This policy applies to the core prelicensure nursing courses – N305, N306, N307, N311, N314, N315, N401, N402, and N406 only. Adherence to these guidelines are not required in other prelicensure nursing courses.
Exam items will be derived from the course Learning Outcomes which support overall BSN Program Outcomes and Nursing Competencies. Each semester is designed to expand upon the knowledge gained in the previous semesters; therefore, questions may reflect outcomes and expectations from previous courses within the Nursing Program and pre-requisite courses, such as Anatomy and Physiology.
Course Exams administered in nursing courses will maximally account for 80% of the total course points. Weighting of exams and other assignments is established in the criteria for grade determination found in each course syllabus. Students must achieve an overall course exam straight (not weighted) average of 75% or higher to pass the course. Grades from other assignments will then be calculated to obtain overall course grade. All nursing course examinations should be given in a manner and style consistent with the 2023 NCLEX-RN Test Plan (available at NCSBN.org) and consists of a minimum of 90% NCLEX-RN style questions. Exam items will follow NCLEX-RN item writing guidelines, including, but not limited to:
• Use of “client” instead of “patient”
• Use of neutral, universal language, avoiding bias language, colloquialisms, and stereotypes
• Client age and/or gender should be provided as needed when relevant to the question
• Proper grammar and spelling
• Abbreviations should be spelled out
• Positive wording (no EXCEPT or NOT questions) should be used
• Key words will be bolded, for instance: most, priority, first
A blueprint should be constructed and used to develop the examination. At minimum, the blueprint will include:
1. Concepts/chapters covered on the exam
2. Number of exam items pertaining to each concept/chapter
3. Exam items should be mapped to the following:
a. course learning objectives
b. NCLEX-RN Client Needs categories
c. Bloom’s taxonomy level
d. QSEN competencies
Additional information may be added to the blueprint at the discretion of the course instructor. Blueprint items 1 and 2 above will serve as a study guide for the students.
Faculty should use the blueprinting capabilities of the computerized examination software to create the exam (when unavailable faculty may create their own). In applicable nursing courses, such as core nursing courses, faculty should adhere to the NCLEX-RN Client Needs category distribution percentages defined in the 2023 NCLEX-RN Test Plan as follows:
Client Needs – Percentages
Management of Care 15-21%
Safety and Infection Control 10-16%
Health Promotion and Maintenance 6-12%
Psychosocial Integrity 6-12%
Basic Care and Comfort 6-12%
Pharmacological and Parenteral Therapies 13-19%
Reduction of Risk Potential 9-15%
Physiological Adaptation 11-17%
The percentage of item types for each examination should align with the following guidelines:
Cognitive Operational Levels
Junior I Junior II Senior I Senior II
Bloom’s Taxonomy Knowledge 10% 5% 0 0
Comprehension 30% 15% 10% 0
Application 50% 60% 70% 80%
Analysis or higher 10% 20% 20% 20%
Dosage Calculation* 0 10% 10% 10%
The majority of the exam should consist of multiple-choice items written in compliance with the current NCLEX-RN test plan.
Number of alternate item types per exam
Alternate formats – Faculty are encouraged to expose students to item types in class prior to use in an assessment
Junior I Junior II Senior I Senior II
Select all that apply (multiple response, drag and drop, ordered response) 5 5 10 10
Other (fill-in, matching, bowtie, matrix, hot spot etc.) 5 5 10 10
Next Gen Case study with 3 questions per case 2 3 4 5
*N305 – Dosage Calculation examination: A twenty item dosage calculation examination will be conducted during N305. Students must achieve 100% on this examination to pass the course. Students who are unsuccessful on the first attempt must meet with the NCLEX-RN Success Coach for training/remediation and may be referred to open lab for hands-on dosage calculations practice as appropriate. Students will then be provided a second attempt to pass this exam. This process will be repeated up to a maximum of four total attempts. Students must pass the dosage calculation exam demonstrating safety within the Junior I semester or repeat N305.
All core nursing curriculum courses will include a minimum of three course exams – two content specific examinations and a comprehensive final examination. At least one course exam must be administered with grades released to students prior to midterms.
Core nursing courses are defined as follows:
N305, N306, N307, N311, N314, N315, N401, N402, and N406
Each core nursing course exam shall consist of a minimum of 50 items. The final comprehensive examination will consist of a minimum of 75 items. The final examination may include a maximum of ten (10) items total from previous exams deemed relevant to the essential course content.
