To ensure public protection, the United States and its territories require entry into the practice of nursing to be regulated by licensing authorities within each jurisdiction. Each jurisdiction requires all candidates for licensure as entry-level nurses to pass an examination which assesses the knowledge required to perform safely and effectively. NCLEX stands for The National Council Licensure Examination which is a standardized exam used by each state board of nursing to determine if RN or LPN/LVN candidates are competent for entry-level nursing practice.

There are two NCLEX tests offered by the National Council of State Boards of Nursing (NCSBN): the National Council Licensure Examination for Registered Nurses - NCLEX-RN and the National Council Licensure Examination for Practical Nurses - NCLEX-PN . The NCLEX-RN is for registered nurse candidates while the NCLEX-PN is for practical and vocational nurses. The main difference between the two tests is the number and difficulty of correctly answered questions required to pass the exam. The States and territorial boards of nursing use these exams in making licensure decisions.

The NCLEX-RN has 265 questions and the minimum number you need to answer is 75. The NCLEX-PN has 205 questions and the minimum number you need to answer is 85. Both tests require an understanding of nursing practice and cover the following categories of client needs:

• Safe, Effective Care Environment

  • Management of Care

  • Safety and Infection Control

• Health Promotion and Maintenance

  • Growth and Development Through the Life Span

  • Prevention and Early Detection of Disease

• Psychosocial Integrity

  • Coping and Adaptation

  • Psychosocial Adaptation

• Physiological Integrity

  • Basic Care and Comfort

  • Pharmacological and Parenteral Therapies

  • Reduction of Risk Potential

  • Physiological Adaptation

Using this method (CAT) each exam is unique and the questions are retrieved from a database as the exam progresses. The computer measures the ability of the candidate using the answers provided previously and changes the difficulty and topic of the new questions accordingly - if you answer correctly the computer will select harder questions and if you are answer incorrectly it will choose easier questions. The software estimates your ability every time you provide the answer to a question and with each new answer you provide the estimate of your ability gets more precise.

The exam software selects questions that it believes you will have a close to 50% chance of answering correctly not too hard or too easy for the ability it believes you have. This is done so that a well prepared candidate will be asked more difficult questions thus having a good chance of passing the exam by answering the minimum number of questions while less prepared candidates are not forced to guess the answers to questions too difficult for them. The expected number of correct answers is half the total number of questions you are presented with because of the adaptive nature of the test.

After you answer the minimum number of questions for the exam the software will analyze your performance and it may shut-down the computer. This means that you either passed or failed the exam. The computer will shut-down only when the program running the test has determined with 95% certainty that your ability is either above or below the passing standard.

The only way to get additional questions is if you are very close to the passing score either 2.5% above or 2.5% below it. If this is the case you should not worry about failing but instead should concentrate on answering correctly the next set of questions. You must understand that you are very close to passing the exam if you answer most questions correctly from this point on. You must answer the maximum number of questions on the exam only if at the end of each set of questions you are within the 2.5% above or below the passing score. The time you spend on each question is not an important factor with regard to passing but you should answer the required number of questions in the allotted time.

If you are required to answer the maximum number of questions and the computer still isn't 95% sure you can pass, the 95% confidence requirement is dropped. If at this point you have a score higher than the minimum required you pass the exam otherwise you fail. If you run out of time and did not answer the minimum number of questions required you fail automatically. If you run out of time but you answered the minimum number of questions required and for the last 60 questions your score was never below the passing standard you pass otherwise you fail the exam. This does not mean that you have to answer the last 60 questions correctly but only that at any point during the last 60 questions your score was above the minimum required to pass the exam. You can think about it this way: for each correct answer add one to your score while for each incorrect answer subtract one. Adding your scores one at a time for each question answered should never result in a negative score in order for you to pass if you run out of time but you have answered the minimum number of questions required.

The NCLEX-RN and NCLEX-PN questions are mostly multiple-choice questions with four answers. In some cases the NCLEX exam uses more difficult question formats such as multiple-choice questions that require you to select one or more correct answers, fill-in-the-blank questions or questions that require you to identify an area on a picture. Both exams cover mostly the same topics but the NCLEX-RN is more difficult.

You must apply to your state board of nursing in order to take the NCLEX examination. That board of nursing will decide whether or not you are eligible for the NCLEX examination. If you are eligible you must register to take the exam using the Authorization to Take the Test (ATT) provided by the board of nursing in your state. They will also provide you with a list of testing centers and instructions for how to schedule and take the licensure examination.

Here are a couple of things you might want to consider if you are taking the NCLEX exam:

• attend an NCLEX review class to refresh your knowledge

• always read and understand the entire question before answering it

• answer and understand 3000 - 4000 practice questions

• you can't change an answer once you moved to another question so forget about it good or bad what it is done is done so it is better to concentrate on the current question instead of pondering if you were right or wrong

• always pick the answer you believe is best the test is not designed to trick you but good reading and comprehension skill are required

• always think about the safety of the patient when answering the NCLEX questions

After you take the test you will have to wait for the results. The time you need to wait depends on how the results are reported in your state: mail, online, phone or email. If you fail the test you will receive a summary of your test performance indicating topics where you did well and topics that you need to study further. You will be able to take the test again after a mandatory waiting period (usually 45 days) which may vary from state to state. Good luck!