What should a candidate expect when they see an NCLEX Highlight item? 

Highlight items are presented as a sentence or several sentences forming a paragraph. The candidate must click to highlight and select text as a response to the item. Not all text included in the sentence or paragraph is enabled to be selected. In such cases, the candidate will see the ø symbol displayed when the mouse hovers over the text. This indicates the text is not a response option, and the candidate will not be able to select it. Text that is enabled to be selected is identified by a highlighted hue when the mouse hovers over the test. The candidate should review any remaining text, select their response choice(s) and click submit to move to the next item. Please visit the NCLEX Candidate Tutorial in the Prepare section at NCLEX.com for an opportunity to see and practice NCLEX item types.

When will the new exam format go in effect? 

The new NCLEX exam format, which includes Next Generation NCLEX clinical judgment items, became effective April 1, 2023.

What are NGN case study and stand-alone items? 

NGN case study items are item sets composed of six items that are presented as part of an unfolding case scenario that are displayed with exhibit tabs such as Nurses’ Notes, Vital Signs, and Diagnostic Results. NGN stand-alone items are items administered independent of other items. Any type of item can be used in a stand-alone item. For more information on stand-alone items, please read the Spring 2021 issue of Next Generation News.

What are the benefits of implementing new scoring methods? 

The new scoring methods allow for moving beyond the current scoring model that is based on candidates’ responses being scored as ‘all correct’ or ‘all incorrect’. The new partial credit scoring model allows for polytomous scoring methods meaning some items are no longer scored as completely correct or incorrect. Currently, Multiple Response Select all that Apply only allows for all correct or incorrect scores. The new polytomous models gives candidates points for partial understanding.

When will the new scoring methods go into effect? 

The new scoring methods went into effect April 1, 2023 with the 2023 NCLEX launch.

Are traditional NCLEX Multiple Response Select all that Apply items scored with partial credits in the new 2023 NCLEX with NGN items? 

Yes, the traditional NCLEX Multiple Response Select all that Apply items are scored using the +/- scoring method with the new NCLEX with NGN items that went live on April 1, 2023.

Are candidates able to test with accommodations for the new 2023 NCLEX with NGN items? 

Candidates will follow the same process as the NCLEX to request testing accommodations and are encouraged to contact their nursing regulatory body for more information.

What changes in the NCLEX Test Plans were made with the launch of the Next Generation NCLEX (NGN)? 

Beginning with the 2021 NCLEX-RN and NCLEX-PN Practice Analyses, NCSBN asked respondents regarding the relevancy of clinical judgment while performing entry-level nursing activities. Data gathered from the Practice Analyses inform the subsequent NCLEX-RN and NCLEX-PN Test Plans. With the launch of the Next Generation NCLEX (NGN) in April 2023, updated NCLEX-RN and NCLEX-PN Test Plans also become effective with clinical judgment represented as an NCLEX Integrated Process.

Are items in case studies dependent on the correct response to a prior item in the same set? 

Each case study includes a client scenario and follows Layer 3 of the NCSBN Clinical Judgment Measurement Model (NCJMM) in sequential order focused on each step from “Recognize Cues” through “Evaluate Outcomes”. Each item within a case study is independent of each other and scored accordingly. Candidates will not be able to go back to view previous responses and care is taken to avoid cuing within each case study.

Do items provide the candidate with normal reference ranges? 

Beginning with the launch of the Next Generation NCLEX, items that contain a numeric laboratory value will include the corresponding normal reference range.

Why did NCSBN change the NCLEX? 

The NCLEX measures the foundational knowledge and skills needed for safe nursing practice for entry-level nurses, regardless of academic background. Every three years NCSBN conducts a practice analysis to evaluate the knowledge, skills, and abilities needed for entry-level nurses and to evaluate the validity of the test plan that guides content distribution of the licensure examination. The practice analyses have highlighted changes in healthcare including an increase in acutely ill clients. Nurses are responsible for a significant proportion of the judgments and decisions made in healthcare and newly licensed nurses are required to make progressively more complex decisions about patients.

