Verbal Study Guide for the NLN PAX

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General Information

There are two types of questions in this section of the NLN PAX test. The first kind is a typical multiple-choice question about a reading passage of about 400 to 500 words in length. These passages cover various topics, such as health, nature, science, and social studies. The second type of question presents a sentence and asks for the meaning of one word that is marked in that sentence.

The following information covers improving your reading and comprehension, especially in a timed situation. We also have some ideas for addressing the vocabulary questions.

All questions on the NLN PAX are typical multiple-choice questions with four answer choices. You will have 40 minutes to answer 60 questions.

Reading Comprehension Questions

Put simply, reading comprehension is your ability to understand and regurgitate information you have just read. It is important when reading to not just skim over the text, but to fully absorb the information presented to you. It is especially valuable to notice the main idea and key details.

Purpose for Reading

When taking the NLN PAX, you will be asked to read passages across different genres and topics and answer questions about their contents. The ability to read with the goal of finding the most important information will come in handy, both while taking the test and during your career as a nurse.

Main Ideas and Details

A text almost always has a major focus, a prominent message it is trying to send, or a key concept it is meant to inform on; this is called the main idea. In order to support the main idea of a piece, an author must utilize supporting details, which are more specific and distinct pieces of information. It is important to recognize the difference between the main idea and details to comprehend the purpose of any given passage.

Scan Before Reading

Under the umbrella of reading falls scanning: the ability to rapidly skim the text in order to find specific information or the main idea. Although it is recommended you fully read the passage for the NLN PAX, scanning can be helpful in the beginning to get an idea of the overarching purpose of the passage before attempting the questions.

Topic Sentences

Topic sentences are used to tell the reader what a specific paragraph or passage is about and tend to be the first sentence of the paragraph. Think of a topic sentence as a road map, guiding the reader through the paragraph. Reading topic sentences can be extremely helpful in attempting to find the main idea of a passage.

Main Ideas

It is common for the NLN PAX to directly ask, “What is the main idea of the passage?” in multiple-choice questions. When reading the answer options, think about what the author wants the reader to take away from the passage. What is the key concept? Scan for repetitive phrasing, argumentative statements, and a strong claim in the conclusion or introduction.


Details are a bit trickier to understand but can be easy to spot once you identify the main idea. Details are supportive bits of information that usually answer questions like who, what, when, and where, whereas the main idea tends to tackle how and why. Details are found in the body of each passage or paragraph, usually after the first sentence, known as the topic sentence.

Author’s Tone

The author’s tone is the way in which an author intertwines their opinion into their writing, but it is not always obvious. Most passages will not blatantly state whether the author feels positively or negatively or agrees or disagrees. Instead, you need to look at specific words. Does the author use neutral phrases? Or are there words like great, bad, good, positive, negative? The author’s tone is the attitude they are exhibiting in the passage.

Relying on the Text

We all have a plethora of prior knowledge we can access, accumulated over time from classes we have taken, reading we have done, and our general experiences. However, it is important when answering the questions in the reading section to use only the information provided for you. Try to avoid relying on what you already know about a topic or subject, and focus on what the passage says directly.

Types of General Comprehension Questions

The general questions vary between asking what the passage states, what the author’s purpose is, determining the main idea or topic, and even titling the piece. Here are some of the possible types.

Stated Material

Information in the passages can almost always be broken down into two categories: stated and inferred. Stated information is directly said by the author in the passage, and you will often be asked to identify these details in multiple-choice questions. This is called explicit information.


Making inferences takes more skill than identifying stated material; in order to infer, you must extract information based on what the text says. Questions requiring you to make inferences may ask which is most likely, reasonable to expect, what will probably happen and similar phrases, all asking you to make decisions based on the information provided.

The Best Title

Sometimes, the NLN PAX will ask you which of a few options would be the best title for a given passage. For these questions, think back to the passage’s main idea and decide which title best informs the reader what the passage will be about.

Comparisons and Contrasts

Often, you will be asked to identify similarities and differences in a passage, following a compare and contrast model. Authors will most often compare two things by explaining them in the same way and in the same format, making it easier for you as the reader to compare.

Intended Audience

Texts with different intended audiences will be written in different ways. For instance, a piece of children’s literature will not sound the same as a research paper intended for the medical community. The intended audience will help you further decipher the main idea and purpose.


Often, readers confuse the topic and the main idea of a passage. The topic is the subject matter the writing covers and is more general and overarching than the main idea. For example, the topic of a text could be African animals or global warming.

Main Idea

The main idea of a text is more specific than the topic but falls under that umbrella. The main idea is related to the purpose, whereas the topic is the subject. For example, the topic of a text may be global warming whereas the main idea is the effect of ice melting on polar bear survival.


