The National Council Licensure Examination for Practical Nurses (NCLEX-PN®) is an exam designed for entry-level practical nurses and vocational nurses (LPN or VN).
Click the “Start Test” button above to take a free NCLEX-PN practice test!
About the NCLEX-PN Exam
The NCLEX-PN is a computer-adaptive test (CAT), which means that after each scored response, the computer recalculates your ability estimate using all of your previous answers and the difficulty of those items. It then selects an appropriately challenging item while also meeting the NCLEX test-plan requirements.
The exam contains between 85 and 150 items and ends under one of the three pass/fail rules explained below. There are 15 pretest questions embedded in the total number of questions. Pretest questions are used to determine the usefulness of such items in future iterations of the exam, which means they are not scored. However, you will not be able to tell the difference between scored questions and unscored pretest questions, so do the best you can on each consecutive question.
NCLEX-PN Outline
In terms of content and structure, the NCLEX-PN covers several content areas, each with specific weights. Below are the content areas, potential topics, and specific weight ranges per section (which are dependent on the number of questions you end up completing).
- Coordinated Care: 18%-24%
- Safety and Infection Prevention and Control: 10%-16%
- Health Promotion and Maintenance: 6%-12%
- Psychosocial Integrity: 9%-15%
- Basic Care and Comfort: 7%-13%
- Pharmacological Therapies: 10%-16%
- Reduction of Risk Potential: 9%-15%
- Physiological Adaptation: 7%-13%
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Top 5 Most Challenging NCLEX-PN Questions
Now that you know more about the exam, try your hand at some targeted practice!
Over the last year, we’ve compiled the data from about 4,000 test-takers who tried their hand at the practice test at the top of this page. According to the data, around 85% of people answered these five questions incorrectly.
Answer each question and read through the answer explanation, whether you got the answer right or wrong. This will help you ensure you’ve got the topic mastered.
Whether you struggled with these questions or aced them on your first try, be sure to take the full practice test to get a better idea of how prepared you really are!
1. A client is to be discharged with a tracheostomy. Which of the following should the nurse most stress when educating the client about home management? Select all that apply.
2. What physiological responses should the nurse expect when applying cold compresses to tissue? Select all that apply.
Cold also results in vasoconstriction, which reduces edema and inflammation; decreased muscle tension, which helps to prevent muscle spasms; and reduced cell metabolism. Heat applications tend to have the opposite effect, resulting in vasodilation, decreased viscosity of the blood, increased permeability of capillaries, and increased tissue metabolism.
3. A client has accidentally splashed a toxic (although not caustic) substance in his right eye, and the nurse must flush the eye. Which of the following steps are correct? Select all that apply.
- Begin irrigation immediately. Remove contact lenses if present and easily removable, but do not delay irrigation.
- Position the client supine with the head turned toward the affected right side, and place a drainage basin beneath the right eye and cheek.
- Irrigate with copious room-temperature water or normal saline.
- Hold the eyelids open and direct a gentle stream across the conjunctival sac from the inner toward the outer canthus. Do not touch the eye or direct a forceful stream at the cornea.
- Continue irrigation for at least 15–20 minutes
4. A client with Alzheimer’s disease has repeatedly gotten out the front door at night and run away. Which of the following suggestions may be helpful to a caregiver? Select all that apply.
Clients should never be locked into a room, and motion sensors with alarms are often terrifying to clients, increasing their stress and need to get away.
5. A client has been diagnosed with Parkinson’s disease and has been prescribed levodopa. Which of the following are contraindications to levodopa? Select all that apply.
Pregnancy is not an absolute contraindication; the potential benefits and fetal risks must be evaluated by the healthcare provider. Macular degeneration is not a contraindication. Clients with controlled open-angle glaucoma may receive levodopa cautiously if intraocular pressure is monitored
How the Test is Scored
The NCLEX-PN is scored using a rather unique system. Rather than receiving a point value that reflects either the number of correct answers or the average difficulty level of questions you answered, the score here will be measured in logits.
Because the NCLEX-PN exam is computer-adaptive, NCSBN uses a logitⓘ A logit is the measurement unit used internally to compare the computer’s estimate of a candidate’s ability with the passing standard. scoring system to determine whether a test-taker passes or fails.
The NCLEX-PN passing standard is −0.18 logits through March 31, 2029.
One of three rules is used to determine whether you pass or fail:
- 95% confidence interval rule: After the minimum number of items, the exam ends when the computer is 95% certain that your ability is clearly above or clearly below the passing standard.
- Maximum-length rule: If you reach 150 items without a 95% confidence decision, the final ability estimate is used. An estimate at or above the passing standard results in a pass; an estimate below it results in a fail.
- Run-out-of-time rule: If time expires before 150 items and you completed the minimum required number of items, you are evaluated using the final ability estimate. If you did not complete the minimum, you automatically fail.
If you have met the passing standard, you will simply be informed that you passed the exam. You will only see a detailed report of how you performed on each section of the test if you failed.
Computer-Adaptive Testing
The NCLEX-PN is computer-adaptive, meaning that the test monitors your responses and adapts the questions to match your abilities. After each response, the computer recalculates your ability estimate using all of your scored answers so far and the difficulty of those items. It then selects an appropriately challenging item while also meeting the NCLEX test-plan requirements.
Study Tips
Start with an NCLEX Practice Test
Before creating your study schedule, take an NCLEX-PN practice test to establish a starting point. You don’t need to wait until you have reviewed every disorder, medication, and nursing procedure. At this stage, the goal is to identify which areas of practical nursing and clinical judgment need the most improvement.
Review your results according to the following “client needs” categories:
- Safe and Effective Care Environment: Can you organize and prioritize care, collaborate with the healthcare team, contribute to the plan of care, identify environmental hazards, and respond safely to emergencies?
- Health Promotion and Maintenance: Do you understand growth and development, pregnancy and newborn care, health screening, disease prevention, lifestyle choices, and age-appropriate care?
- Psychosocial Integrity: Can you communicate therapeutically, recognize changes in mental or emotional status, support clients experiencing stress or loss, and respond appropriately to behavioral concerns?
- Physiological Integrity: Can you recognize and respond to acute, chronic, or life-threatening changes in a client’s physical condition?
- Clinical Judgment: Can you recognize important cues, analyze what those findings mean, identify the priority problem, choose appropriate interventions, take action, and evaluate the client’s response?
Identifying those specific weaknesses will show you where to devote more attention during your study time.
Review Difficult Questions
After each practice session, review every question you answered incorrectly AND every question you guessed on or answered with low confidence. Guessing correctly does not necessarily mean that you have mastered the skill.
For each difficult question, determine which of the following caused the problem:
- You did not know the underlying condition, medication, procedure, or nursing principle.
- You overlooked an important symptom, vital sign, laboratory result, or change in the client’s condition.
- You failed to distinguish an expected finding from a possible complication.
- You confused the responsibilities of the LPN/VN with those of assistive personnel.
- You selected an intervention outside the nurse’s legal scope of practice.
- You made a dosage-calculation or medication-administration error.
- You misread a negative phrase such as “requires intervention”
- You misread a negative phrase such as “requires further teaching” or “needs intervention.”
- You struggled to interpret an exhibit, chart, case study, or unfamiliar item format.
- You spent too long debating between answers without identifying the central nursing issue.
Then, outline a specific plan for improvement based on what you discovered. In other words, don’t just say, “I need to study medications.” Specify that you need to review adverse effects of anticoagulants, calculate oral liquid dosages, or identify which client findings should be reported before administering a medication.
Similarly, replace “practice prioritization” with a more useful goal such as recognizing acute changes, comparing stable and unstable clients, or identifying which findings require immediate reporting.
Utilize Answer Explanations
Answer explanations are an underutilized studying resource. To take full advantage of them, read the explanation for every question you found difficult, including questions you answered correctly.
For each one, make sure you can confidently explain:
- Why the correct answer is the safest and most appropriate response
- Why each incorrect option is less appropriate
- What nursing concept or Client Needs category is being tested
- Which client information is most important
- Whether the LPN/VN should provide care, collect more data, reinforce teaching, collaborate, or report the finding
- How the correct decision would change if the client’s condition or circumstances were different
Don’t stop after reading that one intervention is correct. Determine why it takes priority over the alternatives. Ask whether the decision is based on an immediate threat to safety, an unexpected change, infection prevention, medication risk, scope of practice, or the need to notify another member of the healthcare team.
For case-study questions, review the client’s record again and identify which findings were relevant.
Study Nursing Decisions, Not Individual Questions
Memorizing the answer to one NCLEX question will not prepare you for a different client with different medications, symptoms, test results, and risk factors. Your goal should be to understand the nursing knowledge and decision-making process behind the answer.
For example, determine which finding(s) represented an acute change, why it threatened the client’s safety, and why the other clients could safely wait.
Similarly, don’t study medications as isolated lists of names. Connect each medication’s indication, therapeutic effect, administration route, contraindications, adverse effects, interactions, laboratory monitoring, dosage calculations, client education, and required nursing response.
The exact questions on your test will be different from the ones you encounter during practice. If you can explain a skill without looking at your notes and then apply it correctly to a new question, that is a good indication that you have mastered it.
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NCLEX-PN Online Prep Course
If you want to be fully prepared, Mometrix offers an online NCLEX-PN prep course designed to give you everything you need to succeed!
Here’s what you’ll find in the NCLEX-PN course:
- 110+ Review Lessons Covering Every Topic
- Over 1,600 NCLEX-PN Practice Questions
- 500 Digital Flashcards
- 90+ Instructional Videos
- Money-back Guarantee
- Mobile Access
Everyone learns differently, so we’ve tailored the NCLEX-PN online prep course to ensure every learner has what they need to prepare for the NCLEX-PN exam.
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How to Pass
At this point, you should have a better understanding of the content and structure of the NCLEX-PN. You are undoubtedly ready to begin the process of preparing for the exam. You can help yourself on exam day by getting enough rest, eating properly, and managing your stress. But, the best way to ensure you do well on the NCLEX-PN is to thoroughly prepare.
Mometrix Test Preparation has the test preparation materials you need in the NCLEX Secrets study guide, which gives you real NCLEX-PN content, including expert tips aimed at helping you reduce stress, recall information, and ensure high performance.
In addition to the NCLEX Secrets study guide, Mometrix Test Preparation also offers a comprehensive NCLEX-PN Practice Test, NCLEX Flashcards, and an online NCLEX-PN course!
FAQs
Q
What is the NCLEX-PN?
A
The NCLEX-PN exam is used by members of the National Council of State Boards of Nursing (NCSBN) to ensure that entry-level practical nurses meet set requirements for nursing licensure.
Q
What is a good score on the NCLEX-PN?
A
The NCLEX-PN passing standard is −0.18 logits. Your reported result will be pass or fail; you will not receive a numerical logit score.
Q
How many questions are on the NCLEX-PN?
A
The NCLEX-PN exam contains anywhere from 85 to 150 questions.
Q
When will I receive my test scores?
A
You will receive your NCLEX-PN test scores within six weeks after completing the exam.
NCLEX and NCLEX-PN are registered trademarks of National Council of State Boards of Nursing, Inc., which is not affiliated with Mometrix Test Preparation and does not endorse this page.
