NCLEX^® Study Tips 2022

Passing the National Council Licensure Examination (more commonly known as the NCLEX^®) is the final step that anyone must take before beginning a career as a nurse in the United States. Since passing the NCLEX^® determines whether someone is able to obtain a nursing license, it's very important that prospective RNs and LPNs understand how to study for the NCLEX^®.

Many nursing schools give their students a fair amount of guidance in how to prepare for the NCLEX^® and provide them with full practice exams, but the nursing board exam is difficult, and it is still necessary to dedicate many hours studying for it outside of school—even after you graduate.

Fortunately, you can get a good idea of how to pass the NCLEX^® by familiarizing yourself with the new NCLEX^® format and designing a study plan.

Whether you haven't yet graduated from nursing school or it's been a few months since, these NCLEX^® study tips for 2021 will give you everything you need to start preparing for success. Drawing from recommendations by the National Council of State Boards of Nursing (NCSBN), the most current NCLEX^® test plans, and advice from two registered nurses, our tips will assist you in understanding the NCLEX^® format and creating an NCLEX^® study plan that's right for you.

NCLEX^® Format Guide

Before you decide on the best way to study for the NCLEX^®, you will need to get familiar with how the NCLEX^® is structured, including the new NCLEX^® changes that went into effect in October 2020.

Here are some answers to questions that people usually ask about the NCLEX^® format:

How many questions are on the NCLEX^®?

The NCLEX^®-RN and NCLEX-PN both contain a minimum of 75 questions and a maximum of 145 questions (not including the 15 pretest items). The number of questions you'll see on the NCLEX^® can vary according to your performance on the actual exam.

More specifically, you may be required to answer more or fewer questions so the NCLEX^® scoring algorithm can confidently determine whether you have correctly answered enough questions to place you above the passing standard (or answered enough incorrectly to place you below the standard).

Both of the registered nurses we interviewed, Caralee Applequist (RN, BSN; Boise, Idaho) and Kyirsty Unger (MSN, FNP, RN; Portland, Oregon) report that they completed the NCLEX^®-RN in 75 questions. While testing statistics that reflect the most recent changes to the NCLEX^® are not yet available, past data indicate that candidates usually answer between 100 and 120 questions before the test concludes.

How much time do I have to take the NCLEX^®?

Candidates for nursing licensure are allowed a maximum of five hours to complete the NCLEX^®; however, it's most common for the test to take about two hours.

The time it takes you to finish will depend on both the number of questions you are given and the pace at which you answer them. To ensure that you have enough time to complete the exam, the NCSBN recommends spending no more than two minutes answering each question.

During NCLEX^® testing time, you will have two optional breaks: one after two hours, and another after three and a half hours. These breaks do count against your testing time, but there's a chance you won't need to take any breaks at all.

Both nurses we asked were able to finish the NCLEX^® in 75 questions, but the time it took them to complete the exam was different: Unger told us that it took her about 80 minutes to complete the test and Applequist estimates that she finished in between 90 minutes and two hours.

How do I answer NCLEX^® questions?

According to the NCLEX^®-RN and NCLEX-PN test plans, the NCLEX^® may include the following question types:

• Multiple choice
• Multiple response (also called select all that apply or SATA)
• Fill-in-the-blank
• Calculation
• Hot spots (respond by identifying a specific area in a picture)
• Exhibit (multiple-choice response to medical charts)
• Ordered response
• Audio (multiple-choice response to recorded auscultation sounds or spoken dialogue)
• Graphics (multiple-choice response using photographs or illustrations as answers)

Most questions on the NCLEX^® will require you to provide just one answer, but you'll especially want to practice how to answer multiple-response and ordered-response question types. If you include just one incorrect response, omit one correct response, or provide one out-of-sequence answer, it will result in the entire response being marked as incorrect.

Candidates are not allowed to skip questions on the NCLEX^®, so even though you may not always know the correct answer to a question, you should still think out each question carefully and avoid guessing when possible.

What are the NCLEX^® test categories?

Though the NCLEX^®-RN and NCLEX-PN test plans are somewhat different, they are both organized into the same four main categories of Client Needs: safe and effective care environment, health promotion and maintenance, psychosocial integrity, and physiological integrity. Two of these are divided into further subcategories.

You'll want to plan your NCLEX^® prep strategy around learning these Client Needs as thoroughly as possible. "There's a great bandwidth of information to study," Applequist says. "Everything from prenatal to end-of-life care is fair game on the exam."

