How to Ace the NCLEX-PN

Strategies, Tips and Resources for First Time & Repeat Test Takers

Passing the National Council Licensure Examination for Practical Nurses, or NCLEX-PN, is mandatory for anyone who wants to work as a practical or vocational nurse in the US. Most graduates aim to take it shortly after finishing their nursing program – when concepts and information are still fresh in their minds – so they can quickly move into a career. But as many nurses will agree, preparing for the NCLEX-PN shouldn’t be taken lightly. The following guide walks would-be test takers through the entire process, from registration to a break down of the exam’s categories to study tips to getting results. Get the information you need to get organized, create a study plan, and feel prepared and confident for the big test day.

Before the Exam: Application and Registration

The eligibility requirements to take the NCLEX are determined by each state’s board of nursing or an equivalent regulatory body. Therefore, before getting too deep in the process, prospective LPNs and LVNs should contact their state nursing board for information on requirements and to get the registration process rolling. Nonetheless, there are still some general steps all students must take before studying, regardless of the state in which they plan to work.

1 Submit an application for licensure

Applicants should contact the nursing board for the state in which they want to work for specific details, but minimum requirements to apply typically include graduation from an accredited nursing program, fingerprinting and a background check, and submission of official school transcripts. All states also require a licensure fee to be paid with submission of the application.

2 Register for the NCLEX

Simultaneously, applicants must register for the NCLEX directly with Pearson VUE, the company that administers the exam at its testing centers.

3 Pay for the exam

Payment is due upon registration with Pearson VUE. Students can only pay with credit card, debit card or a prepaid card. Most candidates pay $200, according to the National Council of State Boards of Nursing, but additional fees apply to anyone scheduling tests at sites abroad, changing exam types, or switching state boards after already having registered.

4 Wait to receive an authorization to test

After paying and registering with the applicable state nursing board and with Pearson VUE, applicants will receive an ATT, or authorization to test, which states that the board of nursing has declared you eligible to sit for the exam. An ATT is valid for 90 days and includes important information such as your authorization number and identification number.

5 Schedule a time and place to take the exam

Holding an ATT will allow applicants to log in and choose a time and place to take the NCLEX. Individuals must take the exam within 90 days of receiving their ATT; Pearson VUE does not issue refunds to those who do not take the test within that timeframe. Exam centers are located in all 50 states.

Preparing for the NCLEX-PN

There is no standard recommendation of when to start studying for the NCLEX-PN. Some experts recommend starting six months in advance, while many nurses recommend closer to two or three months. However, what everyone agrees on is that applicants should not cram for the exam. Starting three months in advance — assuming one can set aside three or four hours a day to study — should be sufficient. But creating a study plan a little further out can be valuable too, because it will give applicants time to register for and take prep courses, find a tutor, or put together a study group.

There are five typical ways to study for the exam, which most utilize in some combination:

Enrolling in a test prep course

Students who excel in structured learning environments or like having regular access to instructors should look into NCLEX test prep courses, many of which offer money-back guarantees to students who do not pass.

Taking an online course

Most of the same material learned in a classroom-based test prep course can be learned online as well. Some online schools offer courses, either live or self-paced, from about $250 to $400. The NSCBN learning extension also has its own online tutorial.

Reading a review book

A simple Amazon or Google search reveals multiple phonebook-sized review books with strategies and practice questions for the NCLEX. Many companies produce new guides regularly, if not yearly.

Studying in a group

Students often come together after graduation to review what they learned in their nursing programs, quiz each other, and get help on their weaknesses. For some grads, studying with others is a great way to stay motivated and it can also make studying more efficient and enjoyable.

Getting tutoring

Though perhaps an expensive route, a good tutor combines the intimacy of a study group with the structure of a taught course. Tutors are able to focus on shoring up individual students’ weaknesses since they are not teaching an entire class.

