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Let’s learn about the NCLEX

The next big step after applying for your preliminary visa document and state license is the NCLEX

Before You Begin

The very first thing you should do is join the community of other Canadian to U.S. nurses. We have a Facebook group, Instagram, a Youtube, and this website for tons of resources and support.

The Canadian Travel Nurses (to the U.S.A.) Facebook Group

Our Instagram

Our Youtube

If you do not have the NCLEX, you will need to get it!*

Those who already have the NCLEX (typically those who graduated from a Canadian nursing program after 2015, excluding Quebec), the NCLEX you took in Canada is equivalent to the U.S. NCLEX.

For help along the way, join our facebook group and head to the NCLEX Support Chat CLICK HERE

* With the possible exception of Michigan, but it may only be a temporary exemption.

* When you apply for a state license, they will want a ‘Verification of Practice’ from your provincial college of nursing (e.g. CNO for Ontario) and that is usually where they will get the information they need for your NCLEX if you took the NCLEX in Canada.

WHat is the nclex?

The NCLEX (National Council Licensure Examination) is a standardized exam that all RNs (and LPNs) in the United States, Canada ( as of 2015), and Australia (as of 2020) must pass in order to then get a nursing license.

The administrator of the exam is the National Council of State Boards of Nursing (NCSBN) who developed the NCLEX to test the competency of graduate nurses. The NCSBN created the NCLEX-RN for potential Registered Nurses and the NCLEX-PN for potential Licensed Practical Nurses.

The actual NCLEX itself is often updating and changing its techniques. However, despite any updates, the format remains computer adaptive testing to ensure reliable and valid results.

The NCLEX is a PASS or FAIL exam which compares your ability to answer questions while altering the difficulty of the questions themselves. If you are able to answer moderately difficult questions at least half the time, then you are likely to pass. The exam turns off once there is a 95% certainty that your ability was either able or below the passing standard.

How Do You take the NCLEX?

In order to take the NCLEX, you will need what is called an ‘ATT’ or ‘Authorization to Test’ which is granted by the first state you apply to. Once the state you apply to (for a list of first-time friendly states, consult the ‘Nursing FAQ’ article) approves your education (provided you meet their educational requirements), the next step is typically for them to grant you an ATT.

Next, you must register with Pearson Vue, the administrators on behalf of NCSBN of the NCLEX test. You should aim to book a test as soon as possible to avoid delays. But be realistic with how long you think you will need to prepare.

Branches of Eucalyptus Leaves on a Marble Background

NCLEX Q&A

Where can I take the NCLEX?

Once you are eligible to write the NCLEX (ie. got the ATT), you are able to write the NCLEX at any Pearson Vue testing centre.

CLICK HERE

Pearson Vue has testing locations is the following countries available for you: USA, Canada, Australia, UK, India, Philippines, Mexico, Puerto Rico, Taiwan, Hong Kong, Guam, Northern Mariana Islands, U.S. Virgin Islands, Brazil, England, Japan, and South Africa.

What languages is the NCLEX offered in?

English and French (for French-speaking Canadian candidates).

How much does the NCLEX cost?

$200 USD (for registration in the United States), or $360 CAD (for registration in Canada) or $200 USD (for registration in Australia).

*There is an additional scheduling fee _ tax of $150 USD (in the United States) or $150 CAD (in Canada).

Registering on the NCSBN Website

You will need to register with NCSBN. When you go to do this, they will ask for a code of your nursing program. If you took your nursing program in Quebec, you will notice Quebec is missing from the list of provinces. Just use the general program code for Canada which is CA99F00000.

Canadian Program Codes and other NCLEX information are available at: NCLEX Exam Codes. You can check your jurisdiction with the dropdown menu HERE.

Getting Ready

It is important to begin studying as soon as possible so this doesn’t hold up your dreams of travel nursing to the United States!

You’ll want to start by creating an effective study plan that you will stick to as you prep for the exam.

Here we will go over the steps leading up to and including the exam and aftermath.

PURCHASE STUDY MATERIALS

You will want to get one of the following*:

A comprehensive review book,
A practice app
A practice question/tests guide

Comprehensive Review Books: There are a lot of study guides available on Amazon or online (e.g. I personally used the Saunders, read it once, and passed).

