Are you interested in becoming a Registered Nurse (RN) and wondering how to prepare for the NCLEX-RN exam? The first step in preparing for this exam is taking the Associate of Science in Nursing (ASN) program at Florida National University (FNU). This program is focused on the content areas of the NCLEX-RN exam. That way, you can simultaneously get ready for the exam and obtain the necessary education that is required for licensure. It is a win-win!

What is the NCLEX-RN Exam?

The NCLEX-RN (National Council Licensure Examination for Registered Nurses) is a standardized examination that nursing graduates must pass to obtain licensure as Registered Nurses (RNs). Developed and overseen by the National Council of State Boards of Nursing (NCSBN), the exam ensures that entry-level nurses have the knowledge, skills, and abilities to provide quality patient care and sound clinical judgment as a safe practitioner.

Key Features of the NCLEX-RN Exam

Here are some key features of the NCLEX-RN exam:

Exam Format and Structure

The NCLEX-RN uses Computerized Adaptive Testing (CAT). Questions adjust in difficulty based on your performance. For example, correct answers lead to progressively more complex questions, while incorrect answers may result in easier ones. This method helps assess your competence efficiently and ensures questions remain relevant to your skill level.

Number of Questions

RN candidates must answer 85 items as a minimum and 150 items as a maximum. From the 85-minimum items, 52 items will be related to the eight content areas that are discussed in the section below. Furthermore, 15 items will be pretest items that are unscored and 18 items will comprise three case studies related to clinical judgement (“Next Generation NCLEX-RN test Plan,” 2023).

Case studies are constituted of six items that assess each of the following six domains of the NCSBN Clinical Judgment Measurement Model (NCJMM):
• Recognizing cues
• Analyzing cues
• Prioritizing hypotheses
• Generating solutions
• Taking action
• Evaluating outcomes

The case studies will cover any number of areas of content because clinical judgement is an integrated process. As a result, these are counted independently of the items that are specific to a content area (“Next Generation NCLEX-RN test Plan,” 2023).

Suggested Resources: 2024 NCLEX Fact Sheet | NCSBN

Time Limit

There is a five-hour limit to complete the examination which includes all breaks (“Next Generation NCLEX-RN test Plan,” 2023).

Content and Focus Areas

The NCLEX-RN evaluates the knowledge, skills, and abilities necessary for entry-level nurses to provide quality patient care. The exam tests you across four primary categories and subcategories, ensuring complete coverage of the nursing practice. Below is an explanation of each area.

Safe and Effective Care Environment

This category ensures that you can provide care that promotes patient safety and a supportive environment. It is divided into two subcategories:

Management of Care (15-21% of the exam):

Focuses on ensuring the proper coordination of care and efficient use of resources. Key topics include:
• Prioritization of patient care (triaging)
• Delegation and supervision of care tasks
• Legal and ethical principles, such as informed consent and advance directives
• Advocacy for patient rights and safety
• Case management and continuity of care
• Confidentiality and the Health Insurance Portability and Accountability Act (HIPAA)
• Recognizing and responding to system errors or patient safety hazards

Safety and Infection Control (10-16% of the exam):

Addresses protecting patients and healthcare providers from health and environmental hazards. Key topics include:
• Proper use of personal protective equipment (PPE)
• Handling hazardous materials and biohazardous waste
• Isolation precautions (airborne, droplet, contact)
• Prevention of healthcare-associated infections (HAIs)
• Ergonomics and proper body mechanics to prevent injuries
• Identifying and reporting unsafe conditions

Health Promotion and Maintenance (6-12% of the exam)

This category emphasizes wellness, disease prevention, and early detection for individuals and families across the lifespan. Key topics include:
• Growth and development milestones for all age groups (infants, children, adolescents, adults, and older adults)
• Health screening programs (e.g., vision, hearing, cancer screening)
• Prenatal care, including education on fetal development, pregnancy complications, and maternal health
• Immunization schedules and vaccine administration
• Risk factor identification for lifestyle-related diseases
• Teaching and supporting health promotion behaviors (e.g., smoking cessation, balanced diet, exercise)

Psychosocial Integrity (6-12% of the exam)

