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How to Pass the NCLEX-RN First Time: 18 Do’s & Don’ts


Written By: Darby Faubion BSN, RN

Are you a nursing student or a recent nursing school graduate? Are you concerned about taking and passing the NCLEX-RN? Perhaps you have wondered how to pass the NCLEX-RN exam the first time. If this sounds like you, this article is for you. As you continue reading, you will find facts about the NCLEX-RN and learn 18 simple Do’s and Don'ts to pass the NCLEX-RN the first time you take it.


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What Is The NCLEX-RN?


NCLEX stands for National Council Licensure Examination. The NCLEX-RN is a standardized test that graduates of a registered nursing program must pass to earn a license to practice as a nurse. It is essential to understand that the NCLEX-RN exam is not designed to trick you or make you second-guess what you have learned in nursing school. It is a tool used to determine whether you have retained the information you were taught and can apply it to implement safe nursing practices.


How Hard Is It To Pass The NCLEX-RN Exam?


If you want to become a registered nurse, you have probably wondered how hard it is to pass the NCLEX-RN. The simple answer would be to say that some people take the test and pass it with ease, and others do not. The truth is several factors can impact how hard it is for someone to pass the NCLEX-RN test.


Why Passing The NCLEX-RN Is Important For a Nursing Student?


The NCLEX-RN is used to determine whether a nursing school graduate has met the competency and skills needed to practice independently as a nurse. Obtaining a nursing degree and passing the NCLEX-RN is essential for anyone to be eligible for licensure as a nurse.


Who Prepares The NCLEX-RN Test?


NCLEX examinations, including the NCLEX-PN and NCLEX-RN, are created and owned by the National Council of State Boards of Nursing (NCSBN). The NCSBN is a nonprofit organization offering membership to Nursing Regulatory Bodies worldwide. There are currently eighty-nine members throughout the fifty United States, the District of Columbia, and four United States territories.


Who Administers The NCLEX-RN Test?


The NCLEX-RN is administered by Pearson VUE at one of their Pearson Professional Centers. Pearson VUE is a leader in administering computer-based testing for, not only nursing, but for internet technology, academic, professional, and government programs. The company has more than 5,000 test centers in one hundred sixty-five countries.


When Should You Take The NCLEX-RN Exam?


In most states, the earliest candidates may take the NCLEX-RN is 45 days after their nursing program's graduation date. The timeframe in which a graduate may take the exam varies from state to state. Therefore, it is essential to check with your state's nursing regulatory body to determine if you have a longer waiting period. Also, it is important to keep in mind that, even if you are allowed to take the NCLEX-RN, you don't have to take it until you are ready. Your goal now is to pass the NCLEX-RN. So, study, study, then study some more. Prepare yourself, and when you feel confident, you should take the NCLEX-RN.


Where Should You Take The NCLEX-RN Exam?


The NCLEX-RN can be taken at any Pearson Professional Testing location. When deciding where to test, you should choose a convenient site for you. Be sure you know how to get to the location by driving to the center before test day. Find at least one alternate route to the test center so you will not be late for the exam if traffic is backed up or you are re-routed. Although this may seem menial, it is important because the stress of arriving late or with only a few minutes to check-in can cause unnecessary stress, which may impact whether you pass the NCLEX-RN or not.


How Much Does The NCLEX-RN Exam Cost?


There is a one-time NCLEX-RN registration fee of $200 for candidates seeking licensure in the United States only. Additional fees apply for international test scheduling, changing the nursing regulatory body after paying the initial registration fee, or changing the examination type (RN/PN) after paying the initial payment.

Fee Amount
One-Time NCLEX-RN
Exam Registration Fee
$200
(Source: National Council of State Boards of Nursing, Inc.)


How Long Is The NCLEX-RN Exam?


NCLEX-RN test candidates have up to five hours to complete the examination. The test time includes the time it takes to answer 15 practice questions, unscheduled breaks, and two preprogrammed optional breaks. The optional breaks are offered at the two-hour and three-and-a-half-hour testing intervals. Breaks are not offered as additional time but count against testing time. The total amount of time it takes for each candidate to take the NCLEX-RN is determined by the test candidate’s response to test questions. One candidate may complete the test in less time than another, but both may still pass the NCLEX-RN.


How To Register For The NCLEX-RN Exam?


Candidates who have met eligibility requirements to take the NCLEX-RN exam must first fill out a licensure/registration application. The application can be obtained through your Nursing Regulatory Body (NRB). However, most nursing schools help students fill out the appropriate paperwork in preparation for the examination.


What Is The NCLEX-RN Test Format?


The NCLEX-RN is used to determine if a nursing graduate can apply nursing knowledge in clinical situations while providing patient care. The exam takes candidates beyond a mastery of medical terminology or memorized lab values, or naming organs in each body system. The NCLEX-RN uses the information candidates learned in nursing school to determine if the test-taker will be able to effectively apply that information in a hands-on approach. The test format includes content organized into four major Client Needs categories, two of which are divided into subcategories. The following is a breakdown of the content candidates will see and need to understand to pass the NCLEX-RN.

NCLEX-RN Test Format
Category Percentage of Questions from
Each Category/Subcategory
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
Parenteral Therapies
12-18%
• Reduction of Risk Potential 9-15%
• Physiological Adaptation 11-17%
(Source: National Council of State Boards of Nursing, Inc.)


How Many Questions Does The NCLEX-RN Test Have?


The NCLEX-RN is a variable-length computerized adaptive test (CAT). Candidates answer between 75 and 265 questions. The first fifteen questions are pretest items and are not used to score the exam and determine if a test-taker has passed the NCLEX-RN. Not all candidates will answer the maximum number of questions. However, everyone who takes the exam must complete a minimum of 75 questions. Passing the NCLEX-RN exam is not contingent upon answering a set number of questions. Instead, the test is designed to compare the percentage of correct answers a candidate provides and to determine if the candidate has met the passing standard.


What Type Of Questions Are There On The NCLEX-RN Exam?


Knowing how to pass the NCLEX-RN means knowing what type of questions are on the exam and methods to help you choose the correct answer. The NCLEX-RN examination consists of approximately 80% to 90% multiple-choice questions. The other 10 to 20 percent of questions may be fill-in-the-blank, multiple response, drag and drop, or hot spot questions.

