A Guide to the NCLEX Exam
| Nalea Ko
Developed by the National Council of State Boards of Nursing (NCSBN), the National Council Licensure Examination (NCLEX) is the final step individuals take before obtaining a nursing license. State regulatory boards use the exam to determine if candidates qualify for nursing licensure.
Candidates take either the NCLEX-PN or NCLEX-RN, depending on their career ambitions. Every state requires that future nurses first pass the exam. Among all candidates, including those with different levels of education, about 89.11% passed the RN exam in 2019, and about 74.59% of individuals who took the PN exam passed.
Most applicants take the test about one month after graduating from nursing school. However, employers in some states hire graduates who have yet to take the exam, under the condition that they pass by a certain date.
This NCLEX study guide offers prospective nurses step-by-step instructions on how to pass the NCLEX, including details about test material and format, the scoring system, and what to do after you pass.
NCLEX-PN vs. NCLEX-RN
More than six million candidates have taken the NCLEX since 1994, and the exam continues to serve as a standard tool to evaluate nursing applicants. Prospective nurses take one of two standardized exams to prepare for licensure in their state: the NCLEX-PN or the NCLEX-RN. The two exams feature similar topics and formats, with some exceptions.
The NCLEX-PN suits candidates who earned a diploma in licensed practical nursing or licensed vocational nursing, and prepares candidates to become practical or vocational nurses. The NCLEX-RN prepares applicants to become registered nurses. Applicants who take the RN exam hold an associate in nursing degree or a bachelor’s degree in nursing.
The two exams both have a maximum of 205 questions. However, based on their performance, candidates may only complete the minimum number of questions. The RN test focuses on supervising and managing care, whereas the PN exam covers coordinating nursing care under the supervision of registered nurses.
The tests differ because the roles of registered nurses and practical nurses vary. Licensed practical and licensed vocational nurses perform basic care for patients while working under the supervision of doctors and registered nurses. Registered nurses enjoy more autonomy, working alongside doctors to provide care and administer treatment.
NCLEX Category Breakdown
The test covers four “client needs” categories. Those four areas address the essential competency levels nurses need to perform their duties in a variety of different clinical settings.
NCLEX categories breakdown as follows: safe and effective care environment, health promotion and maintenance, psychosocial integrity, and physiological integrity. Candidates who master these areas do not only pass the exam, but excel as licensed nurses.
These NCLEX categories also contain subcategories, which we explore in greater depth later on in this NCLEX study guide. We also look at the percentage of exam questions featured in each section.
NCLEX Changes During COVID-19
COVID-19 has changed nearly every aspect of life, including NCLEX preparation. The NCSBN reopened Pearson VUE testing centers while adhering to Centers for Disease Control and Prevention guidelines. While the exams' standards and formats remain the same, applicants must follow new safety rules.
All test-takers must now wear a mask, and are permitted to wear gloves. The testing centers have also instituted social distancing and sanitizing measures to keep everyone safe. The number of individuals permitted in test centers has been restricted, and testing centers have increased appointments until Sept. 30, 2020.
How to Study for NCLEX
NCLEX preparation begins with knowing what to expect from the exam. We have gathered and outlined essential information about how to prepare for NCLEX. The next section outlines the exam content, format, time limits, and the grading rubric.
Applicants can also take the RN and the PN practice exams to better prepare for the actual test. The practice exams feature content and formatting similar to the real exam. Questions featured on the practice exams come from old tests that are no longer used.
Practice exams contain two 125-question parts. The RN exam takes up six hours to complete and the PN exam takes up to five hours. Candidates do not always need the full time allotted.
Applicants receive a percentage score after they complete the test.
The NCLEX covers a variety of topics, including fundamental nursing principles and practices. The exam tests an applicant’s knowledge in areas such as safe and effective care environments, health promotion and maintenance, psychosocial integrity, and physiological integrity.
The test also covers a variety of “client needs” categories and subcategories. Sample questions in the psychosocial integrity category cover substance abuse disorders and behavioral interventions. Questions in the safe and effective care environment category address confidentiality and legal rights and responsibilities.
Management of care makes up most questions (about 20%), according to the NCLEX Examination Committee.
The remaining questions cover pharmacological and parenteral therapies (15%); physiological adaptation (14%); reduction of risk potential (12%); safety and infection control (12%); basic care and comfort (9%); psychosocial integrity (9%); and health promotion and maintenance (9%). Actual percentages vary since the test adapts to an applicant’s performance.
The NCLEX uses a computerized adaptive testing (CAT) format that measures an applicant’s performance to determine each subsequent question. If the applicant answers a question incorrectly, the computer then gives them an easier question. Conversely, the better a person performs, the more difficult the next questions become. Both exams mostly ask multiple-choice questions. Applicants also answer fill-in-the-blank, drag-and-drop, and “hot spot” questions.
The NCLEX exam's length depends on the applicant’s performance. The PN exam gives applicants up to five hours and requires that they answer a minimum of 85 questions, with a maximum of up to 205. The RN exam, a far more in-depth test that lasts up to six hours, requires that applicants answer a minimum of 75 questions, with a maximum of 265.
