1. The NCLEX-PN® Examination
Chapter 22
The NCLEX-PN® Examination

2. Chapter 22
Lesson 22.1

3. Learning Objectives Explain the purpose of the NCLEX-PN® examination.
Research the requirements of your state board of nursing for eligibility to take the NCLEX-PN® examination.
Describe how CAT determines whether you pass or fail the NCLEX-PN® examination.
Explain the process of endorsement.
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4. Learning Objectives (cont’d)
Differentiate between a temporary work permit and licensure.
Discuss the proven way of preparing for the NCLEX-PN® examination.
Explain the legal implications of ignoring the NCLEX-PN® confidentiality clause and sharing information about the NCLEX-PN® content with others.
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5. What is the NCLEX-PN® Examination?
National Council Licensing Examination for Practical/Vocational Nursing graduates
Designed to test knowledge, skills, and abilities needed to safely and effectively practice nursing as a new entry level LPN/LVN
The NCLEX-PN® examination results provide the basis for licenses granted to practical/vocational nurses by state boards of nursing.
Review your state’s Nurse Practice Act and the purpose of the licensure examination as it relates to the protection of the public.
Each jurisdiction requires a candidate to pass an examination that measures the competencies needed to practice safely and effectively as a newly licensed, entry-level LPN/LVN.
The boards are the only agencies that can both license a candidate and release the test results to him or her.
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6. How the NCLEX-PN® Examination Is Kept Up-to-Date
Practice Analysis of Newly Licensed Practical/Vocational Nurse in the U.S.
Survey is conducted every 3 years
Sent out to entry level LPN/LVNs
NCLEX-PN® examination reflects the outcome
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7. Endorsement
Standardized examination makes it possible to provide licensure by endorsement from one board of nursing to another.
Implication: Nurses can apply for licensure in a different state without retesting.
Students should search the website of their state board of nursing for information regarding licensure.
How would a student apply for licensure in a different state without retesting?
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8. Content
Four phases of the nursing process are integrated into all areas of the NCLEX-PN® examination:
Data collection
Planning
Implementation
Evaluation
What are the four phases of the nursing process and how are they used in the NCLEX-PN® examination?
Use NCLEX-PN® review books to identify questions within the sections of data collection, planning, implementation, and evaluation.
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9. Levels of Test Questions
Multiple Choice
The majority of test items are multiple choice.
Each item describes a client or clinical situation.
Four options are given from which to choose the correct response.
Alternate Format Item
Fill-in-the-blank
Multiple response
Prioritizing
Figure or illustration
Chart/Exhibit questions
Provide students with examples of each type of test question.
Have students practice answering alternate format questions. Pay particular attention to test items that the students may have little practice with such as fill-in-the-blank and multiple-choice questions that require selection of more than one response.
Review Bloom’s taxonomy in relation to development of test questions.
Suggest that students search the Internet for NCLEX® Examinations and alternate formats at
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10. Test Framework: Patient Needs
Four Major Divisions of Patient Needs
Safe, Effective Care Environment
Coordinated care (12-18% of test items)
Examples: advance directives, client rights, management/supervision, confidentiality, legal responsibilities, ethical practice
Safety and infection control (8-14% of test items)
Examples: accident/error prevention, handling hazardous/infectious materials, medical and surgical asepsis, standard and other precautions, use of restraints
Why are patient needs used as a framework for examinations? (Patient needs provide an overall structure for defining nursing actions and competencies for a variety of patients in many settings and are in agreement with state laws and statutes.)
Provide students with sample questions that address accident/error prevention, handling hazardous and infectious materials, asepsis, and use of restraints.
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11. Test Framework: Patient Needs (cont’d)
Health Promotion and Maintenance (7-13%)
Growth and development throughout life span
Examples: aging process, antepartum/intrapartum/ postpartum and newborn care, developmental stages and transitions, family planning, human sexuality
Prevention and early detection of disease
Examples: data collection techniques, disease prevention, immunization, lifestyle choices
Provide questions that are examples of health promotion and maintenance, such as growth and development, and prevention and early detection of disease. Be sure to focus on questions that identify the levels of prevention.
