Master How to Use ADPIE for NCLEX Exam Questions

Assessment questions are asking you to gather data about the patient; both objective and subjective data. Remember that assessment is the first step in the nursing process, so words that indicate that the question is specifically an assessment question will reflect the need to look for an option that is the initial step. Strategic words can help you identify if the specific question is an assessment question; words like, assess, collect, gather, or do first.

Diagnosis questions require interpretation of the assessment data, analysis, and application of critical thinking. When analyzing the data and recognizing patterns related to the patient’s condition, the nurse begins to identify the patient’s problems or risks. A nursing diagnosis is formed by identifying the problem, writing a diagnostic statement, and validating the diagnosis. A patient may have several nursing diagnoses, that are arranged according to priority, and addressing the patient’s most vital problems first. Because this is the second step in the nursing process, narrowing down the answer choices can be easier if you eliminate options reflecting assessment, intervention, planning or evaluation. Strategic words for recognizing nursing diagnosis questions include “analyze” or “interpret”.

Planning questions involve using the nursing assessment and analysis to determine interventions, goals and outcomes in an individualized cohesive plan. In this plan, SMART goals are set. This acronym stands for specific, measurable, attainable, realistic and time-oriented. The plan tailored to the patient includes both short-and-long-term goals. The plan of care is communicated to the healthcare team and documented. It is important to prioritize patient problems in order of importance when creating the plan; starting with current problems and ending with potential risks/problems. When asked about making a nursing care plan in an exam question, the SMART acronym can direct you on how to answer.

Intervention questions are focused on actions or interventions to achieve goals, assisting in the performance of activities of daily living (ADLs), administering ordered medications, or educating the patient. Remember that for the most part, interventions come after the assessment has been done. Exceptions are emergency situations. So when presented with a question, ask yourself if the assessment has already been completed. Strategic words that will help identify if it is an intervention question include; action or intervene.

Evaluation questions are focused on actual outcomes of care; if expected goals were achieved and the effectiveness of care. Evaluation of successful outcomes are when the patient’s behavior and condition has changed as intended, goals were accomplished, or if progress has occurred. If these components are not met, evaluation highlights barriers requiring modification and refinement. Strategic words that will help identify an evaluation question include “evaluate” or “outcome”.

Read and then reread the entire question to ask yourself what the question is asking. Establish a pattern and identify the answer choices.

If the question is asking you a part of the nursing process, the strategy is to recognize which step in ADPIE it is asking you to identify.

After you rule out the answer options that do not reflect the stem of the question (example; if it is an assessment question, it is looking for options that reflect assessment steps, so eliminate any answer options that are interventions!) it will be easier to narrow down your answer choices and choose the best answer.