How is the Licensing Exam for Nursing Structured?

The licensing exam for nurses seeking entry into professional nursing practice, the National Council Licensure Examination for Registered Nurses (NCLEX-RN) is administered through the National Council of State Boards of Nursing (NCSBN). Before earning an RN license, a nurse must pass the exam, which is designed to ensure that candidates have obtained the knowledge, skills, values, abilities, and attributes essential for entry-level nursing. Although the exam serves as a good indicator of an individual’s competence in the nursing practice, it has a reputation for being quite difficult with an average pass rate of just 73.87% in 2014. As you prepare to take the exam, it is helpful to understand the four main categories of questions that make up the NCLEX-RN exam’s structure.

Safe and Effective Care Environment

In the first section of the NCLEX-RN exam, individuals will be asked questions about how nursing care should be directed to enhance client outcomes and improve healthcare delivery. Since it is essential that registered nurses are able to use the correct precautions needed to protect the health of both clients and other healthcare professionals, this section of the exam is focused strongly on safety measures for the management of care. Test takers should expect questions to assess their knowledge in injury prevention, emergency response, home safety, incident reporting, security plans, safety devices, standard precautions, and infection control.

Health Promotion and Maintenance

Although this category on the licensing exam for nurses is one of the shortest, it counts for a high percentage of the total score due to its importance. Within the second section of the NCLEX-RN, nursing candidates will be evaluated on their ability to incorporate principles and strategies for achieving optimal health. Content in the Health Promotion and Maintenance category can include newborn care, health screening, disease prevention, developmental stages, high risk behaviors, lifestyle choices, self-care, physical assessment, and aging.

Psychosocial Integrity

Beyond the physical aspects of nursing care, registered nurses are given the responsibility of supporting the emotional, mental, and social well-being of patients in a time of hardship. In this section of the NCLEX-RN examination, candidates will be assessed on their knowledge of nursing practices related to meeting the diverse psychosocial needs of clients with acute or chronic illnesses. Aspiring nurses should expect to be questioned on abuse, substance use, crisis intervention, cultural awareness, family dynamics, grief, end-of-life care, therapeutic communication, mental health, behavioral health, and stress management.

Physiological Integrity

As the largest section of questions in the NCLEX-RN exam, the Physiological Integrity category is strongly based on the knowledge needed to promote physical wellness by providing competent care and reducing client risks. This section will cover a large span of information from basic care in performing everyday activities to pharmacological therapies and life-threatening conditions. Content may be related to nutrition, personal hygiene, assistive devices, pain management, drug interactions, diagnostic testing, therapeutic procedures, illness management, medical emergencies, and potential complications.

Overall, the NCLEX-RN examination is administered to eligible registered nurse candidates through computerized adaptive testing (CAT) at testing centers across the United States. All test takers will be required to complete at least 75 and no more than 265 questions in the above four categories during the allotted six-hour time period. Questions may be presented in various formats, including multiple choice, fill-in-the-black, ordered response, charts, graphics, videos, and more. If you receive a passing score on the licensing exam for nurses, then you will be granted licensure to practice as an RN and start out a rewarding career in professional nursing.