• Multiple Choice Questions

give a scenario that includes information referred to as the "stem" of the question. Look for keywords such as best, except, first, most, may, or but. This type of question typically begins with a phrase like, "What is the most appropriate response" or "Which of the following?" Multiple-choice questions usually have four answer options. One answer will be the correct response, and the other three options are called distractors.

• Fill-in-the-blank Questions

usually require you to solve a problem, such as the drip rate for an IV or a medication dosage. After you solve the problem, you will enter the answer in the blank on the test screen.

• Multiple Response Questions

, also referred to as Select All That Apply (SATA), may have four or more answer options, and will have at least two correct answers.

• Drag and Drop Questions

may also be called “Ordered Response." These questions require the test taker to put information in a specific order. A few examples of an ordered response question are being asked to list the steps of a procedure or to prioritize care in steps.

• Hot Spot Questions

ask the test candidate to identify a location, such as a spot on a chart, an injection site, or an area of assessment. These questions will have a diagram or photo with specific directions such as "Identify the spot" or "Select the appropriate location."


How Many Questions Are There In Each Category/Sub-Category On The NCLEX-RN Exam?


Although each NCLEX-RN test-taker will have different questions, according to the percentage chart provided by the National Council of State Boards of Nursing, the following number of questions in each category/subcategory is possible on the exam.

a. Management of Care: 45- 61 questions
b. Safety and Infection Control: 24-40 questions
c. Health Promotion and Maintenance: 16-32 questions
d. Psychosocial Integrity: 16-32 questions
e. Basic Care and Comfort: 16-32 questions
f. Pharmacological and Parenteral Therapies: 32-48 questions
g. Reduction of Risk Potential: 24-66 questions
h. Physiological Adaptation: 29-45 questions



What Topics Are Tested On The NCLEX-RN?


Knowing how to pass the NCLEX-RN first requires knowing what content to expect on the exam. The current test plan for the NCLEX-RN was approved and is effective from April 1, 2019, through March 31, 2023. Content for the examination is based on Bloom’s taxonomy for the cognitive domain. Most items on the test are written at application or higher levels of cognitive ability, requiring complex thought processing.

The National Council of State Boards of Nursing chose to structure the NCLEX-RN based on Client Needs as this framework provides what the NCSBN describes as a “universal structure for defining entry-level nursing actions and competencies and focuses on clients in all settings.”

Each category and subcategory of NCLEX-RN exam content is described below.

1. Safe And Effective Care Environment:

The Safe and Effective Care Environment category is divided into two subcategories: Management of Care and Safety and Infection Control.

• Management of Care:

The content covered by this subcategory is based upon the knowledge that nurses provide and direct nursing care designed to enhance the care setting and protect the patient and healthcare personnel. Questions related to Management of Care may include Advance Directives, Life Planning and Self-Determination, Advocacy, Assignment, Delegation, and Supervision, Patient Rights, Concepts of Management, and Collaboration with the Interdisciplinary Team.

• Safety and Infection Control:

The nurse is responsible for protecting clients and healthcare personnel from health and environmental hazards. Content related to this subsection includes, but is not limited to, Accident/Injury/Error Prevention, Ergonomic Principles, Emergency Response Plans, Handling Infectious and Hazardous Materials, Safe Use of Equipment, Home Safety, and Reporting of Incidents/Irregular Occurrences/Variance.


2. Health Promotion and Maintenance:

The Health Promotion and Maintenance section of the NCLEX-RN focuses on the fact that nurses should provide and direct patient care that incorporates knowledge of prevention and early detection of health problems, normal growth and development, and strategies to achieve optimal health. Several content areas are part of this NCLEX-RN section, including the Aging Process, Ante/Intra/Postpartum and Newborn Care, Developmental Stage and Transitions, Health Promotion and Disease Prevention, High-Risk Behaviors, Health Screening, Lifestyle Choices, Self-Care, and Techniques of Physical Assessment.

3. Psychosocial Integrity:

Psychosocial Integrity encompasses every aspect of supporting and promoting the mental, emotional, and social well-being of patients experiencing acute or chronic mental illness or stressful life events. Questions related to this category of information may include content such as Abuse/Neglect, Coping Mechanisms, Behavioral Interventions, Cultural Awareness/Cultural Influences on Health, Crisis Intervention, Family Dynamics, End-of-Life Care, Grief, and Loss. Religious and Spiritual Influences on Health, Perceptual and Sensory Alterations, Stress Management, Substance Use Disorders, and Dependencies, Therapeutic Communication, and Therapeutic Environment are also included in Psychosocial Integrity.

4. Physiological Integrity:

Physiological Integrity covers the most considerable portion of the exam ranging from 38 to 62 percent of the examination questions. This section is divided into four categories: Basic Care and Comfort, Pharmacological and Parenteral Therapies, Reduction of Risk Potential, and Physiological Adaptation. The following are examples of content covered in each of the four subcategories.

• Basic Care and Comfort

is focused on the nurse’s role in aiding the client and promoting comfort in the performance of daily activities. Questions may be focused on Mobility/Immobility, Elimination, Assistive Devices, Non-Pharmacological Comfort Measures, Personal Hygiene, Nutrition and Oral Hygiene, Rest, and Sleep.

• Pharmacological and Parenteral Therapies

deals with the nurse's role in administering medication and parenteral therapies. This subcategory of NCLEX-RN questions will present scenarios for which the test-taker must identify adverse effects, side effects, interactions, and contraindications of medications. Central venous access devices, dosage calculations, expected actions and outcomes of medications are included in this subcategory. Additionally, test-takers may answer questions related to parenteral therapies and the administration of blood and blood products. Other content includes Parenteral/Intravenous Therapies, Total Parenteral Nutrition, and Pharmacological Pain Management.

• Reduction of Risk Potential

focuses on the likelihood that patients will develop health problems or complications related to existing treatments, health conditions, or procedures. The test candidate may have questions pertaining to Changes or Abnormalities in Vital Signs, Laboratory Values, Diagnostic Testing, Potential for Alterations in Body Systems, Therapeutic Procedures, and System Specific Assessments.

• Physiological Adaptation

relates to the care and management of clients with acute, chronic, or life-threatening physical health problems. Successful testers will identify correct answers to questions about Alterations in Body Systems, Hemodynamics, Fluid and Electrolyte Imbalances, Medical Emergencies, Illness Management, Unexpected Responses to Therapeutic Measures, and Pathophysiology.



