The National Council Licensure Examination (NCLEX) assesses the knowledge, skills, and clinical judgment needed to provide safe and effective nursing care. Developed by the National Council of State Boards of Nursing (NCSBN), the NCLEX-RN is used for registered nurse licensure in the United States, Canada, Australia assessment pathway for certain internationally qualified nurses. The NCLEX-PN is a separate examination used for practical or vocational nurse licensure in the United States.
The NCLEX uses computerized adaptive testing, which adjusts question selection according to each candidate’s performance. It evaluates the ability to apply nursing knowledge, interpret patient information, and make appropriate care decisions. Clinical case studies present realistic situations that assess critical thinking and clinical judgment, helping determine whether candidates are prepared for the responsibilities of entry-level nursing practice.
Both NCLEX-RN and NCLEX-PN currently contain 85–150 questions, with a maximum examination time of five hours, including the introductory screen and breaks. Passing is determined against the examination’s ability standard, rather than a simple percentage of correct answers. The number of questions received does not indicate whether a candidate passed or failed.
The registration process differs across the three countries. In the United States, candidates apply through their chosen state’s nursing board. In Canada, they follow the requirements of the relevant provincial or territorial regulator, with Quebec maintaining its own examination process. In Australia, internationally qualified registered nurses assigned to the Outcomes-Based Assessment pathway complete the required assessment stages, including the NCLEX-RN and a practical clinical examination known as the Objective Structured Clinical Examination (OSCE). Other Australian registration pathways are available for eligible applicants. Passing the NCLEX is an important milestone, but candidates must also meet all applicable registration requirements before practicing.
These are general stages. Requirements and the order of document submission depend on the relevant nursing regulator.
An Authorization to Test (ATT) is issued after the regulator confirms examination eligibility and Pearson registration is complete. Candidates must schedule and take the examination within their ATT validity dates.
These stages apply to candidates required to complete OBA. Eligible internationally qualified registered nurses may qualify for alternative pathways based on their qualifications, registration history, and practice experience.
New York permits foreign nursing education verification through TruMerit’s Credentials Verification Service for New York State or the direct school-verification route described by NYSED. Use the current NYSED instructions when selecting a verification service.
Texas also assesses graduation and nursing practice history. Required credential and verification reports must be sent through the official channels specified by the Board.
Questions use different scoring methods, including zero/one, plus/minus, and rationale scoring. Eligible questions with multiple correct responses can award partial credit.
Present several answer options with one best answer. The correct answer earns 1 point, while an incorrect answer earns 0 points.
Present statements or findings in a grid, requiring one response per row. Each correctly answered row earns 1 point. The maximum score equals the number of rows.
Require selection of a specified number of answers. Each correct selection earns 1 point, and each incorrect selection earns 0 without a deduction. The maximum score equals the required number of selections.
Organize answer options into separate groups, allowing multiple selections within each group. Each correct selection adds 1 point, and each incorrect selection subtracts 1 point. Each group or row is scored independently, with a minimum score of 0. The group scores are then added together.
Require selection of every correct option without specifying how many are correct. One or more options may be correct. Each correct selection adds 1 point, and each incorrect selection subtracts 1 point. Unselected options earn 0, and the total cannot fall below 0.
Present a grid in which multiple responses can apply to a row or category. Each correct selection adds 1 point, and each incorrect selection subtracts 1 point within its column. Negative column scores become 0 before the column scores are added together.
Contain blanks within a sentence or passage that are completed using drop-down menus. Each correct selection earns 1 point, while an incorrect selection earns 0. The maximum score equals the number of drop-down responses.
Contain incomplete table entries that are completed using drop-down menus. Each correctly completed entry earns 1 point, while an incorrect entry earns 0.
Connect one likely clinical condition with two appropriate actions and two parameters to monitor. Each correct response independently earns 1 point, for a maximum of 5 points.
Use linked blanks to connect a clinical conclusion or action with its supporting reason or reasons. For a two-part response, both parts must be correct to earn 1 point. For a three-part response, the main answer must be correct; each correct supporting reason then earns 1 point, for a maximum of 2 points.
Require steps or actions to be arranged in the correct sequence. The complete correct sequence earns 1 point. An incorrect sequence earns 0 points.
Use a shared client scenario and clinical records to support a series of related questions. An unfolding case study contains six connected questions. Each question follows the scoring method for its response format. The total possible points depend on the questions included.
Require selection of relevant predefined words or phrases within a clinical passage. Each correct highlighted segment adds 1 point, and each incorrect segment subtracts 1 point. The minimum total score is 0.
Require selection of relevant predefined findings or values within a table. Each correct selection adds 1 point, and each incorrect selection subtracts 1 point. The minimum total score is 0.
After passing the NCLEX-RN, healthcare worker visa screening is an important step for many international nurses pursuing employment in the United States. This process reviews your education, professional licenses, nursing qualifications, and English proficiency. Certification is available through USCIS-authorized organizations approved for your profession.
Requirements and Documents to Prepare
Document requirements and submission procedures vary by organization. Follow your selected agency’s current checklist when preparing your application.
Visa retrogression occurs when the cutoff dates in the U.S. Department of State’s monthly Visa Bulletin move backward because demand exceeds available immigrant visa numbers. For nurses pursuing employment-based immigration, including EB-3, this can delay immigrant visa issuance or final green card approval, even when an employer’s petition has already been approved.
Your priority date and place in the visa queue remain unchanged by retrogression. Final approval must wait until a visa number becomes available for your category and country of chargeability, usually your country of birth. While waiting, follow the monthly Visa Bulletin, track your documents’ expiration dates, and stay in contact with your employer and immigration representative to prepare for the next stage.