Master the NCLEX with This Study Guide

nursing student holding NCLEX study guide
April 8, 2024

Table of Contents

Here you are. You are about to become a registered nurse (RN) or a licensed practical nurse (LPN) and need to take the final step to achieve that goal that seemed so far away. To make things easier for you, we made this NCLEX study guide so you know step-by-step what to do and how to pass the NCLEX the first time you take it.

What Does NCLEX Stand For?

The National Council of State Boards of Nursing (NCSBN) is responsible for administering the NCLEX, which stands for the National Council Licensure Examination, a standardized test for registered nurses and licensed practical nurses. The newest version of the test is the Next Generation NCLEX (NGN); however, it is still most commonly referred to as NCLEX.

What Is the NCLEX Exam?

The NCLEX exam evaluates whether future registered nurses and licensed practical nurses have the knowledge to practice safely. 

There are two types of NCLEX exams for different nursing licenses: the NCLEX-RN for registered nurses and the NCLEX-PN for licensed practical nurses. The average NCLEX pass rate in 2023 for a baccalaureate degree was 90.17 percent; for an associate degree, it was 87.75 percent; and for LPNs, it was 86.67 percent.

NCLEX-RN vs. NCLEX-PN

Registered nurses need to take the NCLEX-RN since it is designed to measure the candidates’ knowledge within the RNs’ scope of practice. The test has questions about care management or other topics that do not apply to the NCLEX-PN, which is designed within the LPNs’ scope of practice. The following list shows the different categories in each of the exams and the percentage of items for each category on both tests based on the 2023 Candidate Bulletin:

The NCLEX-RN

  • Safe and effective care environment: some text
    • Management of care: 15–21%
    • Safety and infection control: 10–16%
  • Health promotion and maintenance: 6–12%
  • Psychosocial integrity: 6–12%
  • Physiological integrity:some text
    • Basic care and comfort: 6–12%
  • Pharmacological and parenteral therapies: 13–19%
  • Reduction of risk potential: 9–15%
  • Physiological adaptation: 11–17%

The NCLEX-PN

  • Safe and effective care environment:some text
    • Coordinated care: 18–24%
    • Safety and infection control: 10–16%
  • Health promotion and maintenance: 6–12%
  • Psychosocial integrity: 9–15%
  • Physiological integrity:some text
    • Basic care and comfort: 7–13%
    • Pharmacological therapies: 10–16%
    • Physiological adaptation: 7–13%
    • Reduction of risk potential: 9–15%

There are some differences between the NCLEX-RN vs. NCLEX-PN. In the case of the RN test, there is management of care, which measures how the RN prioritizes patient needs, works with interdisciplinary teams, implements care plans, and manages time, resources, and supplies to give patients quality care.

On the other hand, the NCLEX-PN includes coordinated care, which focuses on working on healthcare teams, conducting patient assessments, and conducting smooth transitions between care levels. Furthermore, the listed categories in the tests may have different values in both types of NCLEX, so it is something to consider when you create your study plan.

Steps for the NCLEX Registration

There are some steps you must take to register for the NCLEX. This list shows the steps candidates typically must follow:

  • Submit your application to your nursing regulatory body (NRB).
  • Meet all the NRB’s requirements.
  • Registered for the NCLEX with Pearson VUE and pay the $200 fee.
  • Receive an email authorization to take the test from Pearson VUE.
  • Schedule your exam.
  • On the test day, take a valid identification with you.
  • Take the test and receive your results from your NRB within six weeks.

How to Prepare for the NCLEX

Depending on the time you have left before the day of your test, consider making a study plan and dividing your time to cover the different test sections. There are various ways to find the help you need to prepare for the NCLEX: Uworld, Archer Review, and Kaplan are some options that can help you conquer the test.      

Take note of your weak areas and devote extra time to studying those topics. Take NCLEX practice tests with similar exam questions so you are more familiar with the type of questions and can practice under the same test conditions.    

The Next Generation NCLEX introduced numerous changes, including case studies and new types of questions, like drag and drop, extended multiple-response, and more.

Type of Questions on the NCLEX

Knowing the different types of questions in the test helps you become more familiar with the NCLEX, making you feel more relaxed and confident on the day of the official exam. The following list shows the types of questions on the NCLEX:

  • Multiple choice: Candidates select the best option from a given list.
  • Extended multiple response: Candidates choose all the correct answers from an option list. The Next Generation NCLEX allows partial scores.
  • Drag-and-drop: Candidates match the answers by dragging and dropping the items into the correct categories. The NGN doesn’t require the use of every given option.
  • Hot spot: Candidates must identify an area on an image.
  • Case study: Candidates evaluate real scenarios. 
  • Matrix: Candidates choose the correct answers from a grid or a matrix.
  • Bow-tie: Candidates must analyze an electronic health record to determine the patient’s medical condition.
  • Drop-down: Candidates can use multiple drop-downs from the given options to assess clinical judgment.
  • Fill-in-the-blank: Candidates resolve problems such as determining medication dosage.

How Long Is the NCLEX? 

The test lasts five hours, and you can have 85 to 150 questions. Fifteen of those questions don’t have a score since they are experimental questions for future exams. 

Once you respond to the minimum of 85 questions, the system will determine if you have the necessary knowledge to practice as a nurse, and it can stop delivering questions. However, if the system can’t determine whether you have passed, it will continue giving questions until you prove your competency or until the exam reaches the maximum number of questions. 

