What is the NCLEX?

NCLEX, which stands for the National Council Licensure Examination, refers to the two standardized tests all candidates are required to pass to become either a Licensed Practical Nurse (LPN) or a Registered Nurse (RN).

To become officially licensed, individuals with an approved nursing degree must pass either the NCLEX-RN or NCLEX-PN. This is a crucial step on every nursing journey as it provides states with a way to independently verify knowledge and gauge a nurse’s ability to practice safely.

Who Takes the NCLEX?

Anyone who desires to work as an RN or LPN, or who wishes to further their education and become an Advanced Practice Nurse (APRN) is required to pass the NCLEX exam.

Individuals holding a Practical Nursing diploma who desire to become an LPN must pass the NCLEX-PN. Those holding either an Associate Degree in Nursing and/or Bachelor of Science in Nursing (BSN) who wish to become an RN must pass the NCLEX-RN.

NCLEX-PN vs. NCLEX-RN

Both are Computerized Adaptive Testing (CAT) exams; the overall format is similar but not identical. With CAT exams, the system adjusts question count depending upon provided responses until competency of the covered topics can be determined. Much of the differentiation between the two exams is centered around the actual content of their questions. Both exams can consist of between 75 to 145 questions and are capped at five hours each.

Both exams cover the following topics:

  • Safe and Effective Care
  • Health Promotion and Maintenance
  • Psychosocial Integrity
  • Physiological Integrity

Although LPNs and RNs provide patient care, RNs have a broader scope of practice, and the NCLEX-RN echoes that responsibility. Registered Nurses may oversee LPNs, so the NCLEX-RN is weighted more toward managing others, while the NCLEX-PN is heavily focused on coordinating care between clinicians.

What Types of Questions Appear on the NCLEX?

NCLEX questions are written specifically to test a candidate’s complex thought process. There can potentially be more than one correct answer; selecting the answer that is “most correct” will demonstrate both a candidate’s critical thinking skills and their ability to make efficient decisions.

There are various question formats, including:

  • Chart/Exhibit
  • Drag & Drop
  • Fill in the Blank
  • Hot Spot Items
  • Multiple Choice
  • Multiple Response
  • Ordered Response

It is recommended to thoroughly review each question carefully to fully understand exactly what is being asked. Distractor answers are quite common on the NCLEX and are designed to confuse candidates by providing multiple scenarios. Exam takers must carefully select answers within the scope of practice for a nurse and prioritize patient care accordingly.

Both exams also include the standard memorization and knowledge of facts questions candidates would typically find on any other examination. Dedicate a significant amount of time studying, memorizing, and preparing to answer questions about vital nursing concepts.

The Next Generation NCLEX (NGN)

Asking the Right Questions for Real Life Practice

In 2009, the NCSBN connect with nursing professionals in clinical practice and industry experts and determined level of decision making with nursing had led to numerous errors made by recently licensed nurses. Studies uncovered up to 65% of entry-level nurse errors were related to poor clinical decision-making and only 20% of nurse employers were satisfied with their judgement capabilities.

From 2012-2014, the NCSBN supported two nursing practice and the entry-level nurse studies. Cataloged by more than 2,500 pages, these reports established the need for clinical judgment to be considered one of the top five skills required for recently licensed nurses entering the field to practice. Additionally, problem solving, and critical thinking were also identified as being vital to clinical judgment.

Top Five Skills Required for Recently Licensed Nurses:

  • Clinical Judgement
  • Problem Solving
  • Critical Thinking
  • Active Listening
  • Professional Communication

The RN Nursing Knowledge Survey from 2017 offered more evidence of the need for clinical judgment. Newly licensed RNs, RN supervisors, and RN educators unanimously agreed on the importance of clinical judgment. LPN experts shared the same concerns. As a result of these findings, the NCSBN determined it was vital to move forward with the Next Generation NCLEX (NGN) Project.

Year Long Research and Analysis

The NCSBN’s team of researchers and psychometricians have followed eight evidence-based steps to prepare for the new version of the exam:

NGN Special Research Section

Starting in July 2017, the NCSBN began including a Special Research Section (SRS) as part of the NCLEX-RN exam for select candidates. In October 2020, it began offering an SRS to select PN candidates.

The SRS presents unique item types that are specially designed to evaluate the candidate’s clinical judgment skills.

Candidates receive 30 minutes to complete the SRS after their standard NCLEX exam with no impact on their NCLEX score.

Candidates’ answers provide data to the NCSBN for use in testing and analyzing the new item types.

