Kara Sears
The National Council Licensure Examination, or NCLEX, is a national exam for the licensing of nurses in the United States, Canada, and Australia. The NCLEX is developed and administered by the National Council of State Boards of Nursing, Inc. (NCSBN), which represents various state boards and regulatory bodies in each country. The exam covers a range of topics, including adult medical and surgical care, paediatrics, safety issues in patient care, and ethical and legal nursing problems. While the NCLEX is standardised across all three countries, there are some differences between the US and Canadian versions, including terminology and the option to take the exam in Canadian French. Both the US and Canadian nursing licenses can be transferred between the two countries, and they share the same testing sites.
| Characteristics | Values |
|---|---|
| Full form | National Council Licensure Examination |
| Administered by | National Council of State Boards of Nursing, Inc. (NCSBN) |
| Administered on behalf of | More than 50 State Boards of Nursing in the US, more than 12 Regulatory Bodies in Canada, and four US territories |
| Purpose | Licensing of nurses |
| Availability | United States, Canada, and Australia |
| Availability in Canada | Also available in Canadian French for French-speaking Canadians |
| Requirements | Vary by Board in the US and Regulatory Body in Canada |
| Application process | Contact the relevant Nursing Regulatory Body (NRB) and request a licensure/registration application |
| Application fee | Varies by NRB |
| Registration process | Register with Pearson VUE (the testing vendor) online or by phone |
| Exam fee | Payable to Pearson VUE by credit, debit, or prepaid card |
| Exam format | Multiple-choice, identifying and selecting a particular area of a drawn body part, selecting multiple correct answers, free-response mathematical questions, ordering steps of a procedure |
| Exam topics | Physiological integrity, safety issues in patient care, health promotion and maintenance, ethical and legal nursing problems, nursing management, etc. |
| Passing requirements | Same for admission into nursing practice in the US and Canada |
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What You'll Learn
Exam structure
The National Council Licensure Examination (NCLEX) is a nationwide examination for the licensing of nurses in the United States, Canada, and Australia. The exam is developed and owned by the National Council of State Boards of Nursing, Inc. (NCSBN), which administers the examinations on behalf of its member boards.
In the US, the NCSBN administers the exam on behalf of its member boards, which consist of the boards of nursing in the 50 states, the District of Columbia, and four US territories: American Samoa, Guam, the Northern Mariana Islands, and the US Virgin Islands. In Canada, the NCSBN administers the exam on behalf of more than 12 Regulatory Bodies.
To take the NCLEX, candidates must first complete two separate processes: they must contact their Nursing Regulatory Body (NRB) and request a licensure/registration application, and they must pay a licensing/registration fee to the NRB along with the submission of their application materials. The NRB will have its own eligibility requirements, which may include graduation from an approved program, English language proficiency, background checks, and work visas.
Once the candidate has received authorisation to test (ATT), they can schedule their exam. The NCLEX exam is now computerised and is available in English or Canadian French. The exam consists mostly of multiple-choice questions, but also includes other formats such as identifying a particular area of a drawn body part, selecting multiple correct answers, free-response mathematical questions, and ordering the steps of a medical procedure. The exam covers topics such as safety issues in patient care, ethical and legal nursing problems, nursing management, health promotion and maintenance, and physiological integrity.
The NCLEX is not used to test knowledge of the healthcare system of a particular country but rather to test nursing competence and critical thinking. To ensure fairness, all NCLEX items undergo a rigorous review process to remain free from unintentional bias and to ensure that terminology has only one meaning.
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Question types
The National Council Licensure Examination (NCLEX) is a computerised adaptive test (CAT) used for the licensing of nurses in the United States and Canada. The NCLEX exam is available in multiple languages, including Canadian French. The exam consists of 85 to 150 items, with 15 being unscored pretest items.
The NCLEX exam is made up of three types or levels of questions. Level 1 questions are basic and make up less than 10% of the exam. They test an individual's knowledge and understanding and require the recall of specific facts and information. Level 2 questions require more thinking and make up a larger portion of the exam. Level 3 questions are the most complex and require the highest level of cognitive ability. These questions require candidates to utilise problem-solving skills and apply their knowledge to select the correct answer.
The NCLEX exam covers a range of topics, including:
- Physiological Integrity: This category makes up 43-67% of the exam and includes questions on adult medical and surgical care, paediatrics, gerontology, and common conditions such as diabetes and cardiovascular disorders.
- Safety and Health Promotion: This category covers patient safety, patient care, laboratory tests, nursing procedures, and ethical and legal nursing problems.
- Pharmacological and Parenteral Therapies: This category tests the nurse's ability to administer medications and parenteral therapies, such as IV therapy and blood administration.
- Reduction of Risk Potential: This category focuses on the nurse's ability to prevent complications and health problems related to the client's condition or prescribed treatments.
- Physiological Adaptation: This category includes questions on providing care for clients with acute, chronic, or life-threatening conditions.
The NCLEX exam also includes case studies that present practical clinical scenarios and test items aligned with the cognitive abilities of the clinical judgment model. These case studies assess the candidate's ability to think critically and make safe clinical decisions. The exam may also include new format questions that are not multiple-choice, such as identifying a drawn body part, selecting multiple correct answers, mathematical questions involving medication calculations, and ordering medical procedures.
