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To make sure you are ready to practice nursing competently, your state's nursing board requires you to pass the National Council of State Boards of Nursing Examination (NCLEX). The two versions of the exam are the NCLEX-RN and the NCLEX-LPN. Once you have completed your educational program, passed the NCLEX, and paid your licensure fees, you are ready to work in a clinical setting as an RN or LPN.

NCLEX Registration Process

Both tests are administered by a private company called Pearson VUE. Your state board will list what is needed for eligibility to take the test. In general, states need proof of graduation from an approved nursing education program and a set of fingerprints, which can be obtained from your local police department.

Your nursing state board will give you an Authorization to Test (ATT), which you will turn in to Pearson Vue along with a $200.00 fee. At that point you will be allowed to make an appointment to take your test.

Examination Content

The tests are comprehensive, all the same basic subjects you learned throughout your nursing education. You will not be expected to be exceptionally brilliant, but you will be expected to have sound knowledge about the following topics:

Questions are divided into four categories according to patient needs:

  • Safe and Effective Care Environment (26 to 38$%),
  • Health Promotion and Maintenance (6 to 12%),
  • Psychosocial Integrity (16 to 12%), and
  • Physiological Integrity (38 to 62%)

The first category, Safe and Effective Care Environment, is broken down into:

  • Management of Care (17 to 23%) and
  • Safety and Infection Control (9 to 15%)

The last category, Physiological Integrity, is broken down into

  • Basic Care and Comfort (6 to 12%),
  • Pharmacological and Parenteral Therapies (12 to 18%),
  • Reduction of Risk Potential (9 to 15%), and
  • Physiological Adaptation (11 to 17%)

You will be tested on your approach to the integrative nursing process across all four categories. The nursing process will be covered and includes scientific and clinical reasoning and decision-making, assessment, planning, carrying out plans, and evaluation of the process. Caring, including nurse-patient interaction to promote a feeling of emotional well-being, is also covered. Communication and documentation covers interactions between nurses and patients as well as families and colleagues, and documentation that demonstrates what measures and standards of care are implemented. The last facet of the integrative nursing process is teaching and learning, promoting improved behavior with new knowledge, and abilities.

How to Prepare for NCLEX

First, do not panic. You have been preparing for NCLEX for the past one or two years. Perusing your notes and books, you will probably find a lot of information that seems less daunting in retrospect than it did the first time. Many programs provide their own reviews in preparation for the test. and many hospitals also offer review courses, so check what's available locally.

The NCSBN, which is  responsible for the content of the tests, also offers a $50.00 review course. You can study at your own pace online with over 2000 pages of content and over 1300 questions written in the same style as NCLEX. An interactive feature even allows you to question teachers and get feedback.

Leave the number 2 pencils at home. Pearson Vue sites maintain personal computers for your test. Make your reservations early, because space is limited. Be sure you know how to get to the site so that you will be there in plenty of time. Consider making a dry run from home to the test site before the day of the test, so that you will be confident of how to get there. Dress comfortably and bring a light sweater that you can take off.

You will have five hours to take the NCLEX-PN or six hours to take the NCLEX-RN, including two breaks if necessary. There are about 205 questions on NCLEX-PN and 265 on the NCLEX-RN.

Exam Scoring

The NCLEX is graded pass/fail. Grading is based upon a complex set of algorithms and statistics designed  to demonstrate competency. If you are able to show competency after 75 questions on the NCLEX-RN or 85 on the NCLEX-LPN, the test will automatically shut down.

Although the computer immediately determines whether you pass or fail, it takes about two weeks to get your results from your state's board of nursing. This is because, for quality assurance, Pearson VUE grades your test twice before reporting your result to the state board.

Last year (2012), 87.69% of nurses who took the NCLEX-RN exam passed on the first try and 83.79% of NCLEX-PN test takers passed on the first try. Failing on the first try is not really the end of your career. Persistence is as important as competence, so study some more and try again. Good luck!

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