Whether you’re a new graduate from a practical nursing, associate degree, diploma or BSN program, you have one last hurdle to jump to become a licensed nurse. That hurdle is the NCLEX exam, used in the US and Canada.
Developed by the National Council of State Boards of Nursing (NCSBN), the National Council Licensure Examination (NCLEX) is the basic evaluation of your knowledge and readiness to practice. It’s meant to ensure that the public receives safe nursing care.
About the Exams
The NCLEX-RN is for registered nurses, who plan, direct, and evaluate care. The NCLEX-PN is for practical or licensed vocational nurses, who provide direct care and collect data under the supervision of an RN. Here’s the content list for each exam.
- Management of Care (17-23%)
- Safety and Infection Control (9-15%)
- Health Promotion and Maintenance (6-12%)
- Psychosocial Integrity (6-12%)
- Basic Care and Comfort (6-12%)
- Pharmacological and Parenteral Therapies (12-18%)
- Reduction of Risk Potential (9-15%)
- Physiological Adaptation (11-17%)
- Coordinated Care (16-22%)
- Safety and Infection Control (10-16%)
- Health Promotion and Maintenance (7-13%)
- Psychosocial Integrity (8-14%)
- Basic Care and Comfort (7-13%)
- Pharmacological Therapies (11-17%)
- Reduction of Risk Potential (10-16%)
- Physiological Adaptation (7-13%)
As with most endeavors, planning enhances performance, so here’s a plan to help you prepare for either NCLEX.
Registering for Your Exam
Exam registration is a two-step process. You must submit an application for a nursing license and register for the actual test. To submit an application, contact the Board of Nursing or other regulatory body (BON/RB) in the state where you want to be licensed. Most have online registration availability.
The registration form will walk you through all the necessary steps. Expect to pay a licensing fee, which will vary by state.
NCLEX exams are offered only through an organization called Pearson Vue. You can register online (which is strongly recommended) or over the phone. The fee is $200 in the US and $360 in Canada. The test is available in both English and French.
To register for the examination:
- Obtain a program code for your school. These are available from the NCSBN.
- Select a payment option on the Pearson Vue website; you can use a credit, debit, or prepaid card. If your school, agency, or employer is making a third-party payment, follow the directions on the website.
- Enter your email address (required for registration).
Eligibility and Authorization to Test
Once you create your registration, it remains open for 365 days. The BON/RB will notify Pearson Vue of your eligibility to take the exam. Pearson will then send you an Authorization to Test (ATT) email, giving you the date range within which you must complete the test.
Once you have the ATT email in hand, you can schedule a test appointment. You must provide an acceptable form of photo identification when you arrive for the test and the name on that ID must match your application exactly. Acceptable forms of identification include a driver’s license, passport, permanent residence card, or military ID.
Before the Exam
In addition to studying for the exam, here are some other preparatory necessities.
- Start a folder of important documents that you’ll take with you on exam day. Place copies of the documents below in that folder.
- Find out where the exam will be held. Obtain maps or directions and take a test drive or trip to make sure you know where you’re going and determine how long it will take (if you’re late, you’ll be turned away).
- Print at least two copies of your ATT email; it contains your identification number. Although this is not supposed to be a requirement to enter the exam room, having a paper copy handy is protection against problems like website outages and will help you feel more confident and prepared.
- Notify the exam center well ahead of time if you need any kind of accommodation to take the test.
- Prepare as noted in the Top 10 Tips below.
On Exam Day
Get there early. Allow plenty of time to travel and deal with parking or walking to the exam room. You cannot take anything into the exam room with you except your ID. You won’t need writing implements, as the test is entirely computer-based.
Unlike tests you took in school, NCLEX questions are criterion-reference, which means your answers are judged and graded against a national standard rather than answers of other test-takers. The NCLEX is an adaptive test, which means the answer you give to each question affects the next question. If you answer correctly, the next question will be at a higher level.
The computer will keep providing questions until you have passed or failed. The minimum number of questions is 75 and the maximum is 265.
You are allowed six hours to complete the test. Most of the questions in an NCLEX exam are multiple-choice with four possible answers. You may also have some fill-in-the-blank, graphics-based, or drag-and-drop questions.
You may need to interpret charts, tables, or pictures. The test site attendants will provide you with an erasable board and you will also have access to an on-screen calculator. The computer will shut down when you have:
- Answered 75 questions correctly.
- Answered 75 or more questions but not demonstrated minimum competence.
- Answered the maximum number of questions for the computer to determine if you have passed or failed.
- Used up all the allotted time.