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12. Test Framework: Patient Needs (cont’d)
Psychosocial Integrity (8-14%)
Coping and adaptation
Examples: behavior management, coping mechanisms, end-of-life issues, mental health concepts, religious/spiritual influences, therapeutic communication
Psychosocial adaptation
Examples: abuse and neglect, chemical dependency, crisis intervention, mental health concepts, suicide, therapeutic environment, behavioral interventions
Provide examples of questions to increase the students’ knowledge of the NCLEX-PN® examination.
Have students identify types of questions they feel most unsure about answering.
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13. Testing Framework: Patient Needs (cont’d)
Physiological Integrity
Basic care and comfort (11-17% of test items)
Examples: assistive devices, elimination, hygiene, nonpharmacological pain intervention, nutrition, sleep
Pharmacological therapies (9-15% of test items)
Examples: adverse and expected effects, administration, actions, side effects
Reduction of risk potential (10-16% of test items)
Examples: potential for alterations in body systems, lab values, diagnostic tests, potential complications
Physiological adaptation (11-17% of test items)
Examples: basic pathophysiology, fluid and electrolyte imbalances, medical emergencies, radiation therapy
Provide students with examples of the NCLEX-PN® questions covering the content areas of physiological integrity. Have students identify which content areas they felt they were unprepared to answer.
The content of the NCLEX-PN® examination is divided into four Client Needs categories.
Client needs provide an overall structure for defining nursing actions and competencies for a variety of patients in many settings and is in agreement with state laws and statutes.
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14. Integration of Nursing Concepts and Processes
Clinical Problem-solving Process
A scientific approach to patient care
Includes data collection, planning, implementation, and evaluation
Caring
Interaction with clients, families and others in an atmosphere of trust and respect
Communication and Documentation
Verbal and nonverbal communication with patient and those involved with care.
Documentation (written or electronic) of all events and activities associated with the patient’s care
Teaching/Learning
Assist client to gain information, skills, and attitudes that lead to change in behavior
What are the four phases of the nursing process that apply to LPN/LVNs and are included in the clinical problem-solving process? (data collection, planning, implementation, and evaluation)
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15. Application Process
Complete all eligibility requirements for licensure.
Apply to the state board of nursing.
Obtain “NCLEX® Examination Candidate Bulletin.”
Board notifies Pearson VUE Pearson Professional Testing Center that all requirements are met.
Mail registration form to Pearson Center.
Pearson Center sends candidate an Authorization to Test (ATT).
Review how the application process is completed.
Before they complete the official documents, give students mock forms to practice with.
Review the documentation required by your state board of nursing.
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16. Application Process (cont’d)
Pearson Center sends you an authorization to test (ATT).
Make an appointment to test at any approved Pearson Professional Center (PPC).
Take the NCLEX-PN® examination on the scheduled day.
State’s board of nursing notifies you of test results.
Students should review the Pearson web site at
Take the NCLEX-PN® examination on the scheduled day. Failure to arrive at the test site results in Pearson reporting the student to the state board and forfeiture of the registration.
All boards ask a candidate about previous criminal activity (felonies and misdemeanors). The board will decide if it influences your ability to be licensed.
Be truthful.
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17. Other Important Information
The fee for NCLEX is $200.
Other fees required by the nursing board where you are applying vary.
Fees are non-refundable.
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18. How to Register Internet, mail, or telephone can be used to register.
Pearson VUE will confirm receipt of registration and send an Authorization to Test (ATT) to the candidate.
Once the ATT is received, schedule and test within the validity dates printed on the ATT.
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19. Authorization To Test (ATT)
Time limit for all NCLEX-PN® examination registrations is 365 days.
Validity dates for ATT will not be extended for any reason.
Once approved for testing the candidate must take the NCLEX-PN® examination within the approved time frame.
Schedule taking the NCLEX-PN® examination at a Pearson Center as soon as possible after receiving the ATT.
If the ATT does not arrive within two weeks, call Pearson VUE at the appropriate number listed in the front section of the candidate bulletin.
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20. Examination Security Arrive at testing center 30 minutes early.
Use your name in the exact format as used when applying for the NCLEX-PN® examination
Bring two forms of identification with photo and signature.
Bring ATT.
