The NCLEX Study Guide to Pass the Exam

What is NCLEX?

The National Council Licensure Examination also called NCLEX, is a standardized test that is used to ascertain whether a candidate is prepared to become licensed as an entry-level nurse. The National Council of State Boards of Nursing or NCSBN for short administers and regulates the examinations for more than fifty state regulatory boards in the United States. They ensure that each candidate for licensure has the requirements and competencies to be in the practice of nursing. Thus, the nursing licensure exam was developed.   

There are 2 types of NCLEX exams: NCLEX-RN and NCLEX-PN. 

The NCLEX-RN is the nursing exam for candidates who want to be registered nurses. They either completed an Associate Degree in Nursing (ADN) or a Bachelor’s Degree (BSN). 

On the other hand, the NCLEX-PN is the nursing exam for candidates who want to become practical and vocational nurses. They either completed programs in License in Practical Nursing (LPNs) or Licensed Vocational Nursing (LVNs).

Format and Content

The NCLEX consists of 2 nursing tests: the RN test and the LVN or LPN test. Both of them are almost similar. The difference is that the former emphasizes the management and supervision of individuals, while the latter focuses on assisting and working under the supervision of registered nurses. 

What is the test type for the NCLEX?

The NCLEX contains items with different formats. It usually makes use of multiple-choice. Some other formats would be multiple response, hotspots, ordered response, fill-in-the-blank, graphics, calculation, and audio. 

What does the NCLEX-RN exam consist of?

The RN exam is a computerized adaptive test (CAT) that usually contains 75 to 265 questions out of which are 15 unscored pretest questions. The time limit for the test is 6 hours. It is advisable that the candidate should answer each of the questions in one to two minutes.       

NCLEX- RN Content

Client Needs
Safe and Effective Care Environment – the nurse encourages the achievement of client outcomes. He/she gives and directs nursing care that boosts the care delivery setting to protect clients and healthcare staff. 
Subcategories Description Percentage of Items from Each

Category/Subcategory
Management of Care  The nurse gives and directs nursing care that boosts the care delivery setting to protect clients and healthcare staff.  17–23%
Safety and Infection Control The nurse protects clients and healthcare staff from health and environmental hazards. 9–15%
Health Promotion and Maintenance – The nurse gives and directs nursing care of the client by using knowledge of expected growth and development; early detection and prevention of health problems, and techniques to achieve optimal health. 6-12%
Psychosocial Integrity – The nurse gives and directs nursing care that encourages and supports the mental, emotional, and social well-being of the client who is experiencing stressful events. He/she also helps clients with acute or chronic mental illness. 6-12%
Physiological Integrity – The nurse encourages physical health and wellness by giving care and comfort. He/she reduces client risk potential and manages health alterations.
Subcategories Description Percentage of Items from Each

Category/Subcategory
Basic Care and Comfort The nurse offers comfort and assistance in the performance of daily living activities. 6–12%
Pharmacological and Parenteral Therapies The nurse gives care by administering medications and parenteral therapies. 12–18%
Reduction of Risk Potential The nurse reduces the chances that clients will develop health complications or problems in relation to existing conditions, treatments or procedures. 9–15%
Physiological Adaptation The nurse manages and offers care for clients with chronic, acute, or

life-threatening physical health conditions.

 11–17%

Furthermore, 5 concepts are applied throughout the client needs categories and subcategories:

  • Nursing Process – scientific reasoning approach to client care. It contains analysis, implementation, assessment, evaluation, and planning.
  • Caring – a collaborative environment between the nurse and the client that has an atmosphere of trust and mutual respect.
  • Communication and Documentation – interactions that are verbal and nonverbal between the nurse, client, healthcare staff, and client’s family and friends. All of the events related to client care are recorded either in written or electronic form.
  • Teaching/ Learning – promotion of changed behavior through the facilitation of the acquisition of knowledge, skills, and abilities. 
  • Culture and Spirituality – interaction of the nurse and the client that acknowledges the unique, client-reported, and individual preferences to client care.   

What does the NCLEX-PN exam consist of?

The LPN exam is a computerized adaptive test (CAT) that usually contains 85 to 205 questions out of which are 25 unscored pretest questions. It cannot be taken in paper-and-pencil or oral examination formats. The time limit for the test is 5 hours. For more information, the complete processes and content are stated in the NCLEX Candidate Bulletin at www.ncsbn.org/1213.htm. 

