Congratulations on pursuing a career in healthcare. We’re sure becoming a nurse has been a passion of yours for years and you’ve spent countless hours studying for this role. However, studying to become a nurse is one piece of the puzzle because experience does matter too. We believe knowledge and experience are what will determine your success. The more experience you have, the more opportunities will come your way…and that’s the bottom line!
Before you can start applying for different nursing positions, you’ll need to pass the NCLEX RN exam. Here’s a definition of the NCLEX (National Council Examination for Registered Nurses) and why it’s important. You need to pass this exam because it’s… –
“To ensure public protection, each jurisdiction requires candidates for licensure to meet set requirements that include passing an examination that measures the competencies needed to perform safely and effectively as a newly licensed, entry-level RN” – ncsbn.org
There is NO way to avoid this exam because if you want to become a registered nurse in the United States, you will have to study and successfully pass this examination. The good news is you have a variety of FREE resources available online to help you study and you can visit the National Council of State Boards of Nursing website for more information.
Today, you’re going to learn about the NCLEX and what is the NCLEX passing standard. You’ll learn about the registration process, NCLEX structure, passing the NCLEX, and we will provide some NCLEX tips and tricks. The bottom line is if you want to pass the NCLEX-RN, you need to know what’s required from you – the candidate.
Let’s get started.
Table of Contents
I know many of you have questions about the registration process for the NCLEX examination and how to determine your eligibility. Here is some information to guide you on the right path! First, all the detailed information about applying for the NCLEX-RN examination can be found here – National Council of State Boards of Nursing. Here are the quick steps –
1) Verify with NRB about your eligibility and if you can apply to write the NCLEX. The NRB (Nursing Regulatory Board) is in every state within the United States of America. They will look over your education requirements to determine if you are eligible to sit for the NCLEX in that state.
At this point, the Nurse Regulatory Board is confirming if you have graduated from an accredited or approved nursing program which allows you to sit for the NCLEX-RN examination. For example, a student who has a certified nursing assistant certification will NOT be allowed to sit for the NCLEX because they have NOT met the prerequisites. However, someone with an associate degree in nursing or a bachelor’s degree in nursing is eligible to write the NCLEX examination after successfully graduating from the program. Both these programs will give you the prerequisite courses required by the Nursing Regulatory Board. We recommend visiting your STATE NRB to learn what are their requirements for eligibility.
Visit this page and click on your state Licensing Requirements. Follow the steps required by your state to submit your application. After they will review your application and while they do, you can complete Step Number 2 in the registration process.
2) Register and pay the fees. After graduating from your nursing program and successfully passing the courses, you should apply to write the NCLEX-RN examination right away. You can register for the exam at Pearson VUE. At this time you are only going to register to sit the examination but will NOT schedule a test date until you have received the ATT (Authorization to Test) from the Nurse Regulatory Board. We’ll discuss the Authorization to Test in Step Number 3.
3) The Nurse Regulatory Board will look through your application from Step Number 1 and send you an ATT (Authorization to Test) email to the address you provided during registration. You MUST have this ATT email when scheduling your NCLEX examination through Pearson VUE. Remember, you have already registered with Pearson VUE in Step Number 2 to take the examination and paid the fees. You should only schedule your test date with them once you have received the ATT (Authorization to Test) confirmation.
Each ATT confirmation number is valid for a period of time specified by the NRB (the average length of an ATT is 90 days). Once the NRB has declared you eligible to test and you have received your ATT, you must test within the validity dates on the ATT.
Learn more about the ATT number here.
4) It’s time to write your NCLEX-RN examination on the date you scheduled in Step Number 3. Here are some exam day tips to follow – Exam Day Preparation.
Now that you have successfully met all the requirements and registered for the NCLEX-RN examination, it’s important to understand the structure of the exam. This will help you prepare ahead of time increasing your chances of passing the NCLEX-RN
For you to meet the NCLEX passing standard, it’s important to review the content structure of the examination. A quick view of the National Council of State Boards of Nursing guide will give you a complete overview of the NCLEX structure.
For your reference, the guide can be view here. Scroll down to the 2019-2020 Test Plan Guide.
There are a few important things you need to know about the NCLEX examination structure.
