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The NCLEX-RN® is a licensing exam for registered nurses in the United States. Nursing school graduates must pass this exam in order to begin work as a registered nurse in any U.S. state or territory. The exam is offered year-round at testing centers throughout the country and can be retaken numerous times.
Known more generally as the "nursing boards,” the NCLEX-RN® is the final hurdle that nursing students must clear before they can begin a career as a registered nurse. Registered nurses are largely independent, often running clinics and doing the work of doctors when doctors are not available. States have an interest in regulating who can become a registered nurse in order to keep the public safe. Requiring standardized tests is one way for state boards to ensure and verify the practical education of all RNs.
NCLEX-RN® stands for “National Council Licensing Examination for Registered Nurses.” The exam is offered by the National Council of State Boards of Nursing in conjunction with individual states’ nursing boards. No matter where it is taken, the exam is the same in all U.S. states.
The NCLEX-RN® is distinct from the NCLEX-PN®, a similar exam for practical nurses. Many regard the practical nurse version of the exam as simpler than the registered nurse test, though neither is an objectively easy endeavor. Just the same, practical nurses do not usually have the autonomy or medical authority of a registered nurse, and the skills and responsibilities of their work are less complex. Questions on the NCLEX-PN are phrased accordingly.
There are four sections on each NCLEX-RN®. Sections are organized in terms of “client needs.” These include physiological integrity; psychosocial integrity; health promotion and maintenance; and safe, effective care environment. Most questions are multiple-choice, but some are short-answer, calculation-based, or multiple-answer.
The NCLEX-RN® is a computer-adaptive test, which means that it is taken on a special computer and is automatically scored as it is taken. A correct answer will trigger the exam to present a more challenging next question, while an incorrect response will lead to a simpler prompt. As such, the NCLEX-RN® score is based on more than just number of correct answers. Harder questions are typically weighted more heavily.
Questions in all four sections cover a range of topics. Many questions are fact-specific, but others require students to calculate drug dosages, identify injuries and ailments from given symptoms, and apply rules and medical principles to new fact scenarios. Most students spend a great deal of time studying for the NCLEX-RN®, either by attending professional prep courses or by reading review books and practicing sample problems.
Students can only sit for the NCLEX-RN® after they have successfully completed an accredited nursing school program. State nursing boards must certify that students are eligible to sit for the nursing examination by issuing an “Authorization to Test,” or ATT. This ATT must be submitted with the NCLEX-RN® test application and payment in order to reserve an exam appointment.
A passing score on the test makes a student eligible to receive a nursing license in the state or territory of his choice. Licenses come from state nursing boards. In some states, a passing score is all that is needed to receive a license, but the ultimate decision is up to the state. Some require other skills or certifications in addition to a passing exam score, such as minimum practical experience and hours logged in clinics.