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Whether your career goal is to become a registered nurse (RN) or a licensed practical nurse (LPN), part of the process requires you to pass the National Council Licensure Examination (NCLEX) to get your state nursing license. This prestigious exam determines if a nursing school graduate has the skills and knowledge to practice professional nursing, and the pressure to pass may seem intense. If you’re attempting the nurse licensure exam for the first time or you’ve previously failed and are trying again, this guide provides several helpful NCLEX tips from those who’ve been there and those who now teach others to pass and earn their coveted credentials.
What Is the NCLEX?
The NCLEX is the premier nurse licensure exam developed by the National Council of State Boards of Nursing (NCSBN) to test the competency of graduate nurses in the United States and Canada. The NCSBN developed the NCLEX-RN for prospective registered nurses and the NCLEX-PN for prospective licensed practical or vocational nurses. It constantly evaluates exam materials to keep up with rapidly evolving healthcare technologies and techniques. The NCLEX utilizes computerized adaptive testing technology to ensure valid and reliable results.
Before taking the NCLEX, you must obtain an Authorization to Test (ATT) by applying to your local nursing regulatory body (NRB). Your NRB is the State Board of Nursing or a similar authority where you apply for nurse licensure in your state. Once you receive your ATT, you must register with Pearson VUE, the testing agency that administers the exam on behalf of the NCSBN. You should start this process way before your target exam date, as it can take quite a bit of time to complete. The NCLEX fee is $200 for every exam attempt.
NCLEX Tips from Recent Grads
Nicolas Sanchez is a recent graduate of the University of Nevada, Las Vegas, School of Nursing. He joined HCA Healthcare as an emergency room nurse in June 2022 after passing the NCLEX and earning his RN licensure in Nevada. His top advice is to practice, practice, practice test questions.
“Studying the material doesn’t do you any good if you don’t know how to properly answer NCLEX-style questions. Aim for 50 questions,” Sanchez said. “Don’t cram all your studying the week before. You’ve been studying all through nursing school, so you know much more than you think. As a rule of thumb, start getting really serious a month before you think you want to take the exam and only study a few hours a day.”
McKayla Schulke has been an LPN for about a year and a half though her nursing career began in 2018 when she decided to quit her retail job and accept a certified nursing assistant position. Her original plan was to become a dietician, but that changed when she realized how much she loved being in the nursing field. Her passion led her to start her health and wellness website, Soul Simple By Kayla, which talks about all things related to healthcare and simple living.
Schulke advised first-time test takers to only take the exam when they’re ready and not because they feel obligated to do so by friends, family members or a potential employer. She said if you’re not feeling confident about your abilities, you’re more likely to fail the test and have to repeat it.
“Don’t study the day before your test,” added Sanchez. “Take the day to relax and mentally prepare for the exam. You’ve been working hard to get to this point, so treat yourself.”
Educator Tips for the First NCLEX Attempt
Dr. Stephanie Au, MSN, APRN, FNP-C, DNP, is a family nurse practitioner who’s worked in the pediatric ICU but has experience in many specialties, including plastic surgery, cardiothoracic surgery and family medicine. She’s been the Assistant Clinical Professor of Nursing at the University of California, Irvine, Sue and Bill Gross School of Nursing since July 2018, and before that taught in the nursing BSN and MSN pre-licensure program at UCLA.
“Taking the NCLEX is obviously stressful,” Dr. Au said. “While there isn’t anything that will completely remove stress from this experience, having a systematic approach to working through questions allows the student to feel confident in their knowledge and skills and helps control their anxiety so they can think clearly.”
“I teach my students something I call the ‘Strategic Questions Approach.’ This is a strategy for answering test questions, regardless of whether they’re multiple-choice, select all that apply, matching or otherwise. The method consists of four steps:
Step 1: Rephrase the question in your own words. There are really only two reasons a question will be answered incorrectly. Either there’s a knowledge gap or the question was misread. Rephrasing the question in your own words helps you analyze the question correctly and identify what the question is really asking.
Step 2: Identify whether each answer option provided is either correct or incorrect individually.
Step 3: Provide an in-depth rationale as to why each option is incorrect or correct using your knowledge from pathophysiology, clinical courses, pharmacology and the nursing process.
Step 4: Choose the answer for which you have a rationale. Rather than getting caught in an endless blackhole of self-doubt, trust your gut, trust your instincts and trust your education.”
Dr. Catherine Prato-Lefkowitz, Ph.D., MBA, MSN, RN, CNE, began her career as a psychiatric nurse in the mental and correctional healthcare systems. While she continues to work at the bedside a few days each month to keep her skills current, she has expanded her nursing career to the classroom. She has taught nursing students on-site and online at Walden University, National University, Touro University and the University of Nevada, Las Vegas.
Until recently, Dr. Prato-Lefkowitz was the Director of Nursing Education for the Nevada State Board of Nursing. She’s spent the past three years developing NurseMuse, a study tool designed to provide a new way of learning and creating care plans for nursing students during clinicals. Dr. Prato-Lefkowitz is also releasing a series of books providing insights into what it means to enter the nursing workforce and related fields.