The NCSBN says, “This research helps identify Next Generation NCLEX (NGN) items that are at the appropriate difficulty level for entry-level nurses — items that are neither too difficult nor too easy. The research section also helps gather data related to the time required to respond to the new NGN items. Validating both the content and the measurement properties of items is essential to developing a standard-leading assessment of clinical judgment.”

For more information on the NGN, download the Next Generation NCLEX Guidebook prepared and presented by ATI Nursing Education.

What Information does the NCLEX Cover?

There are four main content categories covered on both NCLEX exams:

  • Safe and Effective Care Environment:
    • Accident Prevention
    • Ethics
    • Client Rights
    • Home Safety
  • Health Promotion and Maintenance:
    • Prevention of Future Health Problems
    • Growth & Development Principles
    • Aging Process
    • Newborn Care
    • Lifestyle Choices
    • Developmental Stages
  • Psychosocial Integrity:
    • Mental Illness
    • Emotional Factors
    • Social Factors
    • Mental Factors
  • Physiological Integrity:
    • Physical Wellness Promotion
    • Risk Management
    • Therapeutic Procedures
    • Abnormal Responses to Therapy



NCLEX examinations are administrated adaptively in variable length formats specific to each candidate. To accommodate possible variations in examination length, content area distributions of the individual examinations may differ up to ±3% in each category.

Before Taking the NCLEX

Authorization to Test and NCLEX Registration

All candidates are required to obtain an Authorization to Test (ATT) through their respective nursing regulatory body (NRB) before being eligible to take the NCLEX. Once a NRB declares an individual eligible to test, their ATT will be delivered directly to the email used during registration. Standard ATTs consist of a candidate’s authorization number, unique identification number, and expiration date. Once issued, an ATT is valid only until the date provided. The average length of validity is approximately 90 days and cannot be extended for any reason.

Everyone wishing to take the NCLEX must register with Pearson VUE, the official testing partner responsible for administering both computer-based exams. This can be done before receiving an ATT, but to schedule an appointment to take the NCLEX examination, an ATT authorization number is needed. Once an ATT is received, it is best to lock in a testing date within the validation window. It is recommended individuals begin the entire process well in advance of their target exam date to avoid any potential timing issues.

NCLEX Fees and Payments

Associated exam registration fees are collected during the NCLEX registration process. Depending on the candidate’s needs, additional fees may apply.

Registration confirmation typically occurs quickly. If, after 48 hours, confirmation has still not been received, do not submit a second registration or payment. It is recommended applicants reach out to NCLEX Candidate Services to verify registration status.

Credit, debit, and prepaid cards are the only acceptable forms of payment to register for the NCLEX.

NCLEX Exam Preparation

Walking in prepared on exam days important, so understanding how to properly prepare is essential. There are numerous resources out there to help candidates walk in confidently to pass the exam. It is extremely important for individuals to be aware of the most effective learning method for their learning style.

Exam preparation comes in many forms including:

  • Web Platforms
  • Mobile Apps
  • Books
  • Live Courses
  • Podcasts
  • Blogs

Since the NCLEX exams have a unique method of testing critical thinking skills, one of the best ways to prepare is by answering practice questions and reviewing rationales on both correct and incorrect responses. The exams test a candidate’s comprehensive recall and assess how well concepts learned in nursing school are applied to real-life scenarios.

Utilizing a computerized platform with practice questions and full-length practice exams is essential in familiarizing oneself with the adaptive style of the NCLEX. Preparing for the exam in the same style as the actual exam is proven to provide a higher success rate.

Be Prepared for NCLEX Exam Day

Arrival and Preparation

Make sure to dress comfortably and review top tips for test day; depending on a candidate’s responses, the examination could last the full five hours. Plan to arrive well ahead of the scheduled start time, anyone arriving more than 30 minutes late may have to forfeit their seat, reregister, and pay an additional exam fee.

Before being allowed to sit for the NCLEX, individuals are required to present one form of acceptable identification. Both the first and last name on the identification must match exactly to the name used to register for the exam.

All forms of identification must be valid and meet the following requirements. If requirements are not met, individuals will be turned away and required to reregister and pay another fee.

  • Identification Requirements:
    • Government-Issued
    • Non-Expired
    • Name (in Roman characters)
    • Recent Photograph
    • Signature
  • Acceptable Forms of Identification:
    • Passport Books & Cards
    • Driver’s License
    • Provincial/Territorial or State Identification Card
    • Permanent Residence Card
    • Military Identification Card

In addition to showing a valid form of identification, candidates will be required to provide a digital signature, have their photograph taken, and undergo a palm vein scan.

