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The Definitive Practice Test Guide for the NCLEX-PN Exam

About the NCLEX-PN Exam

The National Council Licensure Examination for Practical Nurses, or NCLEX-PN exam, is an exam administered by State Boards of Nursing. The exam was developed by the National Council of State Boards of Nursing to assess your competencies in vocational knowledge and readiness to begin working as a practical nurse. This exam is commonly referred to as “Boards” or “State Boards” and a passing score on this test is required in order to become a licensed LPN or LVN.

Unlike most exams, the NCLEX-PN is computer-adaptive, meaning that the difficulty of each question will be determined by your success in answering previous questions. It is designed to be challenging, but not too hard to complete. This process continues until the computer has determined within 95% confidence your overall level of competency in all areas tested, which means the number of questions will vary from one examinee to the next. You can receive anywhere from between 85 and 150 questions while taking the NCLEX-PN.

The total testing time for this exam is five hours. It is primarily composed of multiple choice questions with four possible answers. However, you may encounter some other question types, such as those involving interactive charts, audio or graphics, short answer, and multiple response. The test may also feature “hotspot” questions where you must locate an area on an image, and drag-and-drop/ordered response questions. Additionally, the Next Generation exam (introduced in 2023) has a few new question formats, such as matrix and cloze.

Topics that are covered in the NCLEX-PN exam can be divided into four major categories that address the concept of client (patient) needs. These topics as well as the proportionate weight they are given in the exam are:

  • Health Promotion and Maintenance—6%–12%

  • Psychosocial Integrity—9%–15%

  • Safe and Effective Care Environment
    • Coordinated Care—18%–24%
    • Safety and Infection Control—10%–16%
  • Psychosocial Integrity
    • Basic Care and Comfort—7%–13%
    • Pharmacological Therapies—10%–16%
    • Reduction of Risk Potential—9%–15%
    • Physiological Adaptation—7%–13%

The NCLEX-PN exam is pass or fail only. There is no numerical score assigned as a result. This type of scoring can make many examinees anxious about taking the test. However, understanding what to study, how to study, and what to expect during the actual test can help to calm your nerves and ensure your best performance on the day of the test.

It’s important to note that the 2023 edition of the NCLEX-PN places greater emphasis on clinical judgment in the design of its questions. It also uses case studies with six related questions to assess your abilities.

Sections of the NCLEX-PN Exam

Basic Care and Comfort

The Basic Care and Comfort questions on the NCLEX-PN fall under the topic of “Physiological Integrity” and will comprise 7% to 13% of the test. They will assess your knowledge of the day-to-day client care you will be expected to provide and the approved procedures for accomplishing these tasks. You will need to know how to safely and effectively provide assistance, as well as comfort, during activities of daily living. The needs of every client are different, so you’ll need to know a variety of strategies to use during many different situations.

Coordinated Care

Coordinated Care is one of the two areas covered by questions about “Safe and Effective Environment” on the NCLEX-PN test and is the basis for 18%–24% of the test questions. The main emphasis here is that you know how to collaborate with other healthcare personnel to provide care for clients. You will need to have a certain amount of knowledge of typical healthcare regulations to do this well. Things like advance directives and the referral process should be familiar to you, and you should understand your role in dealing with clients.

Health Promotion and Maintenance

The Health Promotion and Maintenance section of the NCLEX-PN exam accounts for 6%–12% of the questions on the exam. Unlike other sections, these questions have a focus on preventative health and caring for the well client. Topics covered include prenatal, postpartum, and newborn care; aging, developmental stages, self-care, disease prevention, and high-risk behaviors.

Pharmacological Therapies

Questions about Pharmacological Therapies occupy about 10% to 16% of the NCLEX-PN test and make up one of four subtopics falling under the broader heading of “Physiological Integrity.” You’ll need to know about medication administration and be able to monitor clients who are being given parenteral therapies. There are questions about dosage, effects, interactions, and expected outcomes, among other related concepts.

Physiological Adaptation

Occupying about 7% to 13% of the NCLEX-PN® test, questions regarding Physiological Adaptation relate to client physical conditions during chronic care situations and acute/emergency episodes. You’ll need to understand and respond to scenarios involving body system alterations, fluid and electrolyte concerns, and the client’s response to various therapies, among others. This area of study is one of the four parts listed under “Physiological Integrity.”

Psychosocial Integrity

The Psychosocial Integrity section of the NCLEX-PN® exam focuses on the emotional and mental health needs of clients and their families. Topics covered include abuse and neglect, religious and spiritual health, coping mechanisms, cultural concepts, end-of-life issues, grief, stress management, support systems, therapeutic communication, and crisis intervention. Approximately 9% to 15% of the questions on the exam are focused on this topic.