When Should You Start Studying For The NCLEX-RN Exam?


As a nursing instructor, I can tell you it is never too early to begin preparing for the NCLEX exam. No matter what stage you are at in nursing school, if you want to graduate then pass the NCLEX-RN, you should begin studying now. Keep in mind, this does not mean you must carve out an extra hour or more each day strictly for NCLEX prep. You should, however, be intentional about becoming comfortable with different question formats and learning to identify the stem of a question and use it to find correct answers. Investing in an NCLEX prep book is one way to help familiarize yourself with what to expect on the exam.


How Long Do You Need To Study For Your NCLEX-RN Exam?


The amount of time one needs to study before testing to pass the NCLEX-RN varies among individuals. Some sources say potential test candidates should spend at least two months preparing for the exam after completing nursing school. However, if you continue to study and add new content to your study plan throughout nursing school, you could be ready to test as soon as you graduate and your application for testing is approved. One way to prepare is by taking practice tests. The National Council of State Boards of Nursing offers NCLEX-RN Practice Exams on its website. Additionally, NCLEX study books usually come with access to several practice tests. The more often you study and take practice tests, the more likely you will be to pass the NCLEX-RN.


How Is The NCLEX-RN Scored?


As previously mentioned, the NCLEX-RN is administered in a computerized adaptive testing format. A computerized adaptive test is designed to adapt to a candidate's ability to answer questions in real-time by selecting different questions from a question bank. These tests are designed to adjust the difficulty level of questions based on the test taker's response to previous questions. For example, if a question is answered correctly, the next question will be a little more complicated. On the other hand, if a question is answered incorrectly, the computer offers an easier question.

The computer determines if a candidate has passed the NCLEX-RN using one of three rules: the Maximum-Length Exam Rule, the 95% Confidence Interval Rule, or the Run-Out-Of-Time (ROOT.) Rule. The Maximum-Length Exam and ROOT Rules use what is known as an ability estimate to determine whether the candidate has passed or failed the examination. For reference, ability estimate is the level of entry-level nursing skills, knowledge, and abilities the computer has determined a test candidate has achieved. When the ability estimate is above the passing standard, the candidate will pass the NCLEX-RN. If the ability estimate is below the passing standard, they fail.

The following is a list of Exam Rule explanations.

Maximum-Length Exam Rule:

When a candidate demonstrates ability close to the passing standard, the computer program is designed to continue giving additional questions until the maximum number of questions is answered. When the maximum number of questions are answered, the computer determines a pass or fail by calculating a final ability estimate.

• ROOT Rule:

If a candidate runs out of time before the minimum number of questions is answered, the result will be the failure of the exam. When a candidate answers the minimum number of questions but runs out of time, the test is scored using the test taker's final ability estimate from their responses to all questions answered.

• 95% Confidence Interval Rule:

The 95% Confidence Interval Rule is the most used rule for NCLEX-RN test candidates. This rule is applied when the computer determines with 95% certainty that the candidate's ability to practice as an entry-level nurse is clearly above or below the minimum passing standard.


What Score Do You Need To Pass The NCLEX-RN?


Unlike other standardized tests, the NCLEX-RN does not have a minimum passing score. It is, instead, a pass or fail test. Technically, the minimum score to pass the NCLEX-RN is "zero." Don't get excited yet. You do have to get answers right! The score you receive on the NCLEX-RN is referred to as a logit. A logit is a unit of measurement that compares the difficulty of a question to one's ability to answer the question correctly. The more complicated the questions you answer, the higher your logit score.

Further, because the NCLEX-RN gives people different questions, passing or failing does not depend on a simple score. Instead, the test calculates a confidence interval for your logit score. As previously mentioned, the test is designed to determine with at least 95% confidence that you have the ability to practice as a competent nurse.


How Many Times Can You Take The NCLEX-RN Exam?


If you do not pass the NCLEX-RN, you may retest 45 days after your original test date. Candidates are limited to retesting up to eight times in a year. Additionally, per the NCSBN, candidates must pass the NCLEX-RN within three years of graduating from nursing school. Some states have put additional limitations on the number of times a candidate may retest without taking a refresher course. If you fail to pass the exam on your first attempt, your state board of nursing can give you information about the requirements for retesting.


How and When Will You Receive Your NCLEX-RN Test Results?


To ensure quality control measures are met, every NCLEX test is scored twice. The exam is scored at the test center first and again after the record is submitted to Pearson VUE. Scores are calculated as each test item is completed. However, the test center does not release scores. NCLEX-RN exam results are available from the nursing regulatory body and sent to the candidate approximately six weeks after the test. While not all states offer the option, some states provide quick results service, which gives test-takers access to unofficial results after 48 business hours.



WHAT ARE THE DO’S OF PASSING THE NCLEX-RN THE FIRST TIME?

(Passing the NCLEX-RN exam is an essential milestone for nursing school graduates. No doubt, you want to pass the exam on your first attempt. The following is a list of 18 simple Do’s to follow to help you achieve that goal.)

1. Figure out how you study best and cultivate that skill.

Each of us has a slightly different style of learning. By now, you probably know what works best for you. Once you identify the study strategy you feel most comfortable with, tailor that to your study plan as you prepare for the NCLEX-RN. For example, if you are an auditory learner, you may find lectures on YouTube, podcasts that cover NCLEX-RN content, or recorded lectures from your college that you can listen to. If you are a visual learner, you may find that you retain content easier when you draw pictures or graphs of the information you are studying. Using color-coding may also be helpful.

2. Create a study plan and commit to it.

Anyone who wishes to take and pass the NCLEX-RN should recognize the commitment to preparation it takes to be successful. A well-thought-out study plan will include goals you plan to accomplish during each study session. Perhaps you want to master content related to a specific subject or want to answer a certain number of practice test questions. Plan your goals and decide which days you will study and for how long.

3. Familiarize yourself with the test format.

You can find great information about the NCLEX-RN in the NCLEX Candidate Bulletin. The NCLEX test plan, which covers additional test information, can also be found on the NCSBN website. The test plans give an in-depth review of what is covered on the NCLEX-RN. By taking practice NCLEX-RN tests, you will learn how the computerized adaptive testing works and experience the different types of questions the exam may present to you. You can complete practice questions and tests through the NCSBN or by using NCLEX-RN test-prep books to help familiarize you with the types of question-and-answer formats on the exam.