While all study methods can lead to favorable results, certain strategies may be more successful than others for applicants, depending on their individual learning style and preferences. Below is a comparison of some of the most common strategies to help you determine which style would work best.

  • Self-study
    Pros Inexpensive Self-paced and flexible in terms of time and location
    Cons Students must hold themselves accountable Less access to resources and people who have passed the exam
  • Prep courses
    Pros Access to experienced teachers who are familiar with the NCLEX Usually provides texts and resources for studying Provides a structured learning environment Often comes with pass guarantees
    Cons Can represent a considerable expense Not individualized to learners Limited one-on-one help Requires attendance over several weeks, which may not be feasible for some
  • Online tutorials (free or paid)
    Pros Paid tutorials provide bundles of resources, which may include video lectures, email support and mobile apps Often comes with pass guarantees Flexible in terms of location
    Cons High quality and most current tutorials may be costly Not individualized to learners’ own style
  • One-on-one tutoring
    Pros Access to experienced nurses or tutors who are highly familiar with the NCLEX Structured learning environment Flexible in terms of time and location Individualized to learner’s needs
    Cons Can be costly Does not necessarily come with other materials, such as practice question guides, textbooks and/or access to online tutorials

Study Tips

For some, studying for the NCLEX-PN is even more difficult than the actual exam itself. Staying focused and motivated – not to mention setting aside a good chunk of time every day – to review material can be challenging. While complete isolation with study materials may work well for some, here are other study tips to help get you through the process so you feel well prepared for the big day:

Focus on critical thinking strategies

It’s an open secret that students can figure out answers to questions — or at least eliminate wrong answers — not by remembering their nursing training but by using critical thinking skills. In other words, if taking tests isn’t your strong suit, you can become one by learning a few tricks, such as:

  • Look for words in the question that are repeated in one of the answers, either verbatim or as a synonym. It could be the right one.
  • Check for opposite answers because one of them is probably the correct answer. Why else would the exam put so much focus on that stream of thought?
  • See if there is an “all of the above” answer hiding. If all of the answers are quite close, there’s probably one answer that actually encompasses the other three. That answer may be the right one.

Regardless of the study method they choose, applicants should make sure to spend a significant amount of time learning and practicing critical thinking strategies as these can can help test takers narrow down answers to the one that makes the most sense.

Analyze why an answer is incorrect

Some students want to know how many questions they got right and wrong. Others want to see which questions they got wrong so they can memorize the answers. But a winning strategy is to delve deeper into the question and seek out an explanation for why the answer was incorrect (or correct). Doing this will not just increase test takers’ likelihood of nailing that question if it appears on the actual test — it will improve their ability to answer any question with a similar logic structure and also helps individuals understand and retain practical nursing information better, which should be the big picture goal of studying for the NCLEX-PN.

Simulate the examination experience

It’s easy to say that test takers shouldn’t get stressed about time or panic while taking the test, but it’s harder to get to that level of comfort unless they simulate the examination experience ahead of time. For one thing, Pearson VUE has strict regulations for NCLEX-PN procedures – applicants aren’t allowed to take items such as lip balm, watches, coats or water into the testing room. Some items, such as cell phones, can’t be accessed at all, even during break times. Would-be test takers should seriously consider investing in an online program that features simulated Computerized Adaptive Testing, and blocking off five hours to complete a practice exam as if it’s the real thing at least once before taking the real test.

Limit the number of practice tests and instead focus on weaknesses

It might seem counterintuitive, especially given the previous recommendation, but many students waste time taking practice tests instead of targeting their weakest areas. Practice tests should be used to pinpoint the areas and concepts applicants need to work on most. With eight categories and subcategories, students don’t necessarily need to keep practicing all eight. Moreover, not all questions are multiple choice. The NCLEX-PN now uses some “alternate item formats” such as fill-in-the-blank questions and charts to be interpreted. Therefore, students should craft their study plan to question types and categories in which they are weakest. They can take another one or two practice tests later on to track their improvement, make adjustments to their approach, and become comfortable with the exam experience.