Practice Apps: I purchased the NCLEX Mastery App and loved it. I found it got me used to the weird way they ask questions. I found the NCLEX predictable and less stressful because of this.

Practice Question/Tests Guide: I had one just for extra practice and found it helpful. It wasn’t as useful as the other two things, but still helped. Some examples are Lippincott NCLEX Practice Question Guide.

Some will ask if they should take all sorts of crash courses, etc. and I’d say probably not, especially if you have been working as a nurse for some time. Most who have taken the courses have said they weren’t worth it and/or overkill.

STEP ONE: Choose reliable materials & start preparing as soon as possible!

*Suggestion only

MAKE A STUDY SCHEDULE

Make a plan and stick to it!

Create a timeline
Create a study plan

For a timeline, I suggest figuring out what you feel you need. Some people want ample time and others want to get it over with immediately. I took about 4-5 weeks but the usual suggestion is at least 6-8 weeks. It really depends how much time you can put aside for studying every week. With work, family, etc. it will all depend on your current obligations. I spent about 4 weeks around 16-18 hours per day, every day, didn’t see family, friends, or take any time to relax. I don’t recommend doing it so quickly, I just had a deadline to meet (I wanted to be a nurse before I turned 26 years old lol). I wrote my NCLEX 3 days before my 26th birthday.

Once you have a timeline, congrats, now to setup what exactly you will do! Look at your study materials and how many chapters and content there is to go over, and divide the work according to the timeline you set. Give yourself some buffer time/days to catch up if you fall behind or need a sick/recharge day.

STEP TWO: Make a study schedule & stick to it!

Monitor Your Progress...

Track your progress to ensure you are spending your time well. Include practice tests and questions, and even time yourself if you are worried about your speed. The tests will help mimic some of the pressure and get you accustomed to how the actual exam will feel and the style of questions that will be on the NCLEX. After ever practice test, look over your results and analyze your weak and strong areas and adjust your study plan accordingly. Set realistic goals and monitor your readiness for the actual NCLEX.

LEARN THE CONTENT/QUESTIONS

The NCLEX questions are their own breed of question style (and not typically regarded as pleasant).

There are specific areas to expect on the NCLEX:

The ABCs
Maslow’s Hierarchy of Needs
Nursing Process
Patient Safety

ABCS: Always default and ask yourself if a questions is about airway, breathing or circulation. These are typically always the top priority. Always check the question carefully as many nurses hopefuls jump to the airway all the time, but circulation is the underrated answer often times.

Maslow’s Hierarchy of Needs: We all remember that little pyramid thingy and can google it pretty easily. The main needs are physiological, safety & security, love & belonging, self-esteem, and finally self-actualization.

The Nursing Process: This focuses on the nursing assessment, nursing diagnosis, planning, intervention, and evaluation.

Remember, assessment is always the first step and required to plan care. If already done in the question, move along to the next part of the process.

Patient Safety: This is a common one that focuses on prioritizing basic needs of the patient (including oxygen, fluids, etc.), reducing hazards or risks (including injuries or accidents), reducing the risk of transmission of pathogens (immunizations, hand hygiene, etc.), and for good measure, know the medication rights!

NCLEX Question Representation Breakdown:

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%

PRACTICE LOTS!

Use your materials and follow your plan!

Review according to your schedule, then practice using an app to get used to the style of questions and then write practice exams, stopping to assess how you did afterwards. You will gradually improve until you are prepared for the NCLEX.

TIPS:

