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National Council Licensure Examination

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National Council Licensure Examination

The National Council Licensure Examination (NCLEX) is a nationwide examination for the licensing of nurses in the United States, Canada, and Australia since 1982, 2015, and 2020, respectively. There are two types: the NCLEX-RN and the NCLEX-PN. After graduating from a school of nursing, one takes the NCLEX exam to receive a nursing license. A nursing license gives an individual the permission to practice nursing, granted by the state where they met the requirements.

NCLEX examinations are developed and owned by the National Council of State Boards of Nursing, Inc. (NCSBN). The NCSBN administers these examinations on behalf of its member boards, which consist of the boards of nursing in the 50 states, the District of Columbia, and four U.S. territories, American Samoa, Guam, Northern Mariana Islands, and the U.S. Virgin Islands.

To ensure public protection, each board of nursing requires a candidate for licensure to pass the appropriate NCLEX examination: the NCLEX-RN for registered nurses and the NCLEX-PN for vocational or practical nurses. NCLEX examinations are designed to test the knowledge, skills, and abilities essential for the safe and effective practice of nursing at the entry level.

NCLEX examinations are provided in a computerized adaptive testing (CAT) format and are presently administered by Pearson VUE in their network of Pearson Professional Centers (PPC). With computerized exams such as this, the computer selects which question you are asked based on how you answered the previous question. The NCLEX covers a wide range of material. The individual will be scored on their ability to think critically about decisions involving nursing care.

Following the establishment of state boards of nursing in the early 20th century, each board independently developed and administered its own licensure exams. After the start of World War II, state boards of nursing came under increasing pressure to expedite licensing and schedule exams more frequently. In response, participants at a 1942 National League of Nursing Education's (NLNE) National Committee on Nursing Tests conference proposed a "pooling of tests" as a solution, wherein each state would prepare and contribute exams in one or more subjects that could serve as a source of test items. The State Board Test Pool Examination (SBTPE) was given in 15 states during its initial testing year of 1944. By 1950, the SBTPE was used in all 48 states, with each jurisdiction establishing its own pass threshold. The American Nurses Association (ANA) took over management of the SBTPE in 1955, which at the time had 600 questions (plus 120 validator questions) divided into 4 sections and was administered over multiple-days. The NCSBN was created in 1978 and took ownership of the SBTPE, and in 1982, replaced the SBTPE with NCLEX. The NCLEX, which was at the time a test administered using paper and pencil, decreased the total number of questions from 720 to 480 (including up to 75 pilot questions, which had no bearing on the final score). The following year, in 1983, NCSBN once more lowered the number of questions to 370 (including as many as 70 pilot questions). As a paper exam, NCLEX was only provided twice a year. The NCLEX-RN was given over two days in February and November; while the NCLEX-PN was given over a single day in April and October.

In 1994, the NCSBN implemented a significant change to the NCLEX by converting the examination from a paper-and-pencil format to a computerized adaptive testing (CAT) format. Questions for the CAT test were selected from a test bank of 1,700–2,000 pretested, statistically analyzed questions that were coded according to topic and degree of difficulty. Other changes included with the new CAT test was the test now took less than a day and was administered throughout the year. In addition to multiple-choice format questions, the NCSBN began including alternative item formats for the NCLEX-RN in October 2003.

In 2015, NCLEX was adopted in Canada, with changes made to address measuring units, drug names, and other terminology differences between the United States and Canada. Additionally, the NCLEX is available in Canadian French for French-speaking Canadians.

The NCSBN developed an updated version of the NCLEX called the "Next Generation NCLEX (NGN)," which went into effect April 1, 2023.

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