This category ensures you can address patients’ emotional, psychological, and social needs. Key topics include:
• Therapeutic communication techniques
• Recognizing signs and symptoms of mental health disorders (e.g., depression, anxiety, schizophrenia)
• Crisis intervention and de-escalation techniques
• Grief and loss (supporting patients and families through the stages of grief)
• Coping mechanisms and stress management
• Recognizing signs of abuse, neglect, or exploitation
• Providing culturally competent care
• Substance use and dependency issues

Physiological Integrity

This category accounts for the most significant portion of the exam (43-67%) and assesses your ability to promote physical health and manage physiological issues. It is divided into four subcategories:

Basic Care and Comfort (6-12% of the exam):

It covers fundamental nursing care that helps patients with daily living and comfort. Key topics include:
• Pain management (e.g., non-pharmacological interventions, monitoring response to medication)
• Mobility and immobility care (e.g., range-of-motion exercises, prevention of pressure ulcers)
• Comfort measures (e.g., repositioning, warm or cold therapy)
• Assisting with activities of daily living (ADLs) such as bathing, dressing, and feeding
• Use of assistive devices (e.g., walkers, prosthetics)

Pharmacological and Parenteral Therapies (13-19% of the exam):

Focuses on the safe and effective administration of medications and intravenous therapies. Key topics include:
• Calculating accurate medication dosages
• Routes of medication administration (oral, intravenous, subcutaneous, etc.)
• Monitoring for therapeutic effects and adverse reactions
• Medication interactions and contraindications
• Administration of blood products and managing transfusion reactions
• Use of pain medications, sedatives, and antibiotics
• Safe handling of chemotherapy drugs

Reduction of Risk Potential (9-15% of the exam):

Focuses on minimizing the likelihood of complications in patients. Key topics include:
• Monitoring for signs of worsening conditions or complications
• Pre- and post-operative care
• Diagnostic tests and procedures (e.g., interpreting lab values, understanding imaging results)
• Infection prevention and wound care
• Managing medical equipment and devices (e.g., chest tubes, catheters)
• Responding to abnormal findings (e.g., vital signs, blood glucose)

Physiological Adaptation (11-17% of the exam):

This subcategory addresses managing and responding to acute, chronic, or life-threatening conditions. Key topics include:
• Caring for patients with organ failure (e.g., renal, respiratory, cardiac)
• Interventions for fluid and electrolyte imbalances
• Managing chronic illnesses (e.g., diabetes, hypertension, COPD)
• Acute conditions like myocardial infarctions, strokes, and trauma
• Emergency interventions (e.g., CPR, defibrillation)
• Managing complications such as shock, sepsis, or multi-organ failure

What is the Purpose of the NCLEX-RN?

The NCLEX-RN is the final step in becoming a licensed Registered Nurse (RN). The main purpose of the examination is to assess the knowledge required by registered nurses that are newly licensed to practice effective and safe care. The exam goal is to protect public health and safety by making sure you possess the essential knowledge, skills, and clinical judgment required for entry-level nursing practice. Below is an expanded explanation of the purpose and significance of the NCLEX-RN:

Ensuring Public Safety – By setting a minimum competency standard, the exam makes sure that only qualified individuals are granted the authority to practice nursing, reducing the risk of errors.

Standardizing Nursing Competency – The NCLEX-RN creates a uniform standard for nursing licensure across states and jurisdictions in the United States. Regardless of where a candidate studies nursing, they are evaluated against the same criteria, ensuring consistency in the quality of care provided by licensed nurses nationwide.

Testing Critical Thinking and Clinical Judgment – The exam assesses your ability to analyze complex patient situations, make evidence-based decisions, and apply theoretical knowledge to real-world clinical scenarios.

Validating Entry-Level Competence – The NCLEX-RN measures the minimum competency required for entry-level nurses. It evaluates whether you are ready to handle direct patient care responsibilities, manage healthcare resources appropriately, and work collaboratively within interdisciplinary teams. The exam ensures that you can function autonomously within the scope of your practice and deliver care that aligns with professional standards.

Protecting the Integrity of the Nursing Profession – The NCLEX-RN upholds the professional standards of nursing by certifying that all licensed RNs have met the same rigorous requirements. This helps maintain public trust in the nursing profession and reinforces nurses’ credibility as essential healthcare providers.

