Everything You Need to Know About the Nursing Board Examination

According to the U.S. Bureau of Labor Statistics, nurses—whether registered nurses (RNs) or practical nurses (PNs)—must be licensed to practice in the United States. Achieving licensure involves completing necessary training and passing the nursing board examination.

What is the Nursing Board Exam?

The nursing board exam, formally known as the National Council Licensure Examination (NCLEX), is a standardized test that nurses must pass to obtain licensure and practice in their state. There are two versions of this exam: the NCLEX-RN for registered nurses and the NCLEX-PN for practical nurses.

This exam assesses the knowledge, skills, and abilities required for entry-level nursing practice. It covers a wide range of topics, including safety and infection control, health promotion and maintenance, psychosocial integrity, basic care and comfort, and management of care. Administered by the National Council of State Boards of Nursing (NCSBN), the exam uses computerized adaptive testing (CAT) technology to provide a precise and efficient assessment of a candidate’s abilities.

Types of Nursing Board Exams

There are two primary types of nursing board exams:

NCLEX-RN: This exam is for individuals aiming to become registered nurses. RNs coordinate patient care for those who are sick, injured, or disabled. The NCLEX-RN evaluates the competencies necessary for entry-level nursing practice.

NCLEX-PN: This exam is for those seeking to become licensed practical nurses. LPNs provide basic patient care under the direction of an RN. The NCLEX-PN focuses on practical nursing skills and knowledge.

Importance of the Nursing Board Exam

The nursing board exam is essential across the United States to ensure that nurses are adequately prepared to deliver patient care. Given the critical nature of healthcare, nurses must undergo rigorous training, meet educational requirements, and pass this comprehensive exam to practice safely and effectively.

Exam Difficulty and Structure

The nursing board exam can be challenging due to its comprehensive nature. The NCLEX-RN contains approximately 145 questions, while the NCLEX-PN includes around 205 questions. Candidates must answer a minimum of 75-85 questions, depending on the exam type, within a five-hour period. The CAT system adjusts the difficulty of questions based on the test taker’s responses, aiming for a 50% success rate for each question. This adaptive method continues until a pass or fail decision is reached, or the maximum number of questions or time is met.

Despite its difficulty, the exam is passable with the right preparation. For instance, in 2023, the NCLEX-RN had an 89% pass rate for first-time U.S.-educated candidates, while the NCLEX-PN had an 87% pass rate.

Eligibility Requirements

Eligibility for the nursing board exam varies by state, but generally includes completing a state-approved nursing program. After meeting educational and experiential prerequisites, candidates must apply for their nursing license with their state’s nursing board. Registration for the NCLEX can then be completed on the Pearson VUE website, which requires a program code from the nursing school attended and a $200 fee. Once approved, candidates receive an Authorization to Test (ATT) and can schedule their exam through Pearson VUE.

Exam Content and Question Types

The NCLEX exams cover various topics divided into major categories:

• Safe and Effective Care Environment: Safety, infection control, and care management.
• Health Promotion and Maintenance
• Psychosocial Integrity
• Physiological Integrity: Basic care and comfort, pharmacological therapies, risk reduction, and physiological adaptation.

Questions on the exam come in different formats, including multiple-choice, fill-in-the-blank, select-all-that-apply, drag-and-drop, and image-based questions.

Preparing for the Nursing Board Exam

Preparation is crucial for the NCLEX. Prospective nurses should:

• Utilize resources from nursing schools, including mentoring programs.
• Form study groups with peers.
• Review the NCLEX Test Plan provided by the NCSBN.
• Take practice exams to become familiar with question formats.
• Use NCLEX prep books or create personalized study guides.

Effective study habits and balanced self-care are essential. Candidates should plan a study schedule that includes regular breaks and stress management techniques.

Starting Your Nursing Career

The journey to becoming a nurse begins with applying to a nursing school. Completing a nursing program is a prerequisite for taking the NCLEX-RN or NCLEX-PN exam and becoming licensed to practice.

By following these steps and preparing thoroughly, you can successfully navigate the path to a rewarding nursing career.