NCLEX-RN (National Council Licensure Examination for Registered Nurses)/NCLEX-PN (National Council Licensure Examination for Practical Nurses)

The NCLEX license is provided by The National Council of State Boards of Nursing (NCSBN) for Registered Nurses and Practical Nurses. It is recognized or rather required in countries like the U.S., Canada, Australia, and the U.K. The medical students looking to make a career in nursing need to get licensed and obtain one of the two nursing licenses offered by NCSBN.

Although NCLEX is administered at the national level in the U.S., it is issued at the state level by the Nursing Regulatory Body (NRB) of that state. There are a total of 56 NRB in the U.S. which include all of the 50 states along with the District of Columbia and the U.S. territories. Although the syllabus and test format is set by NCSBN, the requirements and rules of who can take the test are decided by the individual NRBs. For example, while one state may allow a candidate with a diploma in nursing to take the NCLEX-RN test, another state might require a minimum of an associate's degree in nursing to take the same test.

Who should take the NCLEX-RN/NCLEX-PN test?

The short answer is - anyone aspiring to become a nurse. Nursing is a field where practical knowledge is as important as (if not more than) theoretical knowledge. Any nursing course will include a certain number of clinical hours set in some sort of medical facility where the candidate can get practical knowledge. On successful completion of the nursing course, the candidate can then take the NCLEX test which will enable him/her to work as a nurse.

What are the prerequisites to take the NCLEX?

The prerequisites to take the NCLEX test, or who can take the test are decided by the state's nursing body. The candidate has to obtain permission from their NRB to sit for the test. It is important to check the requirements of the individual NRB since they vary from state to state. Some points to keep in mind:

• what are the minimum qualifications to take the test. Some states would allow a candidate with any nursing course under their belt to take the test, while some would require a nursing degree before allowing a candidate to take the test.
• check if the nursing course is accredited. Most of the states would require the candidate to complete an accredited nursing course. What this means is that the course has to be recognized by the state board. A nursing course may not be accredited because it doesn't have the required curriculum or because it is at the border of the state and is considered to be out-of-state for that nursing board jurisdiction. Whatever the reason, it is imperative to make sure that the course is accredited by the local NRB, to be allowed to sit for the exam.
• which state to test in. The NCLEX license is only valid in the state it is taken in. It does not mean that the nurse with a valid NCLEX license in one state cannot work as a nurse in another state. It just means that there will be additional paperwork required.

What is the difference between NCLEX-RN and NCLEX-PN?

The duties of an RN and an LPN/LVN are mostly the same, the difference being in the level of care provided. The prerequisites for taking the test also vary depending upon the nursing course required. The syllabus for the NCLEX-RN and NCLEX-PN is almost the same and the questions are also similar, the main difference is the depth of the question being asked. The questions in NCLEX-RN are more focused on management and supervision of care provided and clinical problem-solving. The questions in NCLEX-PN are more focused on assisting in providing care to the patients.
Difference between an RN, LPN and LVN

What is the cost to take NCLEX?

While registering for NCLEX, the candidate has to pay their NRB for licensing and Pearson Vue for administering the test. All of the fee paid at the time of the registration is non-refundable.

The licensing fee has to be paid directly to the NRB. It varies from NRB to NRB. Typically the cost is somewhere between $100 to $200. For example, the Florida Board of Nursing requires a $110.00 Application and Licensing Fee while the New Jersey Board of Nursing requires $200 for the same.

The administration fee of $200 ($360 CAD - for Canadian license) has to be paid directly to Pearson Vue. This fee is for per exam attempt. Once a candidate registers with Pearson Vue and pays the fee, that registration is good for 365 days or 1 exam attempt, whichever is earlier.

Other additional fees might be incurred if changes are made to the registration:

• International fee. There is an international scheduling fee of $150 ($150 CAD - for Canadian license) if the test is scheduled at an international location.
• Changing the exam type from RN to PN or vice-versa. If the candidate has registered for NCLEX-RN and wants to switch to NCLEX-PN instead, they have to pay an additional $50 for a US license, no extra charges for Australian and Canadian license.
• Changing Nursing Body. If the candidate decides to change their NRB after registration, there is an additional charge of $50 for US license ($50 CAD - for Canadian license), while no extra charges for Australian license.
• Change in exam language. The NCLEX exam is administered in two languages - English and French. The candidate needs to choose their preferred language at the time of registering for the test. In case they want to change the language later on, there is no extra charge for the US and Australian license, but there is a $50 CAD charge for Canadian license.

How to apply for NCLEX-RN/NCLEX-PN?

To apply for the NCLEX test, whether RN or PN, the candidate first needs to obtain Authorization To Test or ATT from their state's NRB. Before applying for an ATT, the candidate must be sure to meet the eligibility requirements mandated by their NRB. The ATT is obtained by registering at the respective NRB website and uploading the needed documents. Some items required by almost all the NRBs to be able to issue an ATT:

• Completed application along with a copy of required documents
• Proof of completion of the nursing program from the nursing program
• Pearson Vue fee of $200 is paid and the candidate is registered on their website

Once the initial application is reviewed by the NRB, the candidate will be asked to register on the Pearson Vue website and pay the required $200 fee. The Nursing Board will send the approval of ATT through Pearson Vue. The Pearson Vue registration will be valid for 365 days from the date of registration and the candidate can take the test anytime during this time period, provided the ATT is also valid.

Once the candidate receives the ATT, they can go ahead and schedule their test. The ATT is generally valid for 90 days after it is issued, although it varies from NRB to NRB. The candidate should be ready to schedule the test as soon as they get the ATT. The validity of the ATT cannot be extended for any reason whatsoever. If the ATT expires, the candidate has to start the entire process all over again. If the candidate has been given the green signal by the NRB regarding eligibility and they have not received their ATT after 2 days of applying, they need to contact their NRB. All of the communication, including the delivery of ATT is done online via the email address used at the time of registration.

What are the NCLEX Testing Locations?

There are various Pearson Vue testing locations all over the world. The candidate can choose and schedule their test in a domestic location or an international location online or on phone. For US and Australian licenses, the US mainland and the US territories are considered domestic locations. For Canadian license, the Canada locations and US mainland are considered domestic locations.

Keep in mind that there is an extra charge of $150 for scheduling the test at an international location.

What is the NCLEX-RN/NCLEX-PN exam format?

NCLEX test is a Computerized Adaptive Test (CAT) that is administered by Pearson Vue at the testing site.

• Arrival time. The candidates are advised to arrive at least 30 minutes before the exam start time. If the candidate is more than 30 minutes late for the exam, they will not be allowed to sit for the exam and will have to re-register after paying the fee again.
• Validation. The candidates will have to provide at least one valid ID, along with the ATT number. A palm vein scan will be done and a photo taken prior to the exam.
• Items allowed. No personal belongings are allowed in the exam room. All the items have to stored away in zip lock bags and a locker. The candidates are provided with a dry erase board, and marker in case they have to write something.
• Time limit. The exam is 5 hours long which includes two scheduled breaks and unlimited unscheduled breaks. The first scheduled break is a 10-minute mandatory break after 2 hours of starting the exam and the second optional scheduled break is 1.5 hours later. Candidates need to bear in mind that once the clock starts ticking, it doesn't stop, so they have to be mindful of the duration of the break they're taking.
• Language of the test. The NCLEX is currently administered in two languages - English and French. The candidate has to choose their preferred language at the time of registration. If they want to change the language later on, they have to pay an additional $50 to do so.
• Test format. There are a minimum of 75 questions in the test, which include 15 trial questions at the end. The trial questions are used for feedback purposes and are not scored, but they aren't differentiated as such, so it is best to attempt all the questions. The maximum number of questions in the exam can be up to 145. The number of questions that a candidate has to answer depends upon the answer they choose. The goal of the questions is to make sure to test all of the capabilities of the candidate. Sometimes, the questions might seem the same or similar, but the candidates are advised to never assume that two questions are the same. They may vary on the basis of the setting, symptoms, or the nursing step. Regardless of the number of questions administered, the time allotted for the test remains the same. It is advised to not spend more than couple minutes on a question.
• Types of questions. Most of the questions in the test are standard multiple choice questions with one option to be chosen from the four given options; but there are other forms of questions included as well.
  • Multiple response questions - require a candidate to choose a single or multiple responses as answer the question.
  • Fill-in-the-blank questions - require a calculation based numeric answer to the question.
  • Ordered response questions - require a candidate to arrange options in the correct sequence or order.
  • Chart/exhibit questions - require a candidate to review the information in the chart/exhibit to answer the question.
  • Graphic questions - contain pictures as part of the question or as a part of the options.
• Test interface. The questions appear one at a time on the screen and the candidate does not have the option to go back. A question once answered cannot be re-attempted. Every question has to be answered. The candidate has to make the best judgement based on the options provided.

Once the test is over, the candidate is required to raise their hand and wait to be dismissed.

When and how is the NCLEX exam result sent?

The number of questions administered in NCLEX is not a reflection of a pass or fail. If the candidate is close to the passing standard, they will be administered the maximum number of questions, if not they will be administered fewer questions before determining a confident pass or fail decision. Some candidates might demonstrate their knowledge in the first 60 questions themselves, hence earning a pass score, while it may take entire 130 questions for others, to make that decision. For yet others, a fail decision might be determined in the first 60 questions itself. The number of questions administered is in no way an indication of passing or failing the exam.

The NCLEX exam results are provided by the individual NRB. It takes up to 6 weeks for a candidate to receive their result from the NRB. If a candidate has not received their result after 6 weeks, they should contact their NRB.

Some NRBs participate in the Quick Results Service which allows the candidate to view their unofficial score in as little as 48 hours after taking the test. If the candidate's NRB participates in the Quick Results Service, the unofficial score can be purchased from Pearson Vue by paying them $7.95 online. The candidate still has to wait for the official test result through their NRB and cannot practice as a nurse until the NRB gives them the pass result. Bear in mind, that the quick results service is only provided by a choice few NRBs in the US and not available in Australia and Canada.

In case the candidate fails the test, a Candidate Performance Report (CPR) is sent to the candidate. It is a 2-page report that shows the areas of relative strength and weakness in the test. The 8 sections of the test content are marked as "Below the Passing Standard", "Near the Passing Standard" or "Above the Passing Standard". The CPR gives an idea of the sections, the candidate performed well in and the sections in which they need practice. The candidates can then prepare for their next attempt by working on their weaknesses.

If the candidate is unable to attempt the minimum of 60 questions, they receive an abbreviated CPR which just shows the number of questions the candidate answered and how many were required to be answered. It does not contain any other details.

NCLEX failed! How to retake the NCLEX?

There has to be a minimum of 45 days difference between two NCLEX exam attempts. For some NRBs, this time period may be more, but all NRBs require a minimum gap of 45 days. The maximum number of test attempts that a candidate can take in a year is 8, though some NRBs can allow a fewer number of attempts. The candidate will have to apply for another ATT and start the registration process all over again with their NRB and Pearson Vue.

Cost. One good thing about the cost is that most NRBs will waive the registration fee for retaking the exam. The fee of $200 for registering with Pearson Vue is per exam attempt and needs to be paid again for each exam attempt.

It is imperative to check with the NRB if there are additional restrictions on retaking the NCLEX exam. Some NRBs require the candidate to take Review courses if they don't pass the exam in 3 attempts.