The minimum amount of time to complete a nursing examination in any course shall be 1.5 minutes per test item. Faculty should be aware this may require requesting extra time for final examinations.
Within a reasonable time-frame — recommended two weeks but at least seven  days prior to scheduled assessment — faculty will provide the students with the following information:
Exam delivery method
Number of items on the exam
Points per exam and percentage to overall course grade
Type of items (example: multiple choice, bowtie, fill-in-the-blank, select all that apply, case study, etc.).
Date and time of exam — time allotted to take the exam – begin and end times
Examination Delivery Method
All exams in core nursing courses must be administered on the computerized examination platform adopted by the PLU SoN. Use of computerized exams are recommended for all nursing courses. In the event of software or equipment failure, alternative delivery methods may be used but should be the exception not the norm.
Students are responsible for ensuring their personal devices are equipped to access exams prior to exam start time. Faculty are encouraged, but not required, to provide a simple quiz for students to use to test their devices at the beginning of the course.
Computerized Examination Software Settings
Randomizing exam items, answers, and distractors is required with the exception of items containing unfolding case study scenarios with sequencing of questions related to the item stem.
In the Senior I and Senior II semesters exam items should be presented to the student one at a time without the ability to navigate to the previous items (backtracking). The rationale for this setting is to prepare students for the NCLEX-RN examination.
All exams will have a clearly defined time limit (minimum of 1.5 minutes per item). Additional time should not be allowed. No answers provided after the time limit has expired will be considered in grading of the exam.
Grade Release and Review
Exam results will be returned to students no later than one week after the last student takes the exam. Examination grades compiled in software systems other than the PLU SoN Learning Management Systems (LMS; Sakai and Canvas) will be imported into the LMS in order for students to determine their overall course grade throughout the course. The specific objective to be attained by the student and the method of calculating the final course grade must be written in each course syllabus. Students are responsible for reading each course syllabus to apprise themselves of the particular objectives and grading system for each course.
While the overall course grade may consist of exam points combined with other course assignment points and/or extra credit points, the average of the designated course exam scores must be at least 75% before other scores are added to determine the final grade for the course. This 75% average will be calculated by averaging the scores for all course exams. Failure to obtain a 75% average for course exams will result in course failure regardless of the number of points earned for other course activities. Students who score less than 75% on a course exam, or who have an overall course average less than 75%, should be referred to the NCLEX-RN Success Coach and their advisor should be notified of the student’s status in the course.
All exam reviews must be in-person and proctored to ensure security of exam items.
The type of exam review is at the instructor’s discretion and may include as a group in class, in small subgroups, or individually. Students are not allowed to make notes or access electronic devices (phones, tablets, etc.) during the exam review to prevent threats to exam item integrity.
Exam Administration and Exam Security
Additional student items are not allowed in the testing room unless approved by the instructor. Any items brought into the testing area should be placed in the designated area away from the student’s computer.
• Head coverings (hats/hoodies/scarves) are not allowed in the testing area, with the exception of religious head coverings.
• Students may provide their own ear plugs which must be approved by the proctor prior to the beginning of the exam.
• All documents or items brought into the testing area must be pre-approved by faculty prior to the day of the exam.
• All non-approved items, such as cell phones, smartwatches, and all other electronic devices may not be used during the test and must be turned off and stored in the designated area.
• Written, electronic, or any other materials are not allowed to be used during the exam unless specified by the instructor.
• If a scratch paper is needed for the exam, it will be provided by the faculty and the student must clearly write their name on each sheet. All scratch papers MUST be turned into faculty when the exam is completed prior to the student leaving the testing room.
• Verification of submission of tests conducted in-person using electronic software is required prior to the student leaving the classroom.
• If the test is not administered electronically, test packets and answer sheets MUST have student name and ID clearly written on the first page, be turned in to the instructor at the end of the test period, and be accounted for prior to students leaving.
• Calculators, if necessary, must be provided within exam software or by proctor.
• All borrowed laptops and/or calculators must be returned to the instructor and accounted for prior to student dismissal.
• No exam assistance (answering questions or clarifying test questions or answers) by the instructor and/or proctor is allowed.
• Computer and technical assistance are allowed for computerized exams. Students are responsible for ensuring electronic devices (laptops, tablets, etc.) are fully charged and in good working order prior to the exam. Students should complete the mock test to verify that the software is properly installed prior to the class exam. The time allotted to complete the exam will not be adjusted.
• Scheduled tests and pre-announced quizzes must be taken on the scheduled date, at the scheduled time. A student may take any exam or test one time only. It is the responsibility of the student to be prepared for all testing. Please see the excused absence and make-up procedures below.