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Registration process
The National Council Licensure Examination, or NCLEX, is a national exam for the licensing of nurses in the United States and Canada. The NCLEX is one step in the regulatory licensure and registration procedure for nurses. The registration process for the NCLEX differs depending on whether the applicant is applying in the US or Canada, and which state or province they are applying in.
US Registration Process
To register for the NCLEX in the US, applicants must forward an application to a specific Board of Nursing. Each Board has its own set of NCLEX requirements, qualifications, registration processes, and regulations.
Canada Registration Process
To register for the NCLEX in Canada, applicants must first apply to the National Nursing Assessment Service (NNAS), which assesses the eligibility of Internationally Educated Nurses (IENs). Applicants must also pass an English exam before they can proceed to the NCLEX application. Once the nursing regulatory organisation has declared the applicant qualified, they will receive an Authorisation to Test (ATT) notification, which allows them to schedule the exam. The NCLEX can be taken at any Pearson Professional Testing location, regardless of where the candidate is applying for licensure/registration. After passing the NCLEX, IENs must complete a criminal background check and obtain professional liability insurance.
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Content differences
The National Council Licensure Examination (NCLEX) is a national exam for the licensing of nurses in the United States, Canada, and Australia. The NCLEX was adopted in Canada in 2015, with changes made to address measuring units, drug names, and other terminology differences between the United States and Canada. The exam is available in Canadian French for French-speaking Canadians.
There are two types of NCLEX examinations: the NCLEX-RN and the NCLEX-PN. The NCLEX examinations are developed and owned by the National Council of State Boards of Nursing, Inc. (NCSBN), which administers the exams on behalf of its member boards. These include the boards of nursing in the 50 US states, the District of Columbia, and four US territories (American Samoa, Guam, the Northern Mariana Islands, and the US Virgin Islands). In Canada, the NCSBN represents over 50 State Boards of Nursing and more than 12 Regulatory Bodies, each with its own set of NCLEX requirements, qualifications, registration processes, and regulations.
The NCLEX examinations cover a range of topics, including adult medical and surgical care, pediatrics, and gerontology, safety issues in patient care, laboratory tests, nursing procedures, ethical and legal nursing problems, nursing management, and issues related to giving patients the best care. The majority of the questions fall under the Physiological Integrity category, which deals with adult medical and surgical care, pediatrics, and gerontology. This category includes questions on conditions that nurses commonly treat, such as diabetes, cardiovascular disorders, neurological disorders, renal diseases, and respiratory diseases. The Health Promotion and Maintenance category, which covers topics such as birth control measures, pregnancy, labor and delivery, and newborn infant care, makes up about 12% of the examination.
While the NCLEX USA and NCLEX Canada share the same testing sites, there are significant differences in their exam qualifications, requirements, fees, and regulations. Each Board in the US and Regulatory Body in Canada has its own set of criteria that candidates must meet. In Canada, all Regulatory Bodies require clinical working experience.
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Licensing requirements
The National Council Licensure Examination (NCLEX) is a nationwide examination for the licensing of nurses in the United States, Canada, and Australia. The NCLEX was adopted in Canada in 2015, with changes made to address measuring units, drug names, and other terminology differences between the United States and Canada. The exam is available in both English and Canadian French.
To take the NCLEX, you must complete two separate processes: First, contact your Nursing Regulatory Body (NRB) and request a licensure/registration application. Second, register with Pearson VUE, the testing vendor. The NCLEX is developed and owned by the National Council of State Boards of Nursing, Inc. (NCSBN), which administers the examinations on behalf of its member boards. These include the boards of nursing in the 50 states, the District of Columbia, and four U.S. territories (American Samoa, Guam, the Northern Mariana Islands, and the U.S. Virgin Islands), as well as more than twelve regulatory bodies in Canada.
Each board in the US and Canada has its own set of NCLEX requirements, qualifications, registration processes, and regulations. The NCLEX has two types: the NCLEX-RN and the NCLEX-PN. The majority of the questions on the exam fall under the Physiological Integrity category, dealing with adult medical and surgical care, pediatrics, and gerontology. Other topics include safety issues in patient care, ethical and legal nursing problems, nursing management, and issues related to giving patients the best care. Questions are mostly multiple-choice, but other formats have been introduced, including identifying a particular area on a drawn body part, selecting multiple correct answers, free-response mathematical questions, and ordering the steps of a medical procedure.
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Frequently asked questions
The National Council Licensure Examination (NCLEX) is a nationwide examination for the licensing of nurses in the United States, Canada, and Australia.
There are two types: the NCLEX-RN and the NCLEX-PN.
The NCLEX deals with adult medical and surgical care, pediatrics, and gerontology. Questions may also cover safety issues in patient care, ethical and legal nursing problems, and nursing management.
Most of the questions on the NCLEX exam are multiple-choice. However, new format questions have been added, including identifying a particular area of a drawn body part, selecting multiple correct answers, and free-response mathematical questions.
To take the NCLEX in Canada, candidates must complete two separate processes: contact the Nursing Regulatory Body (NRB) and request a licensure/registration application, and register with Pearson VUE.
