The NCLEX exam is developed by the National Council of State Boards of Nursing (NCSBN) to assess the competency of nursing school graduates in the United States and Canada.
Two Types of NCLEX Examinations
The NCLEX is available in two formats. The NCLEX-PN is a test that assesses aspiring practical nurses (also known as licensed practical nurses or licensed vocational nurses). The NCLEX-RN is a test for registered nurses.
In some ways, the two tests are comparable, yet they have significant distinctions. The RN test focuses on care management and evaluates the advanced scope of practice of registered nurses. More questions about care coordination appear on the PN exam.
NCLEX Exam Focuses on Four Areas
The NCLEX exam is divided into four main areas of focus: creating a safe and effective care environment, health promotion and maintenance, psychosocial integrity, and physiological integrity.
These broad categories are subdivided further into individual topics. The category of safe and effective care, for example, emphasizes the rights and duties of clients.
NCLEX Registration Varies by State
Candidates must first apply for the appropriate nursing credential from their state boards of licensure and registration in order to register for the NCLEX. You should verify with your state regulatory board before applying because each state has its own set of regulations.
Within one year of registering for the exam, candidates must take the NCLEX. To take the NCLEX-RN or NCLEX-PN, test takers must pay a $200 fee, which can be paid online or over the phone.
COVID-19 Impacts NCLEX Procedures
The NCSBN made modifications in 2020 as a result of the COVID-19 pandemic to make testing as safe as necessary. Some of the adjustments, such as the deletion of 15 practice questions, expired by September 2020.
Others, on the other hand, continue to be upheld. To enter the testing facility, all candidates must don masks and keep them on during the exam.
Some testing centers have shut down, and all must adhere to social distancing rules. Candidates may have to wait longer to book their exams due to the limited number of testing places available.
While these requirements could last indefinitely, they will hopefully ease back as the COVID-19 vaccination becomes more widely available.
What are the Different Subjects Tested?
During nursing school, students always focus on how many questions will be asked on certain topics. This is also a common approach to the NCLEX-RN.
Below is a breakdown of the percentage of each question type you can expect to find on the new exam:
- Physiological adaptation: 14%
- Management of care: 20%
- Reduction of Risk Potential: 12%
- Safety and Infection Control: 12%
- Pharmacological and Parenteral Therapies: 15%
- Basic Care and Comfort: 9%
- Psychosocial Integrity: 9%
- Health Promotion and Maintenance: 9%
Finally, the NCLEX-RN is an adaptive exam, meaning it is structured to meet the demands of individual candidates. The test will adapt to the candidate’s performance, which may involve changes to the test’s length. Each candidate’s percentage of questions distributed may differ.
How Long Do You Have to Take The Exam?
There’s no time limit for each question, but the time limit to complete the exam is six hours. Test-takers have optional breaks after two hours and three and a half hours.
When Can I Take the NCLEX?
Although NCLEX test dates are available throughout the year, your eligibility to take the exam must first be approved by your state’s nursing board or regulatory agency. This usually entails completing an application for a nursing license as you approach the end of your training program.
Once the application has been approved and you have registered for the exam through Pearson VUE, you will receive an email containing an Authorization to Test, or ATT. You must have this in order to schedule your test, as it contains:
- Your authorization number
- Your candidate ID number
- Testing validity dates
Your ATT will expire after a certain period of time (usually 90 days), and you must take your NCLEX within the window of time specified by the validity dates.
How Do I Schedule a Test Date?
When you’re ready to test, you’ll get a copy of the NCLEX Candidate Bulletin, which has all the information you need to schedule the exam online or over the phone.
If you’re taking the NCLEX for the first time, you’ll be given test dates within thirty days after calling or submitting an online request. If this is a retake, suitable slots should be accessible within 45 days of your request.
To ensure the best choices of dates and venues, you should plan a test day as soon as possible. There are a lot of individuals that take this exam, so if you wait too long, you might not be able to get an appointment before your ATT expires. You will not only have to re-register, but you will also have to pay the $200 registration cost once more.