The following list features Dr. Prato-Lefkowitz’s tips for first-time test-takers, with some pointers matching Dr. Au’s:
- Read the question and read the answers
- Ask yourself: What is TRUE and what is FALSE
- Individually go over each option, instead of all together
- Don’t analyze the question, always go with the first response and Do Not Change Answers
- Watch out for the words “always” and “never,” and don’t choose these
- Make sure the option focuses on what’s Being Asked
- The question might be asking about COPD and corticosteroids but might tell you the other health problems the patient has. Focus on COPD and corticosteroids, and don’t focus on the other information. Think about the pathophysiology of COPD and think about what you would teach a patient about corticosteroids.
- If you have trouble with SATA (select all that apply), practice these questions every day
- Watch out for key terms in the option: lab values, measurable nursing intervention, etc.
- Remember, there’s an option that includes all options together
- Look for keywords (initiating, activating)
- Look for measurable changes in patient status
- Prioritize the nursing process, ABCs, Maslow’s Hierarchy
- Assessment is always first
- Remember, therapeutic responses: tell me more, can you elaborate on feelings, thoughts, perceptions
- Eliminate non-therapeutic responses: changing the subject, asking them “why,” giving them false hope, telling them what to do, talking about yourself
NCLEX Tips for Subsequent Attempts
General tips for passing the NCLEX also apply to subsequent attempts. However, nurses who’ve previously failed the exam may benefit from additional suggestions that wouldn’t necessarily be relevant to first-time test takers. Our experts weighed in on how to approach taking the nurse licensure exam multiple times.
No matter how much you studied and how prepared you believed yourself to be, you may still fail the NCLEX on the first attempt. Thus, Schulke warned graduate nurses not to think of themselves as failures just because they didn’t pass.
“This test doesn’t define your worth as a human being or a nurse. All it does is let a few people sitting behind a desk know you’re a good test taker,” she said.
However, Dr. Au added that it’s difficult not to fall victim to self-doubt.
“If the first time taking the NCLEX is stressful, having to take it again adds another layer of insecurity and self-doubt,” said Dr. Au. “My tip for students taking the NCLEX a second time is don’t read into the question, meaning don’t put additional context in the question that isn’t there. If the question doesn’t state the patient is having pain, don’t assume they’re having pain.”
“Many students reflect on their own patients throughout their clinical rotations,” she explained. “However, this can lead to the student adding specific context from their patient that isn’t relevant to the question being asked. Keep it simple, keep it at face value and refrain from making it more complicated than it needs to be.”
Dr. Prato-Lefkowitz advised those attempting the NCLEX on subsequent attempts to refer back to the tips provided for first-timers but also sign-up for a live review. She suggested practicing 50 questions each day to become desensitized to them, especially those that require you to select all that apply.
“Write out the rationale for the correct and incorrect answers,” she said. “Explain the disease process out loud and discuss what nursing interventions you would do for that disease process as well as the rationale. Talking out loud, even to yourself, will help you be able to articulate what you’re saying. Even better, try to describe it to a non-medical person in your family or friend circle.”
Tips for the First or Fifth Attempt
Dr. Au offered some parting advice for test takers that she feels is helpful, whether it’s your first attempt at tackling the NCLEX or you’ve tried several times but haven’t found success yet.
“After identifying your answer to a question but before moving on to the next, stop for 2 to 3 seconds and take a slow deep breath,” advised Dr. Au. “Reflect on the question one more time in a calm state and then submit your answer and let that be final. Trust your instincts. Try to limit your self-doubt and insecurities and don’t give them a place in analyzing a patient care problem. Several studies have shown that oftentimes when students change their answers on an exam, they change it to an incorrect answer.”
Prepare for the Next Generation NCLEX
The NCSBN announced in August 2019 that the NCLEX would undergo an update that included format changes. Dubbed the Next Generation NCLEX (NGN), the NCSBN confirmed that the new version would begin on April 1, 2023. Starting on that date, prospective RNs and LPNs/LVNs who began nursing school in or after Fall 2021 must pass the NGN to pursue nurse licensure.
The NGN combines current types of NCLEX items and new NGN items, including different question formats. It still utilizes computer adaptive testing and a mix of questions requiring candidates to demonstrate their nursing knowledge and skills, but now test-takers must apply their knowledge using clinical judgment and critical thinking skills.
The NGN uses case studies like what’s seen in the real world to reflect the critical decisions nurses must regularly make in various healthcare settings. Altogether, it features five types of exam questions. Two question types previously seen on the NCLEX include SATA or extended multiple responses and drag-and-drop questions. The three new test items include drop-down (Cloze questions), enhanced hot spot (highlighting questions) and matrix/grid questions.
Related: What Nurses Should Know about the Next Generation NCLEX
If you have some tips for passing the NCLEX you’d like to share with prospective nurses, please share them below in the comments section.
