The NCLEX-RN at a Glance
What the exam covers, how it thinks, and how it ends.
What it covers: client needs
Every NCLEX-RN draws from 8 categories in set proportions. The percentages are from the NCSBN NCLEX-RN Test Plan.
| Category | Share of the exam | What it's about |
|---|---|---|
| Management of Care | 15–21% | Coordinating care: prioritizing, delegating, legal and ethical duties, and teamwork. |
| Safety and Infection Prevention and Control | 10–16% | Keeping clients and staff safe from harm and infection. |
| Health Promotion and Maintenance | 6–12% | Growth and development, pregnancy and newborn care, screening, and prevention. |
| Psychosocial Integrity | 6–12% | Mental health, coping, crisis, abuse, and therapeutic communication. |
| Basic Care and Comfort | 6–12% | Comfort and daily living: mobility, nutrition, elimination, rest, and hygiene. |
| Pharmacological and Parenteral Therapies | 13–19% | Giving medications safely, dosage math, adverse effects, and blood products. |
| Reduction of Risk Potential | 9–15% | Lowering the risk of complications from tests, procedures, and treatments. |
| Physiological Adaptation | 11–17% | Managing acute, chronic, and life-threatening physical conditions. |
How it thinks: 6 clinical judgment steps
Next Generation NCLEX items are built on the NCSBN Clinical Judgment Measurement Model. Ask yourself the question in the right-hand column at each step.
| Step | What you do | Ask yourself |
|---|---|---|
| 1. Recognize cues | Pick out the findings that matter. | What here is abnormal or concerning? |
| 2. Analyze cues | Connect findings to what could be happening. | What conditions fit these findings? |
| 3. Prioritize hypotheses | Rank the problems by likelihood and urgency. | What is most likely, and what is most dangerous? |
| 4. Generate solutions | Identify the outcomes you want and the actions that get there. | What should happen, and what should I do or avoid? |
| 5. Take action | Choose and carry out the best actions. | Which actions come first? |
| 6. Evaluate outcomes | Compare what happened with what you expected. | Is the client better, worse, or the same? |
How it ends
Length
- 85 to 150 questions
- Up to 5 hours, including the tutorial and breaks
- 15 of the questions are unscored pretest items you can't tell apart
Stopping rules
- 95% confidence: the exam stops once it's 95% sure you're above or below the passing standard.
- Maximum length: at 150 questions, it decides from your final ability estimate.
- Out of time: with at least the minimum 85 answered, it decides from your final ability estimate. Fewer than 85 is an automatic fail, so keep a steady pace.
What the items look like
| Item type | What you do |
|---|---|
| Case study | One client, 6 linked items, one for each clinical judgment step |
| Multiple response | Select all that apply, or select a set number |
| Matrix (grid) | Mark each row, for example indicated or not indicated |
| Drop-down (cloze) | Fill blanks in a sentence or table from drop-down lists |
| Highlight | Click the words in a note or table that matter |
| Drag and drop | Move options into the right places or order |
| Bowtie | Pick the condition, the actions to take, and the parameters to monitor |
Partial credit
Many NGN items give partial credit. Some score each correct choice; others subtract for wrong selections. So on select-all items, choose only what you're confident is right.
Sources
- NCSBN. NCLEX-RN Test Plan (current edition), nclex.com.
- NCSBN. Next Generation NCLEX: Clinical Judgment Measurement Model and item types, ncsbn.org and nclex.com.
- NCSBN. NCLEX scoring and passing rules, nclex.com.
For exam study only. In clinical practice, follow your facility's policies, the prescriber's orders, and current references. Free to print and share for personal and classroom study; not for resale. NCLEX® is a registered trademark of NCSBN, which does not endorse NCLEXSim.
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