Break down the question and get to the point, ask yourself, “What does this question want from me?” and just answer it.
Don’t try to form any conclusions about patterns or odds you are passing or question what level the questions might be at, just do them. I wouldn’t read too much into any coincidences (e.g. clicking option ‘c’ 5 times in a row). Reflect later when the NCLEX is over and you are having a celebratory margarita.
Highlight in your mind the major words, for example, ‘what should you do first...” Watch out for prioritization questions asking what you would do first, next, etc.
Watch out for words like never, always, etc. Most things in healthcare are subjective or do not have absolute answers so beware any answers with such strong absolutes in them.
Cross off in your mind answers that you know are wrong and narrow it down. This improves your odds dramatically of getting the question right.
Keep an imaginary patient in mind and refer to them and how the question is directly affecting them.
Always read and reread the question for good measure to double check your understanding of the question and so you don’t miss any important words.
Watch for questions, especially multiple choice ones, that are trying to test your memory or knowledge. They tend to be easier than critical thinking questions. Try not to second guess yourself too much. Try and think of the answer that comes to mind and then look at your options to click for answers.
Answer every question and do not skip or throw any away.
Beware of ‘all the above’ answers and be very critical before selecting it as an answer.
Most questions can be answered in a couple min or less. Do not agonize too much over each question. Remember, it is mean to test your knowledge... that you already have! You just need to recall things like your ABCs, Maslow’s hierarchy, prioritize, etc. Monitor your pacing each question.
After answering a question, review your response and think, ‘Would I actually do this in real life? Is this reasonable? Is this what I would expect a competent nurse to do?’

STEP THREE: PRACTICE

Take Breaks and Chill Out

Try and manage things so you have a bit of a balance while studying. Have breaks and watch out for your stress levels. Take small break throughout the day while studying, go for walks, eat well, and let your mind unwind at the end of every day. I am perhaps the worst person to advise this as I frequently say things like, “I’ll sleep when I’m dead,” which isn’t exactly healthy. But seriously, google is saying this is good self-care advice...

THE DAY BEFORE THE EXAM...

Try and relax and unwind the day before the exam and mentally prepare yourself for the next day.

Get a good night’s sleep
Eat healthy and stay hydrated
Review the instructions for parking, getting there, and what time you plan to arrive
Have your ID ready
Try not to bring too much stuff if you can help it

THE DAY OF THE EXAM...

Wake up after a good night’s sleep leaving ample time to get ready and get to the test centre with ease.

Have a good, healthy meal beforehand.

Psych yourself up with positive affirmations on the way.

Arrive about 30 minutes early to the test centre and check in.

Follow the NCSBN protocols: These include storing any devices in a zip lock bag provided by the test centre, ensuring any support person waits outside of the test centre for you to finish the NCLEX, have a non-expired picture ID such as a passport, drivers license, PR card, etc., provide a electric signature agreeing to the terms and conditions of the NCLEX, and submit to a photo and palm scan. For more of what to expect, consult the website HERE.

Utilize some deep breathing and relaxation techniques to calm your anxiety prior to writing, tell yourself to take your time, and you know this already. Try and boost your confidence and quell any negative thoughts or feelings. Remind yourself to just focus on what is in front of you, one question at a time.

Stay focused and avoid any overwhelming feelings or thoughts.

MORE NCLEX Q&A

How much time do I have to write the NCLEX?

Up to 5 hours.

Can I skip questions and go back and answer them later?

No, you can only answer the questions in order and there is no way to go back and answer them.

How many questions are on the NCLEX?

75-145 (as of 2020).

The computer system will decide if you pass or fail based on a) if it is 95% positive you are clearly above or below the standard passing threshold, b) if you are close to the passing standard, the computer will simply decide by your final stretch of questions, and c) if you have run out of time and have not answered the minimum number of questions, it is considered a fail. If you have answered the minimum, the computer will review your last 60 questions and decide.

Are there breaks?

Yes, there are two breaks scheduled after 2 hours and after 3.5 hours after the start of the exam. Just a warning, the breaks count towards the testing time!

Do I need a calculator?

No. The computer has a setup for providing a calculator if needed for the question.

The Aftermath of the nclex

That moment when the test shuts off is a bit surreal. You don’t actually know if your did good or bad and just sit there kinda dumbfounded.

You may have to complete a little survey, raise your hand and then the exam administrator will allow you to leave the room.

Getting your results can take up to 6 weeks. Unofficial results can be available for a fee ($7.95 USD) on the Pearson Vue website.

87.53% is the passing rate for the NCLEX-RN and 84.14% for the NCLEX-PN (for candidates educated in the U.S., 2020).

If you failed, you will get a Candidate Performance Report detailing your strengths and weaknesses. You can then retake the test in 45 days and up to 8 times per year.