Exam Pace and Finishing Up

Candidates are allowed up to five hours to complete both the NCLEX-RN and NCLEX-PN exams, including the short tutorial and two optional breaks. The first of the breaks comes two hours into testing, with the second scheduled after three and a half hours of testing. Individuals are recommended to take their time analyzing each question carefully, as once an answer choice is submitted it cannot be changed.

After the exam concludes, there is a short survey for everyone to fill out. Upon completion, candidates are required to raise their hand and wait for the TA to be dismissed.

Even though the exam is graded as individuals progress, everyone’s score goes through a second verification process directly with Pearson VUE. Scores are not available and will not be released at the test center.

Computer Adaptive Testing (CAT)

NCLEX exams are CAT-administered exams which are unique to each candidate. With CAT exams, the system adjusts question count depending upon provided responses until competency of the topics can be determined. The computer uses an algorithm to serve up the next question and will only allow for a maximum of 145 questions to be asked to individuals sitting for the exam.

Individuals on the edge of a passing score will continue to receive questions until time runs out or the confidence threshold is met, and nursing competency has been determined. Because of the adaptive style of the exam, exam duration will vary for everyone.

The responsive computerized exam helps develop a better gauge a nurses’ overall competence. It allows for many questions varying in difficulty to be answered while determining marginal candidates from those who are prepared and ready to practice in the real world.

Why Use the CAT Method?

CAT exam benefits include:

  • Asses capabilities with questions of varying difficulty
  • Reduces item exposure and possible security risks
  • Increases the precision of measurement of candidates’ nursing ability
  • Offers a valid and reliable measurement of nursing competence

CAT Definitions

  • Candidate Ability – The level of entry-level nursing knowledge, skills, and abilities candidates maintain.
  • Ability Estimate – The level of entry-level nursing knowledge, skills, and abilities that the CAT exam has determined a candidate maintains.
  • Passing Standard – A point along the ability range that marks the minimum requirement level to practice entry-level nursing safely and effectively.
  • Logit – A unit of measurement to report relative differences between candidate ability estimates and area specific difficulties.

NCLEX Exam Day Policies

NCSBN Examination Candidate Rules

At exam check-in, everyone is directed to read the full Candidate Statement. Any violation of the NCSBN Examination Candidate Rules or disregarding Test Administrator (TA) instructions, may result in withholding exam results and/or cancellation without refund. The NCSBN and/or NRB may take additional action, up to and including license revocation and referral to law enforcement for criminal prosecution. An electronic signature is required agreeing to the terms and conditions of the NCLEX prior to sitting for the examination.

Additionally, to ensure security, exams are always monitored and recorded by both audio and video.

Electronic Device Policy

All electronic devices, including phones, smart watches, MP3 players, fitness bands, jump drives, cameras, etc. must be placed inside a Pearson VUE provided plastic bag.

  • Refusal to store any electronic device in the approved Pearson VUE bag upon check-in will result in forfeit of exam seat. Individuals will be required to reregister and pay another exam fee prior to making another appointment.
  • Return the bag unopened: Upon completion of the exam, the Pearson VUE bag must be returned unopened, to the administration desk and will be opened and inspected by the TA. Any tampering will result in an incident report.

Personal Items Policy

Personal items must be stored in a locker on site. Pearson Professional Centers are not responsible for items lost, stolen, or misplaced. Any questions regarding what can and cannot be accessed outside the exam room should be directed to the TA.

The following cannot be accessed during the exam:

  • Study Notes
  • Electronic Devices
  • Weapons of any kind

The following may be accessed only while on break:

  • Bags, Purses, Wallets, Watches
  • Coats, Hats, Scarves, Gloves
  • Medical Aids & Devices
  • Food & Drink
  • Gum & Candy
  • Lip Balm

Examination Confidentiality

Disclosure of examination items before, during, or after the examination is prohibited and may result in referral to law enforcement for criminal prosecution.

  • You may not remove examination items and/or responses (in any format) or notes about the examination from the testing room. 

NCSBN Examination Candidate Rules

  • You may not disclose or discuss with anyone, including instructors, information about the items or answers seen in your examination (this includes posting or discussing questions on the Internet and social media websites).
  • You may not reconstruct exam items using your memory of your exam or the memory of others.
  • You may not seek help from any other party in answering items (in person, by phone, text or by email) during your examination (including breaks).
  • You may not copy or reconstruct exam items during or following your exam for any reason. Do not copy exam items word-for-word onto the note boards provided.
  • You must comply with any investigation that needs to be conducted.
  • Note: If you witness any of the above behavior, or any irregular behavior that is in violation of the Candidate Rules, you are required to report it to NCSBN and comply with any follow up investigation.

