NCLEX Examination

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History

The NCLEX-RN and its sister examination, the NCLEX-PN, were originally developed in 1944 as the State Board Test Pool Examination (SBTPE) by the National League for Nursing. As each state had previously administered its own nursing licensure examination, the SBTPE was created to harmonize testing standards and make it easier for nurses licensed in one state to practice in another. The National Council of State Boards of Nursing (NCSBN) took over administration of the test in 1978 and divided it into the NCLEX-RN and NCLEX-PN examinations. In the 1980s, test takers could expect to answer as many as 720 questions.[1]

In 1994, the paper-and-pencil test was replaced by a computer-based test.[2] Today, thanks to computer-adaptive design, candidates taking the NCLEX-RN only answer between 75 and 265 questions, and candidates taking the NCLEX-PN answer between 85 and 205 questions.[3] Every three years, the NCBSN revises the examination and votes on whether to require test takers to answer more questions correctly to pass the examination.[1]

The most recent passing standard for the NCLEX-RN went into effect on April 1, 2013, and it will remain valid until March 31, 2016. The most recent passing standard for the NCLEX-PN went into effect on April 1, 2014, and it will remain valid until March 31, 2017. [4]

Function of the Test

NCLEX Study Guide

The NCLEX-RN and NCLEX-PN are licensure examinations for Registered Nurses (RN) and Licensed Practical Nurses (LPN)/Vocational Nurses (VN), respectively. Candidates take the examinations upon graduating from a school of nursing in order to earn a nursing license. NCLEX examinations test candidates' knowledge, skills and abilities to ensure their ability to provide safe and effective nursing care. Each year, over 200,000 candidates take the NCLEX-RN, while over 75,000 take the NCLEX-PN.[2] Although the NCLEX examinations have traditionally been used for nursing licensure in the United States, they will also be valid for licensure in Canada beginning in 2015.[5]

Test Administration

NCLEX Flashcards

Candidates wishing to take an NCLEX examination must first submit an application for licensure to the board of nursing where they wish to be licensed. Submitting this application makes candidates eligible to register for the NCLEX with Pearson VUE.[6] Both the NCLEX-RN and NCLEX-PN are administered continuously in approximately 240 Pearson Professional Center locations around the world.[2] The fee to register for the examination is $200, though international applicants may be subject to an additional scheduling fee. Because the NCLEX comprises just one part of the application for licensure from a board of nursing, candidates are encouraged to check with their local board of nursing to determine whether additional licensure fees apply.[7]

On the day of the test, candidates must bring an acceptable form of identification—for example, a driver's license or passport—and will also have their identities confirmed at the testing center via a signature, a photograph, and a palm vein scan. Candidates have six hours to complete the NCLEX-RN or five hours to complete the NCLEX-PN, including two optional breaks. Both examinations are only administered via computer. Because the test is adaptive, candidates only see one question at a time and may not return to a question after submitting an answer.[8] Candidates taking the NCLEX-RN must answer between 75 and 265 questions, while candidates taking the NCLEX-PN must answer between 85 and 205 questions.[3]

Candidates may pay $7.95 to receive unofficial "quick results" within 48 business hours of the examination. Official results are mailed to candidates approximately six weeks following the exam date.[9] Candidates who do not pass the examination are issued a Candidate Performance Report (CPR) detailing how the candidate performed in each of the exam content areas. This report is intended to be a guide to help candidates study to pass the examination.[9]

According to NCSBN policies, candidates who do not pass the examination may retake it after 45 days, up to eight times per year. However, individual boards of nursing may set additional restrictions, so candidates are encouraged to contact their local board of nursing to determine the local jurisdiction's exam retake policy.[10]

Candidates who require special accommodations to take an NCLEX examination must contact their board of nursing directly. Accommodations are only provided with the authorization of the board of nursing, and each board of nursing has its own requirements and processes regarding disability accommodations. Due to the possible complexity of this process, the NCSBN encourages candidates to communicate accommodation requests to their board of nursing as early as possible.[11]

Test Format

Sections of the NCLEX Test
NCLEX Test Subject Areas PN % RN %
Coordinated Care 16-22%
Management and Care 17-23%
Safety and Infection Control 10-16% 9-15%
Health Promotion and Maintenance 7-13% 6-12%
Psychosocial Integrity 8-14% 6-12%
Basic Care and Comfort 7-13% 6-12%
Pharmacological and Parenteral Therapies 12-18%
Pharmacological Therapies 11-17%
Reduction of Risk Potential 10-16% 9-15%
Physiological Adaptation 7-13% 11-17%
Total 100% 100%

Test Environment

Both the NCLEX-PN and NCLEX-RN take place at Pearson VUE Testing Centers. For admission, candidates must bring a valid, photo ID. The test is offered every day of the week, though candidates must call and schedule a testing appointment. Candidates will be able to see their unofficial results 48 hours after completing the exam, and the official results will be mailed in about six weeks.[12]