4. Invest in resources that promote test preparation.

Anytime you make a purchase that helps enhance your education, it is a good investment in your future. A few examples of study aids include Lippincott PassPoint, Kaplan NCLEX-RN Test Prep, and Saunders Comprehensive Review for the NCLEX Examination.

5. Trust yourself.

A common mistake NCLEX-RN test candidates make is to second-guess their first answer response. If you answer a question and know without a doubt that you accidentally chose the wrong answer, change it to the correct answer. However, if you are unsure of a question or answer, trust your first instinct. Several studies indicate changing a first answer choice can lower your overall score on a test.

6. Remember and apply your “ABCs.”

Airway, breathing, and circulation are the most significant priorities in patient care. When answering questions, always choose options in A-B-C order.

7. Keep Needs Prioritization at the top of your list!

As you answer questions on the NCLEX-RN, remember needs prioritization as you were taught in nursing school. The nurse should assess the patient and perform the most appropriate intervention first, with life-threatening physical needs addressed first.

8. Learn how to answer Select All That Apply (SATA) questions.

Select All That Apply questions will have at least two correct answer options. Practice these questions by reading each option as a true or false question. Eliminate wrong answers first. Then choose the appropriate responses.

9. Take breaks.

You have five hours to complete the examination. The amount of time allotted for the test takes the need for breaks into consideration. A short break can help you refocus, reduce stress, and increase your productivity on the exam. While some people may test without taking a break, if you need one, take it. If you need to go to the restroom, feel hungry, or feel overwhelmed, you need a break.

10. Be sure to get plenty of rest.

While this tip probably should not need mentioning, you may be surprised how many people try to test when they are physically and mentally tired. Being well-rested means, you should have at least a few nights of uninterrupted, long periods of sleep before test day. A fatigued body and mind will have difficulty recalling and applying information, which could make passing the NCLEX-RN exam difficult.

11. Learn and apply stress management techniques that work for you.

Test anxiety is real. However, if you have made it to the point of being able to take the NCLEX-RN, you have probably already learned a few tricks to help you get through the stress of test-taking. A few ways to help reduce stress are to make time to exercise, eat healthy, get proper sleep, and participate in non-school-related hobbies or activities.

12. Think like a test creator.

The questions on the NCLEX-RN are designed to be specific. Unless a question is a Select All That Apply or order of priority question, there will be one correct answer choice. However, some answer options may seem right but may not be the best answer when considering needs priority. When you remember this, you are thinking like a test creator and will increase your chances of passing the NCLEX-RN the first time you take it.

13. Take an NCLEX prep course, if possible.

Although it is not required, investing in an NCLEX prep course can be beneficial. NCLEX prep courses help test candidates review base content in a focused way and can help improve the quality of their studies. Although you can take practice NCLEX-RN tests on your own, taking them in a review course will allow you to ask questions and get feedback from instructors to help you prepare for the real examination. Another benefit of enrolling in a review course is you will have designated class time dedicated to NCLEX review, helping you be more intentional about studying.

14. Spend extra study time on the type of question that is most challenging for you.

There are several question types on the NCLEX-RN, including multiple-choice, Select All That Apply, fill in the blank, hot spot, and ordered response. Although you should practice answering each type of question, if there is a type of question that is especially difficult for you, spend extra time and effort on those question samples.

15. Be mindful of timing without rushing yourself.

You have five hours from the time the exam begins to complete the NCLEX-RN. While five hours is ample time to complete even the maximum number of questions, you don't want to spend too much time on questions you are unsure of. If you come to a question(s) that you genuinely don't know the answer to, pick the answer you feel is most appropriate and move on to the next question.

16. Learn the difference between real-world experience and NCLEX knowledge.

It can be difficult for some NCLEX-RN candidates to differentiate between their experiences working in the healthcare industry and actual NCLEX knowledge. Questions on the NCLEX-RN are presented so the test-taker should assume they have the "perfect" situation. As you answer the questions, you should assume you have plenty of time and all the necessary resources to perform the nursing task at hand. Choose answers to the questions based on this "scenario of perfection."

17. Search answer options for clues related to the question's topic.

The question stem will point you to the topic of the question. When you have identified the topic, you can search for the appropriate answer to the question based upon topic-related clues.

18. Develop strong test-taking strategies.

Once you have studied content, exam structure, and question types, it can be helpful to develop strategies for taking and passing the NCLEX-RN exam. Some techniques you can implement as you prepare include limiting the amount of time you spend on questions, and unless you are 100% sure you chose the wrong answer, leave it and move on. Also, remember questions are delivered randomly. If you have four questions in a row that you feel like the answer is "D," just go with it.



WHAT ARE THE DON’TS OF PASSING THE NCLEX-RN THE FIRST TIME?

((Now that you have gone through all the Do’s, there are a few more tips you should observe that will help alleviate some of the worries on test day. The following is a list of 18 Don’ts you should avoid to help increase your chances of passing the NCLEX-RN.))

1. Do not try to evaluate yourself during the test.

For some NCLEX-RN test-takers, many of the questions they must answer on the exam are easier, while others may have more complex questions. Don't assume that having easy questions is an indication that you are incapable of answering harder ones. Remember, everyone learns differently and has different strengths. What is challenging for you may be easy for someone else and vice versa. Simply focus on the questions you are offered and answer them to the best of your ability.

2. Do not try to learn content in the few days before taking the exam.

One of the worst mistakes people make before taking any test is trying to cram information in their brains that they should have learned much sooner. Research has shown that people cannot retain much information after trying to cram content. It is believed that cramming undermines the overall learning process as learners have trained their minds to recite information instead of developing a deep understanding.

3. Don’t change your “normal” routine on test day.

If you are the type of person who likes to get work done during the first part of the day, choose a morning test time. Likewise, choose a test date that offers afternoon testing if you enjoy sleeping in. Sticking with a schedule you are accustomed to will make it easier on test day.

4. Do not start your test hungry.

If you don't usually eat breakfast, you don't have to stop by the breakfast buffet on your way to the testing center. However, food fuels your body and mind. Eat something for breakfast and be sure to bring a snack with you. When you are offered scheduled breaks, use that time to eat a snack and refuel your body.