Testing Room Policy

  • The TA will provide you with an erasable note board and marker before you enter the testing room.
  • You may not use the note board to cover any part of the screen during your examination.
  • A clean note board can be requested during your examination by raising your hand. The erasable note board and marker may not be removed from the testing room during the examination except by the TA, and these items must be returned to the TA after the examination.
  • Writing on any materials other than the note board is strictly prohibited and will result in an incident case report and results will be placed on hold (do not make notes to yourself on your hands or anywhere on your body about items you see on the exam).
  • If you experience hardware or software problems during the examination, notify the TA immediately by raising your hand.
  • Earplugs are available from the TA upon request; it is not acceptable to bring your own earplugs.
  • You may not take the examination for somebody else.

Break Procedures

You will be given the opportunity to take a scheduled break after approximately two hours, and again after approximately three and a half hours of examination testing time. Instructions will appear on your computer screen at the appropriate times. All breaks count against testing time. The exam clock will not stop while you are on a scheduled or unscheduled break.

  • To request a break at any other time, or to exit the testing room for any other reason, you must raise your hand and wait to be escorted out of the testing room. A palm vein scan will be taken when you leave, and again when you re-enter the testing room. The TA will resume the exam for you upon your return.
  • Lanyard policy: The TA will attach a lanyard to your locker key. The lanyard must remain visible during the break.

Reporting Examination Concerns

If you have any problems or complaints regarding the examination or its administration, please call Exam Candidate Services toll free at 1-866-496-2539, or email [email protected], within 14 days of your examination.

Exam data is encrypted and transferred electronically to your nursing regulatory body. Please refrain from asking the TA about exam content and/or results. If you have questions about the examination, please contact NCSBN at [email protected].

NCLEX Results & Pass/Fail Rules

The CAT system decides whether candidates passed or failed the NCLEX using one of following rules:

95% Confidence Interval Rule

The most common rule for NCLEX candidates. The CAT algorithm will stop asking individuals sitting for the exam questions when it is 95% certain their ability is clearly above or below the passing standard.

Maximum-Length Exam Rule

When the system gauges an individual’s ability is close to the passing standard, the computer continues to serve questions until the maximum number is reached. At this point, the 95% confidence rule is disregarded, and the system decides whether you pass or fail by your final ability estimate.

  • If an estimate of final ability is above the passing standard, individuals receive a pass.
  • If an estimate of final ability is at or below the passing standard, individuals receive a fail.ceptable to bring your own earplugs.

Run-out-of-time (R.O.O.T.) Rule

If a candidate sitting for the exam runs out of time before answering the maximum number of questions and the computer is unable to determine if the individual passed or failed with 95% certainty, an alternate rule applies:

  • If the minimum number of questions has not been reached, individuals will receive a fail.
  • If the minimum number of questions has been reached, the exam is scored using the final ability estimate the computer is able to determine from the recorded responses.
  • If an estimate of final ability is above the passing standard, individuals receive a pass.
  • If an estimate of final ability is at or below the passing standard, individuals will receive a fail.

Unofficial and Official Results

Candidates whose NRB participates in the Quick Results Service may access their "unofficial" results two business days after sitting for the exam. NCLEX Quick Results Service results do not authorize an individual to practice as a licensed/registered nurse. This service only applies to candidates seeking licensure in the U.S. and can be purchased for $7.95 through the NCSBN Candidate Profile.

Unofficial results are available in every state except those highlighted below:

Official results are only available through the NRB and will be sent directly to anyone that sat for the NCLEX six (6) weeks after the exam. Individuals should not call NCSBN, Pearson VUE, NCLEX Candidate Services, or any testing center for results.

Retaking the NCLEX

Didn’t Pass the NCLEX?

It is not the end of the road for those who do not initially pass an NCLEX exam. Candidates will receive a NCLEX Candidate Performance Report (CPR). An individual’s CPR is a personalized document illustrating how a candidate performed in each content areas. This CPR should be used as a guide to prepare to sit for the exam again.

Retaking NCLEX

If a candidate does not pass the NCLEX and would like to sit again, the following steps are required:

  • Notify the NRB when planning to retake the exam.
  • Determine fees and additional materials required by the NRB.
  • Reregister with Pearson VUE and pay the exam fee.
  • Wait to receive your new ATT.
  • Select a new exam date

Per NCSBN policy, candidates must wait a minimum of 45 days between retaking the exam. The NRB governs this waiting period, and this will reflect on the new ATT’s validity dates.

