Some Basic Facts About the NCLEX Exam

Up until 1944, each state administered their own licensure examination for nurses.  Obviously, this made moving from state to state more difficult.  In 1944, the National League for Nursing created the State Board Test Pool Examination (SBTPE), which was then adopted by all 50 states.  This was the initial name for the NCLEX.  In 1978, the National Council of State Boards of Nursing (NCSBN) took over administration over the exam.  Since then the number of questions has been reduced from a maximum of 720 to a maximum of 265 (some test-takers only take 75).

The NCSBN has voted to raise the passing standard by increasing the number of questions an applicant had to get correct five times on the NCLEX-RN, most recently effective April 1, 2013.   They administer a survey to practicing nurses every 3 years in order to adapt the test to the dynamics of the field and change the test every 3 years.

Each test taker takes a computerized test and has six hours to take the test.  You will have a minimum of 75 questions and a maximum of 265 questions.  Fifteen of those questions don’t count and are merely trial questions for future exams.

One of the important things to remember about the exam is that it is trying to assess entry level nursing knowledge.  Although it may be thought of as more prestigious to get an intensive care (ICU) internship while still in school or to do your final practicum in labor & delivery, that may not be the best preparation for the NCLEX.  The NCLEX is testing entry level nursing knowledge and is geared towards acute care but not necessarily critical care skills.  Niche experiences while in school may help launch your career into that specialty but make sure you study the basics in preparation for the exam.

 

Unlike many school exams, the NCLEX is not just testing content but also how one applies that content.  For example, it will probably not ask you “what is this drug for?”  But it might give you a scenario where a patient was administered 10mg IV hydralazine prn and ask you for an appropriate nursing intervention after giving that drug.  You would have to recognize that hydralazine is typically given for hypertension.  Then as the drug was given prn or “as needed”, the appropriate nursing intervention would be to check the blood pressure 30-60 minutes after giving the drug.  The NCLEX is testing on how you can synthesize knowledge to care for patients.

 

The NCLEX-RN tests on four Client Need categories.  Two of these are broken down into sub-categories.  They tell you the percentage of items from each category that will be on the test.

 

  • Safe and Effective Care Environment
    • Management of Care (17-23%)
    • Safety and Infection Control (9-15%)
  • Health Promotion and Maintenance (6-12%)
  • Psychosocial Integrity (6-12%)
  • Physiological Integrity
    • Basic Care and Comfort (6-12%)
    • Pharmacological and Parental Therapies (12-18%)
    • Reduction of Risk Potential (9-15%)
    • Physiological Adaption (11-17%)

 

The NCLEX-PN (Practical Nursing) tests on the same four Client Need categories with one subcategory modified, but their percentages are slightly different.  The NCLEX-PN tests a minimum of 85 questions and a maximum of 205 questions.  It is also evaluated every 3 years in a similar fashion to the NCLEX-RN.  Because it is similar to the NCLEX-RN, many things that I mention in these blogs will apply to either.

 

  • Safe and Effective Care Environment
    • Coordinated Care (13-19%)
    • Safety and Infection Control (11-17%)
  • Health Promotion and Maintenance (7-13%)
  • Psychosocial Integrity (7-13%)
  • Physiological Integrity
    • Basic Care and Comfort (9-15%)
    • Pharmacological and Parental Therapies (11-17%)
    • Reduction of Risk Potential (9-15%)
    • Physiological Adaption (9-15%)

 

I’ll go more into these categories and give you examples in future blogs.  Just remember as you are studying to think of how an action influences your patient.

 

– Nurse Amy

One thought on “Some Basic Facts About the NCLEX Exam

  1. Hi
    I need your help. My step-daughter has taken her lpn illinois state boards 3 times now and is still unable to pass. She graduated from lpn school this past december 2014. First time she failed the computer kicked her off after only 88 questions she thought she had passed but the paper work came back that she had failed. Second time she took it she had to take all 205 questions and paper work came back that she had failed again. Now this third time her and a girl friend went and took the test together on May 26,2015 and the computer make both of them take all 205 questions her paper work came back that she had failed again but her girl friend passed. this is costing us $300.oo for each time she test. She has been studying her butt off and does not seem to be able to pass this test. When she took the test the first time she was under the impresion that it should not have kicked her off at 88 questions if she was doing bad. They explained to her that the test is set up to help you pass and that if you are not doing good you get more questions. Does this seem right to you. She is so fustrated and has almost given up and we have spent close to $17,000 dollars on her schooling and she did graduate but she is stuck and can not seem to pass the illionis state boards. Can their be something wrong with the computer testing we don’t know what to do.

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