To draw a logical conclusion from a text, you must first identify whether the conclusion is clearly stated or needs to be inferred. Either way, you, as the reader, need to take the information presented to you and draw a conclusion based on fact, detail, and inferences.

Vocabulary Questions

Vocabulary questions are most often about the meaning of a word or phrase. They can be scattered among reading comprehension questions or be discrete questions. When asked about the meaning of a word or phrase, be sure to read around the word and use context clues to decipher it. Let’s look at an example.

The patient in the room down the hall has a voracious appetite; she will not stop eating.

A question may ask you what the word voracious means in the sentence above. Using context clues, we can figure it out. In this case, after the semicolon, the reader is given an example of the word: “She will not stop eating.” Using this clue, voracious cannot mean weak or nonexistent but rather big or never-ending, as she keeps eating.

Let’s try again. In the following sentence, there is an unfamiliar word: pseudonym.

Rather than giving patients her real name, the physical therapist uses a pseudonym.

The clue to deciphering this word comes in the beginning of the sentence. The sentence begins with, “Rather than giving patients her real name,” illustrating immediately that the word pseudonym relates to names and possibly fake names. By using context clues, you will likely be able to narrow down the multiple-choice answers and select the correct option.

Types of Vocabulary Questions

There are three types of vocabulary questions on the NLN PAX. They all require you to assign a meaning to a word, but they do so in different formats. All three types have one thing in common: they all present context for the word in question instead of presenting words in isolation and asking you to give the definition. This way, you have some clue as to what the word might mean. You will find the context especially useful in ruling out incorrect answers.

Matching a Word to a Synonym

One type of vocabulary question you will see on the NLN PAX requires you to choose a synonym for a given word. The question will not use the word synonym, but it will ask you to find a word that means the same thing as one of the words in the sentence. The word will be used in a sentence first, and then you’ll need to decide which of four other words has the same or nearly the same meaning. Here is one example:

The young man could not stop gazing at the gorgeous model. Gorgeous means ____.

Answer choices:

  • crazy
  • lightheaded
  • sensible
  • beautiful

While any of these choices could fit in different situations, you need to use the context of the sentence to determine the best choice. Which one of the choices would tend to make someone continue to gaze at a person? The best choice is beautiful.

Using Word Meaning

Another type of vocabulary question on the NLN PAX is similar to the first kind, except the word you may not know is not pointed out in the question. There will be a descriptive sentence first. Then you will be asked to choose the word that matches the overall meaning of that sentence. Here is one example:

Matt could not fathom why the professor would give him a failing grade. Matt lacked ____.

Answer choices:

  • courage
  • understanding
  • patience
  • money

The word you need to find the meaning of in this sentence is fathom, but it is not pointed out in any way. You’ll just need to know what it means to answer the question. To fathom means to “understand,” so if Matt could not fathom something, he lacked understanding.

Word Usage

The third type of vocabulary question you’ll see on the NLN PAX does not require you to match any two words. It simply asks you to choose the word that would make the most sense in a given sentence. These questions test your ability in appropriate word usage. Here is an example:

The technical speaker used many words that the average person would not understand and the audience complained about his reliance on ____.

Answer choices:

  • language
  • compliance
  • jargon
  • emotion

Another word for “terms the average person would not understand” is jargon, so that would be the correct answer.

Word Analysis

To score well on the word knowledge questions, you must be able to analyze words and decipher their definitions, meanings, and usage.

There are a few methods that can make analyzing words easier, including:

  • recognizing root words
  • recognizing suffixes and prefixes, known as affixes
  • understanding synonyms and antonyms (opposites)
  • identifying the examples and descriptions

Root Words

Root words are smaller segments of words originating in Latin that have meanings of their own. They are often called base words because they form the basis of a new, longer word. Learning popular root words and gaining the ability to recognize them will help you define unfamiliar words. If you know at least the meaning of a segment of the word, you will most likely be able to answer a word meaning or word usage question.

Let’s look at an example. The root word sen means old and is the basis of words like senior, seniority, and senile. All of these words pertain to old: senior meaning the oldest or most experienced, seniority is a status for the old or wise, and senile means someone experiencing confusion due to old age.

Here is a list of some common root words that may help you in defining and understanding challenging words:

  • circ meaning “round” is used in words like circle and circumference.

  • geo meaning “earth” is used in words like geography and geology.

  • auto meaning “self” is used in words like autobiography and automatic.

  • cred meaning “believable” is used in words like credible and credibility.

  • script meaning “to write” is used in words like scripture and prescription.

  • psycho meaning “mind” is used in words like psychology and psychopath.

  • legal meaning “relating to law” is used in words like legality and illegal.

  • act meaning “to move” is used in words like action and inactive.

  • therm meaning “heat” is used in words like thermometer and hypothermia.

  • bene meaning “good” is used in words like beneficial and benefit.


Affixes are short groups of letters added to the beginning or end of a word, changing its meaning. They are used to turn a root word into a different word entirely. There are two types of affixes: suffixes and prefixes.


Prefixes are added to the beginning of a root word to change its meaning. There is actually a prefix in the word prefix! Pre means “before,” telling you the prefixes go at the beginning, or before the root word.

Let’s look at the root word usual. Usual means “normal,” however, this can be quickly changed by adding a prefix. If you add the prefix un, meaning “not,” to the word usual, it becomes unusual, meaning “strange” or “odd.”

Look at this chart for some common prefix examples.

Prefix Meaning Examples
semi- “half” semicolon, semicircle, semi-formal
homo- “same” or “equal” homophone, homosexual, homogenous
re- “again” or “backward” rewind, repeat, revert, retrace
post- “after” postpone, postnatal, postmortem
mis- “incorrect” or “badly” mistake, misunderstand, mistook
non- “not” nonfat, nonfiction, nonsensical
tri- “three” triple, tricycle, triangle
co- “together” or “mutual” coexist, cohabitate, coordinate
inter- “between” interdisciplinary, interview, intertwine

Suffixes are added to the end of a root word to change its meaning. Suffixes sometimes only change the conjugation or tense of the word, but other times they create a different word entirely.

An example of a suffix only changing the word tense would be the suffix -ed, meaning “in the past.” Adding -ed to the verbs walk, jump, or laugh does not change the meaning of the words, but rather when they are happening.

On the other hand, some suffixes completely change the word’s meaning. For instance, the suffix -less means “without.” So the word home completely changes meaning when -less is added to the end. The new word means “without a home.”

Look at this chart for some common suffix examples.

Suffix Meaning Examples
-ward “relating to direction* inward, upward, onward
-ible “capable of being” edible, audible, possible
-esque “reminiscent of” picturesque, statuesque, burlesque
-ship “position held” ownership, kinship, internship
-ish “suggesting” or “like” childish, girlish, snobbish
-ful “filled with” or “marked by” plentiful, doubtful, resentful
-ious “marked by” or “characterized by” religious, studious, nutritious
-y “characterized by” filthy, stinky, cleanly
-ive “having the nature of” creative, decisive, furtive

Improving Vocabulary Skills

Within the verbal section of the NLN PAX, you will be asked questions regarding word knowledge. You will be asked to define unknown words, identify synonyms and antonyms, use words, and understand their meanings.

Improving your ability to identify vocabulary words, and define words that are unknown to you, will help you in answering the vocabulary questions within the verbal section of the NLN PAX.

Studying vocabulary terms daily, and learning to use the surrounding words and phrases to decipher words, will make identifying synonyms, finding meaning, and refining usage much easier.


In general, reading is one of the most beneficial ways to improve your vocabulary. In addition to studying words specifically, reading for a short period of time daily can expose you to new words that might appear on the NLN PAX.

Use the Dictionary

The dictionary is a book filled with endless definitions, along with the word’s etymology (word history and origin), synonyms, and antonyms. Searching the dictionary can not only expose you to words you do not know but also teach you root words, prefixes, and suffixes.

It is important to note that using the dictionary can slow down your reading process, and sometimes the dictionary has multiple definitions for the same word. So, make sure you are using it wisely.

Next time you are reading or studying, instead of passing by a word you do not know, try looking it up in the dictionary.

Record Word Study

Studies have proven that the best way to remember words and notes is to handwrite them. Although handwriting can be tedious in the modern age of technology, physical writing is most effective when it comes to recalling information later on.

The ways in which you can record your word study can vary, and it may take time to find the method that works best for you. Some examples are:

  • notebooks
  • notecards
  • graphic organizers
  • sticky notes

Analyze Unknown Words

Analyzing words you do not know can be intimidating, and is known to be one of the most difficult aspects of the verbal portion of the exam. However, there are a few methods of analyzing words that make the deciphering and defining process easier.

Vary Study Methods

Studying can get old quickly, and it is widely recognized that joy and excitement during the act of studying can improve recall ability and understanding. Varying the way you are studying, and involving engaging activities, can help in the process of studying for the NLN PAX.

Some studying methods include:

  • creating flashcards
  • taking practice exams
  • playing matching and memory games
  • practicing with friends and family
  • using online study tools

All Study Guides for the NLN PAX are now available as downloadable PDFs