How to become an LPN or LVN: steps, requirements, and salary

The LPN credential is the fastest route into licensed nursing practice in the United States. In 48 states, this credential is called an LPN (Licensed Practical Nurse). In California and Texas, the same license is called an LVN (Licensed Vocational Nurse). The exam, scope of practice, and day-to-day work are identical — only the name differs, and only because of historical reasons in those two states.

For someone who wants to be in a direct patient care role without four years of school, an LPN program is a realistic path: as short as 12 months at a vocational school, roughly the same cost as a semester or two of community college, and a full state nursing license at the end of it. The scope of what you can do is narrower than an RN’s, and the salary ceiling is lower. Neither of those things should be minimized — but for a specific set of students and career goals, LPN/LVN is precisely the right entry point.

This guide covers the full pathway: requirements, program types, the NCLEX-PN, salary data by setting and state, and what it takes to advance to RN once you’re licensed.

At a glance: LPN/LVN overview

What does an LPN/LVN do?

LPNs and LVNs provide direct patient care under the supervision of a registered nurse or physician. The scope includes:

• Vital signs and monitoring — blood pressure, pulse, respirations, oxygen saturation, temperature, pain assessment
• Medication administration — oral medications, subcutaneous and intramuscular injections, topical medications (with supervision; IV push medications are restricted in many states)
• Wound care — dressing changes, irrigation, pressure injury monitoring
• Specimen collection — blood draws (phlebotomy), urinalysis, wound cultures
• Patient education — medication instructions, discharge teaching, disease management basics
• Basic assessments — collecting subjective and objective data to report to the supervising RN

The key distinction from an RN: LPNs contribute data and observations to the patient record, but initial comprehensive nursing assessments, care plan development, and clinical judgment decisions belong to the RN. In many states, LPNs cannot administer IV push medications or access central lines without additional training and explicit state board authorization.

Work settings: Long-term care (skilled nursing facilities) is the largest employer of LPNs. Home health is the second-largest. Many LPNs also work in outpatient clinics, physician offices, correctional facilities, and schools. Hospital employment of LPNs has declined over the past two decades — most acute-care hospitals now staff primarily RNs — but it still exists in some community hospitals and step-down units.

Step-by-step: how to become an LPN/LVN

Step 1: Meet basic requirements

Before applying to a program, confirm that you meet the minimum eligibility requirements. These are consistent across most states:

• High school diploma or GED — required for all accredited programs
• Minimum age of 18 at the time of licensure (some states accept 17-year-olds in program; licensure waits until 18)
• Background check — criminal history disclosure required; a felony conviction may affect licensure depending on the offense and state. Contact your state board of nursing before enrolling if this applies to you
• Health and immunization clearance — MMR, Varicella, Hepatitis B series, annual flu shot, TB test (2-step PPD or QuantiFERON-Gold); programs differ on exact requirements
• Current BLS certification — Basic Life Support (American Heart Association or American Red Cross) required before clinical placement
• Drug screening — required at most programs and again at clinical placement sites

Entrance exams: Many LPN programs require a standardized pre-admission exam before acceptance. The most common are the ATI TEAS (Test of Essential Academic Skills) and the HESI A2. Typical minimum scores are 60–65% on the composite for TEAS and 75% on the HESI A2, though competitive programs may set higher thresholds. Check program requirements directly — some vocational schools use their own internal entrance assessment instead.

If your academic record is a concern, LPN programs are among the most accessible entry points in nursing. For more on programs that accommodate lower GPAs, see our guide to nursing schools that accept lower GPAs.

Step 2: Choose your program type

Three types of programs offer LPN training. Each has a different cost profile, schedule structure, and institutional culture.

Community college programs are typically the lowest-cost option and are more likely to offer evening and weekend scheduling for students who need to work during training. Vocational school programs tend to move faster and have less stringent academic prerequisites — the tradeoff is higher cost and fewer financial aid options (some are not Title IV eligible). Hospital-based programs are less common but may offer sponsorship or employment guarantees on completion.

For a detailed breakdown of LPN program requirements and what the curriculum covers, see our LPN degree guide.

Step 3: Complete the program

LPN programs combine classroom instruction with supervised clinical rotations. Theory content covers:

• Anatomy, physiology, and medical terminology
• Pharmacology and medication administration
• Medical-surgical nursing
• Maternal-newborn and pediatric nursing
• Mental health and psychiatric nursing
• Geriatric and long-term care nursing
• Nutrition and diet therapy

Clinical rotations place you in real patient care settings — usually skilled nursing facilities, hospitals, and community clinics. Most programs require 1,100–1,500 supervised clinical hours by graduation, a threshold set by state boards of nursing and accrediting bodies.

Step 4: Apply for the NCLEX-PN

After graduating from a state-approved program, you apply to sit the NCLEX-PN (National Council Licensure Examination for Practical Nurses). The process:

1. Apply to your state board of nursing for licensure
2. The board authorizes NCSBN to release your Authorization to Test (ATT) — a document that must be in hand before you can schedule the exam
3. Register with Pearson VUE (pearsonvue.com/nclex) and pay the $200 NCLEX examination fee
4. Schedule your testing appointment at a Pearson VUE testing center
5. Sit the exam

Step 5: Pass the NCLEX-PN and get licensed

After you pass the NCLEX-PN, your state board of nursing issues your license. License numbers are publicly searchable in each state’s online verification database.

Compact license (NLC): The Nurse Licensure Compact allows LPNs licensed in a member state to practice in any other NLC state without applying for additional licenses. As of 2025, 26 states participate in the LPN/LVN compact, including Arizona, Colorado, Florida, Georgia, Idaho, Indiana, Iowa, Kansas, Kentucky, Maine, Maryland, Mississippi, Missouri, Montana, Nebraska, New Hampshire, New Mexico, North Carolina, North Dakota, Oklahoma, Pennsylvania, South Carolina, South Dakota, Tennessee, Virginia, West Virginia, and Wyoming. This matters especially for LPNs considering travel assignments or planning to relocate. If you license in a non-compact state, you’ll need to apply for endorsement whenever you move to a new state.

Step 6: Find your first position

Most new LPNs and LVNs begin in long-term care facilities (skilled nursing facilities, assisted living), home health agencies, or outpatient clinics. These settings have the highest LPN employment density and the most structured orientation programs for new graduates.

Hospital positions for LPNs are more limited and typically require at least 6–12 months of post-licensure experience. If acute care is your goal, start in a facility that provides skilled nursing services to complex post-surgical or post-acute patients — the clinical exposure is similar without the immediate competition for limited hospital LPN slots.

How the NCLEX-PN works

The NCLEX-PN uses Computer Adaptive Testing (CAT), which means no two exams are identical and the exam adapts question difficulty based on your performance in real time.

The exam runs between 85 and 150 questions. Here is what that range means in practice: the computer is constantly calculating whether it can determine your pass or fail status with 95% statistical confidence. If you answer questions consistently above the pass/fail threshold, the exam ends early — as few as 85 questions. If your performance is close to the threshold, the exam continues gathering data, up to 150 questions. The length of your exam is not a signal of passing or failing. Many candidates who clear all 150 questions pass, and some who finish at 85 fail.

The time limit is 5 hours, with an optional break available at the midpoint.

Content areas tested (NCSBN NCLEX-PN Test Plan):

• Physiological integrity: basic care and comfort, pharmacological therapies, reduction of risk, physiological adaptation
• Safe and effective care environment: coordinated care, safety and infection control
• Health promotion and maintenance
• Psychosocial integrity

Pharmacology is consistently the heaviest content area. Most test prep experts recommend building your drug knowledge early in the process — nursing school pharmacology courses, UWorld question banks, and ATI practice exams all develop the clinical reasoning the NCLEX-PN tests.

First-time pass rate: Approximately 85% for US-educated NCLEX-PN candidates (NCSBN, 2023 data). This is slightly lower than the NCLEX-RN first-time pass rate (~88%), reflecting the different population of test-takers.

How NCLEX-PN differs from NCLEX-RN: The PN exam focuses on basic care, assisting with care under supervision, and contributing to assessments — not the independent clinical judgment and care planning that the RN exam tests. The NCLEX-RN includes Next Generation NCLEX (NGN) question types (launched April 2023) that specifically test complex clinical reasoning; the PN exam format is more stable.

LPN/LVN salary

The median annual salary for LPNs and LVNs in the United States is $59,730 (BLS Occupational Employment and Wage Statistics, May 2024, SOC 29-2061). The range runs from approximately $44,000 at the 10th percentile to $78,000 at the 90th percentile, depending on setting, geography, and experience.

Salary by setting

Nursing care facilities (skilled nursing) employ the largest share of LPNs, but they are not the highest-paying setting. Home health and hospice agencies pay competitively and have grown rapidly as a share of LPN employment.

Source: BLS Occupational Employment and Wage Statistics, May 2024.

Top-paying states

Source: BLS, May 2024. High-cost-of-living states — California, Hawaii, the Pacific Northwest, and the Northeast corridor — dominate the top of the LPN salary range, as they do for most nursing roles.

Note that California and Texas use the LVN title, not LPN. In both states, the scope of practice and NCLEX-PN requirement are identical to LPN states — only the title differs on the license.

Scope of practice: LPN vs RN

The scope of practice distinction matters most when you’re deciding whether LPN meets your career goals or whether you should proceed directly to an RN program.

State supervision requirements vary significantly. Some state boards require physician or RN co-signature for certain LPN medication administration tasks; others grant more independent authority within defined settings. Before assuming any specific task is within your scope, verify with your state board of nursing — the rules differ enough that a practice permitted in Florida may not be permitted in New York.

How to advance from LPN to RN

Most LPNs who want to advance eventually pursue RN licensure through an LPN-to-RN bridge program. The three main paths:

LPN-to-ADN bridge: The most common route. Community colleges accept LPNs with credit transfer for portions of the first year, shortening the ADN completion to 12–18 months rather than the full two years. Total additional cost: approximately $8,000–$25,000.

LPN-to-BSN direct: Some universities offer a direct LPN-to-BSN track that bypasses the ADN and grants a bachelor’s degree in 2–3 years. These programs are less common but offer the clearest path to Magnet hospital hiring and graduate school eligibility.

LPN-to-ADN, then RN-to-BSN: The most flexible option — get licensed as an RN via ADN first, then complete an online RN-to-BSN program while working. Many employers reimburse tuition for the BSN completion.

The cost advantage of bridging: Bridge students often complete their RN faster and at lower total cost than someone starting a full ADN or BSN program from scratch, because LPN clinical hours partially transfer. Depending on the program, LPNs can receive credit for up to one full semester of clinical hours, reducing both time and tuition.

Timeline: With an active LPN license and full-time enrollment, most LPN-to-RN bridge students complete the transition in 1–2 years. Part-time routes stretch this to 2–3 years, but allow continued employment as an LPN during the program.

For guidance on CNA-to-LVN bridge options (a related pathway for those entering from a CNA background), see our CNA-to-LVN bridge programs guide.

Once you hold an RN license, further advancement into advanced practice — nurse practitioner, CRNA, CNM — becomes available. See our how to become a nurse practitioner guide for what that pathway involves.

Is LPN/LVN right for you?

LPN/LVN makes the most sense for a specific set of circumstances:

Good fit:

• You want to enter clinical nursing practice quickly — within 12–18 months
• Financial constraints make a two- or four-year program impractical right now
• You want to work in nursing while you evaluate whether RN-level education makes sense for your career
• Long-term care, home health, or clinic nursing aligns with your interests (these settings employ most LPNs)
• You’re transitioning from a CNA or medical assistant role and want to move up with minimal additional schooling

Consider going directly to ADN or BSN if:

• Your goal is acute-care hospital nursing — most hospitals have reduced LPN hiring substantially
• You’re confident you want an RN scope of practice and have the time and financial access to pursue it
• You’re aiming for advanced practice eventually — an RN license is required before any APRN program, and starting the RN track sooner saves years in the long run

The LPN credential is a real nursing license with a real scope of practice — it is not a stepping stone by default. Many LPNs work the same setting their entire career and find the role deeply satisfying. The question is whether the scope and setting match what you want from nursing. If they do, the 12-month path to a licensed clinical role is one of the better options in healthcare education.

For the full RN pathway, see our how to become a registered nurse guide.