray
B. Continuous O2 at 2L/min via nasal cannula
C. ECG
D. Laboratory tests including cardiac enzymes
This NCLEX question provides vague information about a client in an emergency scenario. There are no objectively wrong or right actions listed in the answer choices. The question requires strong clinical judgement to recognize that the described symptoms are indicative of acute myocardial infarction. Clarification would be needed before simply ordering a chest x-ray as unstable angina requires more urgent care.
This comparison shows how NCLEX questions like to camouflage the most important information in ambiguous phrasing. The scenarios are often more complex. UWorld questions tend to be more clear cut in directing you towards the correct answer.
Other Measures of Difficulty
In addition to the subjective experience of test takers, there are a few other measures that suggest the NCLEX is more difficult than UWorld:
- UWorld’s practice exams have an average score around 60%, compared to NCLEX passing standard of around 75%.
- UWorld questions can be retaken to learn while NCLEX questions count the first try.
- The NCLEX uses computer adaptive testing that adapts to candidate’s ability.
- UWorld allows use of reference sheets but NCLEX does not.
Overall, most nursing students find UWorld style questions to be excellent preparation for NCLEX content. But the actual NCLEX seems to be written in a purposefully vague and confusing way that makes critical thinking incredibly important yet difficult.
Strategies for Handling Tough NCLEX Questions
Here are some tips for dissecting and answering difficult NCLEX style questions:
- Read each question stem carefully 2-3 times to identify key facts.
- Pay attention to phrases like “client need,” “priority,” “best,” etc.
- Watch out for negatives like except, not, least.
- Pick out verbatim buzzwords from the question in answer choices.
- Be systematic in eliminating choices based on information given.
- Don’t overthink answers. Avoid imagining information not provided.
- When uncertain, go with your first gut instinct.
- Learn from UWorld rationales to recognize why answers are right or wrong.
Preparing with resources like UWorld helps build critical thinking skills. But the NCLEX often requires making quick decisions with limited information, like real-world nursing.
Conclusion
In conclusion, most nursing students agree that the actual NCLEX exam is more difficult than UWorld practice questions. The NCLEX emphasizes vague, confusing wording that obscures relevant facts. It covers a wider range of content that requires recognizing obscure concepts. The question styles demand strong clinical judgement and critical thinking abilities under pressure. However, practice questions from UWorld are still excellent for building critical thinking skills and familiarity with NCLEX content. Resources like UWorld prepare students for the level of difficulty they can expect on the actual exam. With smart preparation strategies and commitment to intensive studying, nursing students can overcome the challenges posed by the difficult NCLEX.