What to do if you fail the NCLEX and have to take it again?
Should students give up after failing the NCLEX the first time?
Plan for Students Who Failed the NCLEX
It doesn’t happen often, but as a nursing instructor I am sometimes confronted with the phone call from a nervous student who says, “I failed the NCLEX. What should I do?” Fortunately, there are a series of steps that a student who has failed the NCLEX can take in order to improve their performance on a future, subsequent exam.
Examine the Score Sheet Sent to You by the NCLEX
If a candidate passed the NCLEX, they simply get a piece of paper saying they passed. If the candidate failed, they get an application to reapply for the exam, but also get a score report that breaks the exam down by what areas the student performed above the standard on, met the standard on, and below the standard on. For example, a student might pass most other areas, but fall below the standard on pharmacological interventions, or on psychosocial problems. As frustrating as failing can be, you at least have the luxury of knowing in what areas you did well or poor on, which passing candidates do not get.
Examine your weaknesses
In conjunction with examining the score report (mentioned above), a student who failed the NCLEX should take a diagnostic test. Any of the major testing books have questions at the back of their books or a CD-ROM disk that contains practice questions. Most often, these are broken down by subject or content area. The student should take a few hundred questions from different areas and see how well they do on those subjects. If you are not getting at least 60-65% of those questions correct (questions you have never seen before), then you need to do more practice questions and reading in those areas.
Examine your strengths
If you scored well in a given area, or you are scoring above 70-75% on questions in a given area, you are pretty solid on that area, but you should not completely ignore it. Many students who fail and repeat the exam make the mistake of ignoring areas they were strong on during the first exam. Do practice questions daily or at least weekly in the areas you are weak in. This will buttress (reinforce) concepts that you need to remember. You can’t afford to forget certain concepts.
Every learner is different, but I have found that personally (on my own board exams for LVN/LPN and RN) and among my students that doing practice questions is one of the most important things for studying for the NCLEX, especially for repeat takers. It is great to read the basic textbook of nursing, but doing practice questions is the best way to focus on and reinforce key concepts that are most likely to be tested. Though quantity is important (I advise doing about 3,000-5,000 questions), quality is much more important. One trick that I used and have my students use is to answer the questions and then write short rationales about why the correct answer choice was right, and even why the incorrect answer choices were wrong. Understanding why the incorrect answer choices were wrong can sometimes be more important than understanding why the correct answer was right.
Physical, Mental, and Emotional Health
One of the reasons many otherwise intelligent and knowledgeable candidates fail the NCLEX is because of nerves. They simply become too anxious. There are a few ways to deal with anxiety. The first is to exercise. Exercise is great at relieving stress, but don’t overdo it. Checking with your physician is recommended before starting any exercise program. Another thing nursing students can do to reduce anxiety is to use deep-breathing or progressive relaxation techniques (we learn about many of these types of techniques in nursing school). Some students have anxiety that gets so bad that they need anti-anxiety medication. There is nothing wrong with this, as long as the medications are not abused, used when driving or operating machinery, and ordered and supervised by a licensed medical provider such as an M.D., D.O., or an NP. Some nurses actually turn to hypnosis, which is an expensive yet often effective therapy which can help students relax during studying and the actual test.
Perhaps one of the most important things to do is remain positive. Many intelligent people fail the NCLEX every day. If you let one failure define you, it will defeat you. Don’t be defined by your failures. Think positive and think about passing in your mind. If you can convince yourself that you are a winner and if you can visualize in your mind that you will pass the NCLEX and become a nurse, then you will become a nurse.