NCLEX Practice Test

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The NCLEX is the gateway to nursing practice in the United States. Whether you're pursuing NCLEX-RN licensure as a registered nurse or NCLEX-PN licensure as a practical nurse, consistent practice with exam-style questions is the most effective preparation strategy. This free NCLEX practice test PDF lets you print and review questions offline — perfect for study breaks between clinical rotations, commutes, or group review sessions. Practice with the free NCLEX practice test on PracticeTestGeeks (1,550+ questions with answer explanations).

The 2026 exam now fully incorporates Next Generation NCLEX (NGN) item types that test clinical judgment beyond simple recall. Reviewing both traditional multiple-choice questions and NGN formats in a printable format helps you build the cognitive habits that translate directly to exam-day performance.

NCLEX: upcoming dates and official changes

Facts verified Oct 19, 2026 against National Council of State Boards of Nursing. Dates that have passed are removed automatically.

Facts verified Oct 19, 2026 against National Council of State Boards of Nursing. Dates that have passed are removed automatically.

NCLEX Exam at a Glance

ItemDetailOfficial source
Number of questions85–150 questions for both RN and PNNational Council of State Boards of Nursing
Passing score (NCLEX-PN)-0.18 logits through March 31, 2029National Council of State Boards of Nursing
Passing score (NCLEX-RN)0.00 logits through March 31, 2029National Council of State Boards of Nursing
Retake feeSame registration fee for each retakeNational Council of State Boards of Nursing
Retake policyUp to eight attempts annually; 45-day wait; stricter local rules may applyncsbn.zendesk.com
ValidityAuthorization to Test averages 90 days; regulator determines validityNational Council of State Boards of Nursing
DeliveryIn-person testing at Pearson Professional CentersNational Council of State Boards of Nursing
EligibilityDetermined by the nursing regulatory bodyncsbn.zendesk.com
Score releaseOfficial results within six weeksNational Council of State Boards of Nursing
Registration deadlineTest within your Authorization to Test datesNational Council of State Boards of Nursing
Testing windowYear-round testingncsbn.zendesk.com

Facts verified Oct 19, 2026 against National Council of State Boards of Nursing. Dates that have passed are removed automatically.

Free NCLEX Study Tools

Interactive NCLEX resources on PracticeTestGeeks, free to start:

Next Generation NCLEX (NGN) Item Types

NCSBN introduced six new NGN item types to measure clinical judgment more accurately than traditional multiple-choice questions alone. Extended multiple response questions ask you to select all applicable options from a longer list — partial credit is awarded based on the number of correct selections. Extended drag-and-drop requires ordering or categorizing items, such as prioritizing nursing interventions or matching medications to their mechanisms.

Cloze (drop-down) items embed pull-down menus within a sentence or table, asking you to complete clinical documentation or select the correct value. Enhanced hotspot questions present a graphic — an EKG strip, a body diagram, or a lab report — and require you to click on the relevant finding. Matrix/grid items present multiple rows and columns, often asking which interventions are indicated or contraindicated for a given patient. Finally, the bow-tie item is the most comprehensive NGN format: it presents a case study and asks you to identify the patient's condition, the nursing actions to take, and the outcomes to monitor — all within a single structured item reflecting the full CJMM cycle.

Clinical Judgment Measurement Model (CJMM)

The CJMM describes how nurses think through clinical problems. The six cognitive skills are: Recognize Cues (identify relevant assessment data from the clinical scenario); Analyze Cues (interpret what the data means); Prioritize Hypotheses (rank possible explanations for the patient's condition by likelihood and urgency); Generate Solutions (identify nursing actions that address each hypothesis); Take Action (select and implement the highest-priority intervention); and Evaluate Outcomes (determine whether the intervention achieved the expected result). NGN case studies are built around this model — practicing the six-step cycle on clinical scenarios is the most targeted preparation strategy.