Here's a breakdown of the NCLEX^®-RN knowledge categories, what they cover, and the percentages of questions from each category that make up the test:

• Safe and Effective Care Environment

  NCLEX^® questions in this category are designed to test your judgment of how to work efficiently and safely within the care delivery setting, how to protect clients and coworkers from environmental health hazards, and how to collaborate with others to help them do the same. There are two subcategories:

  • Management of Care (17-23%)

    This covers content related to case management, client rights, ethical practice, legal responsibilities, referrals, and other similar topics.

  • Safety and Infection Control (9-15%)

    This subcategory's topics include accident prevention, emergency response planning, handling hazardous materials, equipment safety, use of restraints, and other topics.

• Health Promotion and Maintenance (6-12%)

  This NCLEX^® category tests your knowledge of human growth and development, disease prevention and early detection, and how to help clients achieve and preserve health. You'll be expected to respond to questions about such topics as: the aging process, newborn care, developmental stages, health screening, lifestyle choices, and related issues.

• Psychosocial Integrity (6-12%)

  Questions in this NCLEX^® category are centered on your ability to assess and promote mental, emotional, and social health of clients, including those experiencing crisis or mental illness. It covers topics related to patient well-being including: abuse and neglect, behavioral intervention, coping mechanisms, cultural and religious awareness, substance use disorders, end-of-life care, and others.

• Physiological Integrity

  To answer questions in this NCLEX^® category, you'll need to demonstrate your knowledge of how to provide assistance and comfort for clients in performing everyday activities, how to administer medications, how to reduce the risk of health complications, and how to care for patients with chronic or acute physical conditions. This knowledge group is divided into four subcategories:

  • Basic Care and Comfort (6-12%)

    These questions relate to knowledge about how to help patients with assistive devices, elimination, mobility and immobility, comfort interventions (non-pharmacological), nutrition and oral hydration, personal hygiene, rest and sleep.

  • Pharmacological and Parenteral Therapies (12-18%)

    These question topics are related to medication administration, including side effects, dosage calculation, expected outcomes, intravenous therapies, pharmacological pain management, parenteral nutrition, and blood products.

  • Reduction of Risk Potential (9-15%)

    This subcategory tests a nursing candidate's knowledge of how to assess abnormalities and changes in vital signs, run diagnostic tests, perform system-specific assessments, identify laboratory values, recognize potential for complications, and apply therapeutic procedures.

  • Physiological Adaptation (11-17%)

    Topics in this subcategory include dealing with body system alterations, fluid and electrolyte imbalances, hemodynamics, illness management, medical emergencies, pathophysiology, and unexpected response to treatment.

How does the NCLEX^® work?

The NCLEX^® adjusts the exam's difficulty in real time by using a system called computerized adaptive testing (CAT) . Each time you answer a question on the NCLEX^®, the computer chooses the next question based on whether you answered correctly or incorrectly. The intention here is to continually challenge you with questions that give you a 50-50 chance of giving the correct answer.

"It's a tricky test to study for in the sense that questions will only get more difficult as you get more correct," Applequist says. "That's hard to simulate on your own."

How hard is the NCLEX^®?

Judging by the most recent NCLEX^® pass rates, the NCLEX^® is a rather difficult test with about 87.5% of candidates educated in the United States passing the NCLEX^® on their first attempt, and only about 42% of them passing on repeated attempts. However, since the NCLEX^® adjusts its difficulty differently for every candidate who takes it, no two tests are alike.

When we asked the nurses how prepared they felt on test day and how difficult the NCLEX^® is, Unger responded, "I felt prepared, but the test is adaptive so there were certainly questions I didn't know. For me, I felt that I knew one-third of them for certain, one-third I could answer from hints in the question itself, and one-third I had no idea." She passed on her first attempt.

Though Applequist also passed on her first attempt, her experience was different. "I felt underprepared and definitely left the test crying," she says. "It's a hard test and it's really hard to gauge how you're doing since it gets increasingly more difficult. I could have used a few more weeks to study."

For even more detailed information on the NCLEX^® format, check out the 2021 NCLEX^® Examination Candidate Bulletin and the NCSBN's page on what the NCLEX^® looks like.

NCLEX^® Study Strategies

Here are some tips for designing an NCLEX^® study plan, including the total length of time you should prepare, how many hours a day to spend studying, and which materials and study techniques are most effective:

How long should I study for the NCLEX^®?