In 2009, NCSBN reviewed several research reports and engaged in professional discussions with nursing experts on the importance of clinical judgment in the nursing profession. This led to funding a thorough literature review on the subject and culminated in a comprehensive white paper. The report provided an overview of the current nursing theories and models of clinical decision-making, along with empirical research on factors that affect decision-making in nursing. Specifically, the report found that 50% of entry-level nurses were involved in practice errors (Smith & Crawford 2002) and a subsequent study by Brennan et al. (2004) found that 65% of entry-level nurse errors were related to poor clinical decision-making. In addition, Saintsing et al. (2011) reported that only 20% of employers were satisfied with decision-making abilities of entry-level nurses.

Between 2012 and 2014 NCSBN collaborated on two studies as part of a strategic job analysis. The fundamental conclusions from these studies provided further evidence of the importance of clinical judgment in entry-level nursing. One major finding was that clinical judgment was one of the top five required skills needed upon entry into the field. Interestingly, two other high priority skills in the top five were problem solving and critical thinking skills, which themselves are vital to clinical judgment. The other two were related to professional communication and active listening.

The RN Nursing Knowledge Survey from 2017 provided additional evidence of the importance of clinical judgment. The overall importance of clinical judgment was rated between ‘important’ and ‘critically important’ by newly licensed RNs, RN educators and RN supervisors. It was also similarly rated across the facility categories of hospital, long-term care, community-based care, and other. The overall result is consistent with previous research showing that clinical judgment is essential to the safe practice of nursing at the entry level.

A panel of subject matter experts consisting of PN Educators, PN Clinicians and Nurse regulators was convened to compare the activity statements included in the 2018 LPN/VN Practice Analysis to the elements of the NCSBN Clinical Judgment Measurement Model (NCJMM). The findings indicated that the entry-level PN was expected to provide care using the nursing process framework and make the necessary clinical judgments within their scope of practice. The NCJMM elements that were most often cited as essential to the practice of the entry-level PN were recognize cues, analyze cues and take action. The element least associated with the entry-level PN activities was prioritize hypotheses. Given these findings, the Next Generation NCLEX item types and NCJMM represent a valid and reliable measurement of PN competence and will be incorporated into the NCLEX-PN examination.

What standards does NCSBN use when developing a new test? 

NCSBN has conducted multi-year studies to support the development of Next Generation NCLEX (NGN). Research studies analyzed items and documented the validity of these items to measure clinical judgment. Validity evidence included 1) the extent to which clinical judgment can be measured, 2) numerous item writing panels comprised of nurse faculty to write items aligned with the NCSBN Clinical Judgment Measurement Model (NCJMM), 3) nursing experts (nursing faculty, clinical educators, clinicians and numerous committees made up of experienced nursing experts) reviewed items to ensure the measurement and content was accurate and correctly classified document the validity of the items to measure clinical judgment, and 4) ensuring that items are statistically sound and reflect contemporary practice.

How does NCSBN define Clinical Judgment for purposes of a Next Generation NCLEX (NGN)? 

To develop a valid and reliable means of measuring clinical judgment, NCSBN conducted extensive reviews of the literature in nursing, decision theory and testing. The result was the assessment framework referred to as the NCSBN Clinical Judgment Measurement Model (NCJMM).

It is important to note that the NCJMM is a framework designed for and specific to testing and should not be construed as a replacement for other evidence-based theories of nursing theory or practice. In particular, the NCJMM does not compete with the Nursing Process or specific pedagogical or andragogical models around the teaching of clinical judgment. Rather, it provides a systematic, evidence-based framework for measuring whether nurse licensure candidates demonstrate at least minimal competence with respect to clinical judgment and decision making.

For the purposes of the NCLEX, Layers 3 and 4 of the NCJMM guide item writers in the development of NGN content; Layer 3 elements provide the primary measurement focus for items and the Layer 4 elements provide context. Each of the Layer 3 and Layer 4 elements are defined in more detail in the publications on the NGN resource page.

What role did nurses play in Next Generation NCLEX (NGN) research? 

Nursing professionals served as the pillars and foundation on which the NGN research, and the NCLEX, is built upon. This included hundreds of nurses participating in various research studies, thousands of nurses providing feedback after formal NGN presentations, and over 250,000 aspiring nurses taking the NGN research section. Clinicians, clinical educators and nurse faculty have played a pivotal role and were consulted at every stage of the NGN research project.

What is the composition of item writing and review panels? 

