The National Council Licensure Examination, or NCLEX, is a nursing licensure exam used to determine preparedness for entry-level nursing. There are two types of NCLEX exams: NCLEX-RN, which is for individuals seeking RN licensure, and NCLEX-PN, which certifies a licensed practical nurse (LPN) or vocational nurse. While prospective RNs must first obtain either a bachelor’s or associate degree in nursing prior to taking the NCLEX, LPNs must obtain a degree in licensed practical nursing. LPN is a certification that can generally be completed in a year, in comparison to 3 or 4 years for RNs. Both NCLEX nursing exams are administered by the National Council of State Boards of Nursing (NCSBN).

The NCLEX is a computer-administered examination. The majority of the questions are multiple-choice with four choices, but candidates may encounter short-answer and fill-in-the-blank questions as well. The NCLEX test is ‘adaptive,’ meaning that the exam ends when the test-taker has either completed 75 questions correctly or 75 incorrectly, or when all questions have been answered or all time has been used up. The exam is scored on a pass/fail system.

As of October 1, 2020, some changes have been made to the structure of the NCLEX exam. The new structure has a time limit of 5 hours and a maximum of 145 questions (in comparison to a time limit of 6 hours and a maximum of 265 questions previously). The types of questions, difficulty levels, and minimum questions answered all remain the same.

The NCLEX uses the Computerized Adaptive Testing (CAT) technique to accurately gauge a candidate’s knowledge. This means NCLEX test questions become harder or easier based on the test-taker’s performance. If a candidate demonstrates preparedness in the questions they have already answered, they will answer more difficult questions as the test continues. The reverse is true for less prepared candidates.

Some questions on the NCLEX will remain unscored. They are included to help the NCSBN produce future versions of the exam but do not affect scores.

The NCLEX is unlike nursing school exams because it focuses specifically on critical thinking skills as well as clinical preparedness, rather than memorization of facts. Many NCLEX topics are centered around patient safety. The questions on the RN exam force the test-taker to imagine real-life scenarios and demonstrate their ability within the RN scope of practice. In contrast, NCLEX-PN questions focus more on coordinating with RNs and other members of the care team.

Four main content areas make up the NCLEX:

Safe & Effective Care Environment – This includes effective management of patient care and the ability to appropriately prioritize and delegate the RN assignment, as well as following safety protocols and infection control guidelines.

Health Promotion and Maintenance – This NCLEX topic is most similar to the Health Assessment course nursing students must complete. It focuses on patient assessment, developmental stages, disease prevention, and identification of risk factors.

Psychosocial Integrity – This topic deals with aspects of nursing care that affect the psychological or social needs of a patient. These include abuse, addiction, cultural practices, familial issues, end-of-life care, and dealing with trauma, among many other mental and emotional concerns the RN should address.

Physiological Integrity – RNs must care for the basic needs of their patients. These include hygiene, comfort, pharmacological therapy, risk reduction/prevention of injury, and responding to the patient’s changing physiological needs (for example fluid imbalances).

These four content areas make up both the NCLEX-RN and NCLEX-PN exams. However, the NCLEX-PN exam includes the additional category of Safety and Infection Control. Although LPNs have a more limited scope than RNs, they have additional responsibilities of ensuring safety and cleanliness and enhancing the care of all patients. The NCLEX-PN tests for proficiency across the LPN’s scope of practice, while the NCLEX-RN tests for RN proficiency across a different practice scope that includes administration of medications, coordination of care with the extended care team, and taking part in the management of their patient’s treatment.

Understanding the style of NCLEX questions is an important part of test preparation. Candidates will need to combine their knowledge in all NCLEX topics in order to be successful, as many questions require preparedness in all four areas as well as critical thinking across content areas.

NCLEX preparation should focus on evidence-based practice. Candidates should be able to use deductive reasoning to decide which answer best prioritizes the four NCLEX content areas.

Don’t fall for trick questions! Some questions may have several right answers, but only one answer that truly fits best. A good rule of thumb is to determine if the patient in your test question scenario is in immediate need of medical intervention. For example, a question might ask what the RN should do if their patient has an SPO2 of 30%. Should they check if the patient is breathing? Should they call the doctor? Should they get a set of vitals, or would it be better to draw labs?

It's always more important to determine if your patient’s breathing is compromised than to check their blood pressure or lab results. Those options may be important, but the NCLEX wants you to logically decide what your very first action should be. That’s why ABC is a common mnemonic device for NCLEX preparation: Airway, Breathing, Circulation. If a patient is having issues with any of these, it must be addressed before any other action is taken.

It's important to understand the endurance required to take the NCLEX exam. While candidates are allowed two breaks, all candidates taking the NCLEX should be prepared to sit for the entire 5 hours.

There are several reputable test-prep resources many candidates use to learn how to study for the NCLEX. Using study guides as well as practice tests and questions are vital to test preparation. While study guides provide guidance on what concepts test-takers should study, practice tests help candidates get into the mind frame of taking the actual exam. While taking practice tests, it could be helpful to use a timer to see how well a candidate can complete tests under time restrictions.

Before taking the NCLEX, all candidates must be authorized to test (ATT). This is a two-step process in which candidates must apply for licensure with the Nursing Regulatory Body (NRB), as well as register and pay a test fee through Pearson VUE. The test fee is $200. After receiving authorization, candidates should be able to schedule their NCLEX exam. The test is offered year-round and must be taken at a Pearson test center. Registration rules and requirements vary by state.