1) The length of the NCLEX-RN can range from 75-265 questions or items. You have six hours to complete the examination which includes sample items, help tutorials, and optional breaks if required. The time will depend on the answers provided by the candidate. For example, depending on the pattern of correct or incorrect answers, the person will receive different questions or items. The reason a person can receive 75-265 questions is that passing the exam depends on how many questions have been answered correctly. You could complete the NCLEX examination in a shorter time compared to others if you already answered most questions correctly.
We will discuss how to pass the NCLEX in the next section.
2) The structure of the exam focuses on four major categories. Within these four major categories “two” of them will be divided into subcategories. The categories on the exam have been selected because they represent critical thinking which is very important as a registered nurse. We have included a chart of the categories and the weight per category.
3) A tutorial will be provided at the beginning of the examination on how to answer the different format questions. Questions will be in a variety of formats i.e. multiple-choice, multiple response, fill-in-the-blank calculation, hot spots, exhibit, ordered response, audio and graphics.
If you DON’T pass the NCLEX examination, you will NOT be licensed in your state…it’s that simple! However, the NCLEX is not graded like typical examinations because it uses something called an NCLEX passing standard. For example, the NCSBN Board of Directors (BOD) will set a criterion or standard of ability for the candidate writing the examination. The board will determine what the candidate needs to know in order to perform their job safely and effectively.
To determine this standard, during the examination, the candidate will answer a series of questions vital to the entry-level nursing practice. If the candidate can answer these questions, then it’s determined they have the knowledge and/or ability to perform as a registered nurse.
So, if you’re wondering “what is the percentage needed to pass NCLEX” exam, then know there is NO percentage but a passing standard. In other words, to pass the NCLEX, a candidate must perform above the passing standard. 😊
Learn more about the Pass and Fail rules here.
The National Council of State Boards of Nursing has gone great lengths to create an examination which is fair and tests the knowledge of the candidate to determine how effective they will be as a registered nurse. The scoring system is different compared to other examinations because the NCLEX scoring system uses something called CAT.
CAT stands for Computerized Adaptive Testing and this system can produce results that are more accurate and efficient while using fewer items. CAT re-estimates the persons ability every time they answer a question. Remember, the NCLEX uses a passing standard to establish how effective the person taking the exam will be as a nurse.
CAT’s (Computerized Adaptive Testing) sole purpose is to grade the NCLEX keeping the passing standard in mind. Each time an item is answered by the candidate, it will re-estimate the person’s ability to be an effective nurse.
Each item on the NCLEX examination is selected from a large pool of items keeping these 3 things in mind –
1) Each item will be pulled from the plan percentages as discussed in this chart –
2) Each item will be challenging enough, and this is determined by how the candidate did on the item before. For example, the computer will select an item the candidate has a 50% chance of answering correctly. This method ensures the question is NOT too easy or too difficult and will give National Council of State Boards of Nursing information about the candidate’s ability from the item.
3) Excludes repeat items – No duplicate question or item will be presented to the candidate.
After taking the NCLEX, you will wonder if you passed or failed the examination. You will start going through your notes to see what questions you answered correctly and which ones you answered incorrectly. You will probably be beating yourself up because you feel you might have gotten a lot of questions wrong and are NOT confident about passing the NCLEX. However, the NCLEX is NOT graded like other typical exams. For example, the percentage needed to pass the NCLEX is determined by these 3 scenarios:
1) MOST candidates fall under this NCLEX rule. The computer stops administering items (questions) if the candidate shows “clearly” that they have the ability to perform as a registered nurse. However, the computer can stop administering items if the candidate is clearly below the NCLEX passing standard The computer will make this decision after it’s 95% sure of the candidate’s “ability” or “inability”.
2) Maximum-Length Exam – candidates will sometimes be very close to the NCLEX passing standard and will continue to receive items until no more items (questions) are available. When this happens, the 95% rule above in #1 is avoided and CAT will determine the candidate’s ability using the “final ability estimate”. At this point, if the final ability estimate is above the passing standard, the candidate passes, and if the final ability estimate is at or below the passing standard, the candidate fails.
3) The Run-Out-Of-Time Rule (R.O.O.T) – if the time runs out and CAT (Computerized Adaptive Testing Algorithm) is not able to determine with 95% certainty the candidate has the ability to perform as a registered nurse, then a different criterion is used.
