1.1 Word Knowledge & Vocabulary
Key Takeaways
- The Verbal section delivers 58 questions in 60 minutes — 50 scored plus 8 unscored pilot items — so pace at roughly one minute each
- Word Knowledge is one of two Verbal subsections and contributes 25 scored items, the same scored count as Reading Comprehension
- Greek and Latin word parts (prefixes, roots, suffixes) are the single highest-yield study target because one element decodes dozens of NEX words
- Memorize the paired opposites first: hyper-/hypo-, brady-/tachy-, intra-/inter-, and macro-/micro- generate many synonym-antonym items
- Suffixes name the action or condition: -itis (inflammation), -ectomy (removal), -emia (blood), -ostomy (opening), -plasty (repair)
- Five context-clue types — definition, synonym restatement, antonym/contrast, example, and inference — let you solve unknown words from surrounding text
- All NEX items are four-option multiple choice; eliminate clear wrongs first, then pick the choice closest to the target word's exact meaning
- Watch the brady-/tachy- and hypo-/hyper- swap traps, where a distractor uses the correct root but the opposite directional prefix
Word Knowledge on the NLN NEX
The Verbal Ability section of the NLN NEX (Nursing Entrance Exam, the National League for Nursing test that replaced the older PAX, Pre-Admission Examination, beginning in 2025) contains 58 questions in 60 minutes. Of those, 50 are scored and 8 are unscored pilot items seeded invisibly among the rest, so you cannot tell which ones count — answer every question as if it matters.
The Verbal section splits evenly into two subsections: Word Knowledge (25 scored items) and Reading Comprehension (25 scored items). Every item is four-option multiple choice. Verbal contributes roughly 36% of your overall NEX result, and each section is reported as a percentile rank, with the three percentile ranks summed into a composite score on a 0–300 scale. Pace yourself at about one minute per question; standalone vocabulary items should take far less, banking time for the longer reading passages in Section 1.2.
What Word Knowledge actually asks
Word Knowledge items come in four recurring formats:
- Synonym — choose the word closest in meaning to a target word (e.g., "lethargic" → drowsy).
- Antonym — choose the word opposite in meaning (e.g., "benign" → malignant).
- Vocabulary in context — a sentence supplies the word; the surrounding text fixes its meaning.
- Word-part decoding — recognize a word's meaning from its prefix, root, and suffix.
The NEX deliberately favors health, science, and academic vocabulary, so a nursing-flavored word list pays off far more than generic SAT lists.
Greek and Latin word parts — the highest-yield strategy
Learning word parts is the most powerful vocabulary move on the NEX: one element unlocks many words. Build your study around the directional pairs first, because the test loves to swap them in distractors.
Essential prefixes
| Prefix | Meaning | Example |
|---|---|---|
| a-, an- | without | anemia (without blood), apnea (without breathing) |
| anti- | against | antibiotic, antihypertensive |
| brady- | slow | bradycardia (slow heart rate) |
| tachy- | fast | tachycardia, tachypnea |
| hyper- | above, excessive | hypertension, hyperglycemia |
| hypo- | below, deficient | hypotension, hypoglycemia |
| dys- | difficult, abnormal | dyspnea, dysphagia |
| inter- | between | intercostal (between the ribs) |
| intra- | within | intravenous (within a vein) |
| peri- | around | pericardium (around the heart) |
| poly- | many | polyuria, polydipsia |
| macro- | large | macrophage (large eater cell) |
| micro- | small | microscope, microbe |
Essential roots and suffixes
| Element | Meaning | Example |
|---|---|---|
| cardi/o (root) | heart | cardiology, tachycardia |
| hem/o, hemat/o (root) | blood | hematoma, hemorrhage |
| nephr/o, ren/o (root) | kidney | nephritis, renal |
| -itis (suffix) | inflammation | arthritis, hepatitis |
| -ectomy (suffix) | surgical removal | appendectomy |
| -ostomy (suffix) | new opening | colostomy |
| -emia (suffix) | blood condition | anemia, leukemia |
| -plasty (suffix) | surgical repair | angioplasty |
Worked example. The word nephrectomy breaks into nephr/o (kidney) + -ectomy (surgical removal) = surgical removal of a kidney. If an answer choice says "inflammation of the kidney," that is the -itis trap; the suffix, not the root, decides the action.
Context clues — solving unknown words from the sentence
When a word is unfamiliar, the surrounding text usually reveals it. Memorize the five clue types and their signal words.
| Clue type | Signal words | Example |
|---|---|---|
| Definition | "is," "means," "refers to" | "Apnea, which means the temporary cessation of breathing..." |
| Synonym restatement | "or," "also known as," "that is" | "The patient was lethargic, or extremely drowsy..." |
| Antonym/contrast | "but," "however," "unlike," "whereas" | "Unlike the acute symptoms, the chronic condition..." |
| Example | "such as," "for example," "including" | "Vital signs, such as blood pressure and pulse..." |
| Inference | overall sentence sense | "The wound was healing; the inflammation had abated." (decreased) |
High-frequency NEX clinical adjectives
These paired words appear repeatedly. Drill the synonym and antonym for each.
| Word | Synonym | Antonym |
|---|---|---|
| Acute | severe, sudden, sharp | chronic, mild |
| Benign | harmless, noncancerous | malignant |
| Chronic | persistent, long-lasting | acute, temporary |
| Deteriorate | worsen, decline | improve, recover |
| Exacerbate | aggravate, intensify | alleviate, relieve |
| Alleviate | relieve, ease, reduce | exacerbate, worsen |
| Lethargic | drowsy, sluggish | alert, energetic |
| Ambulatory | able to walk | bedridden |
| Efficacy | effectiveness | ineffectiveness |
| Prognosis | predicted outcome | — |
Common Word Knowledge traps
- Directional swap: "tachycardia" looks right next to "bradycardia" — both use cardi/o, but only tachy- means fast.
- Diagnosis vs. prognosis: diagnosis = identifying the disease; prognosis = predicting the outcome.
- -tomy vs. -ectomy: -tomy is cutting into; -ectomy is cutting out (removal).
- Too-broad synonym: "strong" can substitute for many words, so confirm it matches the precise target meaning, not just the general tone.
Use substitution for context items: drop each option into the sentence and keep the one that preserves the sentence's logic.
The word "bradycardia" means:
Which word is a SYNONYM for "alleviate"?
In "The doctor noted that the patient's condition had deteriorated significantly since the last visit," what does "deteriorated" most likely mean?
The suffix "-itis" means _____.
Type your answer below
What does the prefix "hyper-" mean?
Match each medical prefix to its meaning.
Match each item on the left with the correct item on the right
"The nurse observed that the laceration was superficial." Here "superficial" most likely means:
Which suffix means "surgical removal"?
Which of the following words contain a root meaning "heart"? (Select all that apply)
Select all that apply