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NCLEX-RN Exam

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If you’re studying to become a nurse, you’ve probably been thinking about the career opportunities you’ll pursue after graduation. But before you can land your first nursing job, there’s one more thing you’ll need to do—become a licensed nurse in your state.

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What Is the NCLEX-RN Exam?

The NCLEX, also known as the National Council Licensure Examination, is the standardized test that every state regulatory board uses to determine if you’re ready to become licensed as a nurse. It’s given by the National Council of State Boards of Nursing (NCSBN) and evaluates your nursing knowledge to make sure you’re qualified to work in hospitals and healthcare facilities. After you’ve completed an accredited nursing program, taking and passing the NCLEX exam is the next step to become a registered nurse (RN).

Who Needs to Take the NCLEX Exam?

Any candidate who has earned their bachelor’s or associate degree and wants to become a registered nurse must pass the NCLEX-RN. To qualify to sit for the exam, candidates must have an approved nursing degree from an accredited program.

What Is On the NCLEX-RN?

The NCLEX-RN exam is a computerized test, made up mostly of multiple-choice questions plus some multiple-response, fill-in-the-blank, and drag-and-drop questions.

There are four major content categories that are covered in the NCLEX exam: Safe and Effective Care Environment, Health Promotion and Management, Psychosocial Integrity,  and Physiological Integrity. To give you a better idea of the kind of NCLEX exam questions to expect, here’s a deeper dive into each category and the specific topics they include:

 

Safe and effective care environment

Questions in this category cover topics related to management of care and safety and infection control, specifically:

  • Advocacy
  • Case Management
  • Client Rights
  • Concepts of Management
  • Confidentiality
  • Continuity of Care
  • Quality Improvement
  • Ethical Practice
  • Informed Consent
  • Accident Prevention
  • Error Prevention
  • Hazardous Materials
  • Surgical Asepsis
  • Standard Precautions
  • Use of Restraints

Psychosocial integrity

This category covers topics such as:

  • Coping Mechanisms
  • Grief and Loss
  • Mental Health Concepts
  • Spiritual Influence on Health
  • Sensory/Perceptual Alterations
  • Stress Management
  • Support Systems
  • Therapeutic Communication
  • Chemical Dependency
  • Behavioral Interventions
  • End of Life Care
  • Family Dynamics

Health promotion and maintenance

This category covers topics such as:  

  • Aging Process
  • Ante/Intra/Postpartum and Newborn Care
  • Developmental Stages and Transitions
  • Disease Prevention
  • Health Screening
  • Physical Assessment Techniques
  • Health Promotion Programs
  • High Risk Behaviors
  • Self-Care

Physiological integrity

This category covers topics related to basic care and comfort, pharmacological therapies, and physiological adaptations, specifically:

  • Assistive Devices
  • Elimination
  • Mobility
  • Non-pharmacological Comfort Interventions
  • Nutrition and Oral Hydration
  • Personal Hygiene
  • Rest and Sleep
  • Adverse Effects
  • Contraindications
  • Blood and Blood Products
  • Central Venous Access Devices
  • Chemotherapy
  • Intravenous Therapy
  • Medication Administration
  • Pharmacological Pain Management
  • Reduction of Risk Potential 
  • Diagnostic Tests
  • Laboratory Values
  • Potential for Complications
  • Therapeutic Procedures
  • Alterations in the Body Systems
  • Fluid and Electrolyte Imbalances
  • Hemodynamics
  • Medical Emergencies
  • Pathophysiology
  • Unexpected Response to Therapies

Now that you know some of the concepts covered in the exam, it’s important to understand the format.

The NCLEX is a computer adaptive test (CAT), meaning the questions you receive are in direct response to the questions you previously answered. For example, if you get an answer wrong, the next question will be slightly easier (and vice versa if you answer correctly). If the computer can assess your level of understanding after the minimum number of questions, your test will end and you’ll either pass or fail. If your level of comprehension is still unclear after several questions, the test will go on until a final determination can be made. This type of format helps the computer to better gauge—and give a more accurate estimate of—your competence and abilities.

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How Much Does the NCLEX Cost?

The cost for registration to take the NCLEX-RN exam is $200. Any additional licensure fees are determined by the individual State Boards of Nursing. For example, if you want to change the regulatory body or registration to a different state, that cost is an additional $50.

How is the NCLEX Scored?

The score you get on your NCLEX-RN exam is referred to as a “logit,” which is a unit of measurement that evaluates the difference between the skills you demonstrate on the test and the difficulty of the questions you answer. Keep in mind, however, that the NCLEX-RN is a pass/fail exam, so the actual score you get doesn’t matter—what matters is that you pass. 

So, what’s considered passing? 

The current passing standard for the NCLEX-RN exam is 0.00, which means you need to answer the medium difficulty questions correctly at least 50% of the time. However, that passing standard could change. Because the practice of nursing is constantly evolving, the NCSBN reevaluates the passing standard every three years or when the test plan changes. This ensures that the passing standards for the NCLEX accurately reflect the knowledge and skills needed for entry-level nurses.

If you do pass the NCLEX-RN, you’re officially a registered nurse. If not, you can re-test. Re-testing for the exam is allowed 45 days after the initial test. After the exam, you’ll get a diagnostic profile that evaluates your test performance and how close you came to passing. The diagnostic profile can be a great resource as you prepare to retake the exam.

What is the Pass Rate for the NCLEX-RN?

Each year, the NCSBN publishes NCLEX-RN pass rate statistics. The 2020 pass rate for first-time test takers was 86%.

NCLEX Tips

  • Schedule your exam time when you know you’ll be at your best. For instance, if you’re a morning person, test in the morning. 
  • Bring snacks in case you get hungry.
  • Arrive early and be prepared with all documents and materials you need.
  • Take advantage of breaks to recharge.
  • Get plenty of sleep the night before the exam.
  • Most importantly, go in with a positive mindset and trust your abilities!
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How Do I Prepare for the NCLEX?

One of the best ways test takers can prepare for the NCLEX-RN examination is to give themselves plenty of time to study. Don’t cram. Make a study plan that includes several practice tests so you get a feel for the format and are confident going into exam day. It can also be helpful to team up with other students who are preparing for the NCLEX to have regular group study sessions.

Many students find it worthwhile to invest in an NCLEX-RN preparation program. Several programs offer one-on-one tutoring and access to study materials based on your learning style.

Earning a BSN after the NCLEX

While some students may be enrolled in a BSN program that licenses them to become a nurse, many obtain their license through a diploma or associate degree in nursing program. If you’re one of the latter, it may be beneficial to consider going back to school to get your BSN.

WGU’s RN to BSN program prepares students to sit for the NCLEX-RN licensing exam, while also delivering expanded knowledge and skills beyond the clinical aspects of nursing: a BSN-prepared nurse is well grounded in evidence-based practice, patient safety, technology integration, and healthcare systems and policy. Plus, WGU’s flexible online degree program makes it possible for current nurses to continue their education while they’re working.

If you're a current RN with an ADN or diploma, WGU’s RN to BSN program could be the perfect fit for you. Learn more and get started today! 

Earn Your BSN

If you're ready to enhance your résumé and take the next step in your nursing career, a BSN could be the perfect fit.

Learn About the BSN Degree