5. Don’t freak out!

When you think about the importance of this exam, it can feel overwhelming. Remember, you made it through nursing school. You have taken more tests than you can probably recall. Take a deep breath, focus, and have confidence in your ability to pass the NCLEX-RN.

6. Don’t rely on past work or clinical experiences.

It can be easy to draw from previous work or clinical experiences to choose answers on the exam. While this is not always the wrong thing to do, it is not uncommon for some facilities to have practices that are correct and as safe as what you learned in nursing school, that does not mean their way of doing things will be the correct answer on the exam. The NCLEX-RN is based on evidence and research-based practices. Instead of drawing from your past experiences, try to answer questions as if you have no real-life clinical or work experiences related to nursing.

7. Don’t just take the practice tests and be done.

Taking a practice test is only the first part of learning NCLEX strategy and preparing to pass the NCLEX-RN exam. Take the time to review questions you got wrong on practice tests. Look up answers and study the rationale for each answer option until you have a clear understanding.

8. Do not focus on the number of questions you receive on the test.

NCLEX-RN candidates may answer between 75 and 265 questions. The exam is scored based on a percentage of correct answers. Therefore, ten candidates may answer different numbers of questions and all pass or all fail. Focus on each question. Answer it and move on to the next. Focusing on the number of questions you are receiving can cause unnecessary stress, which could prevent you from passing the NCLEX-RN.

9. Do not wait too long to take the NCLEX-RN.

Taking the NCLEX as soon as possible after graduation means you will have a fresh recollection of the content you learned. While it is not impossible to pass the NCLEX-RN after waiting a while, your chances of success are greater when you test while the information is fresh in your mind.

10. Don’t consume too much caffeine.

It's no secret that nursing students seem to be fueled by grab-and-go meals and coffee. If you drink coffee or other caffeinated drinks, that's fine. Just be sure to limit them before testing, as excess caffeine can cause anxiety, headaches, and feelings of lightheadedness. These symptoms can cause you to have trouble passing the NCLEX-RN exam.

11. Do not start new medications within a few days of taking the NCLEX-RN.

Of course, there are some circumstances when you absolutely must start a new medication right away. However, if it is possible, avoid beginning any new medications until after you have tested. If you must start new medications, try scheduling your exam at some point after which any adverse reactions should be evident.

Some of the tips to help you pass the NCLEX-RN on your first attempt have to do with how you break down a question to find the correct answer. Here is an example.

12. Never, I repeat... Never do nothing!

Some multiple-choice questions will give you options that suggest you should delay treatment, leave the patient, or do nothing. Don’t fall for it. There is always something to do. This is a sample question similar and some answer options with rationales.

Question:

When making rounds, the nurse notices Mr. Jones winces and shuffles in the bed as if he is in pain, but he denies pain. What is the first and most appropriate nursing action?

Answer Options:


a. Perform a head-to-toe assessment including vital signs
b. Ask the patient if he needs pain medication
c. Listen to the patient because he knows whether he’s hurting or not
d. Instruct the CNA to check on Mr. Jones in an hour

In nursing school, students learn that pain is subjective and that even if we think a patient is in pain, he may not be. While this is true, nursing students also learn to observe for objective signs of pain and act accordingly. In this sample question, although Mr. Jones denies pain, he shows objective signs of pain, including wincing and shuffling in the bed.

Remember, the question asks what is the first and most appropriate nursing action. Let’s look at the answer options and rationale for why they may be correct or incorrect.

• “A” is the correct answer.

The first and most appropriate nursing action would be to assess the patient. When assessing the patient, the nurse can ask the patient to turn from one side to the other or reposition himself to see if there are any signs of pain with movement. Also, vital signs tend to fluctuate when a person is experiencing pain. By checking Mr. Jones’ vital signs, the nurse can compare previous readings to current ones to see if there has been a change.

• “B” is incorrect.

The patient has denied pain. Therefore, offering pain medication is not the first and most appropriate nursing action.

• “C” is incorrect.

While it is essential to listen to Mr. Jones and document his responses to questions, the nurse is also obligated to follow their nursing intuition and dig deeper if there are objective signs of pain.

• “D” is incorrect.

Taking vital signs is part of a nursing assistant's role. However, when a nurse makes rounds and suspects patient distress, such as signs of pain, the nurse should perform a nursing assessment, including vital signs. If the patient is stable, the nurse can then instruct the CNA to perform vital signs checks as a follow-up at a designated time.

13. Do not read quickly through a question, automatically assuming you know the answer.

The NCLEX-RN tests critical thinking, reasoning, judgment, and thought reflection. If you try to breeze through questions, there is a good chance you will overlook important keywords or information. Take your time to read each question-and-answer option carefully before selecting your answer.

14. Don’t downplay the importance of practice tests.

Maybe you made it through nursing school with a 4.0-grade point average. If so, that's awesome. However, it does not remove the need for proper preparation for the NCLEX-RN. Use every opportunity you can do practice, practice, practice!

15. Don’t discard your nursing school notes or study materials.

Nursing school is where most of the preparation for the NCLEX-RN occurs. While using resources like NCLEX study guides is helpful and encouraged, it is always a good idea to keep your nursing school notes handy. If you are weaker in one subject, this is when notes from school can be especially helpful as you may have jotted down something your instructor said that will jog your memory on the test.

16. Don’t expect to have the same questions as other test-takers.

The NCLEX-RN is designed to identify which areas are your strongest and the ones that need improvement. The test is adaptive and determines which questions you will answer by whether a previous question was answered correctly or not. The best thing to do is study all relevant material, take practice exams, and give it your best.

17. Do not second-guess yourself.

It can be easy to second-guess yourself, especially if you are presented with a question covering content that is not one of your strengths. If you have already answered a question, trust your first instinct and stick with your first answer option.

18. Do not give up!!!!

If you are down to five minutes left and have answered 264 questions, you still have a chance of passing. Whatever you do, remember you worked hard to get here, and you deserve this. Never give up!


14 Useful Resources To Help In Your NCLEX-RN Exam Preparation


There are several useful resources to help you prepare for and pass the NCLEX-RN. Social media groups and pages, podcasts, videos, and books offer various content and advice on ways to be successful. Here are a few examples.

