What Is The NCLEX-RN Exam?

April 26, 2024
9 min read


Reviewed by:

Jonathan Preminger

Former Admissions Committee Member, Hofstra-Northwell School of Medicine

Reviewed: 4/26/24

Are you a current or aspiring nursing student who wants to know more about the NCLEX exam? Read on to find out everything you need to know about the NCLEX!

Nurses, often considered the backbone of healthcare, are essential medical professionals whose roles continuously grow to meet the diverse health needs of the world. 

With so many patients' lives in the hands of these in-demand professionals, becoming a nurse is an extensive process! Aside from attending rigorous programs and gaining clinical experience to become qualified to practice, nurses must also write their NCLEX. 

But what is the NCLEX exam? This guide will go over what it is, what’s on the NCLEX, how much it costs, and how to prepare for it.

image of dots background

What Is The NCLEX Exam?

Before delving into the specifics of the exam and the updates of the Next Gen NCLEX, let’s go over the basics! What is the NCLEX exam?

The National Council Licensure Exam (NCLEX) is an exam graduate nursing students must pass in order to become licensed to practice nursing. It gauges graduate nurses’ competency and determines if they’re able to meet national healthcare standards to begin treating real patients.

You’ll need to take the exam if you are interested in becoming a/an: 


Depending on the type of nursing degree you complete, you’ll either want to become a Registered Nurse (RN) or Licensed Practicing Nurse (LPN). As there are differences in the types of roles RNs and LPNs have, they are held to different expectations.

Accordingly, they have to write different NCLEX exams! Aspiring RNs must write the NCLEX-RN, and LPNs must write the NCLEX-PN. 

In comparison, the NCLEX-RN is typically more extensive than the NCLEX-PN. The NCLEX-RN tests on management of care and a wider range of knowledge than the NCLEX-PN. 

Conceptual Changes of the Next Gen NCLEX Exam

The Next Generation NCLEX (NGN) is not a new test but rather an updated version of the NCLEX exam. The primary purpose of the update is to measure the clinical judgment and decision-making skills of the candidates. 

The NGN exam changes will use a framework model known as the NCSBN Clinical Judgment Measurement Model (NCJMM). This model evaluates six steps that candidates must take to answer NGN questions correctly: 

  1. Recognize cues
  2. Analyze cues
  3. Prioritize hypotheses
  4. Generate solutions
  5. Take actions
  6. Evaluate outcomes

Other changes to the exam include: 

  • New item types, including extended multiple response, highlight text, and matrix/grid
  • Exam length 
  • Partial credit scoring methodology 

As you can see there hasn't been a lot of changes to the NCLEX.

When Is Next Gen NCLEX Coming Out? 

The Next Gen NCLEX was released on April 1st. Nursing students who began their schooling in the fall of 2021 and after will take the NGN test.

What Is On The Next Gen NCLEX Exam?

Now that you know what the NCLEX is, it’s important to know what’s on it. The NGN tests a range of skills, abilities, knowledge, and competencies necessary for nurses to safely and effectively care for patients. 

Types Of Questions

You’ll mainly see questions on the Next Gen NCLEX that test your thought process, critical skills, and knowledge of specific aspects of healthcare. Many questions on the NGN will be scenario-based. 

For instance, you may be asked to: 

  • Interpret health information
  • Diagnose a patient
  • Identify which safety procedures are required in common nursing situations
  • Properly assess a patient with a certain illness or symptoms
  • Address patient conflicts

See below for examples of NGN exam questions

Categories On The Next Generation NCLEX

There are four major client care categories on the exam.

1. Safe And Effective Care Environment

The NCLEX-RN and NCLEX-PN differ the most in this category of content. The NCLEX-RN tests on management of care.

Management of care is a nurse’s ability to provide direct care that enhances the healthcare delivery setting to protect the patient and personnel. After all, as a nurse, you’ll be expected to create a safe space for all of your patients.

Instead of management of care, the NCLEX-PN tests on coordinated care, which focuses on how the LPN collaborates with other healthcare members to facilitate effective patient care. 