Test Structure

The NCLEX has two separate exams: the NCLEX-PN and the NCLEX-RN. The NCLEX-PN has eight major domains: Coordinated Care; ; Safety and Infection Control; Health Promotion and Maintenance; Psychosocial Integrity; Basic Care and Comfort; Pharmacological Therapies; Reduction of Risk Potential; Physiological Adaption. The time allotted is five hours. There are usually around 117 questions on the NCLEX-PN. The NCLEX-RN has eight domains as well. They are Management of Care; Safety and Infection Control; Health Promotion and Maintenance; Psychosocial Integrity; Basic Care and Comfort; Pharmacalogical and Parenteral Therapies; Reduction of Risk Potential; and Physiological Adaption. The time allotted for this one is six hours, with an average of 119 questions.[13][14]

Test Content

  • Sample NCLEX-RN Practice Questions:
  1. Which of the following statements about gloves and hand washing is correct?
    A. Sterile gloves should be used whenever touching a patient.
    B. Antimicrobial soap should be used with running water every time nurses wash their hands.
    C. Medical personnel should change gloves when they are performing a procedure on a different part of the same patient’s body.
    D. When washing hands after taking vital signs, the nurse should scrub the hands, wrists, and forearms thoroughly.
  2. Delirium in the older adult can be a serious problem because it can 99
    A. signal an underlying mental health disorder
    B. be linked in a disturbance in sleep
    C. impair motor activity
    D. be a symptom of a serious physical problem
  3. What is the upper limit for a normal triglyceride level?
    A. 160
    B. 190
    C. 200
    D. 230
  4. What stage of Hodgkin’s disease is diagnosed when there are multiple groups of involved lymph nodes on the same side of the body?
    A. Stage I
    B. Stage II
    C. Stage III
    D. Stage IV


  • Sample NCLEX-PN Practice Questions
  1. Which of the following is the most effective method for reducing the spread of nosocomial infections, such as Clostridium difficile?
    A. Placing clients in private rooms
    B. Providing antibiotic prophylaxis
    C. Cleaning the rooms with a disinfectant
    D. Practicing a thorough, consistent handwashing routine
  2. A client has a chest tube in place with a three-chamber chest drainage system. The nurse notes continuous bubbling in the water seal chamber. This indicates which of the following?
    A. Pneumothorax
    B. Suction is adequate
    C. System air leak
    D. The tube is positioned incorrectly
  3. The nurse is educating a 23-year-old client about oral contraceptives. Which of the following should the nurse counsel the client to avoid?
    A. Drinking alcohol
    B. Smoking
    C. Eating a high-fat diet
    D. Doing aerobic exercises
  4. Which pain assessment tool is the most appropriate to use with an adolescent?
    A. Face, legs, activity, cry, consolability (FLACC) scale
    B. Wong-Baker FACES pain rating scale
    C. Children's Hospital of Eastern Ontario Pain Scale (CHEOPS)
    D. One-to-ten scale
  5. A client has developed osteomyelitis of the bones of the left foot following the infection of a diabetic ulcer. The nurse anticipates which of the following treatments to be the primary focus?
    A. Warm wet soaks
    B. Analgesia
    C. Surgical debridement
    D. Intravenous (IV) antibiotic therapy

More free NCLEX practice test questions.

Scoring

Because both the NCLEX-RN and NCLEX-PN examinations are computer-adaptive, criterion-referenced tests, there is no single passing score or percentage. Candidates answer questions until the scoring algorithm has determined with 95% certainty whether the candidate's ability level lies above or below the passing standard set by the NCSBN.[3] Candidates may be presented with 75–265 questions on the NCLEX-RN or 85–205 questions on the NCLEX-PN.[3]

If a candidate runs out of time before the scoring algorithm has reached its 95% certainty level, it is still possible to pass the examination, but only if the candidate's estimated ability level has remained above the passing standard for all of the past sixty questions. This is known as the "Run-out-of-time (R.O.O.T) Rule."[15]

In 2013, 210,550 candidates took the NCLEX-RN examination, of whom 71.12% passed. In the same year, 75,280 candidates took the NCLEX-PN examination, of whom 73.71% passed.[16]

Recent/Future Developments

The NCLEX-PN's most recent passing standard went into effect on April 1, 2014, and will remain valid until March 31, 2017. The NCLEX-RN's current passing standard will remain valid until March 31, 2016.[4]

Answers to Sample Questions

NCLEX RN: 1;C 2;D 3;B 4;B

NCLEX PN: 1;C 2;C 3;B 4;D 5;D

References

  1. ^ a b Kaplan Test Prep Online Pressroom: NCLEX-RN® Examination January 31 2014
  2. ^ a b c Credentialing and Licensing Excellence: NCSBN's Journey January 31 2014
  3. ^ a b c d Computerized Adaptive Testing FAQs January 31 2014
  4. ^ a b Setting the NCLEX Passing Standards January 31 2014
  5. ^ NCSBN Finalizes Agreement with Canadian Nurse Regulators January 31 2014
  6. ^ Registration May 16 2014
  7. ^ Fees & Payment May 16 2014
  8. ^ Exam Day January 31 2014
  9. ^ a b After the Exam May 16 2014
  10. ^ Retake Policy January 31 2014
  11. ^ 2014 NCLEX® Examination Candidate Bulletin May 16 2014
  12. ^ NCLEX Information 14 July 2014
  13. ^ NCLEX FAQ 14 July 2014
  14. ^ NCLEX Exam Day 20 March 2015
  15. ^ Run-out-of-time (R.O.O.T.) Rule May 16 2014
  16. ^ NCLEX Stats 2013 May 16 2014