Getting Your Nursing License

Ok, now you’ve finished your education and you are ready to get licensed so you can find a job and start nursing! There’s one more test you have to take. The NCLEX exam (National Council Licensure Examination) which is given across the country. The National Council of State Boards of Nursing is responsible for the content and design of these exams. There are only two tests—the NCLEX-RN and the NCLEX-PN. After you pass the RN licensure exam, you will not have to worry about it ever again! BSN, MSN and doctorate prepared nurses are still Registered Nurses. There’s no other licensure exam to take. Even though the name includes the word “National”, passing this exam does not give you a license to practice nursing everywhere in the USA. You will choose which state you want to be licensed in. Many states have reciprocity, meaning gaining your license in one state will allow you to practice in some neighboring states. You should contact your state board of nursing to find out exactly what your state’s requirements for licensure are, if they offer reciprocity, and if so, for what other states.

The night before the exam, you should go to bed early and get plenty of rest. Eat a good breakfast so you won’t be thinking about how hungry you are. Take snacks and drinks. High energy foods are best—like fruits, nuts, peanut butter, etc. If you are not permitted to eat them in the testing center, you will have a mandatory break and you can snack then. Testing centers are often kept cool because of all the computers. Dress in layers so you won’t be cold, and you can take something off if it’s too warm.

The NCLEX exam is given by computer. It’s a comprehensive, adaptive test that’s designed to identify whether or not you are able to safely provide BASIC nursing care. While you have to know the content, this exam also tests your critical thinking skills, ability to apply the knowledge you have learned and make competent nursing decisions. “Adaptive” means that the test adjusts to you. You will be given enough questions to answer to determine your ability. Here are some things you can do to help get through successfully:

Don’t wait too long to take the exam. Do it while the material is still fresh in your mind. The sooner, the better.
Practice. Get at least one NCLEX study book. This book not only has questions, but it gives the answers with the rationale. This will help you use your critical thinking skills. Even the creators of the NCLEX will admit that it is a hard test. You are expected to have about 40% wrong answers but still pass.
During the test, take breaks when they are offered. Even if you think you are doing fine, it’s best to give your mind a break, and walk around a couple minutes.
Finishing quickly doesn’t give you a better score. Remember, this exam requires critical thinking skills, so think! Take your time. There’s no prize for finishing first. It’s not a race!
Read the questions carefully, then read each multiple choice answer before you make a decision. Make sure you understand what the question is asking. It’s real easy to jump to the wrong answer if you don’t read carefully.
If you aren’t sure of the right answer, begin by eliminating the ones you know are wrong.
Remember, you are expected to miss a lot of questions. Don’t be discouraged if you think you aren’t doing well. This exam is adaptive. It is designed to challenge your knowledge, so if you are performing above the passing level, you are going to get harder questions. Just keep going and focus on the question you have in front of you. One question at a time.
Find the “key” word in the question. (ie: initial, best, never, only, early, immediately)
Remember: ABC. Prioritize when caring for patients: Airway, Breathing, Circulation—in that order
Make sure you understand the Nursing Process & use it for prioritizing: (Assess, Analyze, Plan, Implement, Evaluate)
Know the 5 rights of Medication Administration (Right patient, right medication, right dose, right route, right time)
Take care of the patient first and equipment later unless it is life supporting equipment that has failed.
Memorize lab values.
Use therapeutic communication.
Answer every question. Remember a guess has 25% chance to be right.
If you have the maximum number of questions, try not to get nervous. Many, many, testers have had the total possible questions. Try to keep focused and answer one question at a time. If the computer continues to give you questions, it is likely that your ability hasn’t been determined one way or the other. Each question is important. You must get as many right as you can, so don’t give up. The last question you answer may just be the one that determines if you pass or fail.

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Kelli Wilson

Kelli has over 16 years experience as an RN. During that time she has had hands on clinical as well as management experience.

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