The National Council Licensure Examination (NCLEX) is the test that all individuals must take before they can apply to become licensed registered nurses (RNs).

Administered by the National Council of State Boards of Nursing (NCSBN), it tests the knowledge you learned in nursing school through various application and analysis questions. If you're preparing to take it, you might have a few nerves -- as well as a few questions. 

What topics does the NCLEX focus on? How is it scored? How many questions are on the NCLEX?

These are only a few of the inquiries you might have. Thankfully, we have the answers. Today, we're taking a closer look at this exam and sharing everything students need to know. 

What Is the NCLEX?

The NCLEX is recognized as the premier nurse licensure exam. It's a computer-adaptive test (CAT), which means its level of difficulty will automatically adjust based on the responses that you provide. This way, the testing material will closely match your knowledge and ability levels.

Anyone who wants to become an RN in the United States or Canada must receive a passing score on the NCLEX to progress in their career.

How Do I Register?

Each state has requirements and processes that students must follow to get their nursing credentials. Before registering for the NCLEX, contact your state licensing board to understand how your process works.

Once you're ready, you can contact your state's nursing board to apply for your RN or LPN license. Then, you can go to the testing center website to register for the NCLEX. To do so, you'll need to enter basic information, including:

• The program code for your nursing school
• Your email address

There's also a $200 fee to take the exam, which you can pay online or over the phone. As soon as your state board confirms your eligibility, the testing center will email you with details on how to proceed, including your official Authorization to Test.  You can schedule your testing date online from there!

What Does It Cover?

The latest test plan was introduced in April 2023. The exam is divided into four major categories of Client Needs. The most up-to-date NCLEX sections include:

1. Safe and Effective Care Environment 
2. Health Promotion and Maintenance
3. Psychosocial Integrity
4. Physiological Integrity

These sections look a little different for the RN Test Plan and the PN Test Plan. Here's what to expect:

RN Test Plan:

• Safe and Effective Care Environment
  • Management of Care
  • Safety and Infection Control
• Health Promotion and Maintenance
• Psychosocial Integrity
• Physiological Integrity
  • Basic Care and Comfort
  • Pharmacological and Parenteral Therapies
  • Reduction of Risk Potential
  • Physiological Adaptation

PN Test Plan:

• Safe and Effective Care Environment
  • Coordinated Care
  • Safety and Infection Control
• Health Promotion and Maintenance
• Psychosocial Integrity
• Physiological Integrity
  • Basic Care and Comfort
  • Pharmacological Therapies
  • Reduction of Risk Potential
  • Physiological Adaptation

This most recent NCLEX iteration now includes a few next-generation features to reflect the modern world of nursing. This includes new, real-world case studies designed to measure your critical thinking and decision-making skills. 

Is There More Than One Kind of NCLEX?

If you're thinking about taking the NCLEX, you might have seen two different acronyms while you did your research:

• NCLEX-RN
• NCLEX-PN

The NCLEX-RN tests candidates who want to become registered nurses. The NCLEX-PN tests individuals who want to become practical nurses, licensed practical nurses, or licensed vocational nurses. You can learn more about how RNs and PNs differ here. 

In some ways, these two tests are relatively similar in structure, content, and format. However, there is one important distinction to note. While the NCLEX-PN exam focuses mostly on patient care coordination, the NCLEX-RN exam analyzes how well a prospective RN can perform care management, along with a more advanced scope of practice. 

This makes it a little more complex, which is why preparation is so important. For instance, you'll need an in-depth understanding of pharmacological therapy to pass the NCLEX-PN, while the NCLEX-RN requires you to learn everything about this topic plus the basics of parenteral therapies. 

How Many Questions Are on the NCLEX?

NCLEX questions will adjust based on your performance and the responses you provide. This means the exam looks different for everyone. 

The minimum number of questions for both the NCLEX-RN and NCLEX-PN is 85 and the maximum is 150. Eighteen questions will make up three 6-question case studies.

Students have five hours to complete the NCLEX-RN and NCLEX-PN exams. 

How Are the Questions Designed?

