Why Thinking Like a Nurse Matters More Than Memorizing

Have you ever finished an NCLEX practice exam, looked at your score, and thought:

"I don't understand. I've studied so much. Why am I still getting these questions wrong?"

If so, you're not alone.

In fact, it's one of the most common conversations I have with nursing students.

Many students assume their problem is that they don't know enough content.

So what do they do?

They buy another review book.

They purchase another question bank.

They watch more videos.

They answer another 500 practice questions.

Then they become frustrated when their scores barely change.

Can I tell you something that may surprise you?

Sometimes your problem isn't content at all.

Sometimes it's the way you're thinking through the question.

Let’s dive in!

"I've Answered Thousands of Questions..."

Not long ago, I was meeting with a student over Zoom.

She looked exhausted.

Before we even started, she sighed and said,

"Rhoda, I don't understand. I've answered thousands of NCLEX questions. I've watched videos. I've read the books. Why am I still getting them wrong?"

I didn't answer her question.

Instead, I smiled and said,

"Let's do just one question together."

She looked a little surprised.

"Just one?"

"Just one," I replied.

I shared an NCLEX question on the screen and asked her to think out loud.

She read the question.

Then, almost immediately, she started reading the answer choices.

I stopped her.

"Wait a second," I said.

"Who is your client?"

She looked back at the question.

"Oh...it's the postoperative patient."

"Good," I said.

"Now what's the condition or procedure?"

"He had abdominal surgery this morning."

"Exactly."

"Now tell me...what does the question want?"

She looked again.

"Oh...it's asking for the first nursing action."

I smiled.

"You've already changed the way you're looking at the question."

Then I asked one more question.

"What is abdominal surgery doing to this patient's body right now?"

She started talking through the physiology.

She wasn't guessing anymore.

She was thinking.

When she finally looked at the answer choices, she selected the correct answer almost immediately.

She laughed.

"That question wasn't nearly as hard as I made it."

I smiled.

"It usually isn't."

Then she became quiet for a moment before saying something I've heard many times over the years.

"Nobody has ever taught me to think like that before."

That sentence has stayed with me.

Because she's right.

Nursing school teaches you a tremendous amount of information.

Question banks give you thousands of questions.

But very few people actually teach you how to think through an NCLEX question.

Step 1: Find Out Why You're Missing Questions

Before you decide you need another review course or another thousand practice questions, I encourage you to do one thing first.

Take a comprehensive NCLEX readiness assessment.

Not because you need another score.

Because you need answers.

Ask yourself:

Where am I consistently struggling?
Is it one content area?
Is it pharmacology?
Is it maternity?
Is it prioritization?
Or am I simply not thinking through the question correctly?

Those are very different problems.

And they require very different solutions.

One student may truly need more content review.

Another student may already know the content but needs help organizing their thinking.

Knowing the difference can completely change the way you study.

Step 2: Slow Down Before You Answer

One of the biggest mistakes I see is students rushing straight to the answer choices.

Don't.

Before you look at a single answer, stop and ask yourself three simple questions.

Who is my client?

Who is the NCLEX asking about?

The newborn?

The older adult?

The postoperative patient?

The patient with heart failure?

Always identify your client first.

What is the condition or procedure?

What's happening with your patient?

What diagnosis, medication, procedure, or complication is the question focusing on?

Now go one step further.

Ask yourself:

"What is this condition or procedure doing to my patient's body?"

That one question activates knowledge you already have.

What does the question want?

Now determine exactly what the NCLEX is asking.

Is it asking for:

The first action?
The priority patient?
The best response?
An assessment?
An intervention?
An expected finding?
A patient who needs further teaching?

Don't answer the question until you know what the question is truly asking.

Those three questions only take a few seconds.

But they completely change how you approach the NCLEX.

Step 3: Start Looking for Clues

Now it's time to think like a nurse.

The NCLEX doesn't give you random information.

Every assessment finding, vital sign, laboratory value, medication, symptom, and change in condition is there for a reason.

As you read the question, begin asking yourself:

Which assessment finding concerns me the most?
Are the vital signs normal, or are they beginning to trend in the wrong direction?
Are there abnormal laboratory values?
Is my patient improving or deteriorating?
Has something changed since the last assessment?
Is there a medication or procedure that explains what I'm seeing?

Don't stop there.

This is where many students miss the question.

They look at each clue individually instead of putting them together.

Instead, stop for a moment and ask yourself:

"What story is this patient telling me?"

That one question changes everything.

Instead of seeing isolated facts, you begin seeing the patient.

For example...

A heart rate of 118.

A blood pressure of 92/58.

Cool, clammy skin.

None of those findings by themselves may seem overwhelming.

But together?

They're telling you a story.

Or imagine another patient.

Temperature 102.6°F.

Respiratory rate 30.

Confusion.

Blood pressure beginning to fall.

Those aren't just four separate findings.

They're telling you another story.

Experienced nurses don't memorize isolated numbers.

They recognize patterns.

They connect clues.

They recognize when a patient's condition is changing.

That's exactly what the NCLEX is testing.

It wants to know whether you can recognize the story before deciding what to do next.

There Has to Be a Better Way

At this point, many students tell me,

"Okay, I know I need to look for clues...but how do I keep all of that organized?"

That's a fair question.

It's also the reason I developed the PRIORITY Method.

Over the years, I realized my students didn't need another acronym to memorize.

They needed a simple way to organize their thinking every single time they answered an NCLEX question.

The PRIORITY Method helps students slow down, connect the clues, and think through patient situations with greater confidence.

I'll be sharing much more about the PRIORITY Method in future blogs because it has become one of my favorite ways to teach clinical judgment.

If you remember only one thing from this article, let it be this:

The NCLEX isn't asking,

"How much can you memorize?"

It's asking,

"Can you think like a safe nurse?"

Before your next practice question, slow down.

Ask yourself:

Who is my client?
What is the condition or procedure?
What does the question want?

Then start looking for the story your patient is telling you.

I think you'll be surprised how differently you begin approaching every question.

And over time...

That's exactly how confident nurses are built.

☕ Coffee with Rhoda

Before you go, can I share one more thought?

As I was writing this article, I kept thinking about all the students I've had the privilege of working with over the years.

So many of them have said something I'll never forget.

"Nobody has ever taught me to think like that before."

Those words stayed with me.

They reminded me that nursing students don't always need more information.

Sometimes they simply need someone to slow things down, ask the right questions, and help them connect the dots.

That's exactly why I created my NCLEX Study Guide.

Not because the world needed another collection of practice questions.

There are already plenty of those.

I wanted to create something that felt like you and I were sitting together, working through one patient at a time.

Inside the guide, I ask the same questions you've seen in this article, explain my thought process, and help you build confidence by thinking through realistic patient scenarios together.

If that sounds like something that would help you, I'd love for you to take a look.

If not, that's okay too.

My hope is that the next time you answer an NCLEX question, you'll pause for just a moment and ask yourself:

Who is my client?

What is the condition or procedure?

What does the question want?

Then...

"What story is this patient telling me?"

If you do that, this article has already accomplished exactly what I hoped it would.

I'll be cheering for you every step of the way.

Rhoda Sommer, RN, MSN Ed
Founder, One on One Tips

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How to Pass the NCLEX

Why Thinking Like a Nurse Matters More Than Memorizing