Summary Preparing for the new nursing licensure exam:The next-generation NCLEX
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Course
NCLEX RN
Institution
NCLEX RN
Abstract
: TheNational Council ofState Boards ofNursing is changingits licensure examto focus on a clinicaljudgment model.This articledescribes thecurrent NationalCouncil LicensureExam (NCLEX), theshift in focus fromthe nursing processto clinical judgment,and the intendedemphasis of thenext-genera...
9/15/22, 9:23 PM Preparing for the new nursing licensure exam: The next-generation NCLEX Nursing : May 2021
Features
Preparing for the new nursing licensure exam:
The next-generation NCLEX
Donna D. Ignatavicius, MS, RN, CNE, CNECL, ANEF
Abstract: The
National Council of
State Boards of
Nursing is changing
its licensure exam
to focus on a clinical
judgment model.
This article
describes the
current National
Council Licensure
Exam (NCLEX), the
shift in focus from
the nursing process
to clinical judgment,
and the intended
emphasis of the
next-generation
NCLEX.
Keywords:
National Council
GAUDILAB/iSTOCK » Licensure Exam,
National Council of
State Boards of
Nursing, NCLEX, NCSBN, next-generation NCLEX, NGN, nursing process, Tanner’s Clinical
Judgment Model
TO BECOME A LICENSED RN, LPN, or LVN, the board of nursing in each state,
commonwealth, or territory requires qualified nursing program graduates, or candidates, to
pass standardized National Council Licensure Exams for RNs and LPNs and LVNs (NCLEX-RN
or NCLEXPN) to measure competencies for safe practice in entry-level nursing roles.1,2 In
terms of format and content, these electronic exams have not changed in more than 15
years. This article discusses the planned transition from the current NCLEX, formerly “the
boards,” to a nextgeneration NCLEX (NGN) to better prepare new nursing graduates to
enter healthcare.
, 9/15/22, 9:23 PM Preparing for the new nursing licensure exam: The next-generation NCLEX Nursing : May 2021
The National Council of State Boards of Nursing (NCSBN) develops licensure exams
consistent with current nursing practice. The organization surveys a large sample of new
graduates every 3 years to determine which skills and competencies are vital for nursing
practice. These data become the basis of the test plans for the NCLEX-RN and NCLEX-PN
and guide the development of the exams.
The test plans include five integrated processes (IPs) for nursing practice.1,2 One IP for the
NCLEXRN is the nursing process, which is defined as “a scientific, clinical reasoning
approach to client care that includes assessment, analysis, planning, implementation, and
evaluation.”2 Nursing diagnosis, which includes the NANDA International (NANDA-I)
classification system, is not included in this IP because NANDA-I is not used by all nurses or
clinical agencies. NANDA-I develops and promotes standardized terminology to improve
healthcare and ensure patient safety through evidence-based care.3 Although the NCSBN
does not address NANDA-I nursing diagnoses on the NCLEX, many prelicensure programs
include these in their curricula. The other four IPs, which are integrated into both NCLEX
exams, are caring, teaching and learning, communication and documentation, and culture
and spirituality.
The current NCLEX is administered as a secure, adaptive electronic test. The total number
of items (or questions) a candidate receives depends on how well he or she answers other
items of varying levels of difficulty. The licensure exams consist of two types of multiple-
choice test items: single-response and multiple-response (also known as select-all-that-
apply) questions. These items present a brief patient (or client) situation and a question,
followed by answer choices. Each client situation is specific, focusing on one aspect of
nursing care rather than a complex clinical situation. Only information needed to answer
the question is provided, and keywords are bolded to reduce potential reading errors.
Today, many nursing educators teach the steps of
the nursing process as a tool for critical thinking and
clinical decision-making.
The exam measures content knowledge as right or wrong, and candidates select one or
more correct answers for these items. (See Current NCLEX multiple-choice test items.)4
The remainder of the NCLEX includes fill-in-the-blank items that typically require drug
dosage or I.V. calculations, drag-and-drop items that require prioritization, items that
require data collection from the medical record, and hot spot items in which participants
select a focused area of an image to demonstrate technical or assessment skills. Most
candidates are provided with only a few of these item types during the NCLEX.5
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