Ultimate NCLEX Exam Guide for RNs
February 2020

The Ultimate NCLEX Exam Guide for RNs

NCLEX Exam Guide for RNs

If you’re an aspiring nurse, you may be wondering what is the NCLEX exam, and how do you pass it? The answer to the question is simple: the NCLEX exam, or the National Council Licensure Examination, is an exam for nurses to get an entry-level license to be able to legally practice nursing in the United States.



You may also be wondering what is the NCLEX-RN exam. This is a similar test, but instead of certifying you as a licensed practical nurse, the NCLEX-RN exam will certify you as a registered nurse. The NCLEX exam provides nurses with an entry-level pathway to a career in nursing, while the NCLEX-RN exam allows nurses who have education and experience to work as registered nurses. For many nurses, getting licensed as an RN is the first step toward becoming a nurse practitioner and/or primary care provider.

Before you sign up for the NCLEX exam, you’ll need to complete your education in order to be eligible. If you’re interested in becoming an LPN, you’ll need to go through an accredited LPN certificate program. If you’re taking the NCLEX-RN, you’ll need at least an associate’s degree in nursing, but it’s preferable that you have a bachelor’s in nursing.


When Can I Take the NCLEX Exam?

Wondering when is the next NCLEX exam? Good news: the date of the exam is up to you. If you’ve already completed the education required to be eligible to take the NCLEX or NCLEX-RN exam, you may be searching for the NCLEX exam date. While you’re able to make your appointment for your NCLEX exam date either over the phone or online, it’s highly suggested that you do so online. The NCSBN (the governing body for the NCLEX and NCLEX-RN) typically has extremely high call volume, and it will be much faster and easier to register online.

First, you’ll need to apply for your nursing license. That, of course, differs from state to state. After that, the NCSBN will verify that you’ve completed the education required to make you eligible for the test. When that’s complete, you’ll receive authorization to test or ATT. You’ll receive your ATT in an email (the email that you provided when applying for your nursing license). The dates for the NCLEX exam are not determined by NCSBN. After you receive your ATT, you’ll have a set amount of time within which you can choose your dates for the NCLEX exam. In most situations, candidates must schedule their exams within a 90-day window after receiving their ATT.

If you’re wondering when is the best time to take the NCLEX exam, this depends on how prepared you feel based on your studies. And if it’s been a while since you’ve completed your nursing program, you may want to take some extra time before applying for your nursing license and getting your ATT. If you excelled in your nursing program and you feel ready to test, you may want to schedule as soon as possible, while the information from your nursing licensing program is still fresh in your mind. You don’t have to worry about wondering when is the NCLEX exam – it’s totally up to you to decide when it makes the most sense for you to take your test.


What is On the NCLEX Exam?

If you’re an aspiring nurse preparing for your NCLEX exam, you’re probably wondering what is on the NCLEX, and you want to examples of what exactly an NCLEX exam question looks like. It’s hard to say exactly what is on the NCLEX due to the way the test is given. While practice tests can give you a good idea of what is on the NCLEX exam, it’s impossible to predict exactly what questions you’ll be asked as you work your way through each computerized NCLEX exam question.

When you begin taking your NCLEX, you’ll be given a baseline question. Whether you get that question right or not will determine the difficulty of the next question. The computer constantly adjusts the questions you’ll be asked based on how well you’re doing. If you answer an NCLEX exam question correctly, the next question will be slightly more difficult. If you answer an NCLEX exam question incorrectly, the next question will be slightly easier. This pattern will continue as the computer program zeros in on your ability.

It’s smart to wonder what to expect on the NCLEX RN exam. Researching NCLEX exam topics and NCLEX categories can help you feel confident and prepared when it’s time for exam day. As you research what is on the NCLEX RN exam, it’s key to remember that you’ll never be able to find the exact questions you’re searching for online. The questions change regularly in order to ensure the validity of the exam. When candidates taking the NCLEX constantly receive new questions, it makes it less likely that exam questions could be leaked, which would create an unfair advantage for future test takers.

The sections on both the NCLEX and the NCLEX-RN are the same, but there are some key differences between the two tests. The NCLEX-RN is more difficult than the NCLEX. The NCLEX-RN is made for nursing professionals who have experience giving direction to others and are ready to work in a supervisory role. The NCLEX is not as complex and is designed for nurses who are just beginning to enter the profession. While both tests are difficult, nurses who have taken both exams agree that the NCLEX-RN is more challenging.

Next, we’ll take a look at the NCLEX categories breakdown for each of the eight NCLEX sections. As of July 2017, the NCLEX special research section was introduced. This 30-minute section of the test is used solely to inform future testing questions and does not affect NCLEX scores. The NCLEX research section helps future nurses taking the test, so it’s important to give valid and honest answers as you progress through this section. Let’s take a look at the NCLEX topic breakdown for each of the eight sections on the exam.