After the Exam
You don’t receive a numerical score on the NCLEX — it is a pass/fail system. The state BON/RB will notify you in writing whether you have passed, about four to six weeks after you complete the exam.
Some BON/RB organizations participate in the Quick Results Service. This allows you to see your unofficial results 48 business hours after you take the exam. There is a fee of $7.95 for this service, which is available on the Pearson Vue candidate website.
If you did not pass, you will receive a profile of your performance, which can help you study to retake the test. You may retest 45 days (this is the minimum; it may vary by state) after the first exam. You will need to contact your BON/RB about the need for a retest, re-register with Pearson Vue and pay another fee.
Top 10 Tips for NCLEX Exam Day
- Remember the basics: avoid alcohol and get plenty of sleep the night before (no last-minute cramming); eat a nutritious meal and take it easy on the caffeine.
- Dress comfortably. You can’t take a hat, gloves, or a coat into the exam room, so dress in layers like a T-shirt, long-sleeved shirt, and vest that you can take off if you get too hot.
- Expect the test to take the full six hours. Don’t try to schedule anything else or make commitments like picking up a child at a certain time; it will likely make you anxious.
- Breathe and relax. Since you have the full six hours, take your time to read questions and answers carefully. Periodically close your eyes or look away from the screen to give your eyes a rest. You’ll have a couple of scheduled break periods when you can get up and move around, or go to the bathroom.
- Stay focused. Use earplugs (the exam proctors usually have them) is you’re easily distracted by noises.
- Don’t panic. Just breathe deeply and remember, as long as the computer is offering you questions, you’re moving forward. Just because someone else finished, that doesn’t mean you’re too slow (that person might have failed the exam and been shut down early).
- Expect the questions to be difficult. The whole point of NCLEX is to challenge your knowledge, and the better you do, the tougher the questions will be.
- Take advantage of the tutorial. You’ll have a short tutorial before you start the actual exam. This offers an opportunity to have a practice run.
- Inform the exam proctors if you run across a duplicate question. Duplicate questions are considered erroneous.
- Go easy on yourself. Tying yourself up in knots because you realize you missed a question is going to increase the chances of making another mistake. Deal with each question and then let it go.
Resources for NCLEX Test Preparation
As with any examination, correct preparation for the NCLEX makes a world of difference. In addition to purchasing resources, think about other strategies that might help you do better on the test. For example, would you learn best in a study group? If so, you could all share the expense of buying several prep books and share them around. Here are some useful resources:
- NCSBN’s Review for the NCLEX-RN & NCLEX-PN Examination – these two excellent tools include NCLEX-style questions, diagnostic pretests (to help you identify areas where you need extra work), and a variety of other study tools. You choose a subscription ranging from three to 15 weeks; Costs range from $50 to $160.
- Saunders Comprehensive Review for the NCLEX-RN Examination, 8th Edition – many experts consider this to be one of the best NCLEX prep books. Like the NCSBN guides, there is a version for the NCLEX-RN and another for the NCLEX-PN. The most recent edition incorporates the NCLEX test plan. The book also comes with a companion CD-ROM and offers 5,100 practice questions, accompanied with detailed answers and explanations. A companion book, Saunders Q & A Review for the NCLEX-RN Examination, focuses on test-taking strategies.
- NCLEX-RN Prep Plus: 2 Practice Tests + Proven Strategies + Online + Video – knowledge is only part of acing the NCLEX; mastering test-taking techniques is equally important. This book focuses on test-taking strategies. Like the Saunders manual, it offers practice questions with answers and explanations, but it should not be considered a comprehensive review manual. Use this resource to sharpen your test-taking abilities. For those who might have failed the NCLEX, this book offers some excellent strategies for a successful second try.
- Prioritization, Delegation, and Assignment – for RNs, delegation skills are vitally important; you’ll be leading teams and supervising the work of other team members. This book will help you prepare for the roughly one-fifth the NCLEX questions that cover prioritization and management of care.
- Davis’s Drug Guide for Nurses and Mosby’s Pharmacology Memory Guide – for the all-important pharmacology topics, these two books focus on boosting your knowledge of medications. The Davis book offers online resources as well as a one-year subscription to their online drug guide. The Mosby’s is designed specifically to help visual learners master pharmacology.
- Kaplan’s NCLEX-RN Content Review Guide – if you’re an ace student and feel you primarily need a general review rather than an in-depth study guide, this is a good choice. It offers a concise overview of all the main exam topics.
You’ve worked hard to acquire your nursing knowledge. Prepare yourself for the NCLEX and you should sail right through this final challenge. Good luck!