Mastering the NCLEX: A Guide for Registered Nurses

The journey to becoming a registered nurse in the U.S. hinges on one significant step: Passing the NCLEX (National Council Licensure Examination).

This examination is vital in determining if recently graduated nursing students are ready to begin their nursing practice.

If you’re preparing to take this crucial test, at NPHub we bring you this guide with everything you need to know about the NCLEX.

What is the NCLEX?

The National Council Licensure Examination (NCLEX) determines if recently graduated nursing students are safe to practice. All nurses must pass it to earn licensure and legally practice nursing in the United States.

There are two types: the NCLEX-RN for aspiring registered nurses and the NCLEX-PN for those aiming to become licensed practical nurses or licensed vocational nurses.

Whichever path you’re on, the exam will test your critical thinking skills based on your nursing school education.

The primary objective? Ensuring that you can make quality nursing judgments and provide safe patient care.

NCLEX Registration & Eligibility

To be eligible for the NCLEX-RN, candidates must graduate from an accredited ADN or BSN program. For the NCLEX-PN, graduation from an accredited LVN program is necessary. Accreditation is a cornerstone if you envisage advancing in nursing.

To register for the NCLEX:

The NGN Test Plans & Framework

In April 2023, the National Council of State Boards of Nursing (NCSBN) introduced the updated Next Generation NCLEX (NGN) for entry-level nurses. It features new question types and a comprehensive assessment framework that accurately reflects a nurse’s capabilities in complex decision-making while caring for patients.

Test Plans: Released by the NCSBN, these plans offer in-depth insights into content areas, guiding nurses on the areas of focus for their preparations.

Clinical Judgment Model (CJM): A fresh framework adopted by the NGN, the CJM scrutinizes a nursing candidate’s proficiency in making prudent clinical judgments in patient care.

The model has distinct, interacting layers:

• Layer 0: Determination of patient needs.
• Layer 1: Embodies the clinical judgment process.
• Layer 2: Progresses upon a correct answer; otherwise, layers are reiterated until achieving the desired outcome.
• Layer 3: Engages cognitive facets of clinical decision-making:
• Form Hypothesis: Identify and analyze cues.
• Refine Hypotheses: Devise solutions.
• Evaluation: Act and assess.
• Layer 4: Establishes both external and internal context for layers 1 and 2, encapsulating:
• The nursing process: Assessment, Analysis, Planning, Implementation, and Evaluation.
• Evaluate a candidate’s ability to discern contextual elements, dissect patient data, rank patient necessities, and display professional comportment.

NCLEX Question Types and Subject Areas

The Next Generation NCLEX (NGN) not only introduces innovative scoring methods but also diversifies the types of questions candidates should anticipate.

Expect a variety of questions such as:

• Multiple-choice questions.
  
• Matrix multiple-choice questions: Displayed in grids of rows or columns.
• Multiple response “Select N” questions: The test-taker is restricted to a specific number of options.
• Drop-down cloze questions: Answers are chosen from a drop-down menu.
• Drop-down table questions: Similar to cloze, but the answer is selected from a table, not a passage.
• Bowtie questions: Possessing a maximum score of five points with five potential correct answers.
• Multiple responses (MR) “Select all that apply” (SATA) questions.
• Matric MR with +/- scoring: Multi-category questions presented in rows and columns.
• Rational scoring questions: These assess “paired” information.

Subject Areas:

The NGN uses diverse scoring techniques and question formats, but its subject areas are similar to previous NCLEX versions and are based on four “client needs” categories.

Here’s a breakdown of the NCLEX subjects & expected exam percentages:

Preparing and Succeeding on Your NCLEX Exam Day

The NCLEX requires diligent preparation and a calm mindset. Here’s a concise guide for your exam day:

Craft a Study Plan:

• Set study days, breaks, and practice sessions.
  
• Focus on understanding, not just cramming.
• Use practice exams for self-assessment and to become familiar with the computer-testing format.

Manage Test Stress:

• Maintain a balanced routine of exercise, relaxation, and sleep.
• Avoid studying on the exam day and indulge in calming activities.
  

Exam Day Tips:

• Ensure a week of proper sleep.
• Arrive early at the Pearson VUE center with the necessary ID.
• Dress comfortably, and consider your personal preferences when scheduling the exam time.
  

Maintain a Positive Mindset:

• Focus on the question at hand during the test, avoiding self-evaluation.
• Trust in your capabilities. Remember, completing nursing school is already a testament to your potential.

Determining Your NCLEX Results and Next Steps

You can quickly check your performance via the Quick Results Service, offering “unofficial results” within two business days.

However, official results, necessary for practice eligibility, will be mailed in approximately six weeks after the exam.

If the outcome isn’t favorable, don’t lose hope. A Candidate Performance Report (CPR) will be provided to aid your next steps, and a retake is possible after a 45-day interval.

Conclusion

Starting a nursing career is challenging yet rewarding. Passing the NCLEX is a pivotal milestone that signifies your readiness and competence as a nurse.

As you approach this significant step, remember that it’s not just about the information, but also about belief in yourself and the skills you’ve gained over the years.

Stay dedicated, use the resources and tips from this guide, and always keep in mind the reason you chose this noble profession.

The nursing world awaits your expertise and compassion, and this crucial exam is your gateway.

You’ve got this!

Frequently Asked Questions (FAQs):

What is the NCLEX? The NCLEX is a licensing examination for nurses in the U.S., consisting of two types: NCLEX-RN and NCLEX-PN.

How do I register for the NCLEX? Apply for licensure to your NRB, then register through Pearson VUE.

How long do I have to take the NCLEX? You have up to five hours, but this can vary based on your answers.

Can I retake the NCLEX if I don’t pass? Yes, you can retake the NCLEX after 45 days.