What Can I Expect on Test Day?
After you schedule your test, make sure you’re well prepared to take it! Read the policies outlined in your NCLEX Candidate Bulletin carefully, and familiarize yourself with the policies at your testing center as well. Some important considerations include:
- Identification: You will need to bring valid (government-issued) personal identification, which includes a photo and a signature. This could be a driver’s license, passport, military ID and so on. The name on the ID that you present at the testing center must be an exact match with the name you used to register for the exam.
If there is a mismatch, you will not be allowed to take the exam. You’ll have to register for the exam again (and yes, pay the fee!).
- Personal Items: When you check in at the testing center, you’ll have to store personal items in a locker. Also, you will have to store smart electronic devices (like your mobile phone) in a sealed plastic bag.
Do not open this bag until after it has been okayed by a testing administrator at check-out!
- Test Format: The NCLEX is a computerized adaptive test, which means that its difficulty will adapt to your abilities as you answer each question. This also means the number of questions you have to answer will vary from person to person.
For example, the NCLEX-RN has a maximum of 265 questions (or 205 for the PN version), but the computer will stop generating questions and end the test if it determines that you are well above (or below) the passing standard.
How do I Prepare For The NCLEX Exam?
- Understand the NCLEX Format
The NCLEX is administered in a CAT format, which stands for computerized adaptive testing. This means that no two exams are alike.The computer algorithm generates each new question during the exam based on your performance on prior questions. The exam bank is comprehensive, with a variety of question forms and content themes.
A minimum of 75 and a maximum of 265 questions will be generated by the test. When the tester has properly answered enough questions to stay over the pass line with a 95% confidence interval, the candidate passes the test. When the candidate does not move over the pass line with 95% confidence, the test is considered failed.
- Use NCLEX Exam Study Aids
There are several study guides and classes that can help you prepare for the exam. Take a review class and follow an NCLEX study calendar.
Additional recommended study aids include:
Saunders Comprehensive Review for the NCLEX-RN Examination
HESI Live Review Workbook for the NCLEX-RN Exam
UWorld NCLEX-RN Content Review Guide Book
- Remember Needs Prioritization
When taking the exam, keep in mind that the exam requires prioritizing from nursing school. Always examine the patient first and administer the best appropriate nursing intervention.
Physical requirements that are life-threatening take precedence. Keeping this in mind will assist you in eliminating test alternatives.
- Find Ways to Manage Your Test Stress
Don’t worry, all you nervous test-takers out there. There are methods for dealing with stress.
Test anxiety is real, but you made it through nursing school, so keep preparing the method that worked for you in the past. Even if you don’t have a history of test anxiety, the stress of such a significant exam may cause you to get uneasy.
- Make a Study Plan
It’s a waste of time to study without a strategy, and it won’t help you pass the NCLEX. It’s not about the number of hours you put in, but rather how you put them to use.
The NCLEX is a comprehensive test model that intends to measure knowledge learned over the period of years, not days, therefore you won’t be able to cram for it.
- The Night Before the Test
Some good advice for the night before the test:
Avoid caffeine and alcohol
Eat a good dinner
Gather the documents needed for testing
Know how to get to the testing center (and an alternate route)
Don’t take any new medicine
- Hone Your Test-Taking Skills
Knowing how the test is written is just as important as knowing the correct answers on the NCLEX. To eliminate erroneous answers, use test-taking tactics, avoid “extremes” like ALL or NONE answers, and remember to always put patient safety first.
With practice, you will notice some themes in answers:
Always assess the patient first, calling the doctor right away isn’t usually the best first step.
Use Airway-Breathing-Circulation approach, etc.
Use deductive reasoning even if you have no idea about the concepts behind the topic
If all else fails, rely on that budding feeling that we like to call “nurse intuition”
- Believe in Yourself
Finally: think positively and talk to yourself in positive terms.