What is the NCLEX-RN Exam?

National Council Licensure Examination for Registered Nurses (NCLEX-RN) is a licensure examination that determines you as a good fit to begin practicing as an entry-level nurse. It is quite different than the test you take in nursing school. While nursing school examinations are knowledge-based, NCLEX-RN focuses more on the application and analysis.

Nursing is both an art and a science. It is a continuously evolving profession that utilizes critical thinking to integrate complex knowledge, skills, technologies, and client care activities into evidence-based nursing practice.

The function of this test is to evaluate your capabilities of becoming a practicing nurse.

Format of NCLEX-RN Exams:

The NCLEX-RN is taken by Computerized Adaptive Testing (CAT.) that facilitates a unique examination for each candidate. This form of testing is designed to adjust the level of difficulty of the exam based on the responses provided by you. If you give a wrong answer, the next question will be easier, and if you answer correctly, the next question will be harder. This process is repeated for each question, creating an exam tailored to your knowledge and skills while fulfilling all NCLEX-RN requirements.

Length of NCLEX-RN Exams:

The length of the NCLEX-RN exam is variable for each candidate. The number of questions can last from 75 to 145, of which 15 are pre-test questions and are not scored. But regardless of the number of questions given to you, the time limit for this examination is 5 hours. These 5 hours include an introductory screen, optional breaks, and the exam.

The length of examination for each candidate is different because you will get a different number of questions depending upon the pattern of correct and incorrect responses. Therefore, you should keep up a reasonable pace while giving the exam to complete it even if the maximum number of questions are allotted to you. It is recommended that you do not spend more than a minute or two on each question.

It is important to note that the length of an examination is not an indicator of passing or failing. You may pass or fail the exam regardless of its duration.

Subjects For the NCLEX-RN Exam.

The exam is based on a diverse range of topics that are crucial for patient care. The topics you need to know for the NCLEX-RN exam are as follows-

  • Safe and Effective Care Environment
    • Management of Care→ 17–23%
      • Advance Directives/Self-Determination/Life Planning.
      • Advocacy
      • Assignment, Delegation, and Supervision
      • Case Management
      • Client Rights
      • Collaboration with Interdisciplinary Team
      • Concepts of Management
      • Confidentiality/Information Security
      • Continuity of Care
      • Establishing Priorities
      • Ethical Practice
      • Informed Consent
      • Information Technology
      • Legal Rights and Responsibilities
      • Performance Improvement (Quality Improvement)
      • Referrals
    • Safety and Infection Control→ 9–15%
      • Accident/Error/Injury Prevention
      • Emergency Response Plan
      • Ergonomic Principles
      • Handling Hazardous and Infectious Materials
      • Home Safety
      • Reporting of Incident/Event/Irregular Occurrence/Variance
      • Safe Use of Equipment
      • Security Plan
      • Standard Precautions/Transmission-Based Precautions/Surgical Asepsis
      • Use of Restraints/Safety Devices
  • Health Promotion and Maintenance 6–12%
    • Aging Process
    • Ante/Intra/Postpartum and New-born Care
    • Developmental Stages and Transitions
    • Health Promotion/Disease Prevention
    • Health Screening
    • High-Risk Behaviours
    • Lifestyle Choices
    • Self-Care
    • Techniques of Physical Assessment
  • Psychosocial Integrity→ 6–12%
    • Abuse/Neglect
    • Behavioral Interventions
    • Coping Mechanisms
    • Crisis Intervention
    • Cultural Awareness/Cultural Influences on Health
    • End-of-Life Care
    • Family Dynamics
    • Grief and Loss
    • Mental Health Concepts
    • Religious and Spiritual Influences on Health
    • Sensory/Perceptual Alterations
    • Stress Management
    • Substance Use and Other Disorders and Dependencies
    • Support Systems
    • Therapeutic Communication
    • Therapeutic Environment
  • Physiological Integrity
    • Basic Care and Comfort→ 6–12%
      • Assistive Devices
      • Elimination
      • Mobility/Immobility
      • Non-Pharmacological Comfort Interventions
      • Nutrition and Oral Hydration
      • Personal Hygiene
      • Rest and Sleep
    • Pharmacological and Parenteral Therapies→ 12–18%
      • Adverse Effects/Contraindications/Side Effects/Interactions
      • Blood and Blood Products
      • Central Venous Access Devices
      • Dosage Calculation
      • Expected Actions/Outcomes
      • Medication Administration
      • Parenteral/Intravenous Therapies
      • Pharmacological Pain Management
      • Total Parenteral Nutrition (TPN)
    • Reduction of Risk Potential→ 9–15%
      • Changes/Abnormalities in Vital Signs
      • Diagnostic Tests
      • Laboratory Values
      • Potential for Alterations in Body Systems
      • Potential for Complications of Diagnostic Tests/Treatments/Procedures
      • Potential for Complications from Surgical Procedures and Health Alterations
      • System Specific Assessments
      • Therapeutic Procedures
    • Physiological Adaptation→ 11–17%
      • Alterations in Body Systems
      • Fluid and Electrolyte Imbalances
      • Hemodynamics
      • Illness Management
      • Medical Emergencies
      • Pathophysiology
      • Unexpected Response to Therapies

Passing Standards for NCLEX-RN Exam:

The passing standards are re-evaluated by the NCSBN Board of Directors (DOB.) once every 3 years. The standard set by the board is the minimum level of ability demanded from you for safe and effective entry-level nursing practice. Hence to pass NCLEX-RN, you must perform above the passing standard. There is no fixed percentage of candidates that will pass or fail in each examination.

Passing or Failing in NCLEX-RN Examination:

3 scenarios govern your passing or failing in the NCLEX-RN exam.

  • Scenario One: The 95% Confidence Interval Rule:
    • This is the most common scenario for NCLEX-RN candidates.
    • The computer stops administering questions to you if it is 95% sure that you are above or below the passing standard.
  • Scenario Two: Maximum-Length Exam 
    • This happens when your ability level is very close to the passing standard.
    • The computer continues to administer questions till the maximum number of questions is reached.
    • At this time, the final ability estimate is taken into consideration.
    • If your final ability estimate is above the passing standards, you pass. If not, you fail.
  • Scenario Three: Run-Out-Of-Time Rule (R.O.O.T.)
    • If you have not answered the minimum number of questions, you fail.
    • If you have responded to the minimum number of questions, the result depends upon the final ability estimates.
    • If your final ability estimate is above the passing standards, you pass. If not, you fail.

NCLEX-RN can be a challenging exam requiring you have high knowledge and skills. So, when you decide to take your NCLEX-RN, make sure you are prepared!