Fingerprints, photograph, signature when you arrive
Test takers are observed and recorded.
Personal belongings are secured outside.
A Pearson staff person escorts you into a secure area.
The computer includes both a calculator and a time device that tells you how much time remains to complete the NCLEX-PN® examination.
Leaving the room is allowed with permission only.
What is the purpose of implementing strict rules for security?
What will happen if a student arrives 30 minutes later than the appointed time? (The student may be required to forfeit the appointment.)
Direct observation by staff as well as video and audio recording occur during the entire examination.
Your fingerprint, photograph, and signature accompany your examination results sent to the board and can be used to confirm your identity.
Erasable note boards are provided for use during the test and collected before you leave the room at the end of testing.
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21. Testing Time Up to 5 hours are available for testing.
Includes a short tutorial on the computer, which shows you how to register the answers to all items
Two preprogrammed optional breaks, plus those you request
The computer notifies you of the optional breaks.
Creating any disturbance can cause you to be dismissed from the room.
What should a student do if the computer seems to be malfunctioning during the testing time ? (Ask for assistance with the computer.)
Individuals taking the test are fingerprinted each time they return to the testing area after a break.
An African-American male is taking the examination in Cincinnati, Ohio, and an Asian woman is taking the examination in Kauai, Hawaii. Can the examination fairly test members of these two different ethnic groups?
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22. Reporting Results of Examination
Results are available only from the board approximately a month after testing.
Do not call the board, the NCLEX Candidate Services, the Pearson Centers, or NCSBN for results.
The results will reach you by mail from the state board of nursing.
Although the computer continuously computes the result of your answers, the Pearson Center does not release final results to you directly.
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23. Overview of NCLEX-PN® CAT
A well-planned examination that takes into consideration differences in nursing regulations within states
Fair to each candidate and provides ample opportunity to demonstrate knowledge and ability as a beginning LPN/LVN
Important nursing content is included, regardless of the number of items chosen by the computer for a candidate.
Previous knowledge about using a computer is unnecessary to take the test.
You use critical thinking, nursing process, and basic nursing knowledge as you do in the real world of nursing.
How does the computer adapt to the examination and the answers given by the test taker? (The computer adapts the examination to the test taker’s answer. This is possible because the computer has a large number of test items stored in memory. As the test taker answers the standardized items the computer chooses the next best item to measure the test taker’s competence.)
Is a test taker allowed to skip questions? (Every question must be answered because the computer calculates each answer before it goes on to the next question.)
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24. The CAT Method of Testing
Computer selects the items you will answer while you are taking the examination
As you answer the standardized items, the computer chooses the next best item to measure your competence.
Based on how many items a candidate answers correctly; and on the difficulty levels of the items
Administers item with difficulty levels so that each candidate will answer about half correctly
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25. The CAT Method of Testing
Testing stops when the minimum number of items is answered, if it can be determined with certainty that the candidate passed or failed.
All candidates answer a minimum of 85 items.
The maximum number of items any candidate will answer during the 5-hour maximum testing period is 205.
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26. Applying for Temporary Permit
Temporary permit allows candidate to work as a graduate practical or vocational nurse (GPN or GVN)
Permit is revoked once examination results are in
Passing the examination allows the candidate to work as a fully licensed practical or vocational nurse (LPN or LVN).
Failing the examination: candidate must work as nursing assistant
Can a candidate retake the examination if it is failed the first time?
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27. Reducing Testing Anxiety
Anxiety increases sharpness, alertness during test
Engage in positive thinking in days before test
Relax the evening before test
Get a good night’s sleep
Follow usual morning routine
Wear casual attire to test
What relaxation techniques and visualization exercises can be used to reduce anxiety?
What methods do students currently use to decrease stress?
Students should implement helpful bedtime rituals to enhance a good night’s sleep before the test, and also eat a good breakfast before the test.
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28. Review Books/ Mock Examinations
Review books and mock examinations can help prepare candidates for test and reduce anxiety.
Review books include:
Outline of content
Items with explanations and rationale
References for answers
Mock examinations also available (for a fee)
Best preparation: study faithfully
Students should study approximately one hour minimum per day.
Encourage students to use a CD-ROM to assist in practicing computer based testing.
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