3 Things to Know Before You Take the NCLEX Exam



The National Council Licensure Examination (NCLEX) is a standardised test administered for nurses in the United States, Canada, and Australia.

Developed by the American National Council of State Boards of Nursing and administered through Pearson VUE, the NCLEX is mandatory for all seeking to work as nurses, nursing aides, and caregivers in any of the countries mentioned.

Here are three essential things to note before taking the exam.

1. There are Two Types of Examination

The type of examination you need to take is dependent on your specific career path.


The NCLEX-RN is an entry-to-practice examination. Thus, it is the licensing examination for those who graduated with a bachelor’s degree in nursing and want to work at hospitals throughout the US, Canada, and Australia. It is also mandatory for immigrants who earned nursing degrees in their home countries with previous work experience in professional healthcare.

The standard NCLEX-RN follows the five-step nursing process with questions categorised under assessment, diagnosis, planning, implementation, or evaluation.


This is the qualification exam for those seeking employment in either practical nursing or vocational nursing. Unlike those taking the NCLEX-RN, examinees hold an associate degree in nursing or took two years of related post-secondary education. In Canada, candidates for NCLEX-PN must also pass the Canadian Practical Nurse Registration Exam (CPNRE.)

2. The Three Subjects that Matter

There are three functional areas that aspiring nurses need to focus on before taking the exam.

1. Prioritisation

Many questions focus on cases where examinees need to prioritise the needs of one patient over another. Questions slanted towards prioritisation cover a broad spectrum of topics, including nursing fundamentals, diagnostics, surgical procedures, and urgent and emergency care. An examinee must carefully read through the rationales and go over them for small – but vital – details to ace these questions.

2. Delegation

Questions related to delegation gauge how examinees cope with technically difficult or complex situations. The examinee may respond as either the lead nurse for a procedure he or a working team member.

3. Safety and Infection Control

Highly relevant given the looming spectre of COVID-19, related questions assess if examinees know standard protocols regarding pre and post-procedure sanitation, patient isolation, and institutional safety.

3. There are Three Levels of Questioning

The NCLEX format follows three levels of complexity:

Level 1 (10% of the exam)

These fundamental questions are a test of personal knowledge and understanding of basic information. Level 1 items are usually multiple-choice questions.

Level 2 (45% of the exam)

Aimed at gauging one’s skills in analysis, observation, and application, Level 2questions take on any of the following forms:

    • Illustrated items, usually anatomical drawings, where examinees need to tick off several responses from a list to either identify body parts or symptoms of a given condition;
    • Free-response mathematical problems calling for detailed computation and solutions; and
    • Items requiring examinees to delineate a medical procedure in the correct sequence.

Level 3 (45% of the exam)

The most complex questions in the exam demand that examinees judge, evaluate, and combine related facts to develop a cohesive diagnosis and care plan for a patient. Level 3 is particularly challenging as it calls upon an examinee’s working knowledge and common sense.


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