Open Journal of Nursing, 2017, 7, 1289-1306 http://www.scirp.org/journal/ojn ISSN Online: 2162-5344 ISSN Print: 2162-5336 DOI: 10.4236/ojn.2017.711093 Nov. 21, 2017 1289 Open Journal of Nursing Impact of Adaptive Quizzing as a Practice and Remediation Strategy to Prepare for the NCLEX-RN Susan Malkemes 1 , Julia C. Phelan 2 1 Passan School of Nursing, Wilkes University, Wilkes Barre, PA, USA 2 UCLA CRESST, Los Angeles, CA, USA Abstract National Council Licensure Examination-Registered Nurse (NCLEX-RN) outcomes are extremely important to nursing institutions and students for myriad reasons. For students, the NCLEX-RN represents one of the final mi- lestones to conquer before entering a nursing career. Nursing programs mon- itor NCLEX-RN pass rates as an important gauge of program quality and minimum levels frequently must be met. This study explored the implementa- tion of an adaptive quizzing and learning system as part of an NCLEX-RN preparation strategy designed to increase student engagement and subsequent success on the NCLEX-RN. The adaptive quizzing system was used as part of an ongoing, proactive strategy to student preparation. This strategy is in con- trast to the practice of using high-stakes exams scores to try and predict stu- dent NCLEX-RN outcomes. In the latter case there is mixed evidence on how scores relate to remediation and moving students toward success based on evidence of need. The study school required students (N = 54) to take regular, adaptive practice quizzes throughout their final year in the nursing program. Students were also given the HESI E 2 in their final semester and all but one student achieved the target threshold with a range of scores (772 to 1028). Despite this variability, 90.7% of the students in the study group passed the NCLEX-RN on their first attempt, with a pass rate of 98% when considering those who passed on the second attempt. NCLEX-RN pass rates at the study school increased by 11.55% following the implementation of the system and in the second year of implementation (the data analyzed for this study) in- creased an additional 3.95% from the previous year. With many factors to consider, we cannot say, unequivocally, that using the AQS resulted in an in- crease in NCLEX-RN pass rates at the study school. Findings from this re- trospective study do, however, support the use of an adaptive quizzing system How to cite this paper: Malkemes, S. and Phelan, J.C. (2017) Impact of Adaptive Quizzing as a Practice and Remediation Strategy to Prepare for the NCLEX-RN. Open Journal of Nursing, 7, 1289-1306. https://doi.org/10.4236/ojn.2017.711093 Received: May 19, 2017 Accepted: November 17, 2017 Published: November 21, 2017 Copyright © 2017 by authors and Scientific Research Publishing Inc. This work is licensed under the Creative Commons Attribution International License (CC BY 4.0). http://creativecommons.org/licenses/by/4.0/ Open Access