The item writing and item review panels are generally a group of 6-10 nursing professionals who are representative of all the U.S. regions and Canadian provinces that use the NCLEX for licensure. Additionally, these educators and clinicians each have a distinct expertise area to ensure a broad range of nursing experience and context. You can read more about NGN item development panels in the Summer 2018 edition of the NGN Newsletter. Information about volunteer is available on the Exam Development Opportunities page.

What research was conducted to validate the new item types? 

Focus group studies, usability studies and cognitive labs studies were employed in the early stages of development to ensure item types were not introducing any construct irrelevant variance into candidate responding. After validation from these multiple methods, items were developed and field tested within the Special Research Section to gather actual responses from candidates. This data provided confirmatory evidence that the item types were measuring as expected based on the empirical results

Did NCSBN work with test preparation and publishing companies to develop questions? 

NCSBN provided information to test preparation and publishing companies prior to the launch of NGN on the NCLEX exam. This was after the NGN research was validated and the test design was determined.

When did the new NCLEX format go in effect? 

The Next Generation NCLEX became effective April 1, 2023.

How can educators prepare students? 

Educators can begin incorporating the clinical judgment measurement model into their curriculum immediately. The model can be used in a variety of nursing education settings, such as simulation labs, clinical rotation post-conference, and standard written exams. The action model template provided in the Spring 2019 Next Generation NCLEX newsletter is a useful tool to develop clinical judgment assessments for students.

Will the cost of the exam change? 

No. The cost of the exam has not changed with the launch of NGN clinical judgment items on the NCLEX Exam.

What are the benefits of implementing new scoring methods? 

The new scoring methods evaluate partial knowledge. Currently the Multiple Response Select all that Apply items only allow for all correct or incorrect scores. With the new polytomous models, candidates can get points for partial understanding.

How can educators prepare their students for the new scoring methods? 

Educators can best prepare their students by reviewing the Summer 2021 issue of Next Generation NCLEX News on scoring methods and the 2023 Test Plans. Educators can also join our mailing list for informational updates.

Are Multiple Response Select all that Apply items be scored with partial credits in the NGN exam? 

Yes, all NCLEX Multiple Response Select all that Apply items are scored using the +/- scoring method on the NGN Exam that went live on April 1, 2023.

Does NCSBN offer or recommend any tools or resources that allow educators to create their own NGN-style items and case studies?

NCSBN does not offer such tools. However, we have provided publishers and vendors with the most current and accurate information available to support their incorporation of NGN clinical judgment items into new or existing product offerings. NCSBN doesn’t endorse any product or publisher and encourages educators, institutions and candidates to research various offerings to determine which will best support their needs.

What are the eligibility requirements for taking the NCLEX? 

Each nursing regulatory body (NRB) has its own eligibility requirements to take the NCLEX. NCSBN does not maintain a list of requirements for each NRB. Contact the NRB where you are seeking licensure/registration for their requirements (applicable only to NRBs of the U.S., Canada and Australia).

How do I register for the NCLEX? 

To take the NCLEX, you will first need to complete two separate processes (applicable only to nursing regulatory bodies of the U.S. & Canada):

1. Contact your Nursing Regulatory Body (NRB) and request a licensure/registration application.
   • Registration process for Australian Health Practitioner Regulation Agency (Ahpra) candidates
   • You will pay a licensing/registration fee to the NRB along with the submission of your application materials.
   • Licensure/registration applications must be obtained from the NRB in the state/province/territory where you are seeking licensure/registration, as requirements vary.
2. Register with Pearson VUE (the testing vendor) using one of the following methods:
   • Online – Visit Pearson VUE and pay with a credit, debit or prepaid card
   • Phone – Call Pearson VUE Candidate Services at 866.496.2539 and pay the exam fee by credit, debit or prepaid card

How do I go about making a change to my registration with Pearson VUE? 

If your Nursing Regulatory Body (NRB) has declared you eligible:

1. You must contact your NRB to make the necessary corrections.
2. Once the correction is confirmed with the NRB, please contact Pearson VUE for a revised Authorization to Test (ATT) if needed.

If you have not been made eligible by your NRB, then you will need to contact Pearson VUE to report the corrections.

I have registered for the NCLEX, when will I get my Authorization to Test (ATT) email? 