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On the day of the NCLEX, candidates should dress in comfortable clothes and arrive at their test site early. Those who arrive late may be stopped from testing and have to begin the registration process again. There are no outside materials allowed in the testing room, so there’s no need to bring a calculator or writing utensils. Before the test begins, candidates must provide their photo ID and signature, as well as a photograph and a palm scan to verify their identity. Personal belongings will be placed in a locker outside the testing room.

Once the test begins, there will be a countdown of the remaining time in the upper right-hand corner. However, individual questions have no time limit and it is up to the individual to decide how they want to pace themselves. There are two optional breaks, prompted to the candidate by the testing computer.

The computer screen will show the question at the top, and two buttons at the bottom. The first button says ‘Next (N),’ and should be selected after the question has been answered. The second button is the on-screen calculator. Some questions contain pop-up boxes or audio clips to provide additional information. If the test prompts you to click on a button for this supplemental material, follow the on-screen instructions.

When the screen shows, ‘Your test is concluded,’ the NCLEX attempt is complete. Remember, this could be in as few as 75 questions or as many as 145. The amount of questions answered is not an indication of pass or fail. Results are released on a state-by-state basis, but most states send official NCLEX results in about 6 weeks. Candidates who pass the NCLEX are officially Registered Nurses and can begin applying for nursing jobs. Candidates who do not pass receive a Candidate Performance Report (CPR) and can retake the exam in 45 days after re-registering and paying a second fee.

What does NCLEX stand for in nursing?

The National Council Licensure Examination, or NCLEX, is an exam used to demonstrate a future nurse’s ability to provide safe and effective care for patients.

Can I take the NCLEX without a nursing degree?

No. Both prospective RNs and LPNs must complete a nursing degree before becoming eligible to take the NCLEX. NCLEX-RN requires a bachelor’s or associate’s degree, while NCLEX-PN requires a practical nursing certification.

As of October 1, 2020, the NCLEX is 5 hours long with 145 questions. The test may end earlier based on performance, but all candidates should be prepared to sit for the entire duration.

The NCLEX is a pass/fail exam. A score of 75 correct answers will yield a passing grade. That’s about 50% of the total questions.

The purpose of the NCLEX is to determine if you are ready to be a nurse! You don’t have to know everything, but you should be able to demonstrate your preparedness to become an entry-level nurse.

Yes and no! Passing the NCLEX-RN means you are officially licensed as an RN in the state where you sat for your exam. Passing the NCLEX-PN means you are licensed as an LPN.

What are some ways aspiring nurses can find support and community among their peers and other nurses?

What is one piece of advice you wish you had when you were working to become a nurse?

What is the most rewarding thing about being a nurse?

What tips can you share to help students prep for and pass their nursing exams?

Nurse Educator

I have a clinical nursing background in long-term and rehabilitative care. I have 17 years as a nurse educator in both the clinical setting and didactic setting. I have taught the 120-hour Certified Nursing Assistant, Licensed Practical Nursing courses, Associate Degree and Baccalaureate Nursing courses in a college setting. In the online setting, I have experience teaching courses at the Baccalaureate Nursing Level as well as the MSN level. I am proficient with Microsoft Office products as well as the Blackboard, Moodle, Canvas, and BrightSpace learning management systems. My specialization in nursing education is curriculum development and revision.

Associate Professor

I have been an RN for almost 43 years and have enjoyed the various places I have worked. I have been a staff nurse, charge nurse, and House Supervisor and learned so much in each role. I currently am in my 7th year of teaching at Biola University in the Nursing Department and am an Associate II Professor. My area of expertise is Mental Health, and I have a passion for helping nursing students understand how to work with these clients so as they graduate they will be prepared to care for them. I have published two peer-reviewed journal articles. One is a research article regarding how spending time with the homeless population helps change nursing students’ perspectives about the homeless population.

Assistant Professor of Nursing

Dr. Lora Walter is an Assistant Professor of Nursing at Chatham University, where she coordinates the RN-BSN and Pathways to Nursing Programs. As a neonatal-certified registered nurse, Dr. Walter worked in a level III neonatal intensive care unit (NICU) for 7 years before moving to academia. Currently, she teaches online in the RN-BSN and MSN programs. She has developed online and on-ground courses, redesigned the curriculum, and converted online into on-ground courses. Dr. Walter also developed a unique hybrid advising method to support undergraduate nursing students. Her pedagogical approach is student-centered, and she uses technology to humanize her online courses. She is passionate about student engagement and implements learning activities that promote connectedness, community, and interaction in her online and hybrid classrooms.

Study groups are a great way to support each other. I have a peer mentorship club and website where nursing students connect and share study methods, struggles, and perils. I highly recommend promoting peer support in some form to advance learning, community, and mentorship.

Do not be afraid of not knowing something. It is expected that a new nurse will lack skills and knowledge, especially in a specialty area that they were not exposed to in nursing school. Pretending to know things can lead to patient harm. Do not be embarrassed to ask for help.

Helping patients and families survive a stressful medical experience. Seeing the look on their faces change from fear to calm is rewarding for the nurse.

What tips can you share to help students prep for and pass their nursing exams?

The underlying premise of nursing is critical thinking and clinical reasoning. This is often referred to as “thinking like a nurse.” I tell my students to prepare for exams and anticipate an assessment of the application of knowledge, not just memorized material. Practicing NCLEX-style test questions is important for exam preparation. Reading and understanding the rationales for both correct and incorrect answers will spur the “thinking like a nurse” methodology.