Safe and Effective Care Environment

In the safe and effective care environment NCLEX questions section, you’ll encounter a number of topics about how to keep patients safe and healthy. You’ll need to understand how keeping a safe and effective care environment can help to improve patient outcomes, as well as things that can go wrong in the care environment that can negatively affect patient outcomes. There are several topics covered in this section, including informed consent, confidentiality, legal rights and responsibilities, assignment and supervision, and establishing priorities. Many nurses find this section to be tough because of how frequently HIPAA laws change. It’s vital to stay on top of the latest developments in healthcare confidentiality so you know what to expect from this section of the exam.


Health Promotion and Maintenance

The health promotion and maintenance NCLEX section are what you automatically think of when you think of a nurse’s duties. NCLEX questions on health promotion and maintenance focus on health and wellness, health screening, the aging process, postpartum care, developmental stages, disease stages/ prevention, lifestyle choices, high-risk behaviors, self-care, physical assessment techniques, and the principles of nursing education. If any areas of the potential NCLEX questions on health promotion and maintenance make you feel nervous, it’s a great idea to talk with your favorite professor or current supervisor about the latest developments in that particular area of nursing.

Typically, 9% of the exam consists of health promotion and maintenance NCLEX questions. To do well on health promotion NCLEX questions, you’ll need to be very familiar with the three levels of prevention: primary, secondary, and tertiary. NCLEX questions on health promotion are tough, and you’ll want to spend a decent amount of your study time going over practice test questions in this section.


Psychosocial Integrity

As a nurse in training, you know that the role of a nurse goes far beyond providing physical healthcare to patients. The psychosocial integrity NCLEX questions ensure that you understand your roles and responsibility in keeping your patients mentally and socially healthy, as well as your communication skills. This convergence of psychological and social health is an essential area for nurses to ensure that their patients are thriving as whole people. Psychosocial integrity NCLEX RN questions cover several areas, including support systems, stress management, therapeutic environment, sensory alterations, perceptual alterations, religion and spirituality and their effect on health, end-of-life care, family health, cultural diversity, grief and loss, abuse and neglect, behavioral interventions, chemical and alcohol dependencies, crisis intervention, and more.

The psychosocial integrity NCLEX PN questions make up approximately 9% of the test, just like the health promotion and maintenance section. Psychosocial integrity NCLEX questions determine a nurse’s ability to help their patient beyond providing direct patient care. When you’re studying for your test, be sure to spend plenty of time studying psychosocial integrity NCLEX review questions.


Physiological Integrity

As you work your way through NCLEX prep, you’ll come to study physiological integrity NCLEX questions. This section of questions is the largest on the test and focuses on direct patient comfort and care. NCLEX questions on physiological integrity encompass several categories of patient care, including basic care and comfort, pharmacological and parenteral therapies, reduction of risk potential, and physiological adaptation.

Questions in the basic care and comfort portion of the physiological integrity section of the NCLEX take up approximately 9% of the exam and include personal hygiene, rest and sleep, oral hydration and nutrition, non-medicinal comfort interventions, assistive devices, elimination, and mobility. Questions in this category include directives on how nurses should provide healthcare for patients, as well as how nurses should advise caregivers to provide care for patients at home.

The questions in the pharmacological and parenteral therapies section make up approximately 15% of the exam and include parenteral/ intravenous therapies, medication administration, nutrition, pharmacological pain management, expected actions and outcomes, dosage calculations, adverse/ side effects of medications, central venous access devices, and blood and blood products.

Questions in the reduction of risk potential section make up approximately 12% of the questions on the NCLEX exam, and include system-specific assessments, therapeutic procedures, diagnostic tests and laboratory values, changes and abnormalities in vital signs, alterations in body systems, the potential for complications in procedures, and system-specific assessments.

The questions in the physiological adaptation section make up approximately 13% of the questions on the NCLEX exam and include pathophysiology, medical emergencies, hemodynamics, illness management, fluid/ electrolyte imbalances, alterations in body systems, illness management, and unexpected response to therapies.

While all sections of the NCLEX are important, spending the bulk of your time on the physiological integrity section of the exam is a smart move. Breaking down your skills and weaknesses within each subcategory of the section can help you to understand where to focus your time as you prepare for your exam.


Studying for the NCLEX

When you’re studying for the NCLEX, it can feel overwhelming to cover everything that you need to know. Let’s take a look at some tried and true ways of studying for the NCLEX that can help improve your chances of a successful test result.

Set aside some time each day to study for the NCLEX. It can be easy to put off studying, but doing a little bit each day is easier and more effective than trying to cram in the days or weeks before the test.

Give yourself plenty of time to study for the NCLEX. If you’re wondering how long should you study for the NCLEX, know that most experts suggest spending at least one to two months preparing for the test. You may need a longer time to study if a significant amount of time has passed since you’ve completed your nursing licensing program.

