NCLEX-RN and Next Gen NCLEX (Online)


For nurses aspiring to work in English-speaking countries like the USA, Canada, and Australia, passing the NCLEX-RN exam is essential. This exam, known as the National Council Licensure Examination (NCLEX), assesses a nurse’s skills and competency. Before taking the NCLEX-RN, candidates typically need to clear an English proficiency test like the IELTS or OET as the first step towards their goal.

Successfully passing the NCLEX-RN is a significant milestone on the path to fulfilling the dream of working as a nurse in these countries. It demonstrates the nurse’s ability to meet the required standards of practice and ensures that they are well-prepared to provide quality healthcare in an English-speaking environment.

Next Gen NCLEX (NGN 2023)

A recent development in the nursing field is the introduction of the Next Gen NCLEX, often referred to as the NGN. Launched in April 2023, the Next Gen NCLEX marks a significant shift in the format of the exam. This update brings about substantial changes to the way the NCLEX is conducted and evaluates nursing competencies.

What is the difference between NCLEX-RN and Next Gen NCLEX?

Both the NCLEX-RN and the Next Gen NCLEX aim to assess a nurse’s proficiency in real-world scenarios. While the previous version of the NCLEX focused on nurses recalling nursing knowledge and applying it to clinical situations, the Next Gen NCLEX takes a different approach. It evaluates a nurse’s ability to analyze and investigate patient data before making appropriate clinical judgments. This shift in focus reflects the evolving demands of nursing practice and ensures that nurses are equipped to handle complex patient care situations effectively.

Test format of NCLEX-RN

The NCLEX is a computer-adaptive exam that includes an on-screen calculator. The test presents various question types and formats based on your performance. As you answer questions, the difficulty level adjusts accordingly. The computer-adaptive nature means that questions are tailored to your responses, with the test adapting based on how accurately you answer.

The NCLEX-RN format is designed around ‘client needs’ and real-world case studies. Rather than just testing your ability to recall nursing knowledge, the questions assess your critical thinking skills. This includes interpreting patient data, applying theoretical knowledge, and making appropriate and safe decisions for patient care. In essence, the NCLEX evaluates your ability to apply your nursing skills effectively in practical scenarios.

What is the duration of the test?

The NCLEX exam has a maximum duration of 5 hours, regardless of the number of questions a candidate must answer, ranging from 85 to 150. This timeframe encompasses the introductory session, any restroom breaks taken during the exam, and the actual test itself. Candidates should plan their time accordingly to ensure they complete the exam within the allocated timeframe.

Pre-test questions

In the NCLEX exam, the first 15 questions are known as pre-test questions. These questions are designed to assess your strengths and weaknesses. The computer uses your responses to these questions to tailor the difficulty level of the subsequent questions, ensuring that the exam accurately evaluates your nursing knowledge and skills.

How many questions do you need to answer?

Candidates appearing for the NCLEX-RN exam are required to answer a minimum of 85 questions. However, since the exam is adaptive, the computer may present up to a maximum of 150 questions based on the candidate’s performance. This adaptive approach ensures that each candidate receives a tailored assessment of their nursing knowledge and skills.

Question types

The NCLEX-RN exam features various question types to assess candidates’ nursing knowledge and skills effectively. These include:

  1. Extended Multiple-Choice questions
  2. Fill-in-the-blanks
  3. Drag and Drop
  4. Chart/Exhibit questions
  5. Audio Item Questions
  6. Cloze question or Drop-down question
  7. Enhanced Hot-Spotting or Highlighting
  8. Graphics Question
  9. Matrix or Grid questions

Each question type serves to evaluate different aspects of a candidate’s understanding and application of nursing concepts in real-world scenarios.

Scoring in Next Gen NCLEX

In the Next Gen NCLEX, there is a Partial or Full-credit system for questions where candidates need to choose more than one correct answer. This system is further divided into two scoring methods:

    • / – scoring: In this method, candidates are awarded scores for each correct answer chosen. However, scores are deducted for every incorrect answer selected, resulting in negative scoring. This scoring approach is applicable to certain question types.
  1. 0/1 scoring: This method awards candidates a score of 1 for each correct answer chosen, with no negative marking for incorrect answers.

Additionally, the Rationale Scoring System is employed to provide feedback on candidates’ responses, helping them understand the reasoning behind correct and incorrect answers. This scoring system aids in identifying areas for improvement and enhancing overall test performance.

Lab scores or values

One notable feature of the Next Gen NCLEX is that it provides reference lab values directly within the exam questions for calculations. In contrast, the previous NCLEX version required candidates to memorize these lab values. This enhancement reduces the burden on candidates, allowing them to focus more on applying their nursing knowledge and critical thinking skills rather than recalling specific numerical data.

NCLEX-RN Exam Registration Process

To register for the NCLEX exam, follow this step-by-step guide:

Step 1: Submit an application to the nursing regulatory body of the country/state where you wish to be licensed or registered.

Step 2: Ensure that you meet all the requirements listed by the nursing regulatory body of the country/state you are applying to.

Step 3: Register for the NCLEX. This can be done by contacting Medcity’s NCLEX division or the appropriate authority overseeing the exam registration process.