Once you have been made eligible by your nursing regulatory body (NRB), you will receive an Authorization to Test (ATT) via the email address you provided when registering. If you have not received an ATT email, you may want to contact your NRB to ensure all necessary materials have been submitted and received, or to find out why they have not granted eligibility to your registration. You must have your ATT email to schedule an appointment to take the NCLEX.

You must test within the validity dates of your ATT (the average length of an ATT is 90 days). These validity dates cannot be extended for any reason. If you do not test within these dates you will have to reregister and pay another exam fee. The ATT contains your authorization number, candidate identification number and an expiration date. You need the ATT to schedule an appointment to take the NCLEX.

Call Pearson VUE Candidate Services at 866.496.2539 or at one of the international telephone numbers in the NCLEX Candidate Bulletin to report a lost ATT or if your NRB has made you eligible and you have not received your ATT.

Can I take the NCLEX at a test center outside of my desired jurisdiction of licensure/registration? 

You are able to take the NCLEX at any Pearson Professional Testing location, regardless of where you are applying for licensure/registration.

The NCLEX is given year round and is administered by Pearson VUE. For candidates seeking licensure in the U.S., domestic test centers are those within the U.S. and American Samoa, Guam, Northern Mariana Islands and the U.S. Virgin Islands. For candidates seeking licensure/registration in Canada, domestic test centers are those within Canadian provinces/territories and the mainland U.S. (not including territories). International locations where the NCLEX is offered include Australia, Brazil, France, Hong Kong, India, Israel, Japan, Mexico, Philippines, Puerto Rico, South Africa, Spain, Taiwan, Türkiye and United Kingdom.

Candidates can find test center locations by going to the Pearson VUE website.

For more information on where the NCLEX is offered, visit the Test Center Locations page.

What forms of identification are accepted at the test center? 

All forms of identification must be valid and meet the following requirements. If the ID does not meet these requirements (See Acceptable ID), you will be turned away and required to reregister and pay another examination fee:

• Physical (non-digital)
• Government-issued
• Non-expired
• Name (in Roman characters)
• Recent photograph
• Signature

Examples of acceptable forms of identification for domestic test centers are:

• Passport books and cards
• Driver’s license
• Provincial/Territorial or state identification card
• Permanent residence card
• Military identification card

The only identifications acceptable for international test centers, including Puerto Rico, are:

• Passport books and cards

Candidates with identification from a country on the U.S. government’s sanctioned countries will have to follow the requirements listed in order to sit for the exam.

For more information on identification, visit the Acceptable Identification page.

Definitions of Domestic and International Test Centers

Which names need to match on my ID and the ATT? 

Only the first and last names need to match between the candidate’s ID and ATT.

For more information on identification, visit the Acceptable Identification page.

Does the address on my ID need to match the address on my ATT? 

No, the address does not need to match between the candidate’s ID and ATT.

For more information on identification, visit the Acceptable Identification page.

When will I get my results? 

Official exam results are available only from the nursing regulatory bodies (NRBs) within 6 weeks of the exam appointment. Pearson VUE and NCSBN do not provide exam results.

Candidates whose NRB participates in the Quick Results Service (only applies to candidates seeking licensure in the U.S.) can access their ‘unofficial’ results 48 hours after their exam date and time (a fee is required).

Will I lose my NCLEX registration fee if I cannot cancel my appointment at least 24-hours ahead of time? 

Yes, the registration fee is forfeited if a candidate cannot cancel outside of 24 business hours from their appointment and/or does not keep their appointment. The candidate will need to reregister and pay another exam fee. Because a test was not administered, the candidate would be able to test after they are made eligible again by their nursing regulatory body and receive a new Authorization to Test. The same policy applies to a candidate who does not test within their authorization period.

May I get a refund for any NCLEX fees? 

No. There are no refunds of NCLEX fees for any reason.

Can you recommend review courses and/or study materials to help me prepare for the NCLEX? 

NCSBN does not recommend or endorse any review courses or study materials. If you are interested in participating in a review course or purchasing review materials, please consult a nursing education professional for suggestions.

How can I lodge a concern at the test center? 

You may ask the TA for a Confidential Comment Sheet to provide any information about your exam appointment to NCSBN, the test centers or Pearson VUE Candidate Services. If you have questions about your testing session, please contact NCSBN within two weeks of your exam appointment.

