The National Council Licensure Examination for Registered Nurses (NCLEX-RN) is offered by the National Council of State Boards of Nursing (NCSBN) and requires test takers to display competencies needed to perform both safely and effectively as an entry-level nurse.
In order to be approved to take the NCLEX-RN, test takers will first need to be approved by their individual board of nursing. Once all eligibility requirements are confirmed, clearance to take the NCLEX-RN will be given and candidates will receive an Authorization to Test (ATT) letter. This letter must be taken to the exam center on the day of the exam.
The test is taken at Pearson VUE testing centers across the country and test takers must pick a time and location to take the exam at the Pearson VUE website. The registration fee to take the exam is $200. Other licensure fees required by the test taker’s board of nursing must be paid as well. There are no refunds of registration fees for any reason.
There is a large range in the number of questions that can be asked; as few as 75 questions or as many as 265 can be asked. Regardless of how many total questions are asked, 15 are considered pretest questions that are not scored. The NCLEX-RN exam must be completed in six hours.
This length of time includes the tutorial, all sample items, and all breaks that are taken during the examination (though taking breaks is optional). There are also two pre-programmed optional breaks in addition to any unscheduled breaks that are taken by the test taker.
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There are four major “Client Needs Categories” that are a part of the NCLEX-RN exam: Safe and Effective Care Environment, Health Promotion and Maintenance, Psychosocial Integrity, and Physiological Integrity. The Health Promotion and Maintenance and Psychosocial Integrity categories are the shortest, comprising only six to 12 percent of the total exam.
The Physiological Integrity category is the longest, comprising anywhere from 38 to 62 percent of the total exam. While many questions are in a multiple choice format, there are a variety of alternative question formats that can be used during any part of the exam, including fill in the blank, ordered response, and others. Questions may be asked that include multimedia of some kind as well.
Overview of the NCLEX-RN
The NCLEX-RN exam is in the Computerized Adaptive Testing (CAT) format. The reason for this is that the format allows the computer to determine the ability of the candidate as it relates to whether he or she meets the passing standard. In other words, with every answer provided by the test taker, the computer reevaluates his or her abilities. Based on a test taker’s answers, up to any given point in the exam, the next question provided is selected with the belief that the test taker should have a 50 percent chance of answering it correctly.
The more questions that are answered correctly, the more likely a test taker is to receive more difficult questions for the rest of the exam. It also means that those who answer the most questions correctly will be given the fewest number of overall questions. It is highly recommended that test takers avoid rapidly guessing items. This will only mean test takers will then be given even easier questions which they are highly likely to then also get wrong, further decreasing the chances of passing the exam.
Test takers will either pass or fail the NCLEX-RN exam, however the criteria used to determine whether a test taker passed is not completely straightforward, as the NCSBN website outlines three different testing scenarios that determine passing or failing.
The most common scenario is that, once the minimum number of questions have been answered and the computer is 95 percent certain that the test taker displays an ability that is above the passing standard, no more questions will be administered and the test taker will pass. There are additional scenarios under which the test taker will pass the exam that relate to the maximum number of questions asked during the exam, and also a scenario in which the test taker runs out of time.
The NCLEX-RN exam is scored twice: once at the test center by the computer, and again when it is verified by Pearson VUE. Test takers will not be given the results of their exam at the testing center. Results are available only through the boards of nursing and will be mailed to test takers approximately one month after they complete the exam. Unofficial results can be obtained through the NCLEX website approximately 48 hours after completing the exam, though there is a fee associated with this service.
When a test taker does not pass the exam, the board of nursing sends them a Candidate Performance Report. This provides a summary of their strengths and weaknesses and is intended to help guide him or her with how to best prepare for retaking the exam. Those who need to retake the exam must wait approximately 45 to 90 days to take it again (the specific time frame is determined by each board of nursing).