When you began your nursing education journey, you probably wondered about the strange word mentioned frequently by your instructors. The word, “n-clex,” was strange. But, then state board licensure was mentioned and soon you understood that strange word was an abbreviation: NCLEX. Short for National Council (of State Boards of Nursing) Licensure Examination, this is the exam that nurses must pass to become licensed. Nurses must be licensed for legal employment. The exam in taken after the completion of a nurse education program. Knowledge of the NCLEX is a priority for nursing students.
The licensure exam is developed by the National Council of State Boards of Nursing (NCSBN). It is given in all of the states in the U.S. The NCLEX has also been given for nursing licensure in Canada since 2014. The test is published in both English and French. The exam is called an computerized adaptive test (CAT). This means it adjusts in difficulty to ensure the test taker demonstrates a required level of proficiency. The number of questions required will vary depending on the progress of the test taker. Initially, the test can be between 60 and 260 questions. In October, 2020, due to COVID-19 restrictions, the test changed to a minimum of 75 questions (60 + 15 pretest items) up to 130 total items. Those who don’t meet the passing standard fail the exam and must retest. Those meeting the passing standard pass the test. Results are provided to the state and the license is granted.
Nursing instructors focus on ensuring students learn to be safe practitioners. The NCLEX exam focuses on safe clinical practice. Many areas of practice are included in the exam such as medical-surgical, pediatric, maternal-infant, mental health and community nursing. Aspects include health promotion, pathophysiology, safety, and psychosocial integrity. The nursing program includes all aspects of nursing care in order to prepare students for NCLEX success. Only through NCLEX success can the graduates of the program become nurses. So, NCLEX preparation becomes part of every course. Many programs also add a NCLEX-preparation program with standardized testing into the curriculum.
What can students do to prepare for the NCLEX? Through classroom participation and clinical experiences, the needed information and skills should be gained. Study to pursue the highest grades possible will help. Many course resources will focus on NCLEX test-taking skills. Here are a few recommendations to assist with taking the NCLEX:
- Review information and study with your peers whenever possible.
- Practice NCLEX-style questions. They can be found in textbooks or in NCLEX review resources.
- If your nursing program offers an NCLEX review program (ATI, HESI, etc.) use the resources any changes you get. Some programs have an app available for your phone or tablets so questions can be done whenever you have time.
- Always read each question carefully to determine what is being asked.
- Note words like first, best, priority, significant, and appropriate.
- Priorities in NCLEX questions will be airway, breathing and circulation (ABC’s), safety, infection control, and nursing process.
- Review fundamental topics such as positioning, mobility, growth and development, communication.
- Practice the variety of question formats: multiple-choice, fill-in-the-blank, select-all-that-apply, order, etc. (A future post will look at the various types of questions.)
- Consider a review course after you graduate. If you have had a NCLEX program built into your program, save money by using the resources you already own. Often they continue for 3-6 months after graduation. Check out your state’s requirements along with NCSBN guidelines for NCLEX testing.
While the focus of nursing education is creating safe nurses who can provide for the health needs of their patients, some focus must be placed on preparation for the licensure examination. The NCLEX is mandatory and ensures nursing graduates are ready to meet the standards of entry level nursing practice. Licensure ensures safety for the community. Knowledge of the exam and preparation are priorities for nursing students.