Is there a separate NCLEX-RN for Canadians and Australians?

The same NCLEX-RN exam is used for Canadian and U.S. entry to nursing practice. For questions about whether you can practice in another state/province/territory, please contact the nursing regulatory body for that jurisdiction. Links to all nursing regulatory bodies’ websites and contact information are available on the NCSBN website.

Can a candidate skip questions? 

No. Candidates have to answer a question in order to move onto the next question.

For more information, visit the Computerized Adaptive Testing section.

Is it true that candidates who receive the minimum number of items and the last item is “easy” will fail the examination? 

The CAT algorithm selects items that are of optimal difficulty for the candidate. Therefore, each item selected with be relatively difficult for the candidate. Candidates cannot reliably identify which items are easy and which are difficult with regard to the NCLEX scale. At the end of an examination, a candidate is usually receiving items that they have approximately a 50% chance of answering completely correct. The candidate’s sense of what is easy and what is difficult is relative to their ability. Because the examination is adaptive, both high and low ability candidates will think the items at the end of the exam are challenging.

If a candidate fails the exam after taking the minimum number of items, does this mean they did very poorly? 

This means that it took only the minimum number of items for the scoring algorithm to determine with 95% certainty that the candidate’s nursing ability was below the passing standard.

When candidates retake the exam do they start at the same difficulty/ability level ‘where they left off’ from the previous examination? 

No. The NCLEX uses computerized adaptive testing (CAT) to administer the items. Initially, everyone is administered an item with a relatively low difficulty level, and his/her progression on the exam from that point onward depends on their performance. A complete overview on how CAT works can be found on the Computerized Adaptive Testing information page.

On the Candidate Performance Report (CPR), what does ‘Near the Passing Standard’ mean statistically? 

‘Near the Passing Standard’ means a particular candidate’s ability estimate is not clearly above or clearly below the passing standard in a content area.

Why do candidates only get performance reports if they fail? 

The NCLEX is designed as a screening tool used to identify candidates that can demonstrate that their nursing ability is sufficient to be competent in practice. Providing more detailed feedback for candidates who fail is done in an attempt to help the candidate direct their remediation strategies. Providing feedback to people who do not need remediation serves no purpose and could be misused by candidates or employers in making employment decisions.

Will students have exams that focus on nursing specialties? 

The NCLEX is computer adaptive and items are selected based on each candidate’s ability. Each exam adheres to the test plan content area percentages. The items fall across all difficulty levels and cover all areas of the test plan. Entire exams are not focused on specific nurse specialties.

How does the NCLEX address terminology differences between jurisdictions using the NCLEX? 

Since the beginning of its development, the NCLEX has served as a fair, reliable tool to measure the minimum competency required to deliver safe, effective entry-level nursing. The exam is developed to ensure that no candidate is afforded an unfair advantage when testing. The language and terminology selected for exam items must be universal and support the assessment of one construct—entry-level nursing knowledge while eliminating the inadvertent assessment of other factors.

Does the NCLEX bold key words in items? 

Yes, the NCLEX bolds key words such as best, most, essential, first, priority, immediately, highest, initial, next, refute, increased, decreased and support.

Does NCSBN use generic and trade names on items with medications? 

The NCLEX uses consistent language for every examinee. In order to achieve accurate, stable measurement, terminology used in exam items can have only one meaning. NCSBN understands most clinicians acknowledge both generic and brand/trade names when referring to drug medications. At this time, the NCLEX will reflect, on most occasions, the use of generic medication names only. We take into account that the use of the medication generic name is more consistent while a brand/trade medication name may vary. Some items may refer to general classifications of medications.

Is there a ‘need to know’ list of drugs for the NCLEX? 

NCSBN does not specify a list of medications that are on the exam.

Which units of measurement will be used with lab values on the NCLEX exam? 

On average, NCLEX items currently include a combination of international systems of units (SI) and imperial measurement options used in the nursing profession. The unit of measurement presented in the item will be familiar to the NCLEX candidate.

What is an integrated process? 

The NCLEX incorporates processes considered fundamental to the practice of nursing and therefore are integrated throughout the NCLEX Test Plan client needs categories. Clinical judgment is included as an integrated process in the 2023 NCLEX Test Plan.

At what cognitive level is the NCLEX written? 