Facebook Groups/Pages:

Social media is one of the most popular ways to connect with others and share ideas. Facebook remains a common site for people to access groups and pages to find tips on passing the NCLEX-RN exam.

Three of the most popular Facebook Groups/Pages focused on NCLEX-RN content information are:

NCLEX2021
Archer Review
NCLEX Pass Question


Reddit Communities:

Reddit is an online collection of forums where people share content and news on various topics. It can be a valuable tool for nursing students and nursing school graduates preparing to take the NCLEX-RN. The following is a list of subreddit communities associated with nursing that NCLEX-RN candidates may find helpful.

R/Nurse: This Reddit community offers nursing news and information on up-to-date topics that NCLEX candidates may use.
R/happynursing: This community is focused on efforts to help promote the success of nursing students as they endeavor to complete nursing school and pass the NCLEX-RN.


YouTube Videos/Channels:

There is more to YouTube than your favorite music videos or recipe hacks. There are more videos and channels on YouTube related to nursing and the NCLEX-RN than we dare to mention here. One of the great things about YouTube is that both audio and visual learners seem to benefit from the content on the nursing channels or videos. Some of the most popular YouTube Videos/Channels related to NCLEX-RN content are listed below.

RegisteredNurseRN offers free NCLEX skills, reviews, and tips. This YouTube channel also offers insight on how to find the right job.
Speed Pharmacology provides pharmacology videos designed to help viewers recall information about medications, expected outcomes, possible side effects, and adverse reactions.
Simple Nursing is a YouTube channel with tons of videos covering every NCLEX-RN topic.


Podcasts:

Podcasts are a series of audio episodes focused on a specific theme or topic. Nursing podcasts are excellent resources for finding information related to the NCLEX-RN examination. Here are a few popular podcasts you may find interesting.

All Things Nursing with Nurse Chioma is a podcast where nursing students and graduates can find education and information to help them pass the NCLEX-RN, advance their careers, and create a positive work-life balance.
Kaplan NCLEX Prepcast offers an in-depth look at topics found on the NCLEX-RN.
NURSING.com’s podcast can be accessed on iTunes, Google, and Spotify.


Books:

Passing the NCLEX-RN exam takes determination. Investing in study guides focused on the exam can make a huge difference in test success. A few books that come highly recommended include the following.

Saunders Comprehensive Review for the NCLEX-RN Examination: This book contains more than 5,000 practice questions. The question categories are challenging, unique, and offer customizable exams that allow candidates to study at their cognitive level.
Prioritization, Delegation, and Assignment: Practice Exercises for the NCLEX Examination: Using a simple to complex approach, this book keeps students challenged. It offers easy-to-follow information to establish a foundation that helps students understand care management.
HESI Comprehensive Review for the NCLEX-RN Examination: Complex chapters are broken down into clinical concepts and areas in an easy-to-follow format. This book offers resources such as HESI hint boxes, fill-in-the-blank sections, and critical thinking study questions.



What Next After You Successfully Pass The NCLEX-RN?


So, you have passed the NCLEX-RN; now what? There are a few things to consider/do to help you get moving in the right direction with your nursing career.

1. Decide which type of setting that most interests you.

The wonderful thing about nursing is there are a variety of settings where new nurses can work. While you may not be offered a position in your preferred environment right away, keep pursuing it.

2. Think about earning a specialty certification.

Nurses are not always required to get a specialty certification. However, if you are interested in a particular specialty, earning a certificate in that specialty could be beneficial.

3. Consider a Nurse Residency Program.

While most facilities will hire newly licensed graduates, you may find a nursing residency is a great way to transition from the role of student to nurse.

4. Networking with other nurses and healthcare professionals is essential before and after passing the NCLEX-RN exam.

Creating a network of peers and adding to your network can often help you find job and learning opportunities before they are publicly advertised.


NCLEX-RN FIRST TIME PASS RATE STATISTICS EVERYONE TAKING THE EXAM SHOULD KNOW

(The following data will provide you insights on the NCLEX-RN exam first-time test results.)

Most Recent NCLEX-RN Pass Rates


While the statistics discussed below may not impact whether you pass the NCLEX-RN exam, they can provide some insight into the NCLEX-RN and candidates.

1.

In 2020, more than 189,000 nursing graduates took the NCLEX-RN. Nearly 84% of first-time test takers passed the NCLEX-RN.

2.

Of the NCLEX-RN candidates tested in 2020, 71,642 had earned associate degrees in nursing. 80,024 held Bachelor of Science in Nursing (BSN) degrees.

3.

The year-to-date totals for NCLEX-RN examinations administered for 2021 are as follows:

a. First-time candidates who were educated in the United States: 177,065
b. First-time internationally educated test candidates: 26,326


The NCSBN publishes NCLEX Statistics quarterly and annually.


Number Of Students Who Took The NCLEX-RN Test In The Last 5 Years


According to the National Council of State Boards of Nursing, more than 189,000 candidates took the NCLEX-RN in 2020. That number is up from 168,642 in 2016. 902,263 nursing graduates have taken the NCLEX-RN in the past five years.

YearTotal Taken
2016168,642
2017171,833
2018180,050
2019192,428
2020189,310
(Source: National Council of State Boards of Nursing, Inc.)


National First Time NCLEX-RN Pass Rates For The Last Five Years


Of the nearly one million people who took the NCLEX-RN in the last five years, 751,573 passed the NCLEX-RN exam on their first attempt. This means an average of 83.26% of test-takers pass the NCLEX-RN the first time they test.

YearStudents
Passed
Pass %
2016137,32581.43%
2017143,12083.29%
2018151,63884.22%
2019160,69783.51%
2020158,79383.88%
(Source: National Council of State
Boards of Nursing, Inc.)


Latest NCLEX-RN First-Time Pass Rates In Your State (January 1 -December 31, 2020)


177,394 nursing graduates took the NCLEX-RN in 2020. According to the NCSBN, 153,579 test candidates passed the exam the first time. The chart below reflects the number of tests administered in each state as well as how many people passed NCLEX-RN on their first attempt. The highest pass rates were in the District of Columbia and New Hampshire, with pass rates of 94.79% and 96.21%, respectively.