After Passing the NCLEX

Find Your First Nursing Job

Many medical institutions proactively hire nurses with the contingency of a passing score on the NCLEX prior to beginning employment. Individuals may actively enter the workforce upon receipt of official NCSBN official results in the mail. If a position is not secured prior to sitting for the exam, it is time to begin hunting for a nursing position.

A single application can be very time consuming. Allow yourself enough time to accurately fill out each submission. Letters of recommendation for up to five different sources are recommended to submit with each application. An individual’s nursing program is the perfect time to begin gathering this information so when the time comes to land a nursing job there are fewer hurdles in the process.

Don't Toss All Those Study Materials

Many individuals consider getting rid of their college textbooks, class notes, journals, and papers. Everyone might want to consider keeping these valuable tools for the time being, as they are extremely helpful to refer to for career nurses. When entering the nursing field and actively using your hard-earned knowledge and skills for the first time, it is beneficial to have some of these items to refer to and stay on top of the various areas of nursing practice.

Consider Advancing Your Education

Every nurse entering the workforce typically does not know exactly what specialty they would like to pursue to advance their education. Gathering research on what local institutions offer new graduate nursing programs and their hiring specialties is highly advised either during nursing school or soon after entering the workforce. Most programs have dedicated training programs designed for recently licensed nurses. Applying to an advanced nursing program is not for everyone, but the research is great to have done ahead of time should a nurse decide to pursue later in their career.

Education does not stop after passing the NCLEX and entering the field as a licensed nurse. Medical knowledge is constantly evolving, and nurses are constantly learning new skills and technologies with every shift. To be a top performer, it is essential to deep dive into your specialty and always strive to be an expert.

Many nurses prove themselves as an expert in the field by earning certifications in their respective specialty. Achieving a specialty specific certification shows administrators, peers, and patients that an individual has a high level of nursing knowledge and is an expert in the field. It is not uncommon for a nurse to obtain two or more certifications and cross over into new specialties.

Why Study for the NCLEX with BoardVitals?

We provide access to 3,500+ NCLEX-RN and 1,600+ NCLEX-PN practice questions written and reviewed by top nurses and nursing educators. Written in the same style as the actual exam, each of these questions is accompanied by detailed explanations and rationales to provide a comprehensive understanding of the topics found on the exam.

Preparing for the NCLEX with BoardVitals allows access to many features above and beyond the competition. Bonus features details below:

Unlimited CAT Practice Exams

To simulate actual NCLEX exam conditions, our question banks are equipped with CAT technology. Users can create a CAT practice exam to provide a sense of the style and difficulty of the exam at an individualized level. Every time a user answers a question correctly, subsequent questions will increase in difficulty until a question is answered incorrectly. Similarly, questions will get easier as more questions are answered incorrectly.

The number and difficulty of questions will vary for each user, because the exam is considered complete once the competence of a candidate is determined. As you review, your questions on practice exams will reflect your improved understanding.

Users can create an UNLIMITED amount of CAT practice exams.

Alternate Question Formats

There are many types of questions that can appear on the NCLEX exam. Our question banks include every question format found on the actual exam to help candidates feel confident they are prepared walking in on exam day. Various forms of NCLEX questions include:

  • Select all that apply (SATA) or multiple response items
    • Requires examinees to select more than one correct answer
  • Graphic items
    • Items with graphics as answer options instead of text
  • Hot spot items
    • Requires examinees to select an area of a figure to answer the presented problem
  • Drag and drop ordered response items
    • Requires examinees to move options in a certain order
  • Fill in the blank calculation items
    • Examinees must type in numbers in a calculation
  • Audio questions
    • Examinees select an answer based on an audio clip
  • Exhibit questions
    • Examinees will read a problem and interpret the information on a chart/exhibit to answer the problem

Vital Concept

Every question has a Vital Concept section, which provides additional key information and/or a summary of important points for quick recall. Designed to help not only understand where many candidates go wrong, this section also highlights key takeaways important to understand for each concept and knowledge area tested.

Detailed Explanations for Distractor Answers

Our question banks have always included detailed explanations, and the NCLEX specific question banks include additional details that focus specifically on the distractor explanations meant to trip up candidates on exam day. These distractor explanations include graphics and images when applicable to help retain the information better.

Free NCLEX Trial

Sign up for a free trial today and see how easily BoardVitals can help you prepare for and ace your exam:

NCLEX-RN Trial
NCLEX-PN Trial

Additional Nursing Resources:

Footnotes:
*NCLEX® is a Registered Trademark of the National Council of State Boards of Nursing

References:
1.https://www.ncsbn.org/
2.https://www.nursingworld.org/
3.https://nurse.org/