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Taking and Passing the NCLEX

Dec 19, 2019
The Trusted Team

Preparing For The NCLEX

Almost every nurse today can remember taking their NCLEX exam. The National Council Licensure Examination is the tool used to demonstrate to the state licensing boards and future employers that a nurse has met a standard of knowledge and an understanding of the fundamentals of nursing.

The National Council of State Boards of Nursing (NCSBN) is a not-for-profit organization whose U.S. members include the nursing regulatory bodies in 50 states, the District of Columbia, and four U.S. territories. Over 5.7 million candidates have taken the NCLEX exam since 1994. The pass rate for 2017 was 87.1% total for all graduate nurses coming from associates, bachelors, and diploma programs. 

How to Take the NCLEX

Taking the NCLEX is one of the final steps on your way to becoming a fully fledged registered nurse. Now that you’ve graduated nursing school, what’s the next step? First, in order to take the NCLEX, you must apply to your state’s board of nursing for confirmation that you are indeed eligible to sit for the exam. Your board of nursing will then email you what is called an “ATT,” or “Authorization to Test,” which is valid for a specific amount of time (usually about 90 days).

The next step is to pay your exam fees through Pearson (the exam company). Finally, you will need to find an authorized testing center near you. Testing centers fill up quickly, so don’t wait until your ATT is close to expiring, be sure to get your testing site and date nailed down as soon as your receive your ATT. 

Now that you have your ATT, have paid your fees, and secured a date and place to take the NCLEX. What next? It’s important to familiarize yourself with the exam itself.

The NCLEX is a computer-based exam that uses a computer-adaptive form of testing. This means that when you answer a question correctly, the computer will generate a higher-level question next for you. Wrong answers result in lower-level questions. The difficulty level is intended to give the student a 50% chance of answering the question correctly. The exam is available for RN, as well as LPN, accreditation (NCLEX-RN and NCLEX-PN, respectively). This process continues until a pass or fail is achieved with as few as 75 or as many as 265 questions for RNs, and as few as 85 or as many as 205 questions for LPNs.

A Closer Look at the Exam

Most of the NCLEX is comprised of multiple choice questions, but you will also have fill-in-the-blanks, ordered responses, and possibly hot-spot questions. You may also need to review tables, graphs, charts, sounds, pictures, and/or video in order to answer questions correctly. You cannot skip questions; in order to move to the next question, you must provide an answer. 

The maximum amount of time provided to take the NCLEX-RN is six hours, while the maximum time provided for the NCLEX-PN is five hours, including breaks and the pre-exam tutorial taken before the actual test.

Exam Make-Up

The NCLEX is based on a framework of catering to patients that is divided into four main categories and 6 subcategories. Understanding these categories and how they are structured will help you plan your study strategy better and improve your chances of passing. 

  1. Safe and Effective Care Environment
    - Management of Care: 17-23%
    - Safety and Infection Control: 9-15%
  2. Health Promotion and Maintenance: 6-12%
  3. Psychosocial Integrity: 6-12%
  4. Physiological Integrity
    - Basic Care and Comfort: 6-12%
    - Pharmacological and Parenteral Therapies: 12-18%
    - Reduction of Risk Potential: 9-15%
    - Physiological Adaptation: 11-17%

Questions from these categories and subcategories are integrated with the below fundamental processes to the practice of nursing. 

  1. Nursing Process
  2. Caring
  3. Communication and Documentation
  4. Teaching and Learning

What if you don’t pass the first time? 

First of all, don’t panic. Take a deep breath. Don’t allow yourself to become discouraged. You can take the exam again as many times as allowed by your state nursing board during your 365 day eligibility period. Of course, you will have to pay the fees again and schedule the test again through a testing center.

You will also receive a NCLEX Candidate Performance Report if you fail the test. This report allows you to see where you scored poorly so you can work to improve your weak areas and get you better prepared to pass the next time around! 

Cheaters never prosper.

It goes without saying, but cheating is a no-no. Any student who is found guilty of cheating or misconduct during the exam is removed from the testing facility and has their testing fees forfeited. Your exam results may be cancelled or forfeited as well, and your licensing board can choose to deny you a license or prevent you from taking the exam in the future. Definitely not worth the risk! 

man nurse sitting at cafe with laptop studying for the NCLEX

Does Nursing School Prepare You?

While much of what you’re learning in nursing school and clinicals does prepare you to take the NCLEX, many schools do offer some extra test prep to help you out. There are various ways in which they do this, but the most common is to have the option for an in-person prep course at the end of your program, which frequently use the Kaplan curriculum.

The instructors will help introduce you to the exam content, how the questions are written, and how to dissect the information to fully understand what the question is asking. There are practice questions taken throughout as well as a mock exam at the end of the course to give you an idea of what test day will feel like. 

Some schools also employ preparatory courses throughout the program. After speaking with a number of recent graduates and nursing students, it seems the ATI course is very common. ATI consists of a series of books that are typically distributed to follow along with the material you’re covering during your program. 

Our own Nurse Advocate, Ashley Elsbernd, chimes in:

“Speaking from personal experience, we moved through the ATI books as the semester progressed, taking practice tests in the books at various points along the way. When we got to the end of the semester, we then took a computer-based exam on the material covered in the book, much like a system-focused mini NCLEX. As frustrating as extra work and tests were on top of the already heavy workload of nursing school, I found these to be both a helpful review as well as a good way to decrease anxiety the day of the NCLEX due to familiarity with this type of testing.”

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