Here’s the new criterion used in this scenario…
a) If the minimum number of items has not been answered by the candidate, then they fail automatically.
b) If the minimum number of items have been answered, then the CAT algorithm will look at the last 60 items estimates: If the last 60 items answered were consistently above the passing standard, the candidate passes. However, if the candidate answered the last 60 items and they were below the passing standard even once over the last 60 items, the candidate fails. This does not mean that the candidate must answer the last 60 items correctly. Each ability estimate is based upon all previous items answered.
These NCLEX examination tips are NOT listed from MOST to LEAST important. We have listed these as they appeared when brainstorming in our group. We recommend reading through this list 3 times and creating your own list based on what you find is MOST important or useful to you. 😊
1) Read the Entire Question (Only the Question Nothing Else)
It is stated that the question itself will contain all the information you need to successfully answer it. We have narrowed it down to three elements that each question will contain.
a) The first part will contain information related to the case itself. Ask yourself what information within the question is case-related?
b) Now that you have identified the case-related information, you will be asked a specific question about the case itself.
c) The third part will provide answer options to the question. If you are answering a multiple-choice question, you will be provided with 1-4 options. A different question in another format will either ask you to type numbers, click a diagram, arrange priorities, etc.
So, here’s a great trick to use when answering such a question. Start by reading every word in the question, and do NOT speed read. It’s important to focus on just the words and the question without reading too deep into it. Many times, we tend to think too deep into the question adding irrelevant information into it. All the information about the question is clearly stated in the question itself so choose the best answer based on the information you have been provided.
The next tip will teach you a great way to dissect the question to make it easier to answer.
2) Rephrase the Question to Identity Core Issues
This is one of our favorite NCLEX examination tips because it helps remove unnecessary information from the question. We recommend identifying the core issues when writing the NCLEX examination. For example, MOST questions will ask you about the skills, abilities, or knowledge you need to assist the patient. However, the exam has been prepared to include distracting words to confuse you when answering the question. This is a common practice to find out if you can identify the core issues and avoid being distracted by unnecessary information.
One great trick that can help increase the chances of answering such questions successfully is to rephrase the question to identify core issues in the question.
Original Question –
“A 45-year old man is scheduled to be discharged following bypass surgery and he has been in the hospital for 8 days. Does the nurse place a high priority on teaching the patient what point before he is discharged?”
Question Rephrased –
“Following bypass surgery, what is the MOST important teaching point for a patient to know when going home/being discharged?”
In the above example, we have eliminated all unnecessary information that didn’t provide insight into the question and didn’t help you determine the answer. For example, a patient’s age and him being in the hospital for 8 days won’t help us identify the answer in this scenario. However, focusing on the core issues like a “bypass surgery” and that the patient is being “discharged” does require us to assess the situation differently and choose the correct answer based on this information we have. So, the core issue here is we are trying to determine what important teaching point does a bypass patient need when going home? That is all! 😊
3) Understand the Entire Question (Positive or Negative Style)
When writing the NCLEX, you will be faced with positive and negative style questions. A positive style question may ask what a nurse should do or what is the first course of action in each situation. A negative style question may ask what the nurse should avoid or NOT do in the situation. You will know when the question has a negative style because of the keywords embedded in the question. For example, “what prescription is unsafe, not beneficial”, or “what information does the patient NOT understand or is causing confusion”.
When writing the NCLEX exam, it’s important to pay attention to the connotation style of the question. Is the wording to “avoid” “decrease”, “never”, “unacceptable” (negative) or “increase”, “early”,” best”, “should do” (positive)?
Keep an eye on these types of keywords to either determine the “best” course of action or the course of action to “avoid”. Choose your answer based on this style of wording.
4) Eliminate the Incorrect Answers
One of the best ways to improve the likelihood of getting the question correct is to remove irrelevant information. This can be in the form of removing wording or even incorrect answers from the question. By doing this, you will focus on the core information that matters and this can help you narrow down to the correct answer. For example, if you are answering a multiple-choice question that has 4 answer options and you know two answers are incorrect, then don’t pay attention to them anymore. By doing this you have increased your chances of getting the question right by 50%.