NCLEX-PN Content

Client Needs
Safe and Effective Care Environment – The practical/vocational nurse gives nursing care that contributes to boosting the health care delivery setting and protects clients and healthcare staff.
Subcategories Description Percentage of Items from Each

Category/Subcategory
Coordinated Care The LPN/VN works with healthcare team members to facilitate successful client

care.

 18–24%
Safety and Infection Control The LPN/VN play a part in protecting clients and healthcare staff from environmental and health hazards. 10–16%
Health Promotion and Maintenance – The practical/vocational nurse provides nursing care for clients  by using knowledge of expected growth and development, and early detection and prevention of health problems. 6-12%
Psychosocial Integrity – The practical/vocational nurse gives care by assisting with the promotion and support of the mental, emotional, and social well-being of clients. 9–15%
Physiological Integrity – The practical/vocational nurse assists in the encouragement of physical health and well-being. He/she provides care and comfort, reduces risk potential for clients, and assists them with the management of health alterations.
Subcategories Description Percentage of Items from Each

Category/Subcategory
Basic Care and Comfort The LPN/VN gives comfort to clients and assists in the performance of daily living activities. 7–13%
Pharmacological Therapies The LPN/VN gives care such as administering medications

and monitoring clients who are receiving parenteral therapies.

 10–16%
Reduction of Risk Potential The LPN/VN reduces the chances of clients developing health complications or problems in relation to treatments, procedures, or existing conditions. 9–15%
Physiological Adaptation The LPN/VN participates in giving care for clients with chronic, acute, or life-threatening physical health conditions. 7–13%

Just like the NCLEX-RN, the LPN test has 5 concepts that are applied throughout the client needs categories and subcategories:

  1. Clinical Problem-solving Process (Nursing Process) – scientific reasoning approach to client care. It contains data collection, implementation, evaluation, and planning.
  2. Caring – a collaborative environment between the practical/vocational nurse and the client that has an atmosphere of trust and mutual respect.
  • Communication and Documentation – interactions that are verbal and nonverbal between the practical/vocational nurse, client, healthcare staff, and client’s family and friends. All of the events related to client care are recorded either in written or electronic form.
  • Teaching/ Learning – assisting in the promotion of changed behavior through the facilitation of the acquisition of knowledge, skills, and attitudes.
  • Culture and Spirituality – interaction of the nurse and the client that acknowledges the unique, client-reported, and individual preferences to client care.   

How to pass the NCLEX?

The NCLEX uses logits for their test scores. These are units of measurement that determine the relative difference between the estimated ability of a candidate and the difficulty of the questions they answer. The standard passing score for the RN exam is 0.00 logits, and for the LPN exam, it’s -0.21 logits. 

Also, the NCLEX exams make use of the 95% Confidence Interval Rule. It means that after you have answered the minimum number of questions, there will be an assessment. The computer will determine whether or not there is at least a 95% certainty that your ability is above or below the standard passing score. The exam will continue until it is assessed that you reached at least 95% confidence.

But, if you end up answering the maximum number of questions, then regardless of the computer being at 95%, you’ll pass or fail based on the final estimate of your ability. 

NCLEX Registration, Costs and Policies

To take the NCLEX exam, you must know the registration process:

Step 1: You must meet the requirements for eligibility to take the exam.

You cannot register to take the NCLEX until after you apply for a license through your state’s nursing regulatory body (NRB). You must have the following educational requirements:

  • For licensed practical or vocational nurses, an accredited LPN or LVN certificate program.
  • For registered nurses, an accredited associate’s degree in nursing or a bachelor’s degree.

Step 2: You’ll be considered eligible if you received an Authorization to Test email.

Through the ATT email, you’ll receive your authorization number, candidate number, and the validity dates, which is usually an average period of 90 days, and a list of testing centers. By getting your ATT, you’ll be able to schedule your NCLEX exam.

Step 3: Your Candidate Bulletin will show you the details of registering to take the NCLEX. 

You need to register and pay for the appropriate fees at Pearson VUE testing centers. You have to have an Acknowledgement of Receipt of Registration and your ATT. 

Step 4: You need to schedule for the  NCLEX at Pearson Vue testing centers.