State Total Taken Passed Pass %
Alabama 3,756 3,287 87.51%
Alaska 304 269 88.49%
American
Samoa
4 0 0.00%
Arizona 3,530 3,228 91.44%
Arkansas 2,229 1,858 83.36%
California 12,325 11,200 90.87%
Colorado 2,170 1,968 90.69%
Connecticut 1,999 1,790 89.54%
Delaware 515 482 93.59%
District Of
Columbia
192 182 94.79%
Florida 18,480 12,720 68.83%
Georgia 4,611 4,096 88.83%
Guam 25 24 96.00%
Hawaii 437 399 91.30%
Idaho 826 737 89.23%
Illinois 7,495 6,501 86.74%
Indiana 4,073 3,573 87.72%
Iowa 2,138 1,851 86.58%
Kansas 1,897 1,634 86.14%
Kentucky 3,322 2,949 88.77%
Louisiana 2,158 2,002 92.77%
Maine 972 866 89.09%
Maryland 2,814 2,460 87.42%
Massachusetts 4,216 3,785 89.78%
Michigan 4,891 4,354 89.02%
Minnesota 3,782 3,170 83.82%
Mississippi 1,886 1,670 88.55%
Missouri 3,926 3,533 89.99%
Montana 560 499 89.11%
Nebraska 1,349 1,215 90.07%
Nevada 1,305 1,216 93.18%
New Hampshire 739 711 96.21%
New Jersey 3,949 3,461 87.64%
New Mexico 966 828 85.71%
New York 10,923 9,085 83.17%
North Carolina 4,467 4,109 91.99%
North Dakota 593 543 91.57%
Northern Mariana
Islands
17 11 64.71%
Ohio 8,183 6,907 84.41%
Oklahoma 2,192 1,870 85.31%
Oregon 1,511 1,361 90.07%
Pennsylvania 7,893 7,236 91.68%
Rhode Island 777 682 87.77%
South Carolina 2,648 2,395 90.45%
South Dakota 863 797 92.35%
Tennessee 4,081 3,741 91.67%
Texas 13,986 12,690 90.73%
Utah 2,104 1,866 88.69%
Vermont 358 314 87.71%
Virgin Islands 34 31 91.18%
Virginia 4,705 4,094 87.01%
Washington 2,594 2,351 90.63%
West Virginia 1,169 1,055 90.25%
Wisconsin 4,106 3,641 88.68%
Wyoming 349 282 80.80%
Total 177,394 153,579 86.58%
(Source: National Council of State Boards of Nursing, Inc.)


States In The Northeast Region With The Highest And Lowest NCLEX-RN First-Time Pass Rates


New Hampshire and Delaware have the highest first-time pass rates in the northeast region of the United States, while New York and Maryland have the lowest. 83.17% to 96.21% of test-takers in the Northeast region passed the NCLEX-RN exam on their first attempt.

Highest Pass RatesLowest Pass Rates
New Hampshire96.21%New York83.17%
Delaware93.59%Maryland87.42%
(Source: National Council of State Boards of Nursing, Inc.)


States In The Midwest Region With The Highest And Lowest NCLEX-RN First-Time Pass Rates


The percentage of candidates in the nation’s Midwest region who took and passed the NCLEX-RN exam on their first try ranges from 83.82% to 92.35%. Minnesota and Ohio have the lowest pass rates in the region, and North and South Dakota have the highest.

Highest Pass RatesLowest Pass Rates
South Dakota92.35%Minnesota83.82%
North Dakota91.57%Ohio84.41%
(Source: National Council of State Boards of Nursing, Inc.)


States In The Southeast Region With The Highest And Lowest NCLEX-RN First-Time Pass Rates


Florida and Arkansas have the lowest percentage of candidates who pass NCLEX-RN in the southeast region of the US. In the same area, North Carolina and Louisiana have the highest number of candidates passing the NCLEX-RN exam on their first attempt. Overall, success rates in this region range from 68.83% to 92.77%.

Highest Pass RatesLowest Pass Rates
Louisiana92.77%Florida68.83%
North Carolina91.99%Arkansas83.36%
(Source: National Council of State Boards of Nursing, Inc.)


States In The Southwest Region With The Highest And Lowest NCLEX-RN First-Time Pass Rates


Arizona and Texas have the highest number of people who pass the NCLEX-RN exam on their first attempt in the country's southwest region. Oklahoma and New Mexico have the lowest number of candidates in this region who passed the NCLEX-RN on their first attempt, with pass rates of 85.31% and 85.71%, a difference of only 0.4%.

Highest Pass RatesLowest Pass Rates
Arizona91.44%Oklahoma85.31%
Texas90.73%New Mexico85.71%
(Source: National Council of State Boards of Nursing, Inc.)


States In The Western Region With The Highest And Lowest NCLEX-RN First-Time Pass Rates


The western region of the United States reports having passing percentages as low as 80.80% and as high as 93.18%. In this region, Wyoming and Alaska have the lowest percentage of test-takers who pass the NCLEX-RN exam on the first try, while Nevada and Hawaii have the highest number of candidates who passed the NCLEX-RN.

Highest Pass RatesLowest Pass Rates
Nevada93.18%Wyoming80.80%
Hawaii91.30%Alaska88.49%
(Source: National Council of State Boards of Nursing, Inc.)


My Final Thoughts


In this article, we have addressed the question, “how to pass the NCLEX-RN exam the first time?” While everyone learns and applies themselves differently, the 18 simple Do’s and Don’ts to pass the NCLEX-RN first time mentioned here offer some insight into ways you can be successful on your first attempt. Remember, if you have made it this far, you have what it takes!


FREQUENTLY ASKED QUESTIONS ANSWERED BY OUR EXPERT


1. When Was The First NCLEX-RN Exam Administered?

The first NCLEX-RN exam was administered on April 1, 1994. By the end of that year, more than 155,000 candidates took the NCLEX-RN.


2. Is The NCLEX-RN Only For America?

The NCLEX-RN is not offered only in America. Domestic test centers are in the United States, American Samoa, the US Virgin Islands, Guam, and the Northern Mariana Islands. The exam is also offered in Canada, Australia, Hong Kong, Brazil, Japan, India, Mexico, Puerto Rico, South Korea, South Africa, the Philippines, Turkey, and Taiwan.


3. Is NCLEX-RN The Same In Every State?

While test candidates may each be presented with different questions, the NCLEX-RN is the same in every state, which means all candidates have the same chance of passing the NCLEX-RN exam. The diversity in questions is related to the method of testing and how the test determines whether to offer easier or more challenging questions as the candidate progresses.


