Everything You Need To Know About The NCLEX

What to Expect & Tips for Success

The National Council Licensure Examination (NCLEX) was created by the National Council of State Boards of Nursing (NCSBN) and is taken by more than 250,000 nursing candidates every year. Two versions of the test exist, the most popular being the NCLEX-RN for aspiring registered nurses. Prospective licensed practical nurses, also known as licensed vocational nurses in California and Texas, take the NCLEX-PN. Because successful passage is required to practice nursing, it's not to be taken lightly. The following comprehensive guide helps nursing candidates be better prepared for the NCLEX while also highlighting recent changes to the format and testing procedures.

What You Should Know: NCLEX Basics

Before delving into the nitty-gritty details, this introductory section covers the basics by providing a brief summary of testing requirements, registration processes and exam administration.

Testing

Once a student understands testing basics and procedures, the next step is to complete the examination. The following section provides a short preparation timeline, information about test scores, and details on rescheduling and retaking the exam.

Cost

Taking the NCLEX is an investment and students should budget for it ahead of time. The numbers below apply to both those taking the test for the first time and to those retaking it.

Navigating The NCLEX-PN and NCLEX-RN Tests

Although the contents of the NCLEX-RN and NCLEX-PN are quite different, the layout is similar. This section explains the four exam categories and their accompanying subcategories, and breaks down the content of each.

Management of Care/Coordinated Care.

RNs answer questions in the management of care subcategory, which covers things like advance directives, client rights, case management, continuity of care, and informed consent. PNs answer questions in the coordinated care subcategory, which is similar to management of care but without principles such as case management.

Safety and Infection Control

Test questions cover injury prevention, handling of infectious materials, ergonomics, restraints, equipment use, and surgical asepsis.

Basic Care and Comfort

This section deals with mobility issues, nutrition and hydration, hygiene, sleep, waste elimination, and assistive devices.

Pharmacological and Parenteral Therapies/ Pharmacological Therapies

RNs have more responsibilities than PNs for administering medication, both intravenously and through the mouth or alimentary canal. Questions covered in this category include drug interactions and side effects, handling blood, giving injections, calculating doses, and managing pain. Candidates for the NCLEX-PN answer a smaller list of questions since they are not responsible for parenteral therapies.

Reduction of Risk Potential

This subcategory covers questions about minimizing complications stemming from a patient's underlying condition or from therapies the patient is receiving. It includes questions about running diagnostic tests, assessing laboratory results, understanding complications from procedures, monitoring changes in vital signs, and applying therapeutic practices.

Physiological Adaptation

This subcategory deals with all the different changes to a patient's physical condition that may take place in a hospital setting, including blood flow, electrolyte imbalances, allergic reactions, and emergencies.

Exam Day: What to Expect

Before entering the testing space, applicants must have their photograph taken and submit a handprint for verification. They must also leave personal items in the break room, as there are strict standards about what may enter the exam room. Once inside, examinees take their seats at individual booths with computers. The test takes a maximum of five hours for PNs and six hours for RNs, although most applicants finish before the buzzer. Test takers are given a short survey once they finish the exam and are then allowed to leave. Below are a few other details about what to expect on exam day.

Final Preparation: What to Bring with You

• Government-issued ID
  Examinees must register and provide a valid form of identification on testing day. Acceptable forms of ID include any unexpired, government-issued ID with a name, photograph and signature.

Exam Period

• Arrival time
  The NCSBN recommends arriving at least 30 minutes prior to the exam.
• Monitoring
  All NCLEX exams are administered at Pearson VUE testing centers, where they are proctored by a testing administrator (TA). The TA collects disallowed personal items before the exam begins, including jackets, bags and food. The TA provides students with a whiteboard and dry-erase marker, and is available should any problems arise during the exam.
• Breaks
  RNs have six hours to complete the exam and PNs have five hours. Examinees are allowed two optional ten-minute breaks: the first is two hours into the exam and the second is three and a half hours into the exam. Both breaks count against the total exam time.
• Guidelines for answering questions
  There are three parts to the exam process: a tutorial, the test and a questionnaire. Applicants cannot skip any of these parts. Once reaching the test, they must answer each question before moving to the next, even if this means guessing. According to the NCSBN, only two percent of test takers fail to complete the exam, so applicants should take their time.

Testing interruptions

Test takers can inform the TA of any interruptions or issues, some of which have exceptions:

• If the room volume is too loud, the TA will provide examinees with earplugs.
• In the rare circumstance that there are technical problems lasting more than 30 minutes, the test taker will reschedule the exam without charge.
• Should test takers receive duplicate questions in the exam, they should inform the TA so they can file a report.

End of the Exam: The Results

Additional Resources

• American Association of Colleges of Nurses
  Nearly 800 nursing schools are members of the AACN, which advocates for bachelor's- and graduate-level nursing education. The AACN's independent branch, the Commission on Collegiate Nursing Education, is one of two main accreditors of nursing programs in America.
  • https://www.aacn.nche.edu/
• Hurst Review Services
  Hurst offers an online review, which costs $300 for RNs and $250 for PNs. It includes access to lectures, online tutors, study guides, and a question bank.
  • https://www.hurstreview.com/index.php
• Khan Academy
  Khan Academy has free NCLEX-RN practice questions as well as multiple video series that cover everything from physiology to mental health.
  • https://www.khanacademy.org/test-prep/nclex-rn
• National Council of State Boards of Nursing
  The NCSBN website seeks to answer just about every question a prospective nurse might have about the NCLEX, but also goes further by informing students about state licensure reciprocity, making research available, summarizing government policies, and producing online courses and webinars. The NCSBN website should be the first stop for anyone with a question about nursing.
  • https://www.ncsbn.org/index.htm
• NCLEX Mastery
  Studying for the NCLEX? There's an app for that. NCLEX Mastery, is available for both RNs and PNs on Android or iPhone, and comes with over 1,600 questions.
  • https://www.nclexmastery.com/