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Frequently Asked Questions About the 2011 NCLEX-P N ® Test P lan

1. What was the basis for making changes in the 2011 NCLEX -P N ® Test P lan?

NCSBN reviews the test plans for both the NCLEX-RN and NCLEX-PN once every three years. The recommended changes to the 2011 NCLEX-PN® Test Plan are based upon empirical data collected from newly licensed nurses, which can be found in the study published by NCSBN entitled Report of

Findings from the 2009 LPN/VN Practice Analysis: Linking the NCLEX-PN® Examination to Practice.

In this study, 6,000 newly licensed nurses were surveyed via a paper survey, with another 6,000 surveyed via the Web. The respondents were asked about the frequency and importance of performing 150 nursing care activities. The data was analyzed and used to determine whether changes were needed in the test plan. The practice analysis provides validity and evidence to support the activities that entry-level nurses are performing and the importance of those activities. Based upon the most recent survey results, as well as expert opinion and feedback from stakeholders, the NCSBN Delegate Assembly adopted the 2011 NCLEX-PN® Test Plan in August 2010.

2. Who provided feedback on the test plan? Recommendations regarding the 2011 NCLEX-PN® Test Plan were sent to boards of nursing, the

NCSBN Board of Directors, the NCLEX Examination Committee, the Practice Analysis Panel of Experts, and NCSBN legal counsel. Feedback to the NCLEX Examination Committee regarding the test plan recommendations was requested. The feedback was reviewed and appropriate changes were made to the test plan. The NCLEX Examination Committee then recommends the test plan changes to NCSBN's governance body, the Delegate Assembly. This process helps to ensure a comprehensive review of the test plan and involvement of groups with a variety of viewpoints. rationales for those decisions? · Based upon empirical data from the practice analysis, expert judgment, and feedback from stakeholders, the "Client Needs" structure was retained as the framework for the 2011 NCLEX-PN® Test Plan. Rationale: The practice analysis data and expert opinion supported retaining this structure.

3. What decisions were made for the 2011 N CLEX -P N ® Test P lan and what are the

In addition, the "Client Needs" structure provides a common framework that is easily understood by candidates and other stakeholders. This structure also facilitates reliable item coding.

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The eight categories/subcategories of the 2008 NCLEX-PN® Test Plan are retained in the

2011 NCLEX-PN® Test Plan.

Rationale: These content areas continue to be easily recognized and are understood by key stakeholders.

1 Copyright © 2010 National Council of State Boards of Nursing, Inc. (NCSBN) All rights reserved. The NCSBN logo, NCLEX®, NCLEXRN® and NCLEX-PN® are registered trademarks of NCSBN.

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Bulleted concepts, specific changes and rationale are as follows: o Staff Education ­ an integrated process throughout the test plan o Disaster Planning ­ changed to Emergency Response Plan as this is more comprehensive o Medical and Surgical Asepsis combined with Standard and Transmission-based Precautions o Disease Prevention ­ combined with Health Promotion as an integral part of this content o Expected Body Image Changes ­ subsumed under Developmental Stages and Transitions o Family Planning and Human Sexuality ­ subsumed under Developmental Stages and Transitions, Lifestyle Choices o Immunizations ­ subsumed under Health Promotion/Disease Prevention o Situational Role Changes, Unexpected Body Image Changes ­ subsumed under Coping Mechanisms o Substance Related Disorders ­ changed to Chemical and Other Dependencies to be more comprehensive o Mental Illness ­ subsumed under Mental Health Concepts o Suicide/Violence Precautions ­ subsumed under crisis intervention o Palliative and Comfort Care - subsumed under Non-Pharmacological Comfort and/or Pharmacological Pain Management o Pharmacological Agents/Actions ­ subsumed under Expected Actions/Outcomes o Adverse Effects ­ combined with Contraindications, Side Effects, and Interactions o Pharmacological Pain Management ­ added for clarification o Changes/Abnormalities ­ added to Vital Signs for clarification o Potential for Complications from Surgical Procedures and Health Alterations ­ listed as a separate bullet point for clarity Rationale: These changes were necessary based upon the NCLEX Examination Committee review and assignment of each of the 2009 Practice Analysis task statements to a category/subcategory of the "Client Needs" structure. Other revisions are necessary for reasons of conceptual clarity, currency and correction of redundancy.