Know your strengths and weaknesses. It’s ok to admit that some areas of the test are harder for you than others. Be careful that you don’t simply spend the bulk of your time going over material that you already know. While it’s important to study all aspects of the exam, you don’t want to spend the entire time studying things you already know to boost your ego.

Just get to it. Don’t spend so much time researching how to study for the NCLEX that you run out of time to go over all the material you need to know.

When you find something that you don’t know, don’t freak out! If you’re researching what to study for the NCLEX and you’re seeing areas that are tough for you, simply know that that’s where you’ll want to spend a significant amount of time. One of the best ways to study for the NCLEX is to take practice tests. Let’s take a look at how practice tests work, and how to make them advantageous for your personal study plan.


Do Practice NCLEX Exams Help?

When you’re searching for practice NCLEX exams, you may notice that many practice NCLEX exams are both time-consuming and expensive. You may be wondering if it’s worth it to go through the process of NCLEX exam practice. In a word: yes! NCLEX exam practice gets you ready for the real thing by creating a similar environment to the actual test. In addition to preparing you for your actual exam by giving you an idea of the types of questions you’ll encounter, taking an NCLEX practice exam also helps you learn to calm your nerves long before exam day by practicing what you’ll do when you encounter a question that you’re not sure how to answer.

NCLEX practice exams can be the difference between passing and failing for many people. When you begin your process of studying for your NCLEX, it’s a good idea to take an NCLEX practice exam before you even begin the formal studying process. NCLEX practice exams can give you an idea of where you stand and can help you figure out where you need to focus your studies.

While some NCLEX RN practice exams are pricey, there are several free NCLEX practice exams available online. Free NCLEX practice exams are a great way for you to understand what to expect from the real exam. You may want to do a hybrid of a free NCLEX practice exam along with an exam that you have to pay for. If you decide to do a paid practice exam in addition to a free NCLEX practice exam, be sure that you’re purchasing the practice exam from a reputable company.

As you work your way through your NCLEX practice exams, pay attention to the sample questions for the NCLEX exam that are tough for you, and take note of these topics. Being able to reference these down the line can help to inform your study plan in a personalized way that you won’t get from even the best study guide. Periodically, return to your NCLEX practice exam to see how you’re progressing. You’ll be able to refine your study plan, and you’ll be encouraged to keep up the hard work as you see your scores increase over time.


How Do I Know If I Passed?

If you’ve taken the NCLEX, congratulations! You’re probably frantically googling the NCLEX pass rate, wondering how to pass the NCLEX, and trying to find good signs you passed NCLEX. In order to understand whether you’ve passed the test, it’s essential to understand how the NCLEX works.

Passing the NCLEX can be as simple as answering a certain number of questions correctly, but it typically isn’t that simple. As you answer questions on the NCLEX, the computer will adjust the difficulty of the following question based on whether the previous question was answered correctly. As you progress through the questions, the computer works to determine your skill level. Eventually, the computer will determine whether you’ve passed or failed. For some candidates working on passing the NCLEX, this happens in as few as 75 questions. For others, they end up needing to answer the maximum amount of questions – 265. If a candidate maxes out the NCLEX scoring algorithm and answers all the questions, their score will be a simple percentage of the number of questions they got right divided by the total number of questions.

If you’re looking for good signs you passed the NCLEX, consider the difficulty of your questions. One of the NCLEX tips and tricks to figure out whether it’s likely that you’ve passed is to decide if the questions seemed to get harder as you made your way through the exam. If your questions got tougher and tougher, it’s likely that you did well, and the computer adjusted the difficulty by making questions harder as you went along. Passing the NCLEX may feel difficult because the questions increase in difficulty when you’re doing well, but the test getting harder is actually a good sign. If you’re wondering what is a passing score for NCLEX, it’s hard to say, as there is no hard and fast number of questions each candidate needs to answer correctly before the computer determines that they’ve passed. Many people who take the test find themselves wondering what is a passing score on the NCLEX, only to feel frustrated when they can’t find the answer.

87% of NCLEX test takers and 92% of NCLEX-RN test takers pass on the first try, which is a testament both to their hard work and to the competence of nursing education programs. If you’re wondering how to pass NCLEX RN after failing, the best course of action is to look over your candidate performance report to find your areas of weakness. If you felt you were well prepared for the exam, it’s likely that you were just slightly short of passing. There’s no need to think that your career as a nurse is over. Some focused study on your areas of weakness will likely get you a passing score the next time around, especially since you have a better idea of what to expect than when you took the test for the first time.

If you’re wondering is the NCLEX hard to pass, you’re not alone. While the test is tough, preparation and persistence are key to a positive result. So make sure you know all the items we covered in the NCLEX Exam Guide. Good Luck!


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