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NCLEX-PN Review & Study Guide

5 Test Prep Tips to Help You Pass the NCLEX-PN on Your First Try.

Africa-American nurse at a desk

You’ve worked hard, studied, and completed the educational requirements to become a licensed practical nurse, but you still have one last hurdle to clear — the licensing exam. Known formally as the National Council Licensure Examination (NCLEX), the test is conducted in two categories: NCLEX-PN for practical nurses and NCLEX-RN for registered nurses.

It’s definitely stressful knowing you have to pass this examination to become a licensed practical nurse, but you’ve learned the skills and have the knowledge necessary. You simply need some preparation and study specifically geared to the NCLEX-PN.

And that’s what we’re going to get you started on in this study guide.

To create this guide, we’ve gleaned information from some of our amazing Eagle Gate College instructors and a few recent graduates who passed the exam. This information will provide the background information you need, along with some tips on how to prepare for the NCLEX-PN. The goal? To pass the exam on your first try!

Let’s get into it.

What Is the NCLEX-PN Exam?

You may have heard this test referred to as “The Boards.” That’s because it is administered by the individual State Boards of Nursing. The National Council Licensure Examination (NCLEX-PN) is a national exam that determines your ability to practice nursing.

The NCLEX-PN is a test that measures your knowledge and expertise of the essential skills that are required to safely enter the field of practical nursing. The exam is updated every three years to ensure it is current with the latest techniques and practices in the nursing profession and the medical world.

How Many Questions Are on the NCLEX-PN Exam?

The NCLEX-PN exam is a computer adaptive test (CAT) that can consist of anywhere between 85 to 205 questions. Regardless of how many questions you answer, you will be given 25 “experimental” questions that will not count towards your score. These questions are used to create questions for future editions of this exam. You cannot tell which questions are these experimental questions, so you need to treat every question with the same focus.

The variability in test length can seem odd, especially when compared with the tests you’ve taken to complete your practical nurse coursework. A CAT is different for every test taker.

The test uses an algorithm to continually track your answers. It starts with a relatively easy question. If you answer that correctly, the computer selects a slightly more difficult question. If you missed the first question, a slightly easier question is given. This give and take proceeds through the test, and this allows the computer to determine your level of competence.

The better you perform, the fewer the questions you’ll be required to complete to pass the exam. The minimum number of questions you could answer to pass the NCLEX-PN is 85 questions. The average number of questions given is 112.

What Types of Questions Are on the NCLEX-PN Exam?

The NCLEX-PN exam covers four areas (or categories) of questions. These are organized by Client Needs Categories. Two of the four categories have subcategories within them that are basically separate concepts but fall under the umbrella of the category.

Here are the four categories with how much of the test each makes up:

Healthcare professionals in a hospital hallway

1. Safe and Effective Care Environment:

The LPN/VN provides nursing care that contributes to the enhancement of the health care delivery setting and protects clients and health care personnel. There are two concepts within this section:

  • Coordinated Care (18-24% of the NCLEX-PN exam) — Some of the nursing actions included in this subcategory are Advanced Directives, Advocacy, Client Care Assignments, Concepts of Management and Supervision, Ethical Practice, Quality Assurance, Resource Management, and others.
  • Safety and Infection Control (10-16% of the NCLEX-PN exam) — Some of the nursing actions included here are Accident/Error Prevention, Handing Hazardous Materials, Injury Prevention, Medical and Surgical Asepsis, Incident Reporting, Use of Restraints and Safety Devices, and others.

Sample Question #1 (Coordinated Care): The nurse in a long-term care facility is making client care assignments for unlicensed assistive personnel (UAP). Which of the following statements by the nurse would provide the UAP with the best directions about the assignment?”

  • A. “Encourage the client to increase daily fluid intake.”
  • B. “Ambulate the client 20 ft (6.7 m) every 4 hours beginning at 0900.”
  • C. “Assist the client to perform passive range-of-motion (ROM) exercises.”
  • D. “Reinforce physical therapy instructions about the proper use of a walker.”

Sample Question #2 (Safety and Infection Control): The nurse is reinforcing teaching with a client who is using a mechanical lift. Which of the following information should the nurse reinforce?

  • A. “Place your hands on the sling.”
  • B. “You should lie prone on the sling.”
  • C. “Place your arms across your chest.”
  • D. “You will need to rock to a standing position.”

2. Health Promotion and Maintenance:

The LPN/VN provides nursing care for clients that incorporates knowledge of expected stages of growth and development, and prevention and/or early detection of health problems.

