NCLEX-RN Exam: Format, Registration Process and Tips

Every registered nurse aspirant is required to take the NCLEX-RN (National Council Licensure Examination for registered nurses) exam to obtain certification in any of the 50 U.S. states, the District of Columbia, or four U.S. territories, which include the Virgin Islands, American Samoa,  Northern Mariana Islands and Guam. It is designed to test the abilities, skills, and knowledge of a nurse, required for the safe nursing practice at the entry-level. The exam is organized by the NCSBN (National Council of State Boards of Nursing, Inc.) and is conducted by the testing vendor, Pearson VUE. Your competence level is gauged through an interactive system, known as CAT (Computerized Adaptive Testing).

Levels of Examination

The licensure exam, NCLEX-RN, generally uses the 5-step process. Each question falls in any one of the following categories:

  • Assessment
  • Analysis
  • Planning
  • Intervention and implementation
  • Evaluation

Topics to be Covered for the Exam

The content of the exam generally comprises of the following:

  • Physiological Integrity This section includes approximately 43-67 percent of the questions. Thus, it contains the exam’s majority questions. This category includes questions based on:
    • adult surgical and medical care
    • pediatrics (include child abuse, growth and development, usual childhood traumas such as fractures and burn injuries, common infectious diseases of children, and birth abnormalities)
    • gerontology (study of the elderly and the effects of aging)
    • infectious diseases
  • Safe and Effective Care Environment This section includes approximately21-33 percent of the questions. This category includes questions based on:
    • Safety issues in patient care
    • Topics related to the administration of medicine to the patients
    • Isolation precautions
    • Safety measures to prevent injuries and infections in the future
    • Special safety measures for patients with psychiatric problems
    • Safety for pediatric patients

This section may also include the following topics:

    • Questions on laboratory tests
    • Test results and its unique nursing procedures
    • Legal and ethical nursing problems
    • Nursing management
    • Issues associated to give the best care to the patients
  • Health Promotion and Maintenance This section includes approximately 12 percent of the questions. This category comprises of questions based on:
    • birth control measures, pregnancy, labor and delivery (understand all components of a patient’s pregnancy)
    • Care for a newborn infant, their growth and development
    • Diseases that may spread easily like sexually transmitted infections
    • Development of the fetus, knowledge of proper diet, signs and symptoms of pregnancy complications
    • Certain pregnancy-related procedures
  • Psychosocial Integrity This section includes approximately12 percent of the questions. The questions are generally asked on:
    • Patients with psychiatric difficulties and their unique issues
    • Coping mechanisms for diverse circumstances
    • Psychosocial issues that fall short of psychiatric illness
    • Disorders: eating disorders, depression, organic mental disorders, schizophrenia, personality disorders and anxiety disorders
    • Therapy through communication, substance abuse, and crisis intervention

Types of Question

Most of the NCLEX questions are in multiple choice patterns. Recently, a new format has been added by the NCSBN which includes:

  • selection of multiple correct answers via check boxes
  • recognition and selection of a specific area of a drawn body part
  • ordering the steps of a nursing or medical procedure
  • free response mathematical questions which involve medication calculations

The questions are of three different levels:

  • Level 1 This section includes approximately 10 percent of the total questions and comprises of basic questions. It tests the knowledge, understanding and skills of an individual to recall the specific information and facts. It is possible that the exam may contain Level 1 questions.
  • Level 2 This section is based on analysis and application type questions. It requires individuals to know specific information and then implement it in analyzing the question.
  • Level 3 This section of the examination contains complex questions and requires an individual to evaluate, judge, and combine information in the end. Upon reading the question, the individual needs to apply the facts, rules, and processes they know and then constantly make decisions on the given situation.Level 2 and level 3 generally covers 95 percent of the total questions.

The NCLEX-RN Exam Format

The NCLEX-RN is a computer-based test taken at a Pearson Professional Center. There are a large number of testing centers in different states of the U.S. The centers can also be found in 175 different countries. Approximately 90% of the examination consists of multiple-choice questions while the remaining consists of filling in the blanks, putting a number of steps in the correct sequence, identifying a correct area on a picture, or choosing correct answers from a list of options. It may also consist of questions asking information about a chart, graph, or audio clip. Pictures may also be used as an option for answers.  The question will appear just once on the computer screen and won’t be repeated.

Depending on how you answered the previous questions, you can expect a total of 75 to 265 questions. Among the first 75 questions, only 60 will be counted. The remaining 15 are “trial” questions and will be utilized on future tests. You will not be able to identify these questions; thus, it is recommended to attempt each and every question.

The maximum time period to complete the RN test is 6 hours. A break of 10 minutes 2½ hours after the commencement of the exam and another optional break about 4 hours after the exam are given to you. You may take breaks at any time of the exam, but you will lose the given additional break time.

You can make a maximum of three attempts to qualify the exam.

NCLEX-PN Sample Test Study Guide –

Exam Process

All applicants must follow the given process:

    • Scheduling
      Once you are declared eligible, you will receive ATT (Authorization to Test) letter. Schedule your exam either by phone or online. It’s compulsory to take the test within the dates of validity of your ATT, which in any case is not extendable.
      • Scheduling via Phone
        You can schedule your examination directly through Live Chat Operators. For this, visit, provide the required information, and click on ‘Start Chat.’ In case, chat is not unavailable, call at the following numbers:

        • America Region
          Contact Number: 866-49-NCLEX / 866-496-2539
          Office Hours: 7:00 a.m.–7:00 p.m. CT, Monday–Friday, closed on local holidays
        • Europe, Middle East, Africa Region
          Contact Number: +44-161-855-7445 (Toll)
          Office Hours: Monday–Friday, 9:00–18:00 CET (8:00–17:00 GMT), closed on local holidays.
        • Asia-Pacific Region
          Contact Number: (India) +91-120-439-7837
          (Asia-Pacific Region) +852-3077-4923 (Toll)
          Office Hours: 9:00 a.m.-6:00 p.m. local time for each country, Monday-Friday, closed on local holidays 

Note: Pearson VUE will correspond with you only via email. Correspondence from Pearson VUE may go to the junk or spam folders automatically. So, check these folders.

Change the Regulatory Body/Nursing Board or Language of the Exam

You can change the regulatory body/nursing board by requesting via and paying a fee of $50. If you are a Canadian NCLEX candidate and want to change the language of the exam, then also you need to pay $50.

Exam Outside the U.S.

You can contact the customer service at if you wish to schedule your NCLEX-RN licensure examination at a test center, which is located outside the U.S. or Canada. For this, you will have to pay VAT (Value Added Tax) and fee of $150.

Things to Keep in Mind on the Exam Day

On the exam day, you must keep in mind the following points:

  • Do not forget to take your original ATT letter and acceptable ID to the Pearson Professional Center.
  • Gloves, scarves, hats and coats are not allowed in the testing room.
  • Try to reach the examination center before 30 minutes. After ½ an hour of the commencement of the exam, no applicant will be allowed to enter the examination hall.
  • You need to provide your signature, palm vein scan, and a recent photograph.
  • You need not bring any paper or writing instruments for rough work. An erasable note board/marker and an on-screen calculator will be provided for making notes.
  • Since the time period for completing the exam is six hours, including the two optional breaks, take required time to analyze each and every question carefully.
  • After completing the exam, a short computerized survey will be displayed. Raise your hand and wait for your turn till the TA release you.

Exam Results

If the board you have applied for is a part of Quick Results Service, you may receive your “unofficial” results within 48 hours after the completion of the exam by paying $7.95 on the Pearson VUE NCLEX Candidate website. The board will mail the official results to you in approximately 1 month after the exam.

Candidates Who Don’t Pass

An NCLEX CPR (Candidate Performance Report) will be received, in case, you don’t pass the exam. It will indicate your performance in each section of the test. You may use this as a guide to prepare yourself in order to retake the examination.

Retaking the NCLEX Licensure Test

You may retake the exam 45 to 90 days after you took the previous exam. The state board of nursing determines the time period. To retake the exam, follow the below steps:

  • Notify your board of nursing that you want to retake the examination, and determine the fees and documents required.
  • Re-register with the testing vendor Pearson VUE and provide a fee of $200.
  • Upon receiving the ATT, schedule your NCLEX-RN test again.  

Tips to Pass the NCLEX-RN Exam

You may use the following tips to pass the NCLEX exam:

  • If you have completed your graduation recently, you are aware of enough content. Try to formulate new strategies to answer higher-level questions.
  • Try to categorize each and every question according to its essential topic which may help you in saving enough time and will be essential for you to answer in a better way.
  • Get to know the question format, content, length and passing-level-difficulty of the exam. Be prepared to sit and attempt all 265 questions, and work on your stamina to take the test.
  • As there is a limited time period, make use of your valuable study hours by focusing on the areas, which needs your attention.
  • Plan your studies and practice sessions accordingly keeping in mind your test date. Ensure that you cover all the essential topics.
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