Most nursing programs recommend that you give yourself about six months before your testing date to study for the NCLEX^®, and that you should start preparing for the NCLEX^® around the time you begin your final semester of nursing school. This should give you enough time to thoroughly cover the knowledge categories that appear on the NCLEX^®, and will also allow you to take advantage of study resources such as NCLEX^® practice tests, or classmates who are also studying for the NCLEX^®.

While it's a good idea to take the NCLEX^® soon enough after nursing school that the information you've learned is still fresh, you may want to take a month or two after graduating to study for the nursing exam. "I studied for about two months on my own," Applequist says, "but my college also added in NCLEX^® prep our senior year. We took two or three full exams in school. I think ideally I could have used about three months studying after graduating to not feel so busy with it."

However, if you're able to dedicate enough time to NCLEX^® preparation while in nursing school, you may feel ready to take the NCLEX^® right after you graduate. Unger, who took the exam just two days after graduating, says, "I went to an accelerated program that gave practice exams throughout the year. Otherwise, a few weeks before graduation I checked out a quiz book from the library and worked through several practice tests."

"It's okay to take some time, too, and just enjoy that you graduated from nursing school," Applequist adds. "I feel like that can get totally forgotten in studying for boards."

How many hours a day should I study for NCLEX^®?

Most test prep experts recommend that your NCLEX^® study plan should allow you to spend an average of three to four hours each day preparing for the exam, and to take days off to give your brain a rest. You may also set a goal for how many NCLEX^® questions to work through each day. Depending on your schedule, the hours you spend studying for the NCLEX^® may be more spread out or concentrated on certain days, but you should strive for consistency.

Reflecting on her NCLEX^® study schedule, Applequist says, "I was working at a summer camp, so time was quite limited. I would study for an hour or two in the morning, and then study for much of the days on my weekends off. I didn't have a question per day goal; instead I tried to roll through at least 75 questions on the weekend." Her advice: "Keep to a routine, but also give yourself some breaks with studies. It can be very overwhelming if you spend too much time each day studying."

Alternatively, you might aim to study for the NCLEX^® by doing practice exams until you can regularly answer a high percentage of the questions correctly. Of her NCLEX^® study habits, Unger says, "I didn't make a schedule, but I studied until I consistently passed with 80% accuracy."

What is the best way to study for NCLEX^®?

When deciding the best NCLEX^® review strategies for you, you'll need to consider your budget, educational resources, and learning style. The most effective study strategies for the NCLEX^® are sure to involve practice exams since they allow you to review material and develop NCLEX^® test taking strategies at the same time (you'll have a few options for these ranging from test prep books to online review courses and Qbanks such as UMock NCLEX^®). You should also plan to incorporate NCLEX^® study techniques for memorizing information such as lab values and medication dosages.

NCLEX^® study ideas

Aside from NCLEX^® prep books, online review courses, and practice exams, it will be helpful to integrate NCLEX^® study techniques for refreshing and memorizing the knowledge you learned in nursing school. It's a good idea to study with peers who are also prepping for the NCLEX^® if they're available.

Effective NCLEX^® study techniques include:

• Flashcards for NCLEX^® vocabulary, lab values, medication facts, etc.
• Mnemonic acronyms
• Visualizing medical procedures
• Explaining NCLEX^® questions with answers and rationales to classmates
• Reviewing your study guides and tests from nursing school
• Working with a tutor

When we asked the nurses about the best NCLEX^® study techniques that worked for them, Applequist responded, "I made flashcards to memorize lab values and numbers—that was helpful to roll through most days."

"I think practicing with classmates helped most," Unger told us, "because we could talk through the rationales for the answers together."

Am I ready for the NCLEX^®?

The best way to know if you're ready to pass the NCLEX^® will be your practice exam scores—just remember not to get discouraged by low practice test scores when you are beginning to study for the NCLEX^®.

"If you're struggling with test taking," Unger advises, "know that it's all just a system to get used to. Go to a tutor or take a prep course until you feel comfortable, then the test shouldn't surprise you. When you start doing well on your practice tests, you should be fine."

"Be thoughtful in your studies," Applequist says, "but don't make yourself crazy with details."

Studying for the NCLEX^® is hard work, so it's important to take care of yourself while you prepare. To make sure you stay healthy, happy, and motivated up until test day, Applequist recommends: "Plan something nice for yourself after your exam—regardless of the outcome, you will have accomplished something big just by taking it. Also know that being an RN is really fun and it totally makes getting through the NCLEX^® worth it!"

UMock is an ideal resource for test prep to supplement the helpful tips we've provided above. If you'd like to try our product for NCLEX^® exam prep, we offer a 10-day trial free of charge. Click here to find out more!