Since the practice of nursing requires application of knowledge, skills and abilities, the majority of items are written at the application or higher levels of cognitive ability, which requires more complex thought processing. These questions require a candidate to utilize problem-solving skills in order to select the correct answer.

What is the readability level of the NCLEX? 

The NCLEX-RN and NCLEX-PN is designed to measure one construct, nursing ability.  To this end the goal of the NCLEX is to use language that is construct focused without making the exam unnecessarily difficult. A readability analysis is performed on all operational pools.  The NCLEX-RN exam does not exceed 1,300 Lexiles and the NCLEX-PN 1,200 Lexiles. 

Are NCLEX item banks rotated? 

The NCLEX master pool contains enough items to make up multiple operational pools. To maintain exam security and ensure that repeating candidates will not receive the same items from one attempt to the next, operational item pools are rotated regularly.

What item formats are on the exam? 

Examples of item formats can be found in the NCLEX Tutorial, offered in both English and French.

Any item formats, including standard multiple-choice items, may include multimedia such as charts, tables and graphic images.

Is there a certain percentage of different item formats on the NCLEX? 

There is no established percentage of items formats that will be administered to candidates. The NCLEX is computer adaptive and items are based on the candidate’s ability. There are different item types used on the NCLEX and across all difficulty levels.

How are items scored? 

NCLEX items have multiple item formats. There is partial credit scoring for items for which more than one key exists. There will be three methods for scoring items for partial credit: plus/minus, zero/one, and rationale scoring. Examples of these scoring rules as applied to different item types/formats can be found in the Summer 2021 issue of Next Generation NCLEX News, called Next Generation NCLEX: Scoring Methods, in the NGN Resources section. 

Do calculation items have a decimal place? 

Yes, unless the item requests that the candidate records their answer using a whole number. If asked to record to one (or two) decimal places, the candidate must enter the decimal point for the answer to be correct.

When should a candidate round a calculation item? 

Answers to calculation items should be rounded at the end of the calculation.

Can candidates answer an item and move to the next item even if they did not open all of the exhibit tabs? 

Yes. The candidate is not prompted to open all of the exhibit tabs. It is important that the candidate review each exhibit tab entirely and make an answer selection before moving to the next item.  If the candidate does not answer an item but tries to move on to the next item, a prompt will appear informing the candidate “You cannot continue with this question unanswered.” 

How do you keep up with current practice with questions in the pool and how often are they reviewed? 

All NCLEX operational items are reviewed on a continuous basis to ensure that they contain accurate content and reflect current entry-level nursing practice. In cases where there is an immediate change in nursing practice, such as changes in guidelines and policies, all items relevant to the topic in question will be reviewed to ensure that item content remains accurate. If necessary, items can be pulled from the operational pool as needed to ensure only current content remains on the exam.

How is the NCLEX translated? 

To meet the needs of French-speaking, Canadian NCLEX-RN candidates, NCSBN offers the NCLEX-RN examination in French. NCSBN translates two operational item pools each year into French. Following this forward translation by a translation professional with expertise in Canadian French, NCSBN works with Canadian regulatory bodies to identify a Canadian Translation Panel. The panel consists of three nurses proficient in English and French who review each translated item for accuracy and contextual equivalency. This method, referred to as a mixed method, process oriented approach, is supported in the literature as a preferred method for ensuring construct equivalence in health care measurement instruments.

Following the Canadian Translation Panel’s approval the French NCLEX Operational pool is administered to French Canadian NCLEX-RN Candidates. Once sufficient candidate response data is obtained, the items are subject to a separate Differential Item Functioning (DIF) analysis, to ascertain whether the items appropriately measure candidates’ nursing ability irrespective of the language in which these test items were administered. Items identified as possessing DIF are reviewed by the NCLEX DIF panel for presence of bias. In addition to the construct equivalence confirmed by the Canadian Translation Panel, the use of DIF analysis is supported in the literature as a preferred method to ensure measurement equivalence.

What is the definition of the ‘entry-level nurse’? 

The NCSBN Board of Directors voted to revise the definition of the NCLEX entry-level nurse from having six months experience or less to having no more than 12 months experience. The dates of implementation for the revised definition are:

April 1, 2017, for the NCLEX-PN Exam
April 1, 2019, for the NCLEX-RN Exam

Does the practice analysis include nurses from all jurisdictions using the NCLEX? 

