02.03 What is the NCLEX?

What is the NCLEX?

NCLEX (National Council Licensure Examination) is a nationwide examination for the licensing of nurses in the United States and Canada since 1994 and 2015, respectively. There are two types, the NCLEX-RN and the NCLEX-PN. After graduation from a school of nursing, one takes the NCLEX exam to receive his or her nursing license. A nursing license gives an individual the permission to practice nursing, granted by the state where he or she met the requirements (source).

Nearly 300,000 aspiring nurses take the NCLEX each year with an overall pass rate for RN candidates in 2016 of 70.18% and 70.59% for PN candidates.

Pass rates in 2016 for first time US educated tests takers was around 84%.

Goal of the NCLEX

It is the mission of the NCSBN to determine if you will be a safe entry level nurse able to think critically.

Computer Adaptive Testing

The NCLEX is administered via a computer adaptive testing mode. Essentially, in this style of testing, the computer selects the next question based on how you performed on the previous item.

According to Nursing Now, the test “compares an individual’s knowledge to a predetermined standard rather than to the performance of others who take the same test.” (source)

So let’s dive into some of the various algorithms used to deliver questions:

• Passing Standard: this is the level at which, if you score above, you receive a “passing” score, if you score below, you receive a “failing” score. Passing or failing is independent of test length or time.
• 95% Confidence Interval: the test will end when it is 95% confident that you are either above or below the “passing standard”. This is the rule that will end most tests. With each successive question, the test become more confident in your ability and your confidnece interval narrows. The image below comes from the NCSBN, the lines indicate the 95% confidence interval with the red line indicating the “passing standard”, you can see that at 60 questions, the test is 95% confident this student is below the passing standard. When it comes down to it, no matter how long your test keeps going, if it’s still going, you’re still in the game. This is why test length really doesn’t matter. What matters more is questions difficulty rating. And question difficulty is based on how you performed on the previous question. This is also the reason the number of correct answer you get really doesn’t matter all that much.

• Maximum-Length Exam Rule: you are allowed a maximum of 265 for RN and a maximum of 205 for PN.
• Run-out-of-time Rule: this rule is pretty simple, you get 6 hours to take the test. If the test is unable to determine with 95% confidence your ability before the 6 hours you will receive a failing score. If however, the test determines that your ability is above the passing standard after 6 hours you may still receive a passing score.

This is a complex algorithm and what we’ve done with SIMCLEX is strive to mimic this test setting as closely as possible, something that no other NCLEX Question Database can do.

Question Selection

As stated above, questions are selected based on the result of the previous question while your 95% confidence interval continues to narrow.

Aside from the criteria listed above, the test will also deliver you questions from specific nursing categories in a set distribution.

According to the most recent (2016) test plan that distribution is as follows:

Safe and Effective Care Environment

• Management of Care: 17-23%
• Safety and Infection Control: 9-15%

Health Promotion and Maintenance: 6-12%

Psychosocial Integrity: 6-12%

Physiological Integrity

• Basic Care and Comfort: 6-12%
• Pharmacological and Parenteral Therapies: 12-18%
• Reduction of Risk Potential: 9-15%
• Physiological Adaptation: 11-17%

You can find the entire NCLEX Test Plan as published by the NCSBN here.

Per NCSBN Test Plan here are some examples of what will be included in each section (this outline comes directly from their test plan at the link above)

NCLEX FAQs

Let’s address some of the most common questions regarding the NCLEX:

•  Can you skip questions?
  • No
• Will I get a test report?
  • Only if you fail. If you do fail and receive a “Candidate Performance Report” use this report to restructure your studying.
• Does the NCLEX bold key words, i.e., most, priority, best, highest?
  • Yes, the NCLEX bolds key words such as best, most, essential, first, priority, immediately, highest, initial, next, refute, increased, decreased and support.