4. Do I Have To Take The NCLEX-RN In The Same State As My Nursing School?

The NCLEX-RN can be taken in any state that is convenient for you. The testing center will transmit your results to the board of nursing where you applied for licensure.


5. What States Have Unlimited NCLEX-RN Attempts?

The number of NCLEX-RN attempts allowed in each state varies. Currently, thirty-nine states allow unlimited NCLEX-RN attempts. Delaware, Florida, Georgia, Indiana, Michigan, Mississippi, Montana, South Carolina, Tennessee, Vermont, and Wyoming are the only states that do not allow unlimited attempts at passing the NCLEX-RN. Even the states that allow unlimited attempts at passing the NCLEX-RN exam may require candidates to take a refresher course after a designated number of failed attempts. Your state’s nursing regulatory board can give you information about any requirements or limitations associated with unlimited testing.


6. How Many Hours Should You Study To Pass The NCLEX-RN Exam?

As mentioned in the above article, the amount of time it takes to study and pass the NCLEX-RN exam varies from one candidate to another. Some nursing instructors suggest taking at least one to two months after graduation to study and take practice exams before sitting for the exam. Others suggest spending two hours per day studying. The simple answer is, when you feel confident with your knowledge and skills and can take and pass practice tests, you are ready to take the exam.


7. Are Two Weeks Of Study Enough For My NCLEX-RN?

Passing the NCLEX-RN exam is a final milestone in achieving the goal of becoming a licensed registered nurse. Devoting only two weeks of study to NCLEX-RN preparation is not advisable. Instead, you should prepare for the exam throughout the entirety of your nursing program. The last two weeks before taking the exam should be devoted to taking practice tests and reviewing the rationale for answers, not trying to cram information in hopes of passing.


8. Can I Take The NCLEX-RN Without Studying?

You can take any exam without studying, but your chances of passing are not as good. If passing the NCLEX-RN exam is important to you, you should be intentional about studying. Studying before the NCLEX-RN exam will help you refresh your knowledge. Taking practice tests will familiarize you with the testing format, which significantly improves your chances of passing.


9. How Many Practice Questions Should I Do Before NCLEX-RN?

Reviewing and answering practice questions is one of the best ways to improve your chances of passing the NCLEX-RN exam. While there is no set number of questions you should attempt on practice tests, most nursing instructors agree that you should try and answer 2,500 to 3,000 questions correctly.


10. Does The NCLEX-RN Test Format Change OR Does It Remain The Same?

The National Council of State Boards of Nursing periodically updates content for the NCLEX-RN and may change the format. However, the current test plan is effective through March 31, 2023. Any changes that may occur will be no earlier than that date.


11. Can I Take NCLEX-RN In Any Language Other Than English?

Regardless of the nursing board or the testing center location, the NCLEX-RN is only offered in the English language.


12. Will My NCLEX-RN Test Be Timed?

Candidates taking the NCLEX-RN have up to five hours to complete the exam. This allotted time includes the introductory pretest questions, preprogrammed breaks, and unscheduled breaks.


13. Can I Pick My NCLEX-RN Exam Date?

The earliest a candidate can take the NCLEX-RN is 45 days after graduating from a nursing program.


14. Can I Take The NCLEX-RN Test Again?

While passing the NCLEX-RN exam on the first attempt is everyone’s goal, there are circumstances that may lead to an unsatisfactory result. Don’t beat yourself up about it! You can, and should, take the NCLEX-RN again. According to NCSBN guidelines, you may retest no sooner than 45 days after the date of your most recent test.


15. Is The NCLEX-RN Harder Than Nursing School?

Most people agree the NCLEX-RN is easier than nursing school. The exam is designed to test a candidate’s ability to analyze situations and apply nursing knowledge which is learned in nursing school. If a nursing program is a high-quality, accredited program and a student retains the information they were taught, passing the NCLEX-RN exam is likely.


16. Will My Nursing School Pay For My NCLEX-RN?

Nursing schools typically do not pay for the NCLEX-RN exam. The school may include testing fees as part of its fees to help alleviate some of the stress students experience as they prepare for testing. However, payment remains the student’s responsibility.


17. Can I Take The NCLEX-RN After 10 Years Of Finishing Nursing School?

While your nursing degree will not “expire,” some states require NCLEX-RN candidates to take refresher courses if too much time has passed since graduating and the test has not yet been taken. It is advisable to direct this question to your state board of nursing regulatory body to be sure you meet the state’s requirements for testing and licensure.


18. Can I Take My NCLEX-RN Exam Online?

The NCLEX-RN exam is only offered at Pearson Professional Testing locations. It is administered year-round by Pearson VUE.


19. How To Find Out If I Passed The NCLEX-RN Early?

Some test candidates may access unofficial NCLEX-RN test results two business days after taking the test by accessing NCLEX results in the NCSBN’s Quick Results Service. The Quick Results Service results only serve to let the candidate know whether they passed the exam and do not authorize test-takers to practice as a nurse.


20. How Long After Passing The NCLEX-RN Will I Receive My License?

Official results should be expected approximately six weeks after taking and passing the NCLEX-RN exam.


21. Do The NCLEX-RN Test Results Expire?

NCLEX-RN test results do not expire. However, registered nurses must meet their state's continuing education and license renewal requirements to remain inactive practice.


22. Despite My Best Efforts, What If I Fail The NCLEX-RN Test?

The NCSBN provides an NCLEX Candidate Performance Report to individuals who do not pass the NCLEX-RN. This is an individualized report that shows how well you performed in each test content area. Per NCSBN policy, you can retake the exam after at least 45 days have passed from your test date. Take the time between tests to use practice NCLEX-RN exams and study any content area where you did not perform as well. When you are ready, contact your state’s Nursing Regulatory Body to notify them of your intention to retest and reregister with Pearson VUE.


Darby Faubion BSN, RN
Darby Faubion is a nurse and Allied Health educator with over twenty years of experience. She has assisted in developing curriculum for nursing programs and has instructed students at both community college and university levels. Because of her love of nursing education, Darby became a test-taking strategist and NCLEX prep coach and assists nursing graduates across the United States who are preparing to take the National Council Licensure Examination (NCLEX).