This category accounts for from 6-12% of the NCLEX-PN exam. Tested nursing actions include the Aging Process, Ante/Intra/Postpartum and Newborn Care, Developmental States and Transitions, Disease Prevention, Immunizations, Lifestyle Choices, Self-Care, Health Promotion Programs, and others.

Sample Question #3: The nurse is reinforcing teaching with a client about the signs of hunger in a newborn. Which of the following signs should the nurse reinforce?

(Select all that apply)

  • A. Open hands
  • B. Quivering bottom lip
  • C. Rooting movements
  • D. Sucking on the hands
  • E. Hand to mouth movements

3. Psychosocial Integrity:

The LPN/VN provides care that assists with promotion and support of the emotional, mental, and social well-being of clients.

The category accounts for 9-15% of the exam. Tested nursing actions include Coping Mechanisms, Grief and Loss, Mental Health Concepts, Spiritual Influence on Health, Support Systems, Chemical Dependency, Behavioral Management, Coping Mechanisms, End of Life Care, and others.

Sample Question #4: The nurse is assisting to evaluate the coping strategies of the spouse of a client who had a stroke 5 days ago. Which of the following statements by the spouse would indicate ineffective coping?

  • A. “I sleep only for short periods of time since my spouse became ill.”
  • B. “I feel frustrated when my spouse turns away and will not talk with me.”
  • C. “I eat meals in my spouse’s room so my spouse will not have to eat meals alone.”
  • D. “I have been performing a few household chores each day before visiting my spouse.”

Medical professional taking a patient's vital signs

4. Physiological Integrity:

The LPN/VN provides comfort to clients and assistance in the performance of activities of daily living. This category is broken into four concepts:

  • Basic Care and Comfort (7-13% of the NCLEX-PN exam) — The nursing actions tested include Assistive Devices, Elimination, Mobility, Non-pharmacological Comfort Interventions, Nutrition and Oral Hydration, Personal Hygiene, and others.
  • Pharmacological and Parenteral Therapies (10-16% of the NCLEX-PN exam) — Tested nursing actions include Adverse Effects, Expected Effects, Medication Administrations, Pharmacological Pain Management, and Side Effects.
  • Reduction of Risk Potential (9-15% of the NCLEX-PN exam) — Tested nursing actions include Diagnostic Tests, Potential for Body System Alterations, Potential for Complications of Diagnostic Tests, Treatments and Procedures, Vital Signs, and others.
  • Physiological Adaptation (7-13% of the NCLEX-PN exam) — Tested nursing actions include Alterations in Body Systems, Basic Pathophysiology, Fluid and Electrolyte Imbalances, Medical Emergencies, and Unexpected Response to Therapies.

Sample Question #5 (Basic Care and Comfort): The nurse is reinforcing teaching with a client about using crutches. Which of the following information should the nurse reinforce?

  • A. “The stairs should be avoided while using crutches.”
  • B. “The elbows must stay straight while ambulating with crutches.”
  • C. “Three finger widths should separate the axillae and the crutches.”
  • D. “Bearing weight on the affected leg should be avoided when using the four-point crutch gait.”

Sample Question #6 (Pharmacological and Parenteral Therapies): The nurse is caring for a client who has a prescription for ampicillin 375 mg, p.o., every 6 hours. The nurse has ampicillin 250 mg per 5 mL of solution available. How many mL should the nurse administer to the client with each dose? Record your answer using 1 decimal place.

Sample Question #7 (Reduction of Risk Potential): The nurse is caring for a client with peptic ulcer disease (PUD) who vomited 150 mL of blood-tinged green liquid. Which of the client’s laboratory test results would be a priority to check?

  • A. Serum pH
  • B. Hematocrit (HCT)
  • C. Serum sodium level
  • D. Blood urea nitrogen (BUN)

Sample Question #8 (Physiological Adaptation): The nurse is talking with a client who had a subtotal gastrectomy 1 month ago. Which of the following statements by the client would be a priority to follow up?

  • A. “I occasionally take an over-the-counter (OTC) laxative.”
  • B. “I eat several small meals each day.”
  • C. “I avoid drinking liquids with meals.”
  • D. “I feel tired all the time.”

Most of the questions on the NCLEX-PN exam are delivered in a multiple-choice format with four answer choices, however, there are other types of questions, such as multiple-response, fill-in-the-blank, hot spots, charts, and drag-and-drop.

Sample Question Answers: 1)B  2)C 3)C,D,E 4)A 5)C 6)7.5 mL 7)B 8)D

How Long Is the NCLEX-PN Exam?

You are allotted a total of 5 hours to complete the NCLEX-PN exam, regardless of the number of questions you’re given.

Prior to the exam, you’ll watch a short instructional video.

During the exam you will be given two optional breaks:

  1. One break is available 2 hours into the exam.
  2. A second break can be taken after 3.5 hours into the exam.

The test will automatically stop on its own once you’ve answered the minimum number of questions required to pass the NCLEX-PN exam.

Woman with a stethoscope taking notes

Is the NCLEX-PN Exam Difficult?

With the CAT style of this test, the difficulty is based on your performance. In other words, if you are doing well and answering the questions correctly, the subsequent questions will become more difficult. This also decreases the number of questions you will be asked as the computer continues to upgrade your performance with each correct answer.

If the questions appear to remain simple, that could be an indication that you’re not performing well.

What Is the Passing Score for the NCLEX-PN Exam?

There is no set number of questions you’re required to answer to pass the NCLEX-PN exam. As previously stated, however, the better you perform on the exam, the fewer questions you’ll be given. The computer will stop administering questions when it is 95% certain that your ability is either clearly above or clearly below the passing standard.

How Many People Pass the NCLEX-PN on Their First Try?

According to the NCBSN, around 80% of all candidates passed the NCLEX-PN exam on their first attempt in 2021.

Those numbers show the high likelihood that you’ll pass the NCLEX-PN on the first attempt. After all, if 8 out of every 10 potential practical nurses pass the test in one try, there’s no reason you can’t be in that group. Some focused preparation is all you need to do to bolster your chances.

How Do I Register for the NCLEX-PN Exam?

Before you register for the NCLEX-PN, do yourself a favor and take a week or two to relax and enjoy some free time. It’s essential that you feel mentally and physically prepared to take on prepping for the exam.

Once you feel ready, you can schedule your exam by registering with Pearson VUE for an Authorization to Test (ATT). We recommend you schedule your test date a couple of months out to give yourself enough prep time before taking the exam.

7 Simple Steps to Register for the NCLEX-PN Exam

The official steps to register for the NCLEX-PN exam are as follows:

Step 1:

Submit an application for licensure/registration to the nursing regulatory body (NRB) where you wish to be licensed/registered.

Step 2:

Meet all of the NRB’s eligibility requirements to take the NCLEX exam.

Step 3:

Register for the NCLEX with Pearson VUE.

Step 4:

Receive NCLEX Registration Acknowledgement email from Pearson VUE.

Step 5:

Confirm NRB eligibility in the Pearson VUE system.

Step 6:

Receive Authorization to Test (ATT) email from Pearson VUE.

Step 7:

Schedule your exam with Pearson VUE.

Stethoscope next to money

How Much Does the NCLEX-PN Cost?

It costs $200 to take the NCLEX-PN exam.

There may be additional licensure fees that are determined by the individual State Boards of Nursing. You can pay this fee online or over the phone using a credit, debit, or prepaid card.

How Do I Study for the NCLEX-PN Exam?

As you know from friends, everyone prepares for exams in their own way. Plus, this exam is likely to be different from anything you’ve taken before (other than a practice NCLEX-PN test, of course). Regardless of your study prep methods, you need to put in the time to prepare adequately.

Fortunately, there are myriad online resources, practice questions, and study guides that can provide you the tools you need to pass the NCLEX-PN.

To make things easier, we’ve created a list of the top five test prep tips that will help you pass the NCLEX-PN on your first attempt.

Tip #1: Understand the NCLEX-PN Exam Format

Before taking the exam, you’ll need to familiarize yourself with the exam format to avoid being surprised when you show up.

We’ve provided you with an overview of the NCLEX format, but for more in-depth information, check out the 2020 NCLEX-PN Examination Test Plan. This plan will be effective through March 31, 2023, the time of the next NCLEX-PN update.

Tip #2: Create Your Personalized Study Plan and Schedule

This isn’t an exam to cram for. After all, this is going to be your career and it never hurts to keep up-to-date with your skills and necessary knowledge. This will be true throughout your career.

To create a personalized study plan, designate the days of the week you wish to study and the amount of time you plan to study on each of those days. To be valuable, your sessions on these days should last at least two hours. Of course, if you’re in total study mode, it never hurts to continue for as long as you feel fresh. There’s no such thing as too much preparation for the NCLEX-PN!

Tip #3: Take the NCLEX Practice Exams

You will want to schedule at least two NCLEX practice tests before sitting for the real exam.

You can register for the practice exams directly through this link to the NCLEX Practice Exam landing page.

These practice exams familiarize you with the computer testing experience of the NCLEX-PN. Practice exams help lessen your stress level when you’re taking the actual exam. Plus, you’ll see the questions you are missing, providing insight into areas you need further study/preparation.

Tip #4: Develop a Plan to Help Manage Stress and Anxiety on Test Day

As with any standardized exam, you should follow a few simple tips and techniques to give you a better shot at passing the NCLEX-PN exam.

By understanding the format of the NCLEX-PN exam, you’ll know what to expect and feel more comfortable come testing day. You already know that the more questions you answer correctly, the more challenging they will become.

But this exam is a marathon, not a sprint. With from 85 to 205 questions you’ll need to pace yourself. Don’t rush; there’s no reward for finishing early. Once you answer a question you cannot return to it. Your answer is logged.

Take your allotted breaks during the exam. Taking a step away from the screen and getting a drink of water and a light snack can make all the difference in your testing results. Make sure to take the time to clear your mind during your break before you jump back into testing.

Close up of laptop and stethoscope

Tip #5: Be Ready for Exam Day

You didn’t get this far into your nursing career to not understand how to perform well on tests. This exam isn’t any different; it just means so much more. The night before your test stay in, and get to bed early. In the morning, eat something for breakfast. You don’t want to run out of gas halfway through your potential five hours.

For your convenience the NCSBN offers several NCLEX-PN tips for exam day:

Be Prepared. 

When you arrive for your NCLEX, you’ll need an acceptable form of ID. You no longer need to bring a paper copy of the Authorization to Test (ATT) for admittance to the NCLEX. For further details, please visit Authorization to Test.

At the Risk of Sounding Repetitive, Don’t Forget Your ID.

Candidates without proper ID will not be allowed to take the NCLEX.

Know the NCLEX Candidate Rules!

These rules include policies specific to personal items, confidentiality, NCLEX administration, and break procedures.

Dress Comfortably.

You’re required to leave hats, scarves, gloves, and coats outside the testing room. However, provisions are made for religious and cultural attire.

Arrive Early.

Plan to arrive 30 minutes before your exam. If you are more than 30 minutes late, you may have to forfeit, re-register, and pay another exam fee.

Provide Your Biometrics.

In order to be tested, the following biometrics will be taken: signature, photograph, and palm vein scan.

Receive Materials.

You may not bring in paper or writing utensils. It is a computer-administered exam. However, you will be provided an on-screen calculator and erasable note board/marker for making notes will be provided.

Set Your Pace.

You’ll have up to 5 hours to complete the NCLEX-PN, including the short tutorial and the two optional breaks. Take time to analyze each question carefully—once you submit an answer you can’t return to that question. Learn more about computer adaptive testing (CAT) here.

Finishing Up.

At the end of the exam, you will receive a short, computerized survey. Upon completion, you can raise your hand and wait for the TA to dismiss you.

What to Do After the NCLEX-PN Exam?

Exam results are available only from your nursing regulatory body (NRB) and will be sent to you approximately six weeks after taking the exam.

How to Retake the NCLEX-PN Exam?

If you have a bad day and you don’t pass the NCLEX-PN on your first try, you can always retake it.

The NCSBN provides a performance report from the exam, allowing you to see where you need to improve before your next attempt.

To retake the exam, you’ll just contact your NRB and notify them you plan on retaking the exam. You will simply re-register with Pearson VUE, pay the $200 fee, and wait to receive your new ATT to schedule your exam.

How Many Times Can You Fail the NCLEX-PN?

According to NCSBN, candidates can take the NCLEX-PN up to eight times a year. You must wait at least 45 days before taking the exam again. To be sure, contact your desired nursing regulatory body to learn more about their policy for NCLEX-PN retakes.

Young medical students in a hallway

Advancing Your Career as a Licensed Practical Nurse

We hope you found this article helpful, and feel the information provided will help you pass the NCLEX-PN.

We know it can be seriously stressful preparing for and contemplating the upcoming NCLEX-PN exam, but you should proceed with confidence. You’ve done the coursework necessary to get you to this point. This exam will provide the confirmation that you’re ready to get on with your exciting new career as a licensed practical nurse.

If you’re ready to take the first step towards a future nursing career, you can enroll in the Practical Nursing Program at Eagle Gate College.