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The following is a comparison of the percentage of items shown for the test plan categories, comparing the new 2011 NCLEX-PN® Test Plan to the 2008 NCLEX-PN® Test Plan. 2011 PN TEST PLAN CATEGORIES Percentage of Items 12-18% 8-14% 7-13% 8-14% 11-17% 9-15% 10-16% 11-17% Client Needs Categories/Subcategories Safe Effective Care Environment Coordinated Care Safety and Infection Control Health Promotion and Maintenance Psychosocial Integrity Physiological Integrity Basic Care and Comfort Pharmacological Therapies Reduction of Risk Potential Physiological Adaptation Percentag e of Items 13-19% 11-17% 7-13% 7-13% 9-15% 11-17% 9-15% 9-15%

2008 PN TEST PLAN CATEGORIES Client Categories/Subcategories Needs

Safe Effective Care Environment Coordinated Care Safety and Infection Control Health Promotion Maintenance Psychosocial Integrity Physiological Integrity Basic Care and Comfort Pharmacological Therapies Reduction of Risk Potential Physiological Adaptation and

2 Copyright © 2010 National Council of State Boards of Nursing, Inc. (NCSBN) All rights reserved. The NCSBN logo, NCLEX®, NCLEXRN® and NCLEX-PN® are registered trademarks of NCSBN.

Rationale: The percentage of items allocated to the test plan categories and subcategories is based on empirical data from the practice analysis study as well as psychometric considerations regarding the minimum number of examination items that are necessary to reliably sample a content category. 4. What are the cognitive levels of the test items on the 2011 NCLEX -P N ® Test P lan ? Since the practice of nursing requires the application of knowledge, skills and abilities, the majority of items on the examination are written at the application or higher levels of cognitive ability using Bloom's taxonomy and revised taxonomy (Bloom, 1956; Anderson and Krathwohl, 2001). These "higher level" items require more complex thought processing and problem solving. For example, a pediatric client undergoing a medical procedure may additionally have a mental illness and therefore all factors must be considered in order to prepare the client for the procedure and to correctly answer the item. 5. What is the percentage of test items that are allocated for nursing practice specialty areas such as Pediatric Nursing? The framework for the test plan is based on "Clients Needs"; therefore, it is not possible to specify the percentage of test items that address a particular nursing specialty such as Pediatric Nursing. Nursing content related to this nursing practice specialty can be found in many areas of the test plan. At first glance, it may seem as though the only test plan category which assesses the Pediatric Nursing competencies is the "Health Promotion and Maintenance" category where age-related activities are specified. However, a more detailed analysis reveals that many test plan areas address the care competencies required for Pediatric Nursing. It should be noted that there are similar analogies for other nursing practice specialties and sub-specialties such as Psychiatric Nursing and Geriatric Nursing. 6. What was the timeline for implementing the test plan? October 2009 November 2009 April 2010 August 2010 April 2011 NCLEX Examination Committee reviews LPN/VN Practice Analysis results and makes recommendations for the test plan Proposed test plan is sent to Member Boards for feedback NCLEX Examination Committee reviews feedback on the test plan and submits recommendations to the Delegate Assembly Delegate Assembly action is provided Implementation of the test plan and passing standard

7. What is the rationale for the timeline for implementation of the test plan? This timeline is needed in order to analyze the data and to ensure adequate time is available for the stakeholders to provide feedback. The NCLEX Examination Committee is committed to stakeholder involvement and listening to feedback. Additionally, NCSBN needs time to communicate any changes about the test plan. So, while there is pressure to implement the test plan as soon as possible, there is an obligation to assure that everyone is informed. 8. Will the proposed 2011 NCLEX -P N ® Test P lan still use the term prescription to indicate medications, treatments, procedures, and interventions prescribed by the primary health care provider? Yes. Almost from its inception, the NCLEX examination has used the term "prescriptions" to indicate what is commonly referred to as "orders." The Detailed NCLEX-PN Test Plan and the current NCLEX Examination Candidate Bulletin also contain information about the NCLEX test plans and terminology used in the examinations.

3 Copyright © 2010 National Council of State Boards of Nursing, Inc. (NCSBN) All rights reserved. The NCSBN logo, NCLEX®, NCLEXRN® and NCLEX-PN® are registered trademarks of NCSBN.

9. What background references may be helpful for individuals interested in the test plans? Anderson, L. W., Krathwohl, D. R. (eds). (2001). A taxonomy for learning, teaching, and assessing. A revision of Bloom's taxonomy of educational objectives. New York: Addison Wesley Longman, Inc. Bloom, B. S., Engelhart, M. D., Furst, E. J., Hill, W. H., & Krathwohl, D. R. (1956). Taxonomy of educational objectives: The classification of educational goals. Handbook I. Cognitive Domain. New

York: David McKay.

National Council of State Boards of Nursing. (2010). Report of findings from the 2009 LPN/VN practice analysis: linking the NCLEX-PN® examination to practice. Chicago: Author. If you have questions about the NCLEX-RN® Test Plan, contact the Examinations Department (toll-free) at: 866.293.9600 or by e-mail: [email protected]

4 Copyright © 2010 National Council of State Boards of Nursing, Inc. (NCSBN) All rights reserved. The NCSBN logo, NCLEX®, NCLEXRN® and NCLEX-PN® are registered trademarks of NCSBN.

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