Both exams also test on safety and infection control. This includes knowledge such as how to prevent accidents and injury, how to apply infection controls, and how to practice safety in healthcare settings.

2. Health Promotion And Maintenance

This section of the exam tests nurses’ knowledge of expected growth and development and how to appropriately integrate this into client care. It also tests on prevention and early detection of health problems and strategies to achieve optimal health. 

3. Psychological Illness

Nurses aren’t only responsible for patching up cuts and bruises! They must also care for and advocate for their patients’ mental health.

As such, the NCLEX tests a nurse’s ability to promote and support the emotional, mental, and social well-being of their patients. It will also test the correct ways to treat acute or chronic mental illnesses.

4. Physiological Integrity

You’ll be tested on your ability to provide patients with care and comfort, reduce client risk potential, and manage health alterations. In this section, you’ll be expected not only to know how to care for living patients but also those who have passed away. You will be asked about correct postmortem care. 

You’ll also be tested on your knowledge of pharmacological and parenteral therapies. Expect to be asked how to administer certain medications, how much to administer, and the potential adverse reactions to medicine.

Next Gen NCLEX Exam Format

We’ve answered the question “What is the Next Generation NCLEX?” but you may also be wondering what the Next Gen NCLEX looks like. 

The NCLEX typically only has multiple-choice answers on it. However, you may see other formats as well. These formats include multiple responses, fill-in-the-blank calculations, hot spot questions where you’re required to click on the correct area on the screen, and ordered responses.

The Next Generation NCLEX questions may also include multimedia such as charts, tables, graphics, and audio. Students will have five hours to complete the exam. 

Example Test Questions

Here are some example NGN questions below to give you a better idea of what the exam is like. 

Question 1: The nurse cares for a 78-year-old female admitted to the medical intensive care unit in respiratory distress. 

An example of a NCLEX question
Source: University of Maryland, Baltimore

The nurse reassesses the client at 1000 and compares the findings to 0930.  For each finding, click to specify if the finding indicates that the client’s status has improved, declined, or is unchanged. Each row must have 1 option selected. 

Heart rate Improved Declined Unchanged

Temperature Improved Declined Unchanged

Respiratory rate Improved Declined Unchanged

Blood pressure Improved Declined Unchanged

Pulse oximetry Improved Declined Unchanged

Agitation Improved Declined Unchanged

Question 2: A 16-year-old patient with cystic fibrosis is admitted with increased shortness of breath and possible pneumonia. Which nursing activity is most important to include in the patient’s care? 

  1. Perform postural drainage and chest physiotherapy every 4 hours. 
  2. Allow the patient to decide whether she needs aerosolized medications. 
  3. Place the patient in a private room to decrease the risk of further infection. 
  4. Plan activities to allow at least 8 hours of uninterrupted sleep. 

Question 3: A client has returned to his room following an esophagoscopy. Before offering fluids, the nurse should give priority to assessing the client’s: 

  1. Level of consciousness
  2. Movement of extremities
  3. Urinary output
  4. Gag reflex

Now that you have an idea of what to expect on the NCLEX you'll be able to prepare for it.

Next Generation NCLEX Exam Scoring

You can expect to see 80-150 questions on your NGN exam. There is a large range because the test uses Computerized Adaptive Testing (CAT) to administer the exam.

CAT increases the efficiency of the exam because, after each answer, the computer re-estimates the student’s ability based on previous answers. This way, the next question won’t be too hard or too easy to fairly assess each candidate.

Students will have to do a minimum of 80 questions in order to successfully complete the exam. By the 80th question, the computer can be 95% sure whether most students’ ability is above or well below the standard and will stop giving them questions.

If the candidate does not demonstrate a clear ability or inability by this point, the computer will administer a full-length exam of 150 questions to determine their competency.

If a candidate runs out of time before answering all the questions on the Next Gen NCLEX, a final ability estimate is used to determine if they have passed or failed.