How Is the NCLEX Scored?

The test uses different systems to score the answers. The following list shows the methods used in the test:

  • 0/1 scoring: In this method, the score is the sum of all your correct answers in an item. You don’t lose points for your incorrect answers.
  • Rationale scoring: You only earn points when both responses in the pair are correct. This method is applied when a complete understanding of paired information is needed.   
  • +/- scoring: In this method, you get points for every correct answer. However, your incorrect answers deduct one point from multi-point items.

These three methods are polytomous, allowing partial credit scoring. This feature differs from the previous test’s scoring system, which used dichotomous scoring that only gave a point when the candidate selected all the correct answers.

What Does CAT Mean?

The NGN uses computerized adaptive testing (CAT), an algorithm that delivers customized questions according to the candidate’s answers. Therefore, the first questions are easier than the consecutive ones since the CAT tests your knowledge and competency, providing more or less challenging questions based on your previous responses. 

In other words, depending on how you perform, the questions vary from a more manageable level to a more challenging one and vice versa. 

The algorithm determines if you pass the test based on the following rules:

  • Maximum-length exam: When the system delivers the maximum number of questions and the candidate is close to meeting the requirements, the computer determines whether the candidate passed the test.
  • Run-out-of-time exam: If the candidate can’t finish with the minimum number of questions, they won’t pass the test. However, if the candidate answers the minimum number of questions, the computer determines if the candidate passes or fails the test based on their responses.
  • 95%-confidence-interval exam: The test ends when the system is 95 percent certain that the candidate meets the standards to become a nurse or not.

How Long Does It Take to Receive Your Test Results?

Drink a chamomile tea and relax. Nursing regulatory bodies take around six weeks to send your official results. 

The system scores your results in real-time. Nevertheless, Pearson VUE rechecks your test to guarantee an accurate result.  

What Are NCLEX Quick Results?

If your NRB participates in the quick result service, you can have your unofficial test results in 48 business hours. However, only your NRB can give you your official results. Pay the fee in your Pearson VUE account to access your quick results.

Did You Know about the NCLEX Pearson VUE Trick?

The NCLEX Pearson VUE trick is not 100 percent reliable, but some candidates use it to know whether they passed the test and make waiting for the official results easier. The trick is straightforward: Two to four hours after completing the test, you can visit the Pearson VUE login page and click on the link to re-register for the NCLEX. 

At this point, you must provide your credit card information—remember that you may actually have to pay the fee for retaking the test. After completing the requirements, if the page lets you re-register for the test, you may not have passed it. However, if it doesn’t let you re-register, it could mean you passed the test.

Remember that the only institution that can give you the official results is your NRB, and sometimes, this trick can be misleading since it could let you re-register even though you have already passed the test. Therefore, it is always best to wait for your official results.

How Many Times Can You Take the NCLEX?

Maybe you are worried about the steps to take if you don’t pass the test. Therefore, to help you relax, know that only between 14 and 10 percent of candidates in 2023 didn’t pass, so you have excellent chances, and the fact that you are here shows that you are on the right path.

Nevertheless, if you don’t meet the required grade to pass, you can retake the test 45 days after your first attempt. 

You can typically take the test as many as eight times per year. However, you should contact your NRB since this topic has some variations. In addition, candidates must take the NCLEX within three years after completing their nursing programs. 

Tips for the Day of the Test

D-Day has arrived, and you might feel a little anxious, which is fine since you are about to end an essential stage of your life. That is why we want to share some extra tips with you.  

  • Rest the day before the test: At this point, you must prepare yourself to ensure that you are ready to face your incoming challenge. Enjoy nutritious food, sleep well, and try to relax to recharge batteries and give 100 percent the next day.
  • Do the following on the day of the test: some text
    • Wear comfortable clothes.
    • Arrive early to the testing center.
    • Take your photo identification and your ticket.
    • Ensure you receive your materials.
  • Read the questions and answer confidently: You prepared for this test, so believe in your knowledge. Overthinking doesn’t help.
  • Manage your time: Try to spend one minute on every question.
  • Assess the patient: Always attend to the patient before calling another healthcare professional. Prioritize the patient’s needs and manage life-threatening conditions first.
  • Schedule your breaks: Taking a break gives you new energy and clears the mind, so be sure to take one. Remember that the breaks reduce your test time, so plan them well.
  • Use your ABCs: ABC stands for Airway, Breathing, and Circulation.
  • Don’t forget to breathe: Short pauses may help you manage your stress, focus, and clear your mind.
  • Remember the rules for finishing the test: The exam ends with a survey. When ready, you must raise your hand and wait for the exam administrator to dismiss you. 

You Are Ready to Ace the NCLEX 

With this study guide, you have an overview of diverse aspects of the NCLEX, and now it is your turn to make your study plan. Choose the right path to prepare yourself. Whether you like to prepare with someone else or by yourself, look for practice tests so that you have the experience of a similar exam and are more comfortable with the NCLEX on the day of the test.

We know you will conquer the test, so go study, and we’ll see you soon. Future nurses: Per diem nursing jobs await you.

Sources: 

Guillermo Gainsborg, MA
Blog published on:
April 8, 2024

Meet Guillermo, a contributing copywriter for Nursa who specializes in writing nursing content about finances, licensing, technology, and staffing solutions.

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