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The Definitive Practice Test Guide for the NCLEX-RN Exam

About the NCLEX-RN

The National Council Licensure Examination for Registered Nurses, or NCLEX-RN exam, is used to assess the competencies of nurses before they begin working professionally. The NCLEX-RN exam tests a potential nurse’s knowledge and job skills to ensure that they can provide safe and effective client care.

The exam was originally developed in the 1940s, but has undergone many changes since then. The most recent update being the introduction of the Next Generation NCLEX (NGN) in April of 2023. Today, the NCLEX-RN is largely a computer-adaptive test, meaning that the difficulty of each question is determined by previous responses. Examinees will continue to receive questions until the exam has determined that they have sufficient knowledge.

Because of its computer-adaptive nature, test takers can expect to receive anywhere between 85 and 150 questions. Most of the questions are standard multiple-choice, although there are also some in alternative formats, including multiple-choice with more than one answer, fill-in-the-blank calculations, ordered response, and hot spot questions where the examinee must click on a screen location to answer the question. The Next Generation exam introduced several additional alternative formats, include drag-and-drop, cloze (drop-down), and matrix questions.

There are eight core topics covered in the exam including:

  • Basic Care and Comfort
  • Management of Care
  • Physiological Adaptation
  • Reduction of Risk Potential
  • Health Promotion and Maintenance
  • Pharmacological and Parenteral Therapies
  • Psychosocial Integrity
  • Safety and Infection Control

The Next Generation NCLEX places a greater emphasis on clinical judgement, as critical thinking skills are one of the most important qualities in a registered nurse. In addition to questions from the eight core topics, at least 18 questions will involve clinical judgement presented in the form case studies, as well as stand-alone clinical judgement questions.

Sections of the NCLEX-RN Exam

Basic Care and Comfort

The content in this section, Basic Care and Comfort, falls under the larger umbrella of topics related to Physiological Integrity, one of the four major categories of questions on this test. Questions regarding this subcategory make up about 6% to 12% of the test and are related to tasks that increase the comfort of the client during daily living. A question might cover such things as the use of assistive devices, assistance with hygiene, or the monitoring of bodily functions.

Health Promotion and Maintenance

Questions regarding Health Promotion and Maintenance occupy between 6% and 12% of the entire test. Questions in this area of nursing address issues in many categories, including the stages of life, health screening, and lifestyle choices. The content typically relates to the role of the nurse in client education and guidance toward a healthy lifestyle.

Management of Care

The content in this section, Management of Care, falls under the larger umbrella of topics related to Safe and Effective Care Environment, one of the four major categories of questions on this test. Items assessing your knowledge in this area will comprise between 15% and 21% of the test. The questions will concern various aspects of healthcare management, including client rights, legal aspects of care, and quality improvement.

Pharmacological and Parenteral Therapies

The content in this section, Pharmacological and Parenteral Therapies, falls under the larger umbrella of topics related to Physiological Integrity, one of the four major categories of questions on this test. You can expect to see topics from this subcategory in approximately 13% to 19% of the test questions. These questions usually relate to things involved in medicine management and delivery, including drug interaction and side effects. They can also assess your knowledge of the use of blood and blood products, as well as pain management.

Physiological Adaptation

The content in this section, Physiological Adaptation, falls under the larger umbrella of topics related to Physiological Integrity, one of the four major categories of questions on this test. The percentage of test questions regarding this subcategory is between 11% and 17%. Beyond the topic of typical healthcare, these questions deal with providing services for clients with serious, long-term health conditions. The content contains various procedures for managing chronic illness and medical emergencies with these clients.

Psychosocial Integrity

About 6% to 12% of the NCLEX-RN exam is made up of questions from the Psychosocial Integrity section. Much of this area is devoted to mental health concepts and how the healthcare professional can help promote good emotional health. This can be done through such strategies as crisis intervention, sensitivity to stressful events in life, and the provision of supportive practices during client care.

Reduction of Risk Potential

The content in this section, Reduction of Risk Potential, falls under the larger umbrella of topics related to Physiological Integrity, one of the four major categories of questions on this test. 9% to 15% of the test questions will relate to this test subcategory. A major concern in healthcare is the prevention of additional problems caused by treatment and procedures. Medical tests can signal possible adverse effects, enabling professionals to act to reduce the risk. Questions of this type require you to be familiar with many of these tests and how to use the results during treatment.

Safety and Infection Control

The content in this section, Safety and Infection Control, falls under the larger umbrella of topics related to Safe and Effective Care Environment, one of the four major categories of questions on this test. About 10% to 16% of the test items will address this area of nursing. These healthcare questions revolve around things like dealing with emergencies, using equipment safely, and working with hazardous materials.

What to Expect on Test Day

Taking the NCLEX-RN exam can be very nerve-wracking, but understanding what to expect is the best way to reduce anxiety and perform well on exam day. The exam is timed, although the sections are not. Examinees will have up to five hours to complete all of the sections, including two optional breaks. Because the test is rather long, it’s important to ensure that you’ve had a good night’s sleep and a nutritious meal before arriving. You should also dress comfortably, but professionally.

