Tuesday, August 4, 2015

Dissecting the NCLEX-RN

You’ve put in years of study, passed all your university exams, and graduated nursing school. Or maybe you’ve practiced as a nurse in another country and are moving to Canada. This all means one thing: the Canadian entry-to-practice exam, the NCLEX-RN, is next up on your plate.

There’s weeks of study ahead of you: stacks of books and papers, maybe a weekly study group, an instructor-led NCLEX Prep course, and definitely hours of asking your roommate to test you on flashcards. There’s a whole lot of content to cover.

But what’s there to know about the exam itself? Below we’ve rounded up the basic facts about the NCLEX for easy reference.


The content of the NCLEX is divided into four major “Client Needs” concepts, two of which are divided into subconcepts (six in total). The percentages show how much of the exam is dedicated to each:

  • Safe and Effective Care Environment 
    • Management of Care (17–23%)
    • Safety and Infection Control (9–15%)
  • Health Promotion and Maintenance (6–12%)
  • Psychosocial Integrity (6–12%)
  • Physiological Integrity
    • Basic Care and Comfort (6–12%)
    • Pharmacological and Parenteral Therapies (12–18%)
    • Reduction of Risk Potential (9–15%)
    • Physiological Adaptation (11–17%)

In order to keep up with advances in nursing practice, the NCLEX-RN test plan is updated every three years. The “passing standard” is also evaluated every three years, to ensure the required amount of “nursing ability to practice competently at the entry level” is correctly measured and met. Now that the NCLEX is the entry-to-practice exam for not just America but also Canada, Canadian nurses are also part of the evaluation and development process.


The NCLEX exam is written at one of several Pearson Vue locations across Canada, including permanent and mobile test centres (see which is nearest you here).

Test takers are given up to 6 hours to complete the NCLEX-RN, which can include as little as 75 questions or as many as 265. The number of questions depends on the student taking it, due to the use of computerized adaptive testing, or CAT. As you go through the exam, CAT automatically evaluates how you’re doing, based on how many questions you get right and their level of difficulty, until a “pass” or “fail” is determined.

Most of the questions on the NCLEX are multiple choice, with each question comprising a “stem” (the question) and options (the possible answers). There are also “alternate” question types, which incorporate things like audio-visual elements, graphs, calculations, or fill in the blanks.

You can learn more about CAT in our “The NCLEX-RN, CAT, and U” post.


Although CAT makes a pass/fail evaluation right then and there, while you’re sitting the NCLEX hot seat, the exam results are not available immediately. However, it doesn’t take too long to get them. Most Canadian nurses will have their NCLEX results within a few days, depending on your provincial licensing agency.