Step 4: Obtain authorization information necessary for scheduling your exam. This information may include an Authorization to Test (ATT) or similar documentation.

Step 5: Schedule your exam once you have received the authorization information. Choose a suitable date and testing center for your exam.

Following these steps will ensure a smooth registration process for the NCLEX exam, allowing you to progress towards obtaining your nursing license or registration in the desired country/state.

NCLEX Syllabus

The NCLEX exam is structured around specific test plan categories to guide your preparation. Here’s a sample breakdown to help you prepare effectively:


  1. Safe and Effective Care Environment
  2. Health Promotion and Maintenance
  3. Psychosocial Integrity
  4. Physiological Integrity


  1. Clinical Judgment

Focusing on these categories will ensure that you cover the essential content areas tested in the NCLEX exam. Take time to review each category thoroughly and practice questions related to each area to enhance your readiness for the exam.

What are the eligibility criteria in taking the Next Gen NCLEX?

To determine your eligibility for the NCLEX exam, consider the following basic requirements, which may vary depending on the regulatory body and the country/state you are applying to:

  1. Bachelor’s Degree in Nursing:

    • For countries like Australia or Canada, a bachelor’s degree in nursing is typically required.
    • In the USA, even a diploma (GNM) may be accepted.
  2. Authorization to Test (ATT):

    • Obtaining an Authorization to Test (ATT) is essential before scheduling your NCLEX exam.
  3. Submission of Credentials and Information:

    • You must submit all required credentials and information as specified by the nursing regulatory body.
  4. Application with a Nursing Board:

    • Complete the application process with the appropriate nursing board or regulatory body overseeing the licensure process.
  5. Registration for the NCLEX:

    • Register for the NCLEX exam through the designated channels provided by the regulatory body or testing agency.
  6. Payment for NCLEX Application:

    • Ensure that all applicable fees for the NCLEX application are paid in full as part of the registration process.

Adhering to these eligibility requirements will help streamline the application and registration process for the NCLEX exam, allowing you to pursue licensure as a registered nurse in your desired location.

Is there an expiry date for the NCLEX?

The validity of NCLEX test results can be considered lifetime as long as the candidate continues to actively practice nursing. However, if a candidate discontinues nursing practice for an extended period, they may need to retake the NCLEX exam to maintain licensure or registration. This ensures that nurses possess up-to-date knowledge and skills required for safe and effective practice in the healthcare field.

How many times can a candidate appear for the test?

Many aspiring nurses often inquire about the possibility of retaking the NCLEX exam and the frequency of attempts permitted. According to the policy set by the National Council of State Boards of Nursing (NCSBN), candidates are allowed to retake the NCLEX exam after a waiting period of 45 days from the date of their previous attempt. However, it’s important to note that some nursing regulatory boards may impose longer waiting periods between test attempts. Therefore, candidates should familiarize themselves with the specific regulations and requirements of the regulatory body overseeing their licensure process to ensure compliance.

Will the cost of the exam change with the Next Gen NCLEX?

The costs associated with the NCLEX exam remain consistent and do not change with the introduction of the Next Gen NCLEX. The fees for the NCLEX-RN exam registration and international exam scheduling remain the same, as follows:

  • NCLEX RN Exam Registration Fee: $200 (approximately INR 16,500)
  • International Exam Scheduling Fee: $177 (approximately INR 15,000)

Candidates should verify the current fees and any updates from the regulatory bodies or testing agencies administering the NCLEX exam.

Where can I appear for the exam?

In India, candidates can appear for the NCLEX exam at the following test centers:

  1. Hyderabad
  2. Pune
  3. Surat
  4. Mumbai
  5. Ahmedabad
  6. Chennai
  7. Bangalore
  8. Gurugram
  9. Noida
  10. New Delhi
  11. Chandigarh
  12. Jalandhar
  13. Amritsar

These test centers provide candidates with convenient locations to take the NCLEX exam, facilitating the licensure process for nurses aspiring to work in English-speaking countries.

What is the age limit to attend the NCLEX?

Age is not a determining factor for taking the NCLEX exam. Instead, the primary requirement is that candidates possess a nursing qualification. Specifically, candidates applying to countries like Australia or Canada typically need a bachelor’s degree in nursing, while those applying to the USA may also be eligible with a General Nursing diploma (GNM). This emphasis on nursing qualifications ensures that candidates have the necessary educational background to pursue licensure as registered nurses in their desired countries.

How to prepare for NCLEX-RN?

Getting ready for the test is as easy as walking down a lawn with Medcity’s online courses. For the online NCLEX-RN preparation course with Medcity you get an individual trainer, who will be able to assist in your preparations in your flexible timings. No matter whether you are working or not, preparations for NCLEX-RN is made easy with Medcity.

Can I write NCLEX-RN from India?

The good news is that Indian nurses can now take the NCLEX-RN exam in their home country. The US has recognized India as a testing center for the NCLEX-RN, eliminating the need for Indian nurses to travel to the US to take the exam. This development is a significant relief for Indian nurses, as it provides greater accessibility and convenience in pursuing their nursing career goals.

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