NCLEX-RN Exam Guide

The NCLEX-RN is the licensing exam for registered nurses in the United States and Canada. This guide explains how the adaptive exam works, how passing is decided, what it costs and how to prepare.

Who takes it

Graduates of approved registered nursing programs who want a nursing license in the United States or Canada; Australia also uses it for some internationally qualified nurses. You apply to your nursing regulatory body, register with Pearson VUE and schedule the exam once the board makes you eligible.

The format

The NCLEX-RN is a computerized adaptive test with 85 to 150 items and a 5-hour limit that includes breaks.

• Every exam has 15 unscored pretest items.
• Every exam has three clinical judgment case studies of six items each.
• Items follow the test plan’s Client Needs categories, from Management of Care (15% to 21%) to Basic Care and Comfort (6% to 12%).
• You can’t go back to an earlier item.

Besides standard multiple choice, the Next Generation NCLEX (NGN) uses formats such as select all that apply, matrix, drop-down, highlight, bow-tie and drag-and-drop.

How passing works

There’s no percentage to hit. The computer picks each item based on your earlier answers and stops when it’s 95% sure your ability is above or below the passing standard set by NCSBN. Results are pass or fail. Ending at 85 items doesn’t mean you failed, and running to 150 doesn’t either: the exam simply needed more items to decide.

Cost

NCSBN lists the NCLEX registration fee as $200 for U.S. licensure, rising to $350 on February 1, 2027. Your nursing board also charges its own licensure fee. Check nclex.com and your board for current fees.

How hard is the NCLEX-RN?

Because it’s adaptive, the questions get harder as you answer well, so nearly everyone leaves feeling unsure. The hardest items test clinical judgment: deciding which patient to see first, what to do next and what to delegate, rather than recalling facts. Prioritization frameworks (airway, breathing, circulation; Maslow; acute over chronic; unstable over stable) are what get you through those.

How to study

If you have four weeks: take a practice test to find weak Client Needs areas, review pharmacology and the highest-weighted areas, and answer questions every day with full review of the rationales. Learn the NGN formats with the tutorial and sample items on nclex.com.

If you have eight weeks: go through the content systematically by body system, then shift to mixed practice and timed sessions. Practise prioritization and delegation questions daily, because they appear throughout the exam.

Start with free practice on the home page.