Once you have eliminated the incorrect answers from the choices, re-read the question paying attention to the core issues. At this point, narrow down the answer by focusing on the remaining choices and selecting the best answer that solves the core issue in the question.
Multiple-choice questions can be tricky because answer choices can be similar in wording that can confuse you when making your final choice. Our next tip will help you out whenever you start to feel confused with a multiple-choice type question.
5) Find Key Words in The Questions
This was one of the top tricks I learned before writing the NCLEX-RN 3 years ago. It worked wonders in helping me pass the NCLEX-RN examination because it forced me to focus on what matters in the question. A question will contain a core issue(s) that the patient, hospital or nurse is facing and it’s important you identify these issues clearly, so as to have a better SHOT at answering the question correctly. Here are some ways you can do this –
a) When reading over the question take time to identify the words or phrases which provide you with critical information. For example, information pertaining to age, setting, timing, and symptoms.
b) Re-read the question to identify the words that may be causing confusion and can force you to answer the question incorrectly. For example, there is a difference between “likely”, “unlikely”, “mostly”, “increase”, “decrease”, etc
Identify these words and JOT them down because you will be provided with an on-screen board/marker for making notes.
6) Study in Groups (When Possible)
Many of us studied in groups before taking the NCLEX-RN examination because it provided different angles of attack on questions. For example, your view of a question MAY NOT be the same as everyone else’s is so it’s important to gather as much insight as possible before sitting for the NCLEX examination. I believe studying in groups before writing the exam was one of the biggest reasons why I got the percentage needed to pass NCLEX.
We recommend opting into practice tests that are available online and are provided by the National Council of State Boards of Nursing. This way you get exam experience while in groups. You also get a chance to brainstorm different ways to approach questions and identify core issues in the question too. This will only increase your chances of passing the NCLEX. Here’s a thought…why NOT form a group with people who have already written the exam and get their insight too. Some may charge you for helping but it’s worth the investment…right?
7) Focus on the Client/Patient When Answering the Question
You’re writing the NCLEX-RN exam to become a licensed Registered Nurse. Your main responsibility is always the patient first and NOT anyone else. This means most questions will be patient-based and you should identify this early in the question. To better your chances of passing the NCLEX examination, you need to identify the significant or central person in the question. Choosing the wrong answer means you FIRST focused on hospital policies, equipment, hospital rules, or a nurse’s problem. Always evaluate the status of the patient first then focus on equipment, rules, and procedures. I have seen some questions that will be based around the patient’s family or hospital environment first and if this is the case, answer the question accordingly. So,
When reading the question always identify the central person in the question. For example, is the question based around the “patient”, “their family” or “the hospital”. This will help you guide your answer strategy.
8) Pay Attention to Highlighted (Bold) Keywords
Recently the National Council Examination for Registered Nurses has changed the format of the examination and how questions are presented. When writing the exam, you will notice BOLD words in the questions. Use these bold words to your advantage because they can provide important clues into the answer. For example, some bold words that can appear in the question are: best, most, essential, first, priority, immediately, highest, initial, next, refute, increased, decreased and support.
When answering these types of questions, you should pay close attention to how these bold words are used. They will steer you towards the correct answer. Imagine seeing the following type of question –
“Which client statement indicates to the nurse that further teaching is required?”
When reading such a question you know the core word here is “further” and this should help guide you when narrowing down answers. However, we recommend that you still read every question carefully because sometimes these BOLD words can distract you from other important core issues in the question. But, after talking to other nurses who have successfully passed the NCLEX, “bold words” provide important clues into how to answer the question.
9) Watch Out for Switchback Words
A “switchback word” is wording that will change the direction of the question. For example, the MOST common switchback words you will encounter on the NCLEX are: but, although, however, nonetheless, while, even though, regardless of, and others that change the nature of the question.
When dealing with such questions, we recommend reading the question a few times and forgetting anything before the “switchback” word. This is because when “switchback” words are used they are asking you to pay attention to completely something else and not what you have read before. For example,
“You are about to administer the medication ABC to a 70-year old patient who has a blood pressure reading of 160/60, however before you do his blood pressure drops to 120/70…what should you do next?”