Review all six Next Generation NCLEX (NGN) item types and practice each format
Study the six CJMM cognitive skills and apply them to at least 5 practice case studies
Memorize the four NCLEX client needs categories and their approximate percentage ranges
Practice Maslow's hierarchy prioritization with at least 20 mixed-option questions
Drill ABC (Airway–Breathing–Circulation) priority scenarios for physiological integrity questions
Review delegation rules: what RNs can delegate to LPNs/LVNs and UAPs by scope of practice
Complete a timed 75-question CAT simulation to build stamina and pacing awareness
Review pharmacology high-alert medications commonly tested on NCLEX (anticoagulants, insulin, digoxin)
Practice bow-tie items using published NCSBN sample case studies
Review safety and infection control standards including standard precautions and restraint protocols

NCLEX Client Needs Categories

All NCLEX questions are classified into one of four client needs categories. Safe and Effective Care Environment has two sub-categories: Management of Care (~17–23% RN) covers delegation, prioritization, ethics, and advance directives; Safety and Infection Control (~9–15% RN) covers standard precautions, surgical asepsis, and error prevention. Health Promotion and Maintenance (~6–12% RN) covers developmental milestones, health screening, and patient education across the lifespan. Psychosocial Integrity (~6–12% RN) covers therapeutic communication, mental health disorders, coping mechanisms, and crisis intervention. Physiological Integrity is the largest category, with four sub-categories: Basic Care and Comfort (~6–12%), Pharmacological and Parenteral Therapies (~13–19%), Reduction of Risk Potential (~9–15%), and Physiological Adaptation (~11–17%).

Understanding these percentage ranges guides your study time allocation. Because Physiological Integrity accounts for roughly 38–62% of the exam, pharmacology, pathophysiology, lab value interpretation, and disease management should receive the most review time. Don't neglect Management of Care — delegation and prioritization questions account for a significant portion of Safe Care Environment content and appear frequently in the adaptive bank.

CAT Adaptive Testing Explained

The NCLEX uses Computer Adaptive Testing (CAT) to tailor question difficulty to your demonstrated ability level. Each question you answer correctly causes the next question to be slightly harder; each incorrect answer brings a slightly easier question. The exam continues until the computer is 95% confident that your true ability is either above or below the passing standard. For NCLEX-RN, this happens somewhere between 85 and 150 questions. Running out of questions at 150 does not mean you failed — the final pass/fail decision is based on the ability estimate at that cutoff, not the number of questions answered. Focus on accuracy over speed; guessing to finish faster does not help and can lower your ability estimate.

For a fuller set of questions on this topic, see our mark k lectures resource.

Pros

  • Validates your knowledge and skills objectively
  • Increases job market competitiveness
  • Provides structured learning goals
  • Networking opportunities with other certified professionals

Cons

  • Study materials can be expensive
  • Exam anxiety can affect performance
  • Requires dedicated preparation time
  • Retake fees apply if you don't pass

Pros and Cons at a Glance

ProsCons
Validates your knowledge and skills objectivelyStudy materials can be expensive
Increases job market competitivenessExam anxiety can affect performance
Provides structured learning goalsRequires dedicated preparation time
Networking opportunities with other certified professionalsRetake fees apply if you don't pass

Sample NCLEX Practice Questions

Try these questions from our free NCLEX practice tests. The correct answer and an explanation follow each question.

  1. A patient is admitted with suspected pulmonary embolism. Which diagnostic test is the gold standard for definitive diagnosis?

    • A. D-dimer blood test
    • B. CT pulmonary angiography (CTPA)
    • C. Chest X-ray
    • D. Ventilation-perfusion (V/Q) scan

    Answer: B. CT pulmonary angiography (CTPA)

    CT pulmonary angiography (CTPA) is the gold standard for diagnosing PE — it directly visualizes the pulmonary vasculature and identifies filling defects (clots) with high sensitivity (>95%) and specificity.

  2. The physician has ordered a blood test for H. pylori. The nurse should prepare the client by:

    • A. Withholding intake after midnight
    • B. Telling the client that no special preparation is needed
    • C. Explaining that a small dose of radioactive isotope will be used
    • D. Giving an oral suspension of glucose 1 hour before the test

    Answer: B. Telling the client that no special preparation is needed

    A blood test for H. pylori, which detects antibodies to the bacteria, typically does not require any special preparation from the client. There is no need for fasting or specific dietary restrictions before the test. The nurse should inform the client that they can eat and drink normally, ensuring convenience and clarity.

