6 Things To Know About The NCLEX Examination

Before you can practice as a registered nurse, you have to pass the National Council Licensure Examination (NCLEX). It tests what you learned in school, the knowledge you'll lean on caring for real patients. Here are six things to know as you prepare, whether your test date is weeks out or years away.

1 | There Are Two Types of NCLEX Examinations

The NCLEX has two tracks. The NCLEX-RN is for registered nurse candidates; the NCLEX-PN is for licensed practical or vocational nurse (LPN/LVN) candidates. They overlap, but the differences matter.

The NCLEX-RN includes physical science questions and emphasizes assessment and management of care, matching the broader RN scope. The NCLEX-PN leans toward care coordination and data collection, built for practical and vocational program graduates.

2 | The NCLEX Has Four Main Sections

The exam covers four categories: Safe and Effective Care Environment, Health Promotion and Maintenance, Psychosocial Integrity, and Physiological Integrity.

Safe and Effective Care Environment and Physiological Integrity break down further into subcategories, and this is where the RN and PN exams diverge. The RN version adds questions on ethical and legal knowledge and more complex scenarios. It also adds parenteral therapies to the pharmacological section, covering 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?

The Next Gen NCLEX (NGN) launched in April 2023. It runs up to five hours and contains 85 to 150 questions. The count varies because the NGN adjusts question number and difficulty in real time based on your performance. The total includes 15 unscored pretest questions mixed throughout, used to plan future exams.

Most questions are multiple choice, but you'll see alternate formats:

• Multiple Choice: Pick the one correct answer.
• Multiple Response: Pick multiple answers (Select All That Apply, SATA).
• Fill in the Blank: Type the correct answer.
• Hot Spot: Find a spot on a diagram or image, usually a body part.
• Drag-and-Drop: Place items in the correct sequence.
• Exhibit/Chart: Answer based on a chart.
• Audio: Identify a sound, such as heart or lung sounds.

4 | The NCLEX Is Scored Pass-Fail

There's no percentage grade. A scoring algorithm tailors your exam in real time: each question is chosen based on how you answered the last one. Answer correctly and the next question is harder; miss one and the next is easier. That lets the computer zero in on your ability.

The exam ends and decides pass or fail using one of three rules:

1. 95% Confidence Interval Rule: The test ends once the computer is 95% sure you've passed or failed.
2. Maximum Length Exam Rule: The test continues until you've answered every question, then determines a final ability estimate.
3. Run-Out-of-Time Rule: If you hit the five-hour limit without meeting the 95% confidence rule, the computer fails you if you didn't answer the minimum number of questions. If you did, it uses your final ability estimate to decide.

5 | NCLEX Registration Varies by State

To register, first apply for a nursing credential from your state licensing board. Requirements differ by state, so check with your state board of nursing before applying. One thing is nationwide: you have to graduate from a board-approved, accredited program.

To sit for the NCLEX-RN, you need a bachelor's degree (BSN) or an associate degree in nursing (ADN). For the NCLEX-PN, you need an approved certificate or diploma.

6 | Applying for the NCLEX

The registration process runs in steps:

1. Submit an application to the nursing board of the state where you plan to practice.
2. Register for the NCLEX on the Pearson VUE site. You'll need your email and an educational program code from your school. Pay the $200 fee online or by phone.
3. Get a confirmation email from Pearson VUE.
4. Get an eligibility email from your nursing board.
5. Get your Authorization to Test (ATT) from Pearson VUE.
6. Schedule your exam at a Pearson VUE testing center.
7. Test within the validity dates on your ATT.

Pearson VUE never has your scores. Official results come only through your nursing board.