Serving as a Licensing Requirement – Passing the NCLEX-RN is mandatory to obtain an RN license in Florida. Licensure is essential for nurses to practice legally and ensures that they are accountable to state or provincial boards of nursing.

Adapting to Evolving Healthcare Needs – The NCLEX-RN is regularly updated by the National Council of State Boards of Nursing (NCSBN) to reflect changes in healthcare technologies, evidence-based practices, and patient care standards. This helps the exam remain relevant as the healthcare industry evolves.

What are the Eligibility and Requirements of the NCLEX-RN Exam?

To take the NCLEX-RN, candidates must:
• Graduate from an approved nursing program (Associate of Science in Nursing program for FNU).
• Apply for licensure to their respective state board of nursing.
• Receive an Authorization to Test (ATT) after their application is approved.
• Once eligible, candidates can register with Pearson VUE, the testing service provider, to schedule their exam.

Exam Scoring and Results

The NCLEX-RN is scored using a pass/fail system; The adaptive algorithm evaluates whether you consistently meet the minimum competency threshold required for safe nursing practice. Results are typically available through the Florida Board of Nursing within a few days.
The exam determines a passing score based on a 95% confidence interval rule, ensuring you meet or exceed the standard.

How Do You Prepare for the NCLEX-RN Exam?

Preparing for the NCLEX-RN requires a strategic approach, as the exam tests your ability to apply knowledge in practical and clinical tasks. Below is a guide on how to prepare effectively:

Understand the Exam Format

The NCLEX-RN adjusts the difficulty of questions based on your performance. Familiarize yourself with how the exam works to reduce test-day anxiety. Practice various question formats: multiple-choice, select-all-that-apply (SATA), fill-in-the-blank, drag-and-drop, and hotspot questions. The exam allows up to 5 hours, so practice managing your time efficiently.

Know the NCLEX-RN Test Plan

Review the NCLEX-RN Test Plan provided by the National Council of State Boards of Nursing (NCSBN). It outlines major categories and subcategories and the percentage of questions dedicated to each content area (e.g., Safe and Effective Care Environment, Physiological Integrity). Focus your study efforts on areas where you feel less confident.

Develop a Study Schedule

Allocate specific days for each content area to ensure you cover the full test plan. Study daily or follow a schedule that works for you, aiming for consistency over cramming. Incorporate breaks to avoid burnout and ensure better retention.

Use Reliable Study Resources
• Buy an NCLEX Prep Book.
• Use flashcards to review medications, lab values, and disease processes.
• Take practice tests to build stamina and make sure you are ready.

Strengthen Weak Areas

After taking practice tests, identify weak areas and dedicate extra time to those topics. Make sure to review incorrect answers thoroughly and understand the reasoning behind them.

Simulate Exam Conditions

Take practice exams in a quiet environment similar to test-day. Time yourself to build stamina and practice completing the exam within 5 hours. Avoid using study aids during practice tests to make sure you are ready.

Final Thoughts

Preparing for the NCLEX-RN requires exam content mastery, critical thinking, and effective test-taking strategies. By adhering to a personalized study plan and focusing on self-care, you can confidently take the exam and increase your chances of passing. Remember, the NCLEX-RN is not just about memorization but demonstrating your readiness to be a registered nurse.

Eager to Learn More?

The purpose of the Associate of Science in Nursing program at Florida National University is to provide quality nursing education to a culturally, socially, and ethnically diverse community. The program achieves this mission by preparing the graduates for employment at entry-level registered nursing positions. The program further achieves this mission by ensuring mastery of affective, cognitive, and psychomotor skills so that its graduates can become successful licensed registered nurses who are able to provide holistic, safe, culturally sensitive care to a wide variety of clients throughout the lifespan.

Let Florida National University answer any questions if you are interested in our healthcare programs. Contact us today to learn more about our Associate Degree in Nursing.

References

Next Generation NCLEX-RN Test Plan. (2023). National Council of State Boards of Nursing | NCSBN. https://www.ncsbn.org/public-files/2023_RN_Test%20Plan_English_FINAL.pdf