This document outlines Sherri Ward's presentation on using the NCLEX-RN exam blueprint to guide testing in a baccalaureate nursing program. It discusses how the University of Arkansas College of Nursing established question categories in ExamSoft to mimic the NCLEX client needs categories and percentages. It also explains how the reporting features in ExamSoft can be used to track student strengths and weaknesses. The goal is to supplement existing success strategies and help maintain or increase the program's high NCLEX pass rates.

1. EAC 2018 | Fort Lauderdale | June 27-29
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Using the NCLEX-RN Exam Blueprint as a
Guide for Testing in a Baccalaureate
Nursing Program
Sherri Ward, DNP, RN
Clinical Assistant Professor
University of Arkansas for Medical Sciences, College of Nursing

2. UPON COMPLETION OF THIS PRESENTATION, PARTICIPANTS WILL:
 Understand how to establish categories in ExamSoft
 Use those categories to set-up the exam blueprint
 Mimic licensure exam blueprints
 Use ExamSoft reporting features to track student strengths
and opportunities for improvement

3. UAMS CON
 University of Arkansas for Medical Sciences College of Nursing
 BSN, RN-BSN, MNSc, DNP, PhD programs
 BSN program has around 240 students on Little Rock, AR campus
and a small satellite campus
 Attrition rate is less than 10%

4. UAMS CON
 NCLEX-RN pass rate 95.6% in 2017 (153/160)
 Other success strategies in place
 How can we supplement those and keep our scores where they are
or even higher

5. NEW TESTING SOFTWARE
 Spring 2014 – ExamSoft Demonstration
 Security issues with current learning management system testing platform
 College of Medicine and College of Pharmacy already using ExamSoft
 ExamSoft piqued our interest because:
 Question categories
 Test plan blueprints
 Reporting functions

6. PILOT EXAMSOFT
 UAMS CON baccalaureate council faculty voted to pilot
 One junior course – Peds x3 rotations
 Two senior course – Care and Management of Adults & Critical Care
 Fall 2014, Spring 2015
 Bring outcomes to council and vote in Spring 2015
 Post-presentation to faculty
 Ease of Use
 Features
 Student Feedback
 Comparison to current learning management system testing platform

7. SUBCOMMITTEE
 How do we set-up the ExamSoft database?
 Many exam strategies still under discussion – baby steps
 Nursing faculty are responsible for categorizing their own
questions and building their own exams
 Other colleges have support staff for this

8. EXAM BLUEPRINTS FROM LICENSING BOARDS
 USMLE: Medical Step 1 and 2
 NAPLEX: Pharmacology Area’s 1 and 2
 NCCPA: Physician Assistant Knowledge Areas and Cognitive Skills; Diseases and Disorders by Organ
Systems
 NBDE: Dental Biochemistry/Physiology; Anatomic Sciences; Microbiology/Pathology; Dental Anatomy &
Occlusion
 COMLEX-USA: Osteopathic Medicine
 NCLEX: Nursing Client Needs

9. NCLEX-RN CLIENT NEEDS CATEGORIES
 Four major, two divided into subcategories
 Used the categories with % assigned to them, the others are available in category folder only as a
resource
 Bloom’s taxonomy: majority of items written on NCLEX-RN exam are at the application or higher levels
of cognitive ability
 Creating
 Evaluating
 Analyzing
 Applying
 Understanding
 Remembering

10. Physiological
Adaptation
14%
Management
of Care 20%
Safety and
Infection
Control 12%
Health
Promotion and
Maintenance
9%
Psychosocial
Integrity 9%
Basic Care and
Comfort 9%
Pharmacologic
al and Parental
Therapies 15%
Reduction of
Risk Potential
12%
Distribution of Content for the NCLEX-RN Test
Plan
RETRIEVED FROM
HTTPS://WWW.NCSBN.ORG/2016_RN_DETTESTPLAN_E
DUCATOR.PDF

11. Client Needs Percentage of Items from each Category/Subcategory
Safe and Effective Care Environment
 Management of Care 17-23%
 Safety and Infection Control 9-15%
Health Promotion and Maintenance 6-12%
Psychosocial Integrity 6-12%
Physiological Integrity
 Basic Care and Comfort 6-12%
 Pharmacological and Parenteral Therapies 12-18%
 Reduction of Risk Potential 9-15%
 Physiological Adaptation 11-17%
HTTPS://WWW.NCSBN.ORG/2013_NCLEX_RN_DETAILED_TEST_PLAN_EDUCATOR.PDF

14. MANY CLIENT NEEDS SUBCATEGORIES
 Health Promotion and Maintenance (6-12%)
 Aging Process
 Ante-Intra-Postpartum and Newborn Care
 Data Collection Techniques
 Developmental Stages and Transitions
 Health Promotion-Disease Prevention
 High Risk Behaviors
 Lifestyle Choices
 Self Care
 This is just one category example – too much!!!!

15. INTEGRATION
 The following fundamentals of nursing practice are integrated throughout the
Client Needs categories and subcategories:
 Nursing Process
 Caring
 Communication and Documentation
 Teaching/Learning

16. TEST BLUEPRINT
Category # %
Physiological Adaptation (11-17%) 36 51.00
03 - Application (high) 34 48.00
02 - Comprehension (low) 14 20.00
04 - Analysis (high) 12 17.00
Reduction of Risk Potential (9-15%) 10 14.00
Pharmacological Therapies (12-18%) 8 11.00
Basic Care and Comfort (6-12%) 6 8.00
01 - Knowledge (low) 5 7.00
Health Promotion and Maintenance (6-12%) 2 2.00

18. CATEGORIES
 Which categories are appropriate for each question? If not correctly assigned
we fail to meet our objective
 Most test banks have categories preassigned
 The National Council of State Boards of Nursing provides a Test Development
and Item Writing Course

19. REPORTING FEATURES
 Strengths and Opportunities reports for students
 Per exam
 Longitudinally
 Student comprehension
 Educate on the front end and frequently throughout the program
 Print the first report and review
 Have student bring a copy to one-on-one meeting if falling into high risk
category

22. LONGITUDINAL REPORTS
 Can run report at any time during the program
 Most beneficial during Capstone course as they prepare
for NCLEX-RN exam

24. MOVING FORWARD
 All courses live across two semesters
 Collect data
 Student adoption
 Do the exams mimic the NCLEX-RN blueprint?
 Look at pass rates
 Establish “best practice” guidelines
 Questions?

25. EAC 2018 | Fort Lauderdale | June 27-29