The above is just an example, but the key is to understand how the direction of the question has changed after the switchback word “however” which we have bolded above. If you look closely at the question, you’ll notice how information before the word “however” isn’t as significant as it was before the switchback word. The age does matter but the blood pressure of 160/60 doesn’t because the current reading now is 120/70 and your answer will be based on the current reading NOT previous.
When taking the NCLEX exam, you’ll come across questions with switchback words so paying close attention to them is important as they will ALERT you to shifts in thought.
10) Don’t Waste Time and Move On
You will have up to six hours to complete the NCLEX-RN examination. This time includes breaks, etc. When writing this examination, you want to ensure you give yourself enough time to answer most questions. Remember, passing the exam is based on the NCLEX passing standard and this depends on the NCLEX Pass and Fail Rules. In short, to successfully pass the NCLEX, you need to prove through your answers that you can perform your job successfully. So, try to answer as many questions correctly without wasting time because each question is weighted differently and CAT (Computerized Adaptive Testing Algorithm) wants to determine with 95% certainty you can perform as a registered nurse. With that said,
The NCLEX has 265 questions, so answer as many questions as possible. DON’T spend any more than 2-3 minutes on a question. Some questions will require more time but once you have read the question, you should take 2-3 minutes to come up with your answer.
In the worst-case scenario, if you run out of time, The Run-Out-Of-Time Rule (R.O.O.T) will apply. Here’s a video describing this rule –
11) Always Review Class Notes (The Next Day)
This is one of my favorite personal NCLEX tips because it will help you retain information much easier when in nursing school. I used to be a firm believer in cramming for an exam a week before but noticed this strategy doesn’t help with exams that matter. Remember to base your study habits on the exam structure and grading policy. The NCLEX is not an exam you can pass if the CAT (Computerized Adaptive Testing Algorithm) believes you can only perform your duty as a nurse with 70-80% certainty.
Pay close attention to the NCLEX passing standard which clearly states the following –
The most common NCLEX rule for MOST candidates. The computer stops administering items (questions) if the candidate shows “clearly” they can perform as a registered nurse. The computer will make this decision after it’s 95% sure of the candidate’s “ability” or “inability”.
Your focus should be to get as many questions correct on the NCLEX and to help you achieve this, you should start studying from day 1 of nursing school. Nursing deals with critical issues like patient care, medication, sensitive situations, etc. There are both big and small issues related to nursing that you need to know to excel in your career. The same information is required to pass the NCLEX examination. Therefore, putting in long hours of studying is the key to your success.
What worked magic for me was skimming through my class notes the very next day. This helped in three ways –
a) The information was still fresh in mind because I had learned it the day before. This helped me internalize the material easier since it was fresh. Concepts that would have been harder to connect if I waited a week to study were much easier reviewing the next day.
b) I was able to go over my notes jotting them down into a structure easier for me to understand. For example, in class, I would quickly type out notes but wouldn’t structure them in the way I wanted to. However, the next day I can take time to structure them by highlighting key points, correcting spelling errors, adding additional information to a concept to help me understand it while I’m studying.
c) Reviewing notes the next day helped me manage my time better. By the time the NCLEX exam came around my study habits were much better, and I was more disciplined than before. I got into the habit of studying 2-3 hours each night reviewing notes. Since my notes were already organized and structured the way I wanted them to be, I was able to get in a solid 2-3 hours of study time.
Take 1-2 hours every night reviewing your class notes and highlighting key concepts. This is also a great way to learn what nursing concepts you need extra help on so you can research them online or ask your professor for help during your next class.
12) Take Advantage of NCLEX Preparation Courses
This is a huge milestone in your life! Your about to write the NCLEX-RN examination and are focused on passing this exam so DON’T leave any stone unturned. Use whatever resources you have available to study i.e. online study guides, practice tests, groups, etc. Start by visiting the FREE resources available on the National Council of State Boards of Nursing. They provide video resources and other great material. Here is the resources page.
If you are looking for study guides that you can carry around and pull out when you are on the go, then head over to Amazon to view their selection. In the end, use whatever resources you have available to you to study for the NCLEX examination.
