A guide to NCLEX practice questions

The NCLEX RN exam is important to ensure that all nurses moving to the USA are experienced and qualified to get their licensure with the relevant nursing governing bodies. Making sure you are prepared for it can help to give you the best chance of passing, bringing you closer to getting your licensure. Espirita is committed to helping healthcare professionals relocate to the USA. This guide has been made to provide insights surrounding the exam, including practice questions, how the exam is structured and additional tips to help you.

NCLEX practice questions

The NCLEX exam is a comprehensive test designed to assess the ability of nurses who wish to move and work in the USA. The exam is made up of between 75 and 145 questions, and you will have 5 hours to complete it. The questions cover various topics and are formatted differently to provide a comprehensive picture of the nurse’s experience. One of the key benefits of the NCLEX exam is its use of computer-adaptive testing (CAT). This means that the difficulty of the questions will adjust based on the accuracy of your previous answers, making the exam more efficient for all test-takers.

You can view our PDF of NCLEX practice questions and answers to help you study for your exam.

About the NCLEX exam

The NCLEX exam is an essential step to obtaining your nursing licensure to work in the U.S., as it tests your ability to practice and provide care for patients. This is a computerised exam, and you will need to go to a testing centre to complete it.

However, there are two different types of NCLEX exam depending on the type of role you are wanting to register for. They are the NCLEX registered nurse (RN) and NCLEX practical nurse (PN) exams. The difference between these two different types of tests is that the NCLEX RN question topics focus on management care and supervision, while NCLEX PN questions focus on assistance for RNs. Overall, both exams have similar content, but taking the right one will help you to get the licensure you need from the state boards.

Since the 1st April 2023, a new version of the NCLEX exam was released which now includes ‘Next generation’ questions alongside the pre-existing traditional questions. These questions are designed to give a deeper insight into nurses’ clinical judgement of symptoms by introducing case studies in the test.

The types of questions you can expect in an NCLEX exam

When it comes to the questions you can find in the NCLEX exam, there are two different ways that they can be described. The first is the content category that each question is split into. This is for you to demonstrate the scope of your understanding across different specialism areas.

The different content categories of questions are:

These areas of specialism are vital for preparing nurses to meet the diverse and complex needs of patients in various healthcare settings.

The other types of questions found in the NCLEX exam are distinguished by the type of answer they require. Traditional questions typically cover multiple choice, multiple response, fill-in-the-blank and drop-down answers among others.

You can expect different question types in the next generation NCLEX (NGN) questions. Some of the most common types of questions you will find in the next gen questions include drag and drop, highlight text, tick boxes from a grid, bowtie (pairing) and fill in the blank.

Additional NCLEX exam information

NCLEX exam registration

To be able to take the NCLEX exam, you must register with a nursing regulatory body (NRB) and Pearson VUE. To register for the test, you must first obtain an authorisation to test from the relevant regulatory body where you plan to practice. You must meet the requirements of the NRB you wish to register with, make sure to check before you apply since different state’s NRBs will have different requirements. When it comes to registering with Pearson VUE, you will need to pay the registration fee of $200. After your registration and payment are processed, you will receive your authorisation to test (ATT). From this point, you will then have 90 days to book your exam.

NCLEX exam NGN structure

As previously mentioned, the NCLEX exam covers multiple content topics and scenarios that you will have to understand to gain your nursing licensure in the US. The NGN NCLEX questions have offered some key changes to the exam that separate those questions from the traditional ones. Some differences you will find are:

• There are fewer questions (even though they will still use the same adaptive testing)
• Three unfolding case studies throughout the exam, each containing six test items and in total will consist of 18 items)
• Clinical situation information will be presented to candidates in medical record format similar to a table structure (which are designed to assess nurses’ ability to think critically and to make safe clinical decisions across different stages of clinical care)
• New test items, such as highlight the answer, missing words, multiple choice, bowtie, drag and drop and extended multiple responses
• Polytomous scoring (where there are multiple scores available)

The NCLEX NGN questions still uses CAT, and you can still expect between 75 to 145 questions during the exam. Additionally, there are 15 unmarked questions that help to inform test developers evaluate the quality and difficulty of the questions for future exams.

Because of the nature of the exam and the amount and length of questions, you are allowed up to five hours (including time to take breaks) to complete it.

How the exam is scored

The NGN RN incorporates different scoring methods to accommodate various question types. These include:

0/1 scoring: Awards one point for each correct answer and zero points for incorrect answers.

+/- scoring: Gives points for correct answers and deducts points for incorrect answers, potentially resulting in negative scores for some questions.

Rationale scoring: Assesses the ability to identify cause-and-effect relationships, awarding points for each correctly paired answer option. Seen on traditional NCLEX exam questions.

Polytomous scoring: Allows for partial credit on questions with multiple correct answers, giving points for each correct response selected.

These diverse scoring methods ensure a comprehensive evaluation of the candidate’s knowledge and skills, reflecting the complexity and demands of modern nursing practice.

Tips to help you in the NCLEX exam

Preparing for the NCLEX-RN exam requires a thorough approach. It’s essential to use a variety of study materials, including textbooks, online resources, and practice tests, to ensure a comprehensive understanding of the content. For example, many of the nurses we have placed use Uworld and Kaplan to help them study for their NCLEX exams, as these sites offer a wide range of practice questions. We recommend dedicating 8 to 12 weeks of full-time, planned study to adequately prepare for the exam.

During this period, make sure to familiarise yourself with both traditional and NGN question formats, as this will help you become comfortable with the types of questions you will encounter.

Plus, it’s crucial to take care of your well-being by ensuring you get enough rest and managing your stress effectively. A well-rested and relaxed mind will significantly enhance your ability to focus and perform well on the exam.

Start your U.S. nursing career with Espirita

If you’re dreaming of relocating to the U.S. to work in the healthcare industry, Espirita can help guide you, from registering for your visa to placing you in exclusive opportunities. Whilst we can’t help you to take your NCLEX exam, we can help to guide you through the booking process.

Register with us to discover new and exciting job opportunities in the U.S. or apply directly to our registered nursing jobs.