Reduction of Risk Potential

Included as a subtopic under “Physiological Integrity” in the outline of concepts covered on the NCLEX-PN test, questions about Reduction of Risk Potential occupy about 9% to 15% of the test. You’ll need to know all about tests and lab values and their significance in client care. Part of your job will be to spot irregularities in client conditions, especially after medical procedures and during therapies. By doing so, you keep the risk of complications low and help the client avoid unintended risks.

Safety and Infection Control

About 10% to 16% of the NCLEX-PN test questions relate to Safety and Infection Control and are part of the focus on providing a “Safe and Effective Care Environment,” along with the questions on “Coordinated Care” concepts. Topics included all involve making sure the healthcare setting and the care you provide are geared for client health and safety. From preventing and reporting accidents to security issues, your role in promoting client welfare is important.

What to Expect on Test Day

It’s always a great idea to know what to expect on the day of the exam. Since the test can take up to five hours to complete, it’s important that you dress comfortably, have had plenty of rest, and have eaten a nutritious meal beforehand. The NCSBN recommends that you arrive at least 30 minutes before you are scheduled to start the exam, and all examinees who are more than 30 minutes late will have to forfeit, re-register, and pay another exam fee.

You will have to provide biometric data upon arrival to ensure security. You will be asked for your signature, photograph, and palm vein scan.

What to Bring

You will need to bring proper identification on the day of this exam, such as a driver’s license or passport. This identification must be government-issued, non-expired, and contain your name, a recent photograph, and your signature. You’ll also need to bring your Authorization to Test (ATT) email. Note that the names on your ID and the ATT must match exactly or you must provide legal documentation for the change.

What Not to Bring

You may not bring any electronic devices, personal items, test prep material, or testing aids (such as a calculator or scratch paper). You will not need any writing instruments since the exam is computer-administered. An on-screen calculator and note board (to be used as scratch paper) will be provided on the screen while you are taking the exam.

Best Ways to Study for the NCLEX-PN

Take NCLEX-PN Practice Tests

Taking NCLEX-PN practice tests is one of the best ways to ensure that you are prepared to succeed on your testing day. Practice tests can help you to get more comfortable with the testing format and content covered. A passing score is crucial if you are pursuing a career in practical nursing, and taking NCLEX-PN practice tests can help you to achieve a passing score and ensure you can start working as soon as possible.

Use Alternative Study Methods

Practice tests are crucial in passing the exam; however, some test takers find that they can retain information better when they supplement the practice exams with alternative testing methods, such as flashcards, which are a great way of covering questions that may be found in the multiple-choice format. Study guides for the NCLEX-PN can also be used to help ensure that you don’t miss any topic and devote adequate studying time to those subjects that are weighted more heavily on the test.

Simulate the Testing Experience

Another great idea that can boost your performance on exam day is simulating the actual testing experience. While it is impossible to simulate the computer-adaptive component, there are other ways to give yourself a simulated experience that is close to what you may experience on testing day.

You can have several practice tests ready with 205 questions available and time yourself with the full five hours (and two allotted break times) to get an idea of how long the questions generally take for you and how well you perform under pressure. These simulations can help you to feel more comfortable with the format and identify any weak areas that need additional studying.

NCLEX-PN Tips and Tricks

Review the NCLEX-PN test plan.

The National Council of State Boards of Nursing releases a test plan for the NCLEX-PN, which is updated every three years in accordance with updates to the exam itself. It provides a summary of the content and scope of the test and should serve as a foundation for identifying the appropriate study materials.

Start preparing at least three months prior to taking the exam.

The scope and breadth of the content that the exam covers is huge. It was designed to assess your occupational abilities, which means that you will have to spend quite a bit of time preparing. It’s best to start early and give yourself several months to review all of the material.

Use NCLEX-PN practice tests to identify what areas you need to spend the most time reviewing.

NCLEX-PN practice tests can do so much more than familiarize you with the type of questions you encounter. If you take the time to review the ones that you got incorrect, you can often spot patterns in terms of the subject matter. These results can help you identify which areas you should spend more time studying.


1. When will I find out if I passed or failed the NCLEX-PN?

Even though the NCLEX-PN is computer administered, you will not receive your exam scores after you complete the exam. You will be notified of your results by the State Board of Nursing between two and six weeks after you have taken the test.

2. How much does it cost to take the NCLEX-PN exam?

The standard fee to take the NCLEX-PN exam is $200 no matter where you are taking the exam. However, some states may have additional licensure and registration fees. You can find out more about these fees by visiting the website for the National Council of State Boards of Nursing.

3. Can I skip questions while taking the exam?

No, the test is linear due to its computer-adaptive format. You will have to answer each question in order to move on to the next question.

4. What happens if I do not pass the exam?

If you do not pass the exam, you will receive a Candidate Performance Report. This document shows how you performed in each of the test plan content areas, and it should be used as a guide in preparing you to retake the exam. You will have to contact your nursing state board and notify them that you plan to retake the exam. You can then re-register for the exam and pay an additional fee. You will have to wait at least 45 days between your most recent test date and any retakes.