It’s also a good idea to plan to arrive early so that you have extra time to ensure you know where the testing site is and to address any issues that may arise during registration. The testing site will also collect biometric data when you arrive, including a signature, a photograph, and a palm vein scan. And if you arrive more than 30 minutes late, you must forfeit your NCLEX appointment and fees paid. You will have to reregister to take the exam, so having extra time is a great idea.

What to Bring

It’s crucial that you bring a valid form of legal identification, such as a driver’s license or passport. The first and last names on your ID must exactly match the first and last name on your Authorization to Test (ATT) email. If the names do not match, you will be required to reregister and pay additional exam fees.

What Not to Bring

Personal items —including electronics, accessories, and outerwear—are not permitted in the testing room. Some test centers have small storage lockers that may be available for you to use for personal belongings, although you should check beforehand whether your test site has this feature. In the event that you don’t know or cannot determine whether there is storage for personal belongings, it is best to leave these items at home or in your vehicle. During breaks, you will have access to personal items such as purses, lip balm, and medical aids, but you will not have access to electronic devices or study materials.

You also do not have to bring any testing aids, such as a calculator or scratch paper. You will have access to these items on-screen within the test itself.

Best Ways to Study for the NCLEX-RN

Take NCLEX-RN Practice Tests

One of the best ways to make sure you are prepared to take the NCLEX-RN test is by using practice tests to study in the months and weeks leading up to your exam date. Practice tests can help you to familiarize yourself with the nature and format of the questions you will be likely to encounter when taking the exam. Additionally, these practice tests can help you to understand your strengths and in what areas you might want to spend extra time studying. Taking NCLEX-RN practice tests is an easy way to ensure that you are ready to succeed on exam day.

Use Alternative Study Methods

While NCLEX-RN practice tests are a great resource for preparing to take the exam, you may also want to consider supplementing your studying experience with alternative study methods. Many students find that using resources like flashcards and study guides in addition to the practice tests can help them to retain NCLEX-RN information better.

Simulate the Testing Experience

While it may be difficult to simulate the NCLEX-RN exam due to its computer-adaptive nature, it is a good idea to try to recreate the experience to the best of your ability, including going through as many questions on the practice exam as you can within a five-hour window. This process will give you an idea of how long questions will take you, including difficult ones, and knowing this information will put you in a better position to pace yourself accordingly on exam day.

NCLEX-RN Tips and Tricks

Take Your Time

It’s incredibly important to pace yourself when taking the Next Generation NCLEX-RN. You will have up to five hours to complete the exam in its entirety. Normally, with many timed exams, the best practice is to answer the easy questions first, then return to the harder ones. This process is not possible with the NCLEX-RN. Due to its computer-adaptive nature, you cannot move onto the next question until you have completed the last one. Additionally, there is no way to tell how many more questions you will have to answer to finish while taking the exam. So, you will have to take your time to analyze each question carefully (more correct answers mean fewer questions), but pace yourself so that you have enough time to finish within the allotted time. A good pace to aim for while taking the NCLEX-RN is 1-2 minutes per question.

Give Yourself Plenty of Time to Prepare

Passing the NCLEX-RN exam is a major milestone in your nursing career, which means that it should not be taken lightly. Giving yourself plenty of time to study and review test guidelines well before test day—weeks, or even months—is one way to ensure that you are ready to ace the exam when your test day arrives.

Manage Your Anxiety

Because passing the NCLEX-RN exam is such a huge milestone, it is easy to become stressed or anxious about it. Some stress can be good since it indicates that you are serious about performing well. But if your stress level is too high, it can cause you to perform poorly. The best way to deal with pre-exam anxiety is to ensure you are prepared by studying and practicing the exam. And it’s always a good idea to ensure you are taking care of yourself, including getting sufficient sleep, exercise, and nutrition in the interim leading up to the test. Self-care is essential in managing stress and anxiety.


1. How much does it cost to take the NCLEX-RN exam?

The basic fee for the exam is $200, though there may be additional fees for registration and licensing by the nursing board.

2. When will I get my NCLEX-RN results?

Exam results are available from the Nursing Regulatory Bodies of the states, and they are typically sent out approximately six weeks after completing the exam. Some Nursing Regulatory Bodies participate in the Quick Results Service; those that do allow candidates to access their unofficial results 48 hours after their exam date and time for a fee.

3. How is the NCLEX-RN exam scored?

Unlike most standardized exams, you do not receive a score after taking the test. It is pass/fail only. Candidates who fail the exam will receive a performance report with their results, which provides feedback on their performance.

Whereas the previous versions of the NCLEX-RN only had right/wrong answers, the Next Generation NCLEX does grant partial credit on some questions. You will not be made aware which questions offer partial credit during the exam.

4. Can I retake the NCLEX-RN exam?

Yes, you may take the exam again if you fail it. You can take it up to eight times in one year. However, you must wait 45 days in between test dates.

5. What is the NCLEX Next Generation (NGN) exam?

The NCLEX Next Generation exam is the latest version of the NCLEX. It was released in April 2023, and, while similar to previous versions of the exam, includes several updates: new question types (such as matrix, drop-down, and drag-and-drop), the option for partial scoring, and a greater emphasis on clinical judgement using case study questions. If you are taking the NCLEX-RN after April 1, 2023, you will be tested using the NCLEX Next Generation exam.

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