NCSBN invites nurses from all jurisdictions using the NCLEX to participate as Subject Matter Expert nurse volunteers on the NCLEX Practice Analysis Panel and NCLEX Knowledge, Skills, and Abilities Panel. Because the health care industry is rapidly changing, practice analysis studies are traditionally conducted on a three-year cycle. Information gathered in the practice analysis studies assists NCSBN in evaluating the validity of the test plan. Periodically, NCSBN conducts comparative practice analyses to determine whether the current test plan is valid for testing populations in specified locations.

How do the results of the practice analysis translate to a new test plan? 

Respondents of the practice analysis survey rate the importance of each entry-level nursing activity statement, the frequency with which they perform the activity and the relevancy of performing each activity with regard to clinical judgment. These importance, frequency and clinical judgment relevancy ratings are analyzed at the end of the survey process. Overall, tasks or activities that are deemed unimportant or infrequently performed by respondents may be eliminated from the new test plan. NCSBN ensures the remaining activity statements are categorized in the approved NCLEX categories. These categories form the basis of the test plan, and the relative importance, frequency and clinical judgment relevancy ratings of each activity inform the appropriate NCLEX Test Plan category percentages used during exam administration.

Can you explain more about the panel processes including representation, qualification requirements and the recruitment process for entry-level nurses? 

Over the course of a year, NCSBN invites nurses from all jurisdictions using NCLEX to participate on NCLEX Item Development Panels (Practice Analysis and Knowledge, Skills and Abilities [KSA] expert panels, item writing, item review, Regulatory Body Review and Panel of Judges [POJ] for Standard Setting Process). In addition to these item development opportunities, Canadian nurses also review NCLEX items during the Translation Review.

To participate in the development process, experienced nurse volunteers must work with entry-level nurses and be familiar with entry-level nursing knowledge. Input from entry-level nurses is sought out in many areas of the item development process such as Practice Analysis and KSA expert panels and the POJ.

What is the rationale behind the criteria for item writers and reviewers? 

NCSBN recruits nursing instructors in clinical areas as item writers and nurses who are employed in clinical settings as item reviewers. To construct meaningful examination items, NCLEX item writers must be familiar with entry-level nursing knowledge, test construction process and item development theories. These necessary qualifications are in-line with those of nursing educators. Educators with a master’s level or higher degree are invited to participate in the NCLEX-RN item writing process. In terms of reviewing NCLEX items, nurse clinicians, who work with entry-level nurses by providing preceptorship, mentorship and supervision, see entry-level practice first-hand. These expert nurses are able to bring their knowledge of the clinical settings to the item review process and ensure that NCLEX items are reflective of current entry-level nursing practice.

Subject matter experts with entry-level nursing licensure examination item development experience or who have been involved in the development of prep guides or courses in the previous two years cannot volunteer for the NCLEX; the purpose of this is to minimize potential biases that these previous experiences may bring to the NCLEX development process.

What is the timeline for evaluating the NCLEX passing standards? 

The NCSBN’s Board of Directors reevaluates the passing standard every three years or when the test plan changes to ensure that the passing standard for NCLEX-RN and NCLEX-PN examinations accurately reflects the amount of nursing ability currently required to practice competently at the entry level.

How will the change in the passing standard affect the pass rate? 

Anytime there is a change in the passing standard there is an expected temporary effect on the candidate passing rate. Historically, pass rates tend to be lower immediately following a passing standard increase. These pass rates traditionally rebound within three years of a new passing standard being set.

What can nursing schools do to prepare for the NCLEX exam? Is there anything educators should be doing to assist students? 

To better prepare students for the NCLEX, educators can gain familiarity with the current NCLEX Test Plan, its corresponding content distribution and examination delivery methodology. NCLEX resources are available free-of-charge for educators and students.

What information will schools receive regarding the school’s candidates’ performance? 

All nursing programs recognized by their nursing regulatory body may subscribe to NCLEX Program Reports. The NCLEX Program Reports are designed to help program administrators and educators understand how their nursing students performed on the NCLEX examination.  

How do I get information on workshops for item writing in my area? 

NCLEX Regional Workshops are hosted by nursing regulatory bodies (NRBs). If you are interested in a regional workshop, please contact your NRB.