While candidates do not have a time limit to answer each question, they should not spend longer than two minutes on a question.
The NCLEX scoring system identifies a candidate’s skill level by customizing questions. This differs from a fixed test that features the same questions for every candidate, regardless of their abilities.
Questions specifically target a candidate’s ability while factoring in the overall passing standard. According to the NCSBN, this format creates precise results used to gauge a candidate’s readiness for licensure.
No question gets partial credit. The exam adheres to a pass or fail rate that follows three scenarios. At a point in the test the computer stops when it becomes confident that a candidate has passed or failed. This is called the 95% confidence interval rule.
In the second scenario, when the applicant performs near the passing standard, the computer offers the maximum number of questions. In the third scenario, applicants continue until they run out of time.
Candidates can retake the NCLEX up to eight times a year. They must wait at least 45 days between each retake.
How to Prepare for the NCLEX
Preparation for the NCLEX involves more than just studying and taking the practice exam. Keep reading this NCLEX guide to learn about the steps to prepare for the exam, including completing the application and registration forms, paying the registration fee, and preparing for test day.
Registering for the NCLEX is a two-step process. First, the applicant must apply for licensure through their local nurse regulatory body. This ensures that the candidate meets eligibility requirements to register for the NCLEX.
Then candidates must register on the Pearson VUE website or by phone. This generates an authorization to test email that provides dates when candidates can take the test.
For specific licensure eligibility requirements, contact your local nursing regulatory body.
Applicants must pay a registration fee by credit, debit, or prepaid card to take the NCLEX. Charges apply when applicants switch either to or from the PN or RN exams.
In the U.S., candidates pay $200 for the licensure registration fee. Test-takers in Canada pay $360, and those in Australia pay $200.
Other fees include a $50 change of nursing regulatory body charge and a $50 change of exam type charge. Changing the exam language also costs $50.
Applicants may schedule appointments over the phone or online. Visit the NCSBN website to find international and national testing locations.
Testing centers maintain strict guidelines on exam day. Applicants must check in 30 minutes prior to the testing time, and store their electronic devices and personal items such as coats and large jewelry. Only during breaks (scheduled on the second hour and third hour) can students leave and retrieve their belongings. Individuals may take up to two breaks, with time taken out of their allotted testing time.
Tips On Passing the NCLEX In One Attempt
Each exam experience is different and requires its own unique preparation. Understanding how to prepare and sit for the NCLEX exam can make your study sessions more effective and improve your chances of success. The following sections offer some study tips for the exam, as well as strategies that you can use while actually taking the test.
Tips On Studying for the Exam
Tips On Taking the Exam
FAQs After Taking the NCLEX Exam
How are the NCLEX results processed?
Exams undergo two reviews to ensure accuracy. First, a computer at the testing center grades the exam and submits it to Pearson VUE, where it is reviewed again. The results are then sent electronically to the selected nursing regulatory body. Candidates receive results within six weeks.
What does the number of questions I answered on the NCLEX tell me about my score?
Not much. The number of questions each candidate answers does not determine if they have passed or failed. The computerized adaptive testing format offers candidates the opportunity to demonstrate their skills, whether that happens in the minimum or maximum allotted questions.
What if I run out of time on the NCLEX?
Candidates can run out of time before finishing the maximum number of questions and still pass. It matters more that applicants demonstrate skills above the passing standard. If an individual has answered the minimum amount of questions required when time runs out and they have met the passing standard in their last 60 questions, they pass the test.
Candidates who fail the test must wait a minimum of 45 days before retaking the exam. In the interim, they can review their candidate performance report, which shows in what content areas they excelled or underperformed. However, applicants can register through their nurse regulatory body at any time after failing.
How do I get my NCLEX results and how long does it take?
The applicant’s selected nurse regulatory body provides results about six weeks after they take the exam. Applicants whose nursing regulatory body takes part in the Quick Results Service can sometimes get their unofficial results for a nominal fee.
Nursing Licensure and Renewal
After passing the NCLEX, prospective nurses can begin the licensing process. Applicants must first meet requirements outlined by their state's nursing regulatory body, which validates their educational credentials and NCLEX scores. Nurses usually must complete continuing education requirements to renew their licenses. Renewal requirements vary by state.
States taking part in the compact include Idaho, Montana, North Dakota, South Dakota, Wyoming, Utah, Colorado, Arizona, New Mexico, Nebraska, Kansas, Oklahoma, Texas, Iowa, Missouri, Arkansas, Louisiana, Wisconsin, Indiana, Kentucky, Tennessee, Mississippi, Alabama, Georgia, Florida, North Carolina, South Carolina, Virginia, West Virginia, Maryland, Delaware, New Hampshire, and Maine.
Jenneh Rishe, RN, has been a registered nurse for 12 years, working in many different specialty areas such as internal medicine, trauma, kidney transplant, oncology, and leukemia/bone marrow transplant. She is the founder of The Endometriosis Coalition, a non-profit organization focused on spreading awareness and promoting reliable education for endometriosis. Rische received her BSN from La Salle University, and is currently enrolled in Drexel University's Master of Science in Nursing Education program.
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