6 Things to Know About the NCLEX Examination

Jody Dugan, RN, BSN
By
Updated on September 13, 2024
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    The NCLEX is a critical step in getting your nursing license. Learn how many questions are on the NCLEX and other key facts about this all-important national exam.
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    To practice as a registered nurse, you must first pass the National Council Licensure Examination (NCLEX). This all-important exam tests the knowledge and skills of recent nursing school grads to ensure they’re ready to earn their nursing license — and take care of patients in the real world.

    After graduation, the NCLEX assesses what you learned in nursing school — the knowledge base essential to providing optimal patient care.

    Whether your test date is on the horizon or still years away, this guide details six key facts you should know as you prepare for the NCLEX exam.

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    1 | There Are Two Types of NCLEX Examinations

    The NCLEX offers two testing tracks. The NCLEX-RN is designed for registered nurse (RN) candidates, and the NCLEX-PN is for licensed practical nurse (LPN) or licensed vocational nurse (LVN) candidates. The two versions are similar in many ways but have some important differences.

    The NCLEX-RN exam has physical science questions and emphasizes assessment and management of care. The exam is designed for graduates of registered nursing programs with a broader scope of practice than basic patient care.

    The NCLEX-PN exam focuses more on care coordination and data collection. It is intended for graduates of practical or vocational nursing programs.

    2 | The NCLEX Examination Has Four Main Sections

    The NCLEX is organized into four broad categories: Safe and Effective Care Environment, Health Promotion and Maintenance, Psychosocial Integrity, and Physiological Integrity.

    The Safe and Effective Care Environment and Physiological Integrity category is broken down further into subcategories. This is one area where the RN and PN exams differ. This section on the NCLEX-RN version contains questions assessing ethical and legal knowledge and more complex scenarios.

    Additionally, the NCLEX-RN adds parenteral therapies to the pharmacological therapies section on the NCLEX-PN, addressing central venous access devices, IV therapy, total parenteral nutrition, and blood transfusion.

    NCLEX-RN Test Plan

    1. Safe and Effective Care Environment
      1. Management of Care: 15-21%
      2. Safety and Infection Control: 10-16%
    2. Health Promotion and Maintenance: 6-12%
    3. Psychosocial Integrity: 6-12%
    4. Physiological Integrity
      1. Basic Care and Comfort: 6-12%
      2. Pharmacological and Parenteral Therapies: 13-19%
      3. Reduction of Risk Potential: 9-15%
      4. Physiological Adaptation: 11-17%

    NCLEX-PN Test Plan

    1. Safe and Effective Care Environment
      1. Coordinated Care: 18-24%
      2. Safety and Infection Control: 10-16%
    2. Health Promotion and Maintenance: 6-12%
    3. Psychosocial Integrity: 9-15%
    4. Physiological Integrity
      1. Basic Care and Comfort: 7-13%
      2. Pharmacological and Parenteral Therapies: 10-16%
      3. Reduction of Risk Potential: 9-15%
      4. Physiological Adaptation: 7-13%

    3 | How Many Questions Are on the NCLEX Exams?

    The Next Gen NCLEX (NGN) edition was launched in April 2023. This enhanced version has a maximum time limit of five hours and contains between 85-150 questions.

    The variation in the number of questions is based on the NGN’s ability to adjust the number and difficulty of questions in real time based on your performance. The total also includes 15 unscored pretest questions sprinkled throughout the exam used for planning future exams.

    While the NCLEX mainly consists of multiple-choice questions, there are alternate formats for item responses. Types of questions include:

    • Multiple Choice: Choose the one correct answer
    • Multiple Response: Choose multiple answers; Select All That Apply (SATA)
    • Fill in the Blank: Fill in a blank space with the correct answer
    • Hot Spot: Find a particular area on a diagram or image (usually a body part)
    • Drag-and-Drop: Choose items in one box and place them in the correct sequence in another box
    • Exhibit/ Chart: Answer questions based on a chart
    • Audio: Listen to sounds such as heart or lung sounds and identify what you hear

    Use our NCLEX study guide to master all the question formats.

    4 | The NCLEX is Scored on a Pass-Fail System

    Instead of a percentage-based grade, the NCLEX uses a pass-fail system. The exam uses a scoring algorithm to customize your test-taking experience and questions are based on your answers to previous questions.

    A correct answer is followed by a more difficult question, while an incorrect answer is followed by a question that is less challenging. This method allows the computer to become increasingly more precise in assessing your knowledge.

    The computer will adapt your exam — and decide whether you’ve passed or failed — using one of three rules:

    1. The 95% Confidence Interval Rule: The computer ends the test when it is 95% sure that you’ve passed or failed.
    2. Maximum Length Exam Rule: The computer continues to ask questions until you complete all questions on the test. Once you complete the exam, the computer determines a pass or fail final ability estimate.
    3. The Run-Out-of-Time Rule: If you have not completed the test within the five-hour window and you have not met the 95% confidence interval rule, one of the following will occur:
      • The computer will fail you if you haven’t answered the minimum number of questions.
      • If you answered the minimum number of questions, the computer uses the final ability estimate for the questions you answered to determine if you passed or failed.

    5 | NCLEX Registration Varies by State

    To register for the NCLEX, you must first apply for a nursing credential from your state licensing board. Since each state has its distinct nursing licensure requirements, check with your state board of nursing for details before applying.

    While state-specific mandates exist, graduating from a board-approved and accredited nursing program is a nationwide requirement.

    To sit for the NCLEX-RN you must have either a bachelor of science in nursing (BSN) or an associate degree in nursing (ADN). LPN and LVN candidates must graduate from an approved certificate or diploma program to take the NCLEX-PN.

    6 | Applying for the NCLEX

    There are several important steps in the NCLEX-RN or NCLEX-PN registration process.

    1. Submit an application to your state nursing board or the state you plan to practice.
    2. Register for the NCLEX on the Pearson VUE website. You will need to provide your email address and an educational program code from the school you graduated from. You can register and pay the $200 fee online or by phone.
    3. Receive an email from Pearson VUE acknowledging your NCLEX registration.
    4. Receive an email from your nursing board deeming you eligible to take the exam.
    5. Receive an email from Pearson VUE with your Authorization to Test, or ATT.
    6. Schedule your exam through Pearson VUE at a designated testing center.
    7. Complete your NCLEX within the validity dates listed on your ATT.

    Please note that the Pearson VUE testing site will not have access to your scores. Official results can only be obtained through your nursing board.