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The Distribution of NCLEX Questions on the RN vs. PN Exams and WHY

Although the categories on the NCLEX-RN and NCLEX-PN are the same except for Management of Care vs Coordinated Care, their distribution is different. What I mean by that is the percentage of questions on the test devoted to each category is unique by test. Why is this so?

Each test is based on surveys that NCSBN conducts every 3 years on RNs or PNs. The last RN & PN test changes were made effective in 2019 and 2020, respectively. NCSBN attempts to make the test reflect the type of knowledge and skills needed in practice as RNs and PNs, so as the marketplace changes, so will the NCLEX for each.

The categories are different because the market surveys that guide the NCLEX tests show different practice standards. PN's practice more coordinating care under the delegation of RN's while RN's manage care. They have similar proportions on safety and infection control, health promotion, reduction of risk, and psychosocial integrity because these are common with all patients in today's healthcare market. The basic care and comfort category is greater on the PNs because PNs generally care for patients of less acuity and rely on fewer pharmacological interventions than RNs. This is also why the pharmacological therapy and physiological adaptation sections are slightly leaner for PNs.

I made pie charts of each test so you can clearly see the distribution of the content. So reference those for the rest of the blog.

While questions material changes to keep up with advancements in medical care, the spread of question topics generally stay the same for the RN NCLEX. As you can see - a major section of the RN test is the management of care and safety/infection control which make up the "safe and effective care category". This is over 32% or about 1/3 of the test. The next largest section is pharmacology and physiology which make up a 29% chunk. Finally, smaller sections of reduction of risk, psychosocial integrity, basic care and comfort, and health promotion combine to form the rest. Obviously, this should guide your studying as major effort should be spent towards content within the care, pharmacology, and physiology sections. But you will not do well on the test if you do not have a working knowledge of the smaller sections.

On the PN test, the coordinated care and safety/infection control make up the "safe and effective care category" which is 34% or about 1/3 of the test. The pharmacology and physiology sections make up a slightly smaller chunk of the test as compared to the RN NCLEX at 23% vs 29%. There is more emphasis given to "basic care and comfort" on the PN test at 10% similar to the 9% on the RN examination. Psychosocial integrity, reduction of risk, and health promotion combine to form the rest. So if you are taking the PN test, you need to spend quality time emphasizing pharmacology, physiology, basic care and comfort, and safe care of patients in your studying. However, don't neglect reduction of risk, psychosocial integrity, and health promotion all together or you will not do well.

How will I know what knowledge falls into each category? You might ask...That is a great question. There are candidate guides for each test on NCSBN's website if you want to research them more.

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