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USA for Nurses — Registered Nurse

NCLEX-RN — Registered Nurse Licensure

The NCLEX-RN (National Council Licensure Examination for Registered Nurses) is the gateway exam for any nurse who wants to practise as a Registered Nurse in the United States. It is developed by the NCSBN and delivered through Pearson VUE centres worldwide. Passing the NCLEX-RN proves you have the clinical judgement and nursing knowledge to practise safely at entry level. MCIQ provides one complete preparation package combining the two most trusted NCLEX-RN Qbanks in a single subscription.

Pathway Snapshot

Complete your nursing degree, apply for licensure with your chosen state board, complete CGFNS credential evaluation if internationally trained, register with Pearson VUE, and sit the NCLEX-RN. International graduates must also obtain a VisaScreen certificate for U.S. work visa purposes.

Complete Journey: Nursing Degree → Credential Evaluation (CGFNS CES / VisaScreen) → State Board Application → Authorization to Test (ATT) → Pearson VUE Registration → NCLEX-RN (CAT) → State Licensure → Nursing Practice in the USA.

Eligibility

To sit the NCLEX-RN, you must hold a nursing degree equivalent to a U.S. Bachelor of Science in Nursing (BSN) or Associate Degree in Nursing (ADN) from an accredited institution. Internationally trained nurses must have their credentials evaluated by an NCSBN-approved agency — most commonly the Commission on Graduates of Foreign Nursing Schools (CGFNS, now also operating as TruMerit) through its Credentials Evaluation Service (CES).

English proficiency requirements vary. NCSBN does not mandate a universal English test for NCLEX eligibility, but many state boards and employers require IELTS Academic (commonly 6.5 overall, with 7.0 in speaking) or OET (Grade B in all four sub-skills). For immigration purposes, the CGFNS VisaScreen certificate mandates English proficiency under federal law. Always confirm your specific requirements with the state board where you intend to apply.

Credential Evaluation for International Nurses

Before you can apply for licensure, your nursing education and licensure history must be evaluated.

  1. Apply for the CGFNS Credentials Evaluation Service Professional Report (CES) or VisaScreen (required if you need an occupational visa).
  2. Submit your nursing degree, transcripts, and home-country nursing licence.
  3. CGFNS verifies your documents directly with your institutions and determines whether your education is equivalent to U.S. standards.
  4. Once approved, you receive a report that allows you to proceed with state board application.

Processing times vary; start this step at least 6–12 months before your planned exam date.

State Licensure Application

  1. Select the state where you intend to work.
  2. Submit an application to that state's Board of Nursing, including your CGFNS evaluation report and proof of English proficiency (if required by that state).
  3. The state board determines your eligibility and issues an Authorization to Test (ATT).
  4. You then register with Pearson VUE to schedule your NCLEX-RN.

Requirements vary by state. Always check the specific rules of your chosen state board before applying.

NCLEX-RN Exam Details

The NCLEX-RN is a computer-adaptive test (CAT) using the NCSBN Clinical Judgment Measurement Model (NCJMM). It is not a fixed-length or fixed-difficulty exam. The exam terminates when the algorithm achieves 95% statistical confidence that you are either above or below the passing standard.

FeatureDetails

Format

Computer-adaptive test (CAT). The exam adjusts question difficulty based on your performance in real time.

Question Types

Multiple-choice, select-all-that-apply (SATA), fill-in-the-blank, ordered response, hot spot, matrix/grid, bow-tie, and unfolding case studies (Next Generation NCLEX items).

Number of Questions

Variable: minimum 85 questions, maximum 150 questions. At the minimum length, the exam includes 52 scored standalone items, 18 clinical-judgment case-study items (3 cases × 6 linked items), and 15 unscored pretest items. On longer exams, the case-study and pretest counts remain fixed; only the scored standalone items increase.

Duration

Maximum 5 hours, including the tutorial, two optional breaks, and all testing time.

Passing Standard

0.00 logits, set by NCSBN and uniform across all U.S. jurisdictions. The standard is reviewed every three years; confirm the current figure at nclex.com. Results are reported as Pass/Fail only — no numerical score is given.

Testing Centres

Pearson VUE centres worldwide, including international locations.

Validity

NCLEX-RN results do not expire, but state-specific licensure timelines and continued competency requirements vary.

NCLEX-RN Test Plan (subject distribution)

Client Needs CategoryApproximate Weight

Safe and Effective Care Environment — Management of Care

15–21%

Safe and Effective Care Environment — Safety and Infection Prevention and Control

10–16%

Health Promotion and Maintenance

6–12%

Psychosocial Integrity

6–12%

Physiological Integrity — Basic Care and Comfort

6–12%

Physiological Integrity — Pharmacological and Parenteral Therapies

13–19%

Physiological Integrity — Reduction of Risk Potential

9–15%

The RN exam focuses on management, leadership, delegation, and complex clinical judgement. It tests the nurse's ability to independently evaluate patient conditions, initiate and update care plans, and supervise assistive personnel.

What we offer

One complete NCLEX-RN preparation package combining two industry-leading Qbanks in a single subscription. Uworld Nursing (2,800+ questions). Archer Review (3,100+ questions).

Start NCLEX-RN Prep →

Retake Policy

Candidates who do not pass must wait 45 days between attempts. NCSBN permits up to 8 attempts per year nationally, but several state boards impose stricter limits — some limit total attempts or require remedial education after repeated failures. Always check the retake policy of the state where you are licensed.

How to Book Your Exam

  1. Obtain your Authorization to Test (ATT) from your state board after your application and credentials are approved.
  2. Register on the Pearson VUE website and select the NCLEX-RN.
  3. Choose a test centre and date within your ATT validity window (typically 90 days).
  4. Pay the Pearson VUE exam fee ($200 USD for U.S. centres; an international surcharge of $150 applies for non-U.S. centres, plus any local VAT).
  5. Official results are mailed by your state board within 2–6 weeks. Unofficial quick results may be available through Pearson VUE 48 hours after the exam for a small fee (approximately $7.95 USD).

After the Exam

Passing the NCLEX-RN means your state board can issue your Registered Nurse licence. You are then authorised to practise in that state. To work in another state, apply for licensure by endorsement — no retake of the NCLEX-RN is required. For internationally trained nurses, the CGFNS VisaScreen certificate is also used for occupational visa applications. Specialist nursing certifications (Critical Care, Oncology, etc.) are separate post-licensure credentials from bodies like ANCC and are not part of the NCLEX pathway.

Fees

All fees are approximate and based on 2026 data. Always confirm exact amounts on the official portals before payment.

ItemApprox. FeeNotes

CGFNS CES Professional Report

~$485 USD Required credential evaluation for most states

CGFNS VisaScreen Certificate

~$540 USD Required for occupational visa (includes CES equivalent); confirm current fee at cgfns.org/trumerit.org

State Board Application Fee

$75–$400 USD Varies widely by state

Pearson VUE NCLEX-RN Fee (U.S.)

$200 USD Plus $150 international surcharge if testing outside the U.S.

Background Check / Fingerprinting

$50–$150 USD Varies by state

Licence Issuance

Varies by state Paid to the state board after passing

Note on Fees: All fees are set by NCSBN, Pearson VUE, CGFNS, and individual state boards and are subject to periodic revision. The NCLEX-RN passing standard (0.00 logits) is current as of the 2026 NCSBN test plan and is reviewed triennially. Always confirm exact fees, eligibility criteria, and the current passing standard on the official websites of CGFNS, NCSBN, and your chosen state board before application.