How To Register For The Next Generation NCLEX

There are a few steps to take to register for the NGN:

  • Ensure you meet all the requirements determined by your nursing regulatory body (NBR).
  • Submit an application for licensure/registration to your NBR. If you require any accommodations, you’ll also need to request them through your NBR.
  • Register with Pearson VUE, where you’ll be booking your test, either online, over the phone, or through a third party like your nursing school.
  • Pay your NCLEX fees.
  • Ensure you receive your Authorization To Test (ATT) email confirming your eligibility to schedule and write the NCLEX.
  • Through Pearson VUE, you’ll pick a testing location to write your exam.
  • Through Pearson VUE, you’ll choose your test date and officially book your NCLEX exam.

Each ATT is only valid for 90 days, so you must test within this time period. Additionally, any changes to your test date or location must be made at least one full business day (24 hours) before your test day.

How Much Is The Next Gen NCLEX?

Registering for the NCLEX costs $200. There are additional fees if you’re an international applicant or would like to change the nursing regulatory or exam type (RN/PN) after registration.

How To Prepare For The NGN

If you’re feeling a little overwhelmed after going over the test content and format, here are some tips to help you prepare for the NCLEX.

1. Go Over The Test Content

NCSBN, the administrators of the NCLEX, have uploaded detailed test plans of both types of Next Generation NCLEX exams that go over the type of content you’ll see on the exam, the format, and some sample NGN exam questions. Before you begin studying, you should look over these plans to become more familiar with the exam.

2. Take A Practice Test

NCSBN also has two practice exams based on previous NCLEX questions that students can take to gauge their base knowledge level before studying. These exams simulate real test conditions, so you’ll have five continuous hours to complete each test.

At the end of the test, you’ll get a score report indicating the percentage of answers you got correct. While you won’t have access to the correct answers, these exams are useful tools to help familiarize you with the types of questions you’ll see on test day and help you build a better study schedule based on your initial performance.

3. Give Yourself Enough Time To Study

Since the majority of the exam is knowledge-based, you can expect to memorize quite a lot of information. However, you should also focus on developing your critical skills so you know how to apply the concepts you learn.

To do this, you need to give yourself enough time to study and not rush the process! 

4. Work Smarter, Not Harder

Relying on your own course notes or research to study for the NCLEX is time-consuming and may not be the most effective study method.

Instead, you should use trusted resources that can give you the right materials to study and support you to succeed! For instance, Inspira has 99th percentile tutors who know exactly how to target your weaknesses and help you ace the exam!

5. Keep Practicing

Test anxiety can get the best of us! To reduce the stress you feel on test day, you should continue taking practice tests under similar test conditions throughout the weeks or months you study. Not only will you be able to track your improvement, but you’ll also become comfortable with the test conditions.

FAQs: Next Generation NCLEX Exam

If you have any more questions about the NGN exam, read on to find your answers!

1. What Is The Purpose Of The NCLEX?

The NCLEX is a licensing exam that tests graduate nurses on the skills, knowledge, competency, and abilities required for nurses to practice safely and effectively at an entry level. The NGN update also tests specifically for clinical judgment skills.

2. Does Passing The NCLEX Make You An RN?

Yes, if you complete your BSN and write and pass the NCLEX-RN, you will become a licensed Registered Nurse.

3. Is The NCLEX Hard To Pass?

With adequate studying, the NCLEX isn’t difficult to pass. In fact, the 2021 test statistics show that between 71.92% to 85.69% of first-time test takers passed the exam.

5. How Many Times Can You Take The NCLEX?

Students can take the NCLEX up to 8 times a year.

6. Is The NCLEX An In-Person Exam?

Yes! You must choose a designated test location to write your exam. The test will be administered on a computer at this testing center. Ensure you arrive 30 minutes early, bring a valid ID, and be prepared to have your veins scanned! 

As a high-tech identification method, you’ll be expected to scan your palm veins so that the test center can confirm your identification throughout the exam.

Final Thoughts

As you begin studying for your Next Generation NCLEX, ensure you first congratulate yourself! You’ve finished the hardest part – getting through nursing school. Relish in the fact that this exam is the very last step you must complete before you officially become one of the most important members of the healthcare system!

Subscribe to Our Newsletter

Schedule A Free Consultation

Plan Smart. Execute Strong. Get Into Your Dream School.
Get Free Consultation
image of dots background

You May Also Like