  3. A pregnant client at 28 weeks has a glucose challenge test result of 150 mg/dL. What does the nurse anticipate next?

    • A. Starting insulin therapy
    • B. A 3-hour glucose tolerance test
    • C. Immediate cesarean planning
    • D. No further testing needed

    Answer: B. A 3-hour glucose tolerance test

    A 1-hour value of 140 mg/dL or higher requires a 3-hour glucose tolerance test to confirm gestational diabetes.

  4. A licensed practical nurse is attending an agency orientation meeting about the nursing model of practice implemented in the facility. The nurse is told that the nursing model is a team nursing approach. The nurse understands that which of the following is a characteristic of this type of nursing model of practice?

    • A. A task approach method is used to provide care to clients.
    • B. Managed care concepts and tools are used when providing client care.
    • C. Nursing staff are led by a nurse when providing care to a group of clients.
    • D. A single registered nurse is responsible for providing nursing care to a group of clients.

    Answer: C. Nursing staff are led by a nurse when providing care to a group of clients.

    Administering an additional dose of bumetanide, a potent diuretic, significantly increases the client's risk for hypotension and fluid volume deficit, which can lead to falls. The nurse's failure to adequately educate the client about these risks and the importance of calling for assistance, combined with a lack of immediate follow-up after administering the medication, constitutes a breach in the standard of care. These omissions directly contributed to the client's fall and injury, supporting a malpractice claim.

Take the full NCLEX practice test

For a fuller set of questions on this topic, see our nclex test sample questions resource.

For a fuller set of questions on this topic, see our nclex practice questions pdf resource.

What is the difference between NCLEX-RN and NCLEX-PN?

NCLEX-RN is the licensure examination for registered nurses (RNs) and tests a broader and more complex scope of practice, including independent clinical judgment, management of care, and delegation. NCLEX-PN is the licensure examination for practical nurses (LPNs/LVNs) and focuses on reinforcing the care plan established by the RN or physician rather than independent judgment. Both exams use CAT adaptive testing and now include Next Generation NCLEX (NGN) item types, but the content blueprints and passing standards differ. RN candidates are expected to demonstrate higher-order clinical reasoning across all four client needs categories.

What are the Next Generation NCLEX item types and why were they added?

NCSBN added six new item types to better measure clinical judgment: extended multiple response, extended drag-and-drop, cloze (drop-down), enhanced hotspot, matrix/grid, and bow-tie. Traditional multiple-choice questions test knowledge recall but do not fully capture how nurses think through real clinical situations. The new formats require candidates to analyze patient scenarios, recognize relevant cues, prioritize hypotheses, select interventions, and evaluate outcomes — reflecting the six-step Clinical Judgment Measurement Model. These formats were fully integrated into the NCLEX in 2023 and are now a standard part of every exam administration.

How does NCLEX CAT adaptive testing determine pass or fail?

The CAT engine selects questions calibrated to your current estimated ability level after each response. As you answer correctly, harder questions are selected; incorrect answers bring easier questions. The exam ends when the computer is 95% confident that your true ability is either clearly above or clearly below the established passing standard — or when you reach the maximum question count (150 for RN). A passing decision is based on the final ability estimate, not the number of questions answered. Candidates who answer all 150 questions can still pass if their ability estimate remains above the passing standard at that point.

What are the NCLEX delegation rules for RNs, LPNs, and UAPs?

Delegation on the NCLEX follows scope-of-practice principles. RNs may delegate tasks that do not require nursing judgment to LPNs/LVNs and UAPs. Tasks requiring assessment, nursing diagnosis, care planning, or evaluation cannot be delegated. LPNs/LVNs can perform medication administration (including IV push in some states), wound care, catheterization, and other technical skills within their scope. UAPs (unlicensed assistive personnel) can be delegated routine, stable, predictable tasks such as vital signs on stable patients, ambulation assistance, ADL support, and specimen collection. RNs retain accountability for all delegated tasks and must provide clear instructions and follow up to ensure completion.

How many questions are on the NCLEX?

Both the NCLEX-RN and NCLEX-PN contain between 85 and 150 questions. (Verified Oct 19, 2026 against National Council of State Boards of Nursing.)

What is the passing score for the NCLEX?

The NCLEX-PN passing standard is -0.18 logits through March 31, 2029. (Verified Oct 19, 2026 against National Council of State Boards of Nursing.)
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