After knowing that you are eligible and you have received the ATT email, you can now schedule within the validity dates stated in  your Authorization to Test. You can check out your local testing centers to take the NCLEX at www.pearsonvue.com.   

How much does NCLEX cost? 

The average cost for taking the two types of NCLEX tests is $200. You often pay for the appropriate fees when you register at Pearson Vue testing centers. There may be some additional charges when you want to change your regulatory board, or you want to change the NCLEX exam you want to register to. It will usually cost an additional $50. 

What are the best tips for someone taking the NCLEX?

  • You should research the eligibility requirements and the format of the NCLEX. 

Before you can take the exam, you must know whether you qualify as a candidate or not. You must follow the registration process. Otherwise, you won’t be able to take it. You must also familiarize yourself with the format, although the two types of NCLEX exams are similar. There are differences you must take note of.

  • You should always prepare in advance and never cram.

The NCLEX is a test that will help you be a licensed or registered nurse. You must prepare for it as much as possible. You can make use of study plans so you can schedule your time. You can’t cram it because it covers a lot of subject matter. You need to be able to review all of them properly.  

Kaplan Test Prep’s NCLEX-RN Content Review suggests these methods:

The first method is to choose a date. It should depend on how much time it is that you need to prepare.

The second method is to figure out how many hours a week, you’ll have to consume for studying.

The third method is to divide the calculated hours in your calendar. In this way, you’ll have a well-planned study schedule.

  • You should get as many study resources as you can.

NCLEX practice questions, NCLEX study guides, and NCLEX practice tests can help lessen the burden of taking the exam. You should make use of them effectively. It is beneficial for you to jog down notes as you go along the resource materials. You should also always check the correct answers to those questions you answered incorrectly. These study resources are only as good as how you make use of them.

An example of a study resource you can use is the previous book mentioned, here is an excerpt from it: 

Under the Pharmacological and Parenteral Therapies, these are some of the things you should know about Intravenous Therapy:

You must know the definition of terms of tonicity, ECF, isotonic fluids, etc.The next thing is to memorize or familiarize yourself with the types of IV fluid. You must also know how to administer it by calculating the IV flow rate and being knowledgeable about nursing care. 

Nursing care consists of changing continuous use standard tubing every 96 hours except if it is contaminated. If contaminated, it must be changed immediately. Another is if it is intermittent use tubing, it must be changed every 24 hours except if contaminated. Lastly, change the fluid container every 24 hours.

Thus, study guides and content reviews such as these are very helpful when it comes to studying for the exam. You can also check out free practice tests online. Practice Test Geeks has so many sample tests to choose from because it caters to all types of exams in different fields.    

  • You should get ready for the exam day. 

Preparing for the exam is not the only thing you should take an interest in. You should also be ready for the exam day. You should have a good night’s sleep the day before so that you can answer well. You should also go to the testing center earlier than the time given so you won’t be too rushed. Lastly, be sure to relax and have a good meal. The more stress-free you are, the more comfortable you will be while taking the nursing exam. 

Frequently Asked Questions

How difficult is the NCLEX?

Taking the NCLEX-RN and the NCLEX-PN won’t be too difficult as long as you have studied and prepared in the best way that you can. It requires a lot of dedication and time. It is not something that can be achieved easily without hard work. It won’t be hard as long as you gave it enough focus. That’s why it is always good to answer NCLEX questions you can get from practice tests and study guides.

Can I become an RN with an arrest record?

Yes, it is possible, depending on the circumstances and the state where you live. But some misdemeanors will not let you obtain a license because it is considered as unethical. Also, some nursing schools may accept you, but the board may not issue you a license. 

The nursing board or the school will run a background check on you, so it is better to give your criminal records ahead. If your conviction was expunged, then you might also have the chance to get a license.  

Can I take the NCLEX without a nursing degree?

Yes. You can take the NCLEX-PN. It is an exam for practical or vocational nurses. You are not required to have a nursing degree, but you need to get a certificate from the program. The NCLEX-RN is the one that requires a college degree to be a registered nurse.

How to become a nurse in the USA?

You need to take the NCLEX exam to become a nurse. The state regulatory board will give you your license if you pass the standardized test. 

How to know if you’ve passed or failed the NCLEX-RN?

You will obtain your official  NCLEX results at least 6 weeks after taking the exam from your regulatory board. The passing score for the RN test is 0.00 logits while for the LPN test, it is -0.21 logits.

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