The Ultimate NCLEX Study Guide

The National Council Licensure Examination (NCLEX), developed by the National Council of State Boards of Nursing (NCSBN), is the last step before a nursing license. State regulatory boards use it to decide whether a candidate qualifies for licensure.

You take either the NCLEX-PN or the NCLEX-RN, depending on the role you want. Every state requires it. In 2022, about 63.39% of candidates passed the RN exam and about 67.46% passed the PN exam. Most people test about a month after graduating, though some states let employers hire graduates who haven't tested yet, on the condition they pass by a set date.

This guide covers the format, the scoring, and what to do after you pass.

NCLEX-PN vs. NCLEX-RN

More than six million candidates have taken the NCLEX since 1994, and it remains the standard tool for evaluating nursing applicants. The NCLEX-PN fits candidates who earned a practical or vocational nursing diploma and prepares them to work as practical or vocational nurses. The NCLEX-RN prepares applicants to become registered nurses; most hold an associate or bachelor's degree in nursing.

The two exams cover similar topics in similar formats. The difference comes from the roles. Licensed practical and vocational nurses give basic care under the supervision of doctors and registered nurses. Registered nurses work with more autonomy, alongside doctors, to provide care and administer treatment. The RN test focuses on supervising and managing care; the PN exam focuses on coordinating care under RN supervision.

Category breakdown

The exam covers four client needs categories: safe and effective care environment, health promotion and maintenance, psychosocial integrity, and physiological integrity. Each maps to a core competency nurses use across clinical settings. The categories break down further into subcategories, covered below with the share of exam questions in each.

What to expect

NCLEX prep starts with knowing the exam. Below is the content, format, time limits, and grading.

You can take RN and PN practice exams to prepare; the content and format match the real thing, with questions pulled from retired tests. Practice exams come in two 125-question parts. The RN practice exam runs up to six hours, the PN up to five. You won't always need the full time, and you get a percentage score when you finish.

Content and distribution

The NCLEX tests fundamental nursing principles across the four client needs categories and their subcategories. Psychosocial integrity questions cover topics like substance use disorders and behavioral interventions. Safe and effective care environment questions cover confidentiality and legal rights and responsibilities.

For the NCLEX-RN, management of care makes up the largest share, about 15-21%. The rest: pharmacological and parenteral therapies (13-19%), physiological adaptation (11-17%), reduction of risk potential (9-15%), safety and infection control (10-16%), basic care and comfort (6-12%), psychosocial integrity (6-12%), and health promotion and maintenance (6-12%). Actual percentages vary because the test adapts to your performance.

Testing format

The NCLEX uses computerized adaptive testing. Each answer determines the next question: miss one and the computer serves an easier question; answer well and the questions get harder.

The Next Generation NCLEX keeps most of the familiar formats. Both exams are mostly multiple-choice, with extended multiple response, extended drag-and-drop, matrix (grid), cloze (drop-down), and enhanced hotspot items mixed in.

Length depends on performance. The PN exam gives up to five hours and runs from a minimum of 85 questions to a maximum of 205. The RN exam, more in-depth, gives up to six hours and runs from a minimum of 75 questions to a maximum of 265. There's no per-question time limit, but don't spend more than two minutes on any one question.

Scoring

The scoring system pins down your skill level by customizing the questions, unlike a fixed test that gives everyone the same items. Each question targets your ability while factoring in the passing standard. According to the NCSBN, this produces a precise read on your readiness for licensure.

Extended multiple-response questions give partial credit when you get some, but not all, of the answers. The exam passes or fails you under one of three scenarios. First, the computer stops when it's confident you've clearly passed or failed; this is the 95% confidence interval rule. Second, when you're near the passing standard, the computer gives you the maximum number of questions. Third, you continue until time runs out.

You can retake the NCLEX up to eight times a year, with at least 45 days between attempts.

How to prepare

Prep is more than studying and practice exams. Here's the rest: the application, registration, the fee, and test day.

Application and registration

Registering is a two-step process. First, apply for licensure through your nurse regulatory body, which confirms you meet the eligibility requirements. Then register on the Pearson VUE website or by phone. That triggers an Authorization to Test email with the dates you can test. For eligibility specifics, contact your local nursing regulatory body.

What the NCLEX costs

You pay the registration fee by credit, debit, or prepaid card. In the U.S. the fee is $200. In Canada it's $360, and in Australia it's $200. Other charges: $50 to change your nursing regulatory body, $50 to change exam type, and $50 to change the exam language. Switching to or from the PN or RN exam triggers a charge.

Test day

Schedule by phone or online, and find national and international testing locations on the NCSBN website. Testing centers run strict. Check in 30 minutes before your time and store electronics and personal items like coats and large jewelry. You can only retrieve them during breaks, scheduled in the second and third hour. You get up to two breaks, and the time comes out of your testing window.

Passing on the first attempt

Every exam needs its own preparation. Knowing how to study and how to sit the test makes your sessions more effective and cuts exam anxiety.

Studying

• Test early. Schedule the exam right after your program ends, while the material is fresh, so you spend less time relearning.
• Build both recall and critical thinking. The NCLEX asks you to recall facts like symptoms, side effects, and normal lab values, and to reason through questions where several answers look right.
• Use case studies. The Next Generation NCLEX is built to test clinical reasoning through case studies, so practice making the best decision from the information given.
• Learn the format. Knowing the structure makes your study time count.
• Take practice tests. They show you the common pitfalls before test day.
• Mimic test conditions. Set a timer, kill distractions, and run full practice tests so the stressors feel familiar.
• Study steadily, don't cram. There's too much material to relearn in a few days, so give yourself time to absorb it.

Taking the exam

• Come ready. Dress comfortably, sleep enough, and eat; hunger and drowsiness drag down your performance.
• Visualize the scenarios. Picture the situations in the questions to pull from what you learned in your program.
• Eliminate wrong answers first. Cut the obvious wrong choices, narrow to two, and decide which is more correct.

Licensure and renewal

After you pass, the licensing process starts. Meet your state board's requirements, which validate your credentials and NCLEX scores. Most states require continuing education to renew, and the requirements vary by state.

The Nurse Licensure Compact (NLC) lets nurses work in their home state and other participating states without applying for reciprocity, saving time and money. Participating states 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, Ohio, New Jersey, Vermont, and Maine.

After the exam: FAQ

How are results processed?

Each exam gets two reviews. A computer at the testing center grades it and sends it to Pearson VUE for a second review. Results then go electronically to your nursing regulatory body.

Does the number of questions tell me my score?

Not much. The count doesn't determine pass or fail. The adaptive format lets you show your skill whether you answer the minimum or the maximum.

What if I run out of time?

You can run out before the maximum and still pass. What matters is performing above the passing standard. If you've answered the minimum number of questions when time runs out and stayed above the standard across your last 60 questions, you pass.

What if I don't pass?

Wait at least 45 days before retaking. In between, review your candidate performance report, which shows where you did well and where you fell short. You can re-register through your regulatory body any time after failing.

How do I get results, and how long does it take?

Your nursing regulatory body provides results about six weeks after the exam, though timing varies by state. If your regulatory body uses the Quick Results Service, you can sometimes get unofficial results within 48 hours for a small fee.