Receiving below-passing scores on the NCLEX can be a big blow, but it's not the end of the world. Make sure your second attempt is your last.
The National Council Licensure Examination (NCLEX) is the last major hurdle nurses face before they can apply for licensure. Even for the most confident students, the exam can be nerve-wracking.
Recent and upcoming graduates of nursing programs have had an especially hard time due to extra stressors they experienced during the pandemic.
“There are more candidates receiving a repeat invitation in the past year than in previous years,” says Maria Flores-Harris, executive director of nursing at Kaplan, an education and test-prep company.
We talked to Flores-Harris and two recently licensed nurses to find out their top tips and tricks to passing the NCLEX this year.
First, know that the NCLEX is a challenging exam. Unlike many other standardized tests, the NCLEX uses a pass/fail system. It also does not allow you to go back and change answers.
According to the National Council of State Boards of Nursing (NCSBN), the overall pass rate for U.S. nursing licensure was 86.6% in 2020. So, you are not alone in this experience.
“The fact that you are in good company probably doesn’t make you feel better, but hopefully some of the reasons why you are in this company and the many things you can do to prepare again will help,” Flores-Harris says.
Find relief in the fact that failing the exam won’t stop you from ever becoming a nurse.
[pass on their first attempt] and that’s OK. They have all been amazing nurses for many years,” says Kristyn Chanel, a pediatric emergency room nurse in Houston.
You can retake the exam as soon as 45 days after your first attempt and take it up to eight times in a year.
Also, the majority of states have no time limit on when you need to pass the NCLEX after graduation. The remainder give you a few years to pass the exam. But check with your state board of nursing to find out the current policies in your state, which are subject to change.
It’s become a cliché, but taking the time for self-care is critical, especially during periods of stress.
“Failures are often due to nonacademic reasons. You know more content than you think you do,” says Flores-Harris. “It is often anxiety, personal demands, and lack of self-care that get in the way of passing.”
Research on stress in undergraduate student populations shows that the neglect of self-care can significantly impact academic performance.
The period after graduation or after your first NCLEX attempt is a good moment to take some time off, even if it’s a few days. Use this time to physically and mentally reset.
“I would first take a few days to decompress and tell myself this does not make me a failure,” says Shannon Rosen, an operating room nurse in Naples, Florida. “This just gives me more of an opportunity to prove that my hard work and dedication will pay off, just with a little extra time and effort.”
Failing an exam is never a good feeling. But try not to let it affect your self-confidence, which can also impact academic performance.
“After I took the exam, I thought I had failed and I felt so defeated, but I soon changed my attitude because I knew if I had to take it again, I would need to have a positive mindset,” Chanel says.
Remember that standardized exams are not a reflection of your capabilities or a prediction of your career trajectory. Remind yourself of all the obstacles you faced in nursing school. This is just another challenