Nurse Examination
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Updated/Verified: Mar 5, 2021 | RegisteredNursing.org Staff Writers
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Welcome to RegisteredNursing.org's NCLEX-RN Review Guide. This guide gives you over 85 pages of expert-written guidance covering how and what you need to know to pass the NCLEX-RN exam successfully and become an RN.
Directly below is an accordion-style table of contents focusing directly on the many topics and subcategories of the four main test categories. You can also use the navigation drop-down tool to the left to navigate the various sections of the guide. You'll find test details including how test questions are arranged, designed, and implemented. We also give expert advice on the day of experience, study tips, and tricks, as well as 200+ NCLEX-RN practice test questions with thorough rationales.
Passing this exam will allow an RN to further advance in their career as well as give them the ability to enhance their education via programs such as an RN to BSN or RN to MSN options.
If you enjoy boring power points, reading endlessly from textbooks, or wasting HUNDREDS of $$$ on practice questions, NCLEX®Prep is not for you! Our unique teaching method takes a modern spin on nursing education and is perfect for visual learners. The average user saves 4 hours of study time per week and 50% of NCLEX®Prep students improve their lowest grade by a minimum of 11 points. Nursing.com is used by 270,000+ current and future nurses to get into and pass nursing school, ace the NCLEX®, and succeed as new grads.
According to National Council of State Boards of Nursing, Inc., "Beliefs about people and nursing underlie the NCLEX-RN Test Plan. People are finite beings with varying capacities to function in society. They are unique individuals who have defined systems of daily living reflecting their values, motives, and lifestyles. People have the right to make decisions regarding their health care needs and to participate in meeting those needs. The profession of nursing makes a unique contribution in helping clients (individual, family or group) achieve an optimal level of health in a variety of settings. For the purposes of the NCLEX examination, a client is defined as the individual, family or group which includes significant others and population.
Nursing is both an art and a science, founded on a professional body of knowledge that integrates concepts from the liberal arts and the biological, physical, psychological and social sciences. It is a learned profession based on knowledge of the human condition across the life span and the relationships of an individual with others and within the environment. Nursing is a dynamic, continually evolving discipline that employs critical thinking to integrate increasingly complex knowledge, skills, technologies, and client care activities into evidence-based nursing practice. The goal of nursing for client care is preventing illness and potential complications; protecting, promoting, restoring, and facilitating comfort; health; and dignity in dying.
The RN provides a unique, comprehensive assessment of the health status of the client, applying principles of ethics, client safety, health promotion, and the nursing process. The nurse then develops and implements an explicit plan of care. The nurse assists clients to promote health, cope with health problems, adapt to and/or recover from the effects of disease or injury, and support the right to a dignified death. The RN is accountable for abiding by all applicable member board jurisdiction statutes related to nursing practice."
Please note: The above numbers reflect first-time test taker pass rates.
According to the National Council of State Boards of Nursing, Inc., all those who wish to take the NCLEX-RN Examination must:
If you have to change your testing appointment time for the NCLEX-RN Examination, you must change it by using the Pearson VUE website or by calling Pearson VUE but this must be done at least 24 hours before your scheduled test date and time.
For example, you must change your test time appointment by Friday at least 24 hours in advance of your appointment time, the local standard time when your examination is scheduled on a Saturday.
You can register for the NCLEX-RN Examination using a major credit card, such as VISA, MasterCard or American Express, by either registering at the Pearson VUE website or by contacting Pearson VUE by telephone. You MUST have an email address when you register regardless of whether you are registering by telephone or registering for the test at their website.
Please note that Pearson VUE will NOT send any information or registration acknowledgments via the US Postal Service. They only send this information with email so it is your responsibility to have access to the internet and your email.
The basic registration fee for the NCLEX-RN Examination is $200.00. Additional fees are required if you change the state board of nursing that you want to apply to after you have registered or if you change the language that you choose to use for the examination.
There are NO refunds of these fees for any reason.
The NCLEX-RN Examination is a variable-length computerized adaptive test. It is not offered in paper-and-pencil or oral examination formats.
You may have to take anywhere from 75 to 265 questions depending on how you are doing with answering the questions on the test.
Of the 75 to 265 questions on the test, 15 of these questions are pretest questions. These 15 pretest questions will not be scored and they will NOT be part of or included in your final test score on your NCLEX-RN Examination.
You will have up to a maximum of 6 hours to complete the NCLEX-RN Examination regardless of the number of questions that you will have to answer on this examination.
After you have answered your minimum number of questions, as based on how you have done on the examination, the testing will stop because the test taker is either above or below the passing standard. In other words, the test will stop when you have passed and the test will also stop when it is certain, or almost certain, that you have not passed the NCLEX-RN Examination.
The test will also stop when all the questions are done and also when the 6-hour time limit for the entire examination is over and done.
Based on this information, it is in your best interest to maintain a reasonable pace during the test and take no more than one or two minutes on each question. Keep in mind that you may need the full 6 hours when you have to take all of the available questions for your examination which can number up to 265 questions.
You will get only one question at a time on your computer screen. You can read the question and think about it as long as you like but the question must be answered before you can go on to the next examination question. You must, therefore, answer the question even when you are not certain and not sure that your answer is correct or the test will not proceed to the next question.
Do not waste time on a question; give it your best try. Wild guessing is NOT advised. Select the answer that you believe is the best choice and then move on to your next question.
So, read the question carefully, think about it and then answer it with your best possible response even when you are not sure. Do not get stuck on it. Remember, you only have 6 hours to finish the entire test. Keep up a reasonable and consistent pace as you go through the NCLEX-RN Examination towards its completion.
Now you will learn how to define some of the basic terms and definitions that you will see on the NCLEX-RN Examination.
When you see the word "client", it is the same as the patient and the word client can also refer to an individual, a family, or a group.
A "group" is more than one client or patient. Groups can be defined as populations of people, age groups of people and other groups of people.
NCLEX-RN Integrated Processes are those processes that are recurring themes in nursing and the nursing process. The integrated processes that you will see on your NCLEX-RN Examination are the Nursing Process, Caring, Communication and Documentation, and lastly Teaching and Learning. You will learn about all of these integrated processes during this NCLEX review course.
The word "prescription" is defined as an order, intervention, remedy or treatment ordered or directed by an authorized health care provider such as a doctor, nurse practitioner, and a physician extender like a physician's assistant.
The term "exhibit" indicates that you will see some pictures or diagrams such as a client chart or medical record.
The most important thing that you must bring with you when you go to take your NCLEX-RN Examination is your self-confidence.
You would never have been able to complete your nursing program and graduate from your school if you did not have great good grades and deep knowledge and understanding of nursing and nursing care.
You have the knowledge to pass and ace the NCLEX-RN Examination so take your test with confidence!
In addition to your confidence and a well-rested body and mind, you must also bring personal identification that has your name which fully matches the name that you registered for the test, a recent photograph, AND your signature.
This personal identification can include your current driver's license, a state identification card, a military identification card, a passport, or a permanent resident card with your recent photo; your full name and your signature. You will not be allowed to your the NCLEX-RN Examination if your personal identification does not fulfill these mandated requirements. Additionally, you will also have to begin and pay the fees for the application process all over again.
You should also bring no or as few as possible, personal items to your testing site. When you arrive at your testing site you will be told to put all of these personal items into a locker. No personal items at all are allowed to be brought into the testing area and the test administrators are not responsible for any lost items so bring as little as possible into the testing center. The only thing that you really need when you go to your testing site is your personal identification.
A formal check-in process is done by the test administrators when you arrive at your testing center. This formal check-in process requires that you:
You will be asked to remove any jewelry, watches and outer clothing such as a coat or hat.
After this formal check-in process and identity validation, the testing site administrator will give you brief instructions and then bring you to your seat with your assigned computer that you will use for the entire test. You may not leave this seat for any reason unless you request and are granted permission to leave this seat for a break.
Arrive at least .5 hours before your scheduled testing time. Allow enough time for inclement weather and traffic jams. If you are not sure of how to get to your assigned testing center, do a practice drive several days before your test.
The testing room will be comfortable with an environmental temperature that is regulated with heat during the colder winter months and air conditioning during warmer weather. The testing room will be sparse and quiet. NO talking and conversations are permitted, however, there may be sounds and noises that you may find distracting to you. For example, you may hear typing, coughs, and/or sneezes.
Not all the test-takers in the testing room are tasking the NCLEX RN examination; some of these other test takers may have to type essay answers which you may find distracting.
Ask the test administrator for earplugs to block out these distracting noises if you think that you will be distracted with extraneous noises in the testing room.
You must be 100% aware of and compliant with all the rules and regulations relating to taking your NCLEX-RN Examination. A failure to comply with any rule is grounds for dismissal from the examination.
Other rules and regulations for the examination state that you MUST:
When you are done with your NCLEX RN Examination, you will get a short survey questionnaire that will ask you about the experiences that you have had when checking into the testing site and during the entire time that you were in the testing center and the testing room.
Raise your hand when you are done with this brief questionnaire to let the test administrator know that you have completed your NCLEX RN Examination. The test administrator will collect all the things that you were given by a testing administrator such as your earphones and your note board.
You will see different levels of questions on the NCLEX-RN Examination.
The levels of questions on the NCLEX-RN Examination include knowledge and recall, comprehension of the material, application of the material into nursing practice and higher levels of the cognitive domain of nursing.
The practice of nursing requires the application of knowledge, skills, and abilities into all aspects of nursing care; therefore, the majority of items are written at the application or higher levels of cognitive ability.
Knowledge and recall questions are the simplest of all the types of questions that you will get on the NCLEX examination.
An example of a knowledge and recall question is:
You are caring for a client at the end of life. The client tells you that they are grateful for having considered and decided upon some end of life decisions and the appointments of those who they wish to make decisions for them when they are no longer able to do so. During this discussion with the client and the client’s wife, the client states that “my wife and I are legally married so I am so glad that she can automatically make all healthcare decisions on my behalf without a legal durable power of attorney when I am no longer able to do so myself” and the wife responds to this statement with, “that is not completely true. I can only make decisions for you and on your behalf when these decisions are not already documented on your advance directive.” How should you, as the nurse, respond to and address this conversation between the husband and wife and the end of life?
You should respond to the couple by stating that only unanticipated treatments and procedures that are not included in the advance directive can be made by the legally appointed durable power of attorney for healthcare decisions.
Both the client and the client’s spouse have knowledge deficits relating to advance directives. Legally married spouses do not automatically serve for the other spouse’s durable power of attorney for health care decisions; others than the spouse can be legally appointed while people are married.
Now, here is another knowledge and recall question.
Who is a nurse who worked with the wounded during the Crimean War?
The answer to this question is D, Florence Nightingale. Florence Nightingale cared for the wounded soldiers of the Crimean War. Again, this question is rather simple; it just tests your ability to remember facts that you have learned.
Comprehension questions test your ability to apply a principle to a situation. Now, let's try a comprehension level question.
The answer to this question is A, breaking the mode of transmission. In this question, you had to apply the principles of infection control to proper handwashing.
Now, here is another comprehension level question.
What type of asepsis is used for the administration of topical medications?
The correct response is D, medical asepsis. Medical asepsis is used for the administration of topical medications. In this comprehension question, you are demonstrating your comprehension of the principles of medical and surgical asepsis and medication administration.
Application questions test your ability to apply your knowledge into practice.
You live in your home with your husband and two children. What is the first thing you should do when the smoke alarms in your house start to go off?
The correct answer is A, the first thing that you should do is to evacuate all members of the family. This application question tests your ability to apply the principles of fire safety and RACE to a current situation.
You are caring for a seven-year-old boy in the hospital. You have noticed that the boy is wetting his pants during the daytime hours when he is awake. What should you do?
The correct answer is B, you should understand that this boy is regressing during this stressful hospitalization. With this question, you have applied the principles of mental health and defense mechanisms to a patient situation.
In the past, all of the NCLEX-RN examination questions were only multiple-choice questions with only four choices from which the correct choice had to be selected. Now, these four choices multiple-choice questions are still on the examination, however, new format questions have been recently added.
Fortunately, the majority of the NCLEX-RN examination questions are still the traditional four option multiple-choice questions, but be prepared for alternate format questions.
All of the questions that I just discussed for the knowledge and recall, comprehension and application levels were all traditional four-choice multiple-choice questions.
Most of the four-choice multiple-choice questions are narrative type questions like the ones above, but others can consist of audio clips, tables, charts, graphs, patient medical records and images or pictures. For example, you may get a four-choice multiple-choice question that asks you to select an anatomical body part from a graphic image of the body; you may also get a four-choice multiple-choice question that asks you to select a heart or breath sound that you hear with an audio clip by using your earphones. For example, you may hear a particular breath sound and you will then be asked the name of this abnormal breath sound.
The alternative and new format questions can also consist of tables, charts, graphs, audio clips, and images or pictures, in addition to narrative questions.
The alternative and new format questions are:
Multiple response questions that ask you to select ALL the responses or items in the question that are correct. With this type of alternative and new format question, you will have to select more than one correct answer.
You will not get any credit for a question if you do not answer with ALL of the possible correct answers. For example, you will not get any credit for the question if you only choose three of the four correct answers. There is NO partial credit for questions on the NCLEX examination. Each question is graded as correct or incorrect.
All question types, including the traditional four-item multiple choice questions and al
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