National Council Licensure Examination (NCLEX)
The term NCLEX refers to a three-level examination that assesses the applicant's knowledge and clinical skills as a practical, vocational and registered nurse. The National Council Licensure Examination, or NCLEX, is sponsored by the National Council of State Boards of Nursing. The purpose of the exam is to ensure individuals are able to provide proper nursing care to patients at an entry level.
In the United States, local state boards of nursing have the authority to grant an individual a license to practice their skills. The National Council Licensure Examination, or NCLEX, provides a common system to use as part of the state's qualifications assessment and subsequent licensure.
The test is divided into two subtypes: NCLEX-RN is used for registered nurse licensure, while NCLEX-PN applies to vocational and practical nurses. The exam is computer-based and conducted at test centers throughout the year. The examination tests the individual's knowledge, skills, and ability to provide safe and effective nursing care at an entry level.
The electronic test uses an adaptive learning technique, which means the number of questions asked is determined by how close the candidate is from passing the test. For example, candidates very close to passing will be asked more questions (up to 265 for NCLEX-RN and 205 for NCLEX-PN). Fewer questions are asked of candidates that will clearly pass or fail the test. The average number of questions asked per examinee is around 120.
Candidates will have up to six hours to complete the examination; however, the average time to complete the exam is approximately two hours and 30 minutes. The test measures the examinee's knowledge in the following areas:
- Management of Care: includes case management, client rights, confidentiality of information, ethical practice, legal rights and responsibilities, as well as performance improvements.
- Safety and Infection Control: includes ergonomics, handling hazardous materials, safety precautions, reporting of irregular events, surgical asepsis, and use of restraints.
- Health Promotion Maintenance: includes disease prevention, health screening, high risk behaviors, lifestyle choices, self-care, and physical assessments.
- Psychosocial Integrity: includes abuse, neglect, crisis interventions, cultural influences on health, use disorders, coping mechanisms, grief and loss, support systems, and therapeutic communications.
- Basic Care and Comfort: includes assistive devices, mobility, non-pharmacological interventions, nutrition, hydration, and personal hygiene.
- Pharmacological and Parenteral Therapies: includes contraindications, side effects, interactions, blood and blood products, dosage calculations, administering medicine, intravenous therapies, pain management, and nutrition.
- Reduction of Risk Potential: includes changes in vital signs, diagnostic tests, laboratory values, complications, system assessments, and therapeutic procedures.
- Physiological Adaptation: includes alterations in body systems, electrolyte imbalances, hemodynamics, illness management, medical emergencies and unexpected responses to therapies.
Unofficial results are released to candidates in 48 hours for a small fee. Official results are mailed approximately six weeks following the exam. Raw scores are converted to quality scores that include "Below the Passing Standard," "Near the Passing Standard" or "Above the Passing Standard." The NSCBN policy allows candidates to retake an exam once every 45 days, not to exceed eight times per year. State boards may restrict the total number of times the test can be taken.