An important step on the road to becoming a certified registered nurse is passing the National Council Licensure Examination for Registered Nurses (NCLEX). Simply graduating with a BSN or associate’s degree in nursing is not enough to begin working. In every state, prospective RNs are required to pass the NCLEX exam first.
Established by the National Council of State Boards of Nursing, the NCLEX exam ensures public protection by establishing standards for professional practice, and testing entry-level nursing competence. In short, the NCLEX is designed to determine if you have the skills and critical thinking required to begin practicing as a nurse.
The NCLEX test requires prospective RNs to analyze and apply knowledge obtained in nursing school. You’ll be tested on how well you use critical thinking skills to make decisions about common nursing situations. Here, we’ll tell you what to expect, explore the best study tips and discuss how preparing for the exam may increase your chance of passing.
Sections of the NCLEX Exam
The most important tip anyone can receive regarding the practical aspects of preparing for the NCLEX is to read the most recent NCLEX Examination Candidate Bulletin. This web-based guide provides the most up-to-date information for NCLEX candidates, including registration process, test fees and policies, scheduling an exam appointment, what to bring to the test site, test site rules and regulations, the check-in process and much more.
The NCLEX is divided into sections that support a framework of “Meeting Client Needs.” It is made up of four categories and six subcategories:
- Safe and Effective Care Environment
- Management of Care: 17-23% of questions
- Safety and Infection Control: 9-15% of questions
- Health Promotion and Maintenance: 6 – 12% of questions
- Psychosocial Integrity: 6 – 12% of questions
- Physiological Integrity
- Basic Care and Comfort: 6 – 12% of questions
- Pharmacological and Parenteral Therapies: 12 – 18% of questions
- Reduction of Risk Potential: 9-15% of questions
- Physiological Adaptation: 11 – 17% of questions
The categories and subcategories will be integrated throughout with the following processes, which are fundamental to the practice of nursing:
Nursing process — an approach to client care that is science-based, using clinical reasoning and including assessment, planning, implementation and evaluation
Caring — a collaborative environment in which nurse will provide encouragement, hope and compassion to help achieve desirable patient outcomes
Communication, documentation — the verbal and nonverbal interaction with patients, significant others and fellow healthcare providers, as well as the record-keeping that provides evidence of adherence to standards of practice and accountability
Teaching, learning — the promotion of behavioral changes related to the exchange of healthcare knowledge
Culture, spirituality — a recognition of self-identified, unique and individual preferences for individuals, families or groups
Further information on these nursing processes and other particulars about the NCLEX can be found on the 2016 NCLEX Test Plan, the current version of which is approved through 2019.
What to Expect on the NCLEX Exam
The NCLEX exam is administered by computer; the process is interactive and adaptive. Your answer to each question will determine the next question you are given. For example, answering a question correctly will generate higher-level questions. Incorrect answers will mean returning to a slightly lower testing level. The computer will continue to provide questions until a pass or fail grade is reached.
The number of questions you will answer can vary from as few as 75 to as many as 265. You’ll have six hours to complete the exam. Questions on the NCLEX exam are mostly multiple-choice, with four possible answers for each. There will also be some multiple response, fill-in-the-blank, graphics-based, and drag-and-drop questions. Some questions will require you to interpret charts, tables and pictures.
Note that writing instruments and paper are not allowed at the test site. You will be provided an erasable board and on-screen calculator for making notes and calculations.
Your exam will be considered complete when you have:
- Demonstrated minimum competency and answered the minimum 75 questions, or
- Demonstrated a lack of minimum competency and answered the minimum 75 questions, or
- Answered the maximum number of questions for the computer to decide a pass or fail result, or
- Used the maximum time allowed.
Receiving Your Grade
The NCLEX does not grade on a numerical score – it is a pass/fail system. While your grade will be determined at the conclusion of your exam, the results will not be available to you. Your State Board of Nursing will inform you of a pass or fail grade in about two to four weeks.
If you fail the NCLEX, you are allowed to re-test 45 days after the first test. You will also receive a profile of how you performed on the exam, including how many questions you answered. You may use the profile to help you prepare to take the exam again. Whether you choose to prepare on your own, or participate in formal preparation and practice testing, the diagnostic profile can be a helpful guide.
Study Tips to Help You Pass the NCLEX
- Take advantage of resources that provide practice test questions, study guides and flashcards. Download the free Test Plan mentioned above, and conduct a simple online web search for the latest free guides and sample questions – along with the correct answers.
- Find a study buddy to help you prepare; someone from your college classes would be ideal. You can quiz each other with flashcards, study the rationales, focus on learning key phrases used in the exam, and practice using the nursing process to prioritize – all of which can help you choose the correct answers during the exam.
- Check out NCLEX exam prep applications designed for mobile devices and tablets, so you can study wherever you go.
- Find the study method that works for you. For some, it means locking yourself in a room for a week or two; others prefer to study in smaller chunks; still other candidates take advantage of every available minute to study, whether it’s on the bus, during work breaks or over morning coffee.
- Try a variety of methods to determine what works best for you.
Top 10 Tips For NCLEX Exam Day
- Get plenty of sleep in the days leading up to the exam, and especially the night before.
- Avoid alcohol the night before, and don’t go overboard on caffeine the day of the exam.
- Dress comfortably, in layers that you can add or take off as needed.
- Plan to arrive at least 30 minutes early so you won’t be rushed.
- Take along a high-energy snack, such as fruit, nuts or trail mix.
- Relax. Try not to focus on the length of your exam.
- Take the time necessary to analyze each question, as well as all the possible answers. Once you’ve submitted an answer, you cannot return to the question.
- Plan to be testing for six hours. Don’t become anxious if others finish before you.
- Expect to feel as though you’re only getting half the questions correct. Even if you’re well on your way to passing, the NCLEX is designed to really challenge your knowledge.
- Remember, as long as the computer is still posing questions, you’re still capable of passing.
Preparing for the NCLEX Exam is Key to Success
Passing the NCLEX takes nursing knowledge, skill and preparation. It won’t be easy – but then, neither was earning your ADN or BSN degree! You owe it to yourself to do what it takes to pass the exam, so you can begin to enjoy the challenges and many benefits of your nursing career.