• Public communication about test questions is a violation of the Academic Code of Conduct and the rules governing this violation will be upheld. This includes discussion in public venues or on social media. In the event that a student who has taken the exam discusses the exam with a student who has not taken the exam, both parties will be found to be in violation of the Academic Honesty Policy and the rules governing this violation will be upheld.
• Grades will be entered and calculated based upon the formatting of the LMS. The nursing program does NOT round grades.
• The student will be required to come to campus for all exams.
• Most quizzes and exams will require the use of online testing software. While using testing software, students are unable to print, copy, go to another URL, or access other applications. Once an exam has been started, it must be finished in the same session.
• Students are expected to adhere to the academic standards and policies set forth in the Student Handbook.
• All exams are to be proctored.
• In the event of an unexpected situation that is beyond the student’s control (serious illness, accident, death of an immediate family member, etc.), the student must notify faculty using the preferred method of contact as specified on the course syllabus prior to the beginning of the scheduled examination to request an excused absence prior to the exam.
• If an exam is missed and the absence is excused, students must be prepared to take the examination that was missed on or before their first day back in class. Make-up exams are scheduled outside of class time. Students are expected to arrange their work and family schedules accordingly.
Exams should be conducted in a room large enough to accommodate seating students in every other seat. If this is not possible, two rooms may be reserved as appropriate to enable alternating seats, in which case a second proctor will be necessary. Every student should be seated where they are visible to the proctor. If the room is equipped with cameras to record the exam environments, students should be notified that they are being recorded. Proctors should be actively attentive to the exam environment at all times. Students may not leave the exam room until their exam is submitted (exceptions should, of course, be allowed for emergency situations). When possible, only one student shall exit the room at a time.
The SoN honors accommodations as outlined in the PLU accommodations policy of the Office of Accessibility and Accommodations.
Students scheduling an exam under the PLU OAA accommodations policy must ensure the exam is scheduled within 48 business hours of the original exam date. Students are responsible for arranging their own accommodation testing plan and communicating this plan with the course instructor.
Students intending to use accommodations will discuss their plan with the course instructor within one week of the beginning of the semester or within one week after accommodations have been initiated.
All in-person exam security requirements also apply to assessments taken in the testing center.
Only one (1) makeup exam will be allowed per student per course. In emergency cases, exceptions to this policy will be considered on an individual basis by the course lead faculty.
Makeup exams must be completed within 72 hours of the missed exam or as scheduled per instructor discretion.
Makeup exams may be taken under individual instructor proctoring or in the test center.
All test security requirements also apply to makeup exams.
Students repeating a course
Evidence-based best practices indicate faculty should strive to offer different versions of examinations for subsequent semesters (i.e. versions A, B, C).
Academic Integrity: Examinations
In addition to the standards contained in this SoN Exam policy, the SoN adheres to the academic integrity standards set forth by the university at large (see Student Code of Conduct section of the Student Handbook). Please follow University procedures to report suspected dishonesty.
Faculty are encouraged to place an honor pledge at the beginning of each exam and require attestation by the student.
Exam Development Committee
The Exam Development Committee will be available upon request to review examinations for clarity, spelling, grammar, and cultural or implicit language bias, and to assist with post-exam analysis. The EDC members will provide guidance and feedback to faculty, but all decisions remain solely the faculty discretion.
The EDC is an ad hoc committee and therefore does not meet on a regularly scheduled basis. To be considered for review, faculty should submit examination at least five (5) weeks prior to scheduled date of assessment. For assistance with post-exam analysis, faculty should email the Assistant Dean of Prelicensure Programs to facilitate an appointment with EDC members as needed.
Exams will be reviewed in appropriate order based on date of submission and scheduled date of assessment.
Exam analysis/Item Analysis
Faculty are required to complete an analysis of each exam after all students have completed the exam. Faculty are encouraged to consult evidence-based references on how to complete the test analysis and make decisions based on the results. Helpful resources can be found in the SoN Excellence in Teaching and Learning Sakai site in the Prelicensure Exam Policy section. Additional recommendations for faculty development/evidence-based best practices include:
• Webinar – Nurse Tim Inc -> Item Analysis Made Easy! By Karin Sherrill
o Teaching in Nursing: A Guide for Faculty by Billings and Halstead
o The Nurse Educator’s Guide to Assessing Learning Outcomes by McDonald
o Evaluation and Testing in Nursing Education by Oermann and Gaberson