Take the night off

While it’s tempting to cram up until the last minute, many experts recommend relaxing the day before the exam. Why? The exam does not primarily test memory or recall of nursing facts. Rather, it is testing for cognitive processes. Poor cognitive function is directly correlated to lack of sleep, according to a growing body of research, which suggests that students should instead adopt a consistent study schedule that includes a healthy amount of breaks and sleep. Therefore, students who create a study plan well in advance shouldn’t feel bad about taking the day before the exam off so their brain can rest up — so long as they also take it easy on the alcohol, which impairs cognitive function as well.

Breaking Down the NCLEX-PN

There are four sections of the NCLEX-PN: The first and fourth sections have several subcategories, leaving eight total knowledge areas covered by the exam.

Safe and Effective Caring Environment There are two subcategories in this section:
Coordinated Care

Questions are related to advance directives, client rights and advocacy, client care assignments, collaboration with supervisors, confidentiality and ethics, continuity of care, prioritization, informed consent, information technology, legal responsibilities, quality improvement, referral processes and resource management.

(16 to 22 percent)
Safety and Infection Control

Covers injury prevention, security and emergency response plans, ergonomic principles, handling of infectious materials, home safety, restraints, incident reports, safe equipment use, and standard precautions.

(10 to 16 percent)
Health Promotion and Maintenance

Questions can focus on aging, care for mothers and infants, developmental stages, disease prevention and high-risk behaviors, lifestyle and self-care, and collection of data such as blood pressure and temperature.

(7 to 13 percent)
Psychosocial Integrity

Questions cover patient mental well-being: abuse and neglect, behavioral management, drug dependency, coping mechanisms, crisis intervention, cultural sensitivity and religious beliefs, palliative care and grief, mental health, sensory alterations, stress management and support systems, and therapeutic communication and environment.

(8 to 14 percent)
Physiological Integrity There are four subcategories in this section:
Basic Care and Comfort

Deals with assistive devices, waste elimination, mobility issues, comfort interventions, nutrition and hydration, hygiene, and sleep.

(13 percent)
Pharmacological Therapies

Questions regarding drug administration, expected and unexpected effects of medications, dosage calculations, and pain management.

(11 to 17 percent)
Reduction of Risk Potential

Questions assess PNs ability to monitor for changes in vital signs, run diagnostic tests, evaluate laboratory results, look for alterations in body systems, understand complications from tests and procedures, and apply therapeutic practices.

(10 to 16 percent)
Physiological Adaptation

Covers all the different changes to a patient’s physical condition that may take place in a hospital setting, e.g. blood flow, electrolyte imbalances, allergic reactions and emergencies.

(7 to 13 percent)

On Exam Day: What to Expect

After putting in many hours of studying and getting a good night’s rest, it’s equally important to have an idea of what you’ll be getting into on the day of the exam so you can manage your time wisely and also avoid any unnecessary stress. Below is a list of common questions that NCLEX test takers have on exam day to give you an idea of what to expect and help you get into the proper mindset:

What do applicants need to bring?

The National Council of State Boards of Nursing (NCSBN), which develops the test, advises test takers to arrive at least 30 minutes before the exam with a photo ID that matches the name they provided when registering. Any personal items have to be left in a storage locker outside the testing room. Such items include jewelry, food, wallets and purses, and winter clothing such as hats and coats. Other items, such as cellphones and study materials, will be collected by a test administrator separately before the exam, and cannot be accessed during breaks.

Students will receive a white board and marker on which they can work out problems. Earplugs are also available on request.

How long does the exam take?

Students should be prepared to spend up to five hours on the exam, which will range from 85 to 205 questions, depending upon how well they answer. The NCLEX-PN uses an algorithm that assesses when it has enough information to determine if the test taker passes muster as an LPN. The average test taker faced 117 questions in 2012.

Are there breaks?