With the NCLEX, the question types are varied. They include:

• Multiple Choice
• Matrix Multiple Choice
• Multiple Response Select N
• Drop-Down Cloze
• Drag-and-Drop Cloze
• Drop-Down Table
• Bow-Tie
• Multiple Response Select All That Apply
• Highlight Text
• Highlight Table
• Matrix Multiple Response
• Multiple Response Grouping
• Drop-Down Rationale
• Drag-and-Drop Rationale

Multiple Choice

This is the classic multiple-choice format, with one correct answer. 

Matrix Multiple Choice

These questions are presented as tables, where each row has its own multiple-choice question. Your total score for each item is summed over the rows. 

Multiple Response Select N

Here, there is more than one correct answer. The question will prompt you to select the number (N) of correct responses. 

Drop-Down or Drag-and-Drop Cloze

For drop-down cloze questions, you'll complete a paragraph by choosing from one or more drop-down options. For drag-and-drop questions, you'll drag words from a given word bank to fill in sentence blanks. 

Drop-Down Table

Drop-down tables are divided into columns and rows. You'll select the correct option from each row using a drop-down menu. 

Bow-Tie

Bow-Tie questions address all six steps of the NCSBN Clinical Judgment Measurement Model (NCJMM). Your responses will fall into three categories, which you'll complete by dragging words into each section. 

Multiple Response Select All That Apply

These multiple-choice questions have more than one possible answer. You'll select all that apply.

Highlight Text

You'll read a paragraph and highlight parts of the text based on the prompt. There can be a maximum of 10 sections to highlight. 

Highlight Table

Similar to Highlight Text, you'll highlight the parts of a table in response to a prompt. 

Matrix Multiple Response

These questions are presented in a table. Each column can have multiple correct responses, but you must select at least one.

Multiple Response Grouping

These are also in a table format, which will have between two and five groupings. You'll select at least one option for each grouping.

Drop-Down Rationale

For these questions, you'll complete a sentence by choosing from a list of drop-down menu options. There will be two sections to complete (X and Y) and both must be correct to get a point. 

Drag-and-Drop Rationale

These are similar to drop-down rationale questions, but instead of a drop-down menu, you'll drag items from a word bank to complete the sentence.

It helps to take practice exams ahead of time, so you can familiarize yourself with the layout of this exam. Our 3-Step Strategy gives you access to more than 2,800 practice questions, multiple CAT exams, and multiple readiness assessments so you can track your progress and know when it's time to test.

How Is the Test Scored?

Instead of showing you the number of questions you missed or answered correctly, you'll simply see whether you passed or failed the NCLEX.

However, it's a little trickier than that. 

Remember how the NCLEX uses CAT to personalize your questions? It employs the same strategy to customize your score. Every time you answer a question, the CAT system will analyze your answer to determine what the next question should be. 

As it does so, it's looking for questions that you'll have a 50/50 chance of answering correctly. You'll continue answering questions until the system decides whether you've passed or failed. This is why some people finish with fewer than 100 questions and others have up to 150.

The CAT system uses one of three rules to determine when you've scored a passing grade. Let's take a look.

95% Confidence Interval

With this rule, the CAT system will stop the test as soon as the software is 95% confident that you've either passed or failed. 

Maximum Exam Length

The system will use this rule if you're very close to meeting the passing standard. In this case, the computer will continue to give you questions until you've reached the maximum number allotted. Your final ability estimate will determine if you pass or fail, not the 95% confidence rule. 

Run-Out-of-Time Rule

What happens if the timer runs out and you haven't completed enough questions for the CAT system to know your pass/fail score with 95% accuracy? If this occurs, there are one of two outcomes that might occur:

• You will fail the exam if you haven't answered the minimum number of questions 
• The computer will use its final ability estimate function to determine your pass/fail state based on the questions you did answer

Prepare Now for the NCLEX

This exam is an important part of your journey to becoming a nurse. As you can see, answers to questions such as, "How many questions are on the NCLEX?" aren't as straightforward as most people think. The CAT exam is customized to your knowledge and abilities, so your test won't look like your colleague's. 

At Archer Review, we're here to help you fine-tune your study strategy and take the NCLEX in confidence. We provide tailored study plans, on-demand videos, live crash courses, mock tests, and more to help you prepare. Register today to get started!