She’s parked behind the grocery store. Engine off. Hands still on the wheel. Two textbooks in the passenger seat she has not opened, a half-finished latte, and a pile of Anki cards she abandoned three days ago. And she’s crying — not because something specific happened, but because everything has been happening for months and her body picked this Tuesday afternoon to finally let her feel it.
If that’s you — even a little — I want you to know this post is for you. I’m Chantal. I’m a Family Nurse Practitioner, I co-founded Rubio Board Review with my husband, and I have absolutely sat in that car. Several cars, actually. Across several lifetimes of training.
Let’s talk about what’s really happening when you fall apart in a parking lot. Because here’s the thing — it’s not a character flaw, and it’s not a sign you’re not cut out for this. It’s biology. And once you understand the biology, you can work with it instead of being ashamed of it.
Your tears are not the problem. Ignoring what they’re telling you is.
What’s Happening in Your Body
When you’ve been studying hard, sleeping less than you need, drinking more coffee than water, and carrying the quiet terror of an exam that determines your career — your nervous system has been running hot for weeks. Your hypothalamic-pituitary-adrenal axis is essentially never off. Cortisol stays elevated. Your sympathetic system is dominant.
You’ll recognize this content from nursing school, but let me paint it as a clinical picture you might be missing because the patient is you.
Chronically elevated cortisol shrinks the hippocampus over time and impairs working memory. Your prefrontal cortex — the part you need for clinical reasoning, prioritization, and recognizing the right answer — gets quieter when your amygdala is loud. Your sleep gets fragmented. Your digestion gets weird. You can’t focus, but you also can’t relax. And eventually, your system reaches a threshold and dumps the stress response in whatever way it can.
Sometimes that’s a parking lot cry. Sometimes it’s an irritable outburst. Sometimes it’s a stomach that won’t settle for three days. The body is brilliant — it will find a way to discharge what’s been accumulating.
Crying isn’t weakness. It’s parasympathetic activation. It’s literally your nervous system trying to bring you back to baseline. Don’t shame the very mechanism your body is using to protect you.
Why This Matters for the NCLEX
Here’s where I want to put my clinician hat on for a second, because this isn’t just about feelings. The state of your nervous system on test day directly affects your performance.
When your sympathetic system is dominant, working memory contracts. You hold less information at one time. Recall slows. Pattern recognition — the very skill the NGN is testing — becomes harder because pattern recognition requires a relaxed, integrated cognitive state.
Students who are chronically activated walk into the testing center already at a deficit. Not because they don’t know enough. Because their physiology is working against the kind of thinking the exam demands.
So managing your nervous system isn’t a wellness extra. It’s exam strategy. It’s clinical preparation.
What Actually Helps
Box Breathing
Inhale four counts. Hold four. Exhale four. Hold four. Repeat for two minutes. This activates your vagus nerve, which slows heart rate, drops blood pressure, and signals your brain that the threat has passed. You can do this in the testing center between questions when you feel yourself spiraling. Nobody can tell you’re doing it.
The 5-4-3-2-1 Grounding
Name five things you can see. Four you can hear. Three you can touch. Two you can smell. One you can taste. This pulls your attention out of catastrophic future-thinking and back into your sensory present. It’s a clinical intervention we use with anxious patients. Use it on yourself.
Co-Regulation
Find one safe person you can call. Not someone who will quiz you on potassium ranges. Someone whose nervous system is steady and who can lend you theirs for a few minutes. Humans are built to regulate together. We are not built to do hard things alone.
Sleep — The Non-Negotiable
Memory consolidation happens in slow-wave sleep. The studying you did today is not actually yours until you sleep. Pulling all-nighters before the NCLEX is one of the worst things you can do to your performance. Sleep is studying.
Permission Slip: Take the cry. Take the nap. Take the hour off. The studying you do tomorrow when your nervous system is regulated is worth more than the studying you grind through tonight while dysregulated. I promise you.
The Patient You’re Becoming
Here’s the thing I want you to hear most. You are practicing nursing on yourself right now. The way you respond to your own exhaustion is the way you’ll respond to your patients’ exhaustion. The way you talk to yourself in the parking lot is the way you’ll talk to a postpartum mom who hasn’t slept in three days, or a chemo patient who can’t keep food down.
Be kind to her. The nurse you’re going to be is being formed right now.