There are two scheduled 10-minute breaks, both of which are optional because the exam clock does not stop. Test takers can also take unscheduled breaks by raising their hand and having the test administrator escort them out.

How should people manage their time?

Although candidates should not dilly-dally, only two percent of those who take the exam fail to finish. During the actual exam, applicants are not allowed to skip questions – they have to answer before they can move onto the next question – and they have no way to go back and change their answers later. Students should plan on spending about a minute for each question, but if they occasionally go over they shouldn’t stress. Here’s why: The test is calibrated to find students’ ability levels. As a result, it doesn’t move from an easy question to a really difficult one. Instead, test takers have a decent shot at getting the answer if they think critically about it. Therefore, applicants should avoid guessing without at least ruling out an answer or two first.

After the Exam

There is no published passing score to reach on the NCLEX-PN. Rather, the NCSBN uses a formula to calculate an acceptable passing score. Test takers will continue to be asked questions until the algorithm is 95 certain that an individual test taker has the knowledge and competence to be a licensed practical nurse. A person who gets all the first 85 questions right should be in. If they get them all wrong, on the other hand, the test has probably seen enough to levy a judgment.

After applicants finish the exam, they’ll hear back on one of two things about six weeks later: If they passed, they’ll hear it from their state nursing board and will receive further instructions on finalizing the licensure process. If they didn’t, they’ll receive a Candidate Performance Report with a breakdown of how they did in each category and subcategory so they can know in which areas they fell below the passing standard.

Some state boards, however, allow candidates to see unofficial results sooner if they pay $7.95. After the exam score is verified by a human, Pearson VUE will send the candidate results within two business days. These will be followed by official results from the state nursing board six weeks later.

Q&A: Retaking the NCLEX

Who should retake the exam?

Students who do not pass have the option of retaking the exam and should do so if they still wish to become a licensed practical or vocational nurse.

How long must one wait before retaking the NCLEX-PN?

NCSBN requires a 45-day waiting period for anyone wishing to retake the exam. Some states mandate longer waiting periods, and with good reason — applicants should make sure they adequately prepare to retake the exam, which may involve enrolling in a prep class.

How many times can someone retake the exam?

While the NCSBN does not place limits on the number of times a person can take the exam, states typically do. Applicants should check with their state nursing boards about requirements and retake limitations. The most stringent cap is three attempts.

What are the steps for retaking the test?

Aspiring practical and vocational nurses who need to retake the test should contact their state nursing board for details and to ask if they’ll need to resubmit their licensure application or simply pay an additional fee as these requirements can vary from state to state. The steps for registering and paying with Pearson VUE remain the same. Pearson charges $200 — the same as an initial test. Once the applicant receives an ATT, she or he can schedule an exam for within 90 days.

NCLEX-PN Resources

Care.com

Test takers can use Care.com to find and contact NCLEX tutors in their area. Once they register with the site, they’ll find bios, qualifications and hourly rates.

Hurst Review Services

Hurst charges $250 for an online review service that includes lectures, online tutoring, a study guide and an extensive list of questions.

National Council of State Boards of Nursing

There’s no better resource for NCLEX-PN test takers than the organization in charge of making the test. It provides links to state nursing boards, publishes test plans for applicants, and makes available an extensive FAQ section detailing the exam process.

NCLEX Mastery

NCLEX Mastery makes studying via mobile phone a reality by making over 1,600 questions available via its Android and iPhone apps.

NCSBN Learning Extension

Potential LPNs have four study plans to choose from, depending on their budget and schedule: three weeks, five weeks, eight weeks and 15 weeks. Key features of the paid courses include online instruction, structured practice tests and questions, study groups, and stress-reduction strategies.

Sylvia Rayfield & Associates

Sylvia Rayfield & Associates conducts two-day live reviews and online reviews for students wishing to quickly discover test-taking strategies. Those who purchase review sessions receive 90 days of access to online materials.

Varsity Tutors

Varsity tutors provides paid tutoring services, both in-person and online.