Again, here is the chart of what sections to expect on the examination –
13) Watch Out for Tricky “Hedge” Words
These “hedge” words are tricky because they will shift how the question should be answered. When answering a question on the NCLEX exam, you will either be choosing an answer which solves one core issue or covers all possible scenarios. Therefore, you need to pay close attention to hedge words. Hedge words can be in the form of – “likely”, “almost”, “mostly”, “rarely”, “sometimes”, “usually”, and others. The NCLEX uses these hedges to cover all possibilities.
When answering the question at hand, pay close attention to the hedge words and identify them. We recommend re-reading the question several times and making a mental note of these words to better understand what is being asked in the question. Often an answer will be wrong because it left NO room for exception.
14) Look for Contextual Clue’s to Narrow Down Answers
The NCLEX questions will sometimes contain contextual clues to help you narrow down to the correct answer. However, to start narrowing down to the correct answer, you need to be able to identify the contextual clues in the question. Contextual clues, by definition, will provide more information about words or phrases in the question. This will help the candidate understand the meaning of the words or phrases so they can begin to dissect the question. These contextual clues offer insight – either directly or indirectly – into the portion of text that’s difficult to understand. Here are some examples from yourdictionary.com.
Example 1 –
“It was an idyllic day – sunny, warm, and perfect for a walk in the park.”
When reading you might NOT understand the meaning of “idyllic” but by reading further you know it must mean a beautiful day because of the words after i.e. sunny, warm, and perfect.
Example 2 –
“Felipe is a miser. He’s always been cheap”
When reading this “miser” is NOT a common word used, but you can conclude it’s meaning because of what follows the word miser – “he’s always been cheap”. When you look up the meaning of the word miser in the dictionary, it means spends very little money. This can also mean cheap as indicated in example 2.
When writing the NCLEX exam and you come across a word or phrase your NOT familiar with, then look for the immediate context after to help you decipher the word. Contextual clues, sometimes, will give you everything you need to know about a word or phrase to narrow down the answer choices into a solid guess.
As a registered nurse, you will be faced with different types of information which may or may not make sense. The NCLEX will test your ability to decipher information by asking questions containing words you haven’t encountered before. Use contextual clues to help you understand the meaning of these words and to narrow down to the correct answer.
15) Nutrition and Sleep Will Help You PASS 😊
This one is a NO BRAINER so I won’t get into too many details . A good night’s sleep not only helps our brains to consolidate what we have learned in the day, but is also thought to be vital for good memory functionality. Furthermore, research has consistently shown a positive correlation between sleep and test performance. Setting adequate time to sleep before an exam, will actually benefit your test score rather than staying awake for an additional four to five hours staring at notes that you will not remember.
This is further reinforced by the findings of the “National Institutes of Health who have concluded that, sleep deprived students have lower GPA’s due to the negative impact it has on memory and concentration.” – huffpost.com
Hence, if faced with a dilemma of choosing between whether to stay awake for another extra few hours to cram some last minute studying over opting to sleep, preference should be given to the latter. Remember, while staying up the night before may expand your knowledge by a further 10%, this will be to the detriment to the actual next day (i.e exam day) whereby your concentration levels will be decreased by at least 30%. Hence overall impact will be negative -20% (note these figures are for illustrative purposes only, but you get the point). That’s what will happen if you don’t prioritize your sleep.
Subsequently, recommended time of sleep before an exam is at least 8 hours. So when that time nears, be disciplined with yourself, put away all your study material, be confident in what you know as opposed to what you ‘don’t know’, switch of all your electronic devices and snooze away.
The NCLEX examination does seem like a major hurdle however you can increase your chances of passing the NCLEX by preparing ahead of time. The tips we have provided here are meant to give you the extra preparation and confidence you need before your exam day. We recommend reading through our list again jotting down those points you feel will be the greatest asset while studying. However, even with these tips, we believe nothing can prepare you better than attending and paying attention during class in nursing school. The curriculum in nursing school has been established for the main purpose of helping you reach the NCLEX passing standard and becoming a fully licensed registered nurse. With that said,
Throughout our guide, we have done our best to provide insight into the NCLEX structure, registration process, and passing rules. Take time to familiarize yourself with each section because for you to write the NCLEX, you will need to follow the process outlined above. If you have any further questions, please post them in the comment box below. We would love to hear your feedback 😊