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The NCLEX-RN Client Needs categories explained
The NCLEX-RN test plan, published by NCSBN, organises the exam around the needs of clients. There are four major Client Needs categories, two of which are split into subcategories, giving eight areas in total.
| Category | Subcategory | What it tests |
|---|---|---|
| Safe and Effective Care Environment | Management of Care | Management of Care tests how you run a shift safely: prioritising several clients, assigning and delegating to the right team member, advocacy, informed consent, confidentiality, ethics and escalation. |
| Safe and Effective Care Environment | Safety and Infection Control | Safety and Infection Control covers transmission-based precautions, restraints, fall and fire safety, medication safety systems, sterile technique and error prevention. |
| Health Promotion and Maintenance | Health Promotion and Maintenance | Health Promotion and Maintenance covers growth and development, pregnancy, labor, postpartum and newborn care, screening and immunisation. |
| Psychosocial Integrity | Psychosocial Integrity | Psychosocial Integrity covers mental health conditions, therapeutic communication, crisis and suicide risk, substance use, abuse, grief and coping. |
| Physiological Integrity | Basic Care and Comfort | Basic Care and Comfort covers nutrition and tube feeding, elimination, mobility, skin integrity, rest and non-drug comfort measures. |
| Physiological Integrity | Pharmacological and Parenteral Therapies | Pharmacology is one of the largest parts of the exam. |
| Physiological Integrity | Reduction of Risk Potential | Reduction of Risk Potential covers complications of procedures, surgery and diagnostic tests, lab values and changes in vital signs. |
| Physiological Integrity | Physiological Adaptation | Physiological Adaptation covers acute and life-threatening illness: shock, respiratory failure, neurological emergencies, fluid and electrolyte imbalance and endocrine crises. |
Each area has a set share of the exam in the current NCSBN test plan. Check the test plan on the NCSBN website for the latest percentages, as they are revised periodically.
How to use the categories when you study
- Practise mixed sets first to find your weakest category.
- Spend most of each session on that category until your score catches up.
- Keep reviewing the others so they don't slip.
RecallMed tracks your score in each of the eight areas and lets you practise one category at a time.
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NCLEX® and NCLEX-RN® are registered trademarks of the National Council of State Boards of Nursing, Inc. (NCSBN). RecallMed is independent and is not affiliated with, or endorsed by, NCSBN or any board of nursing. All questions are original, written and reviewed for exam practice, and do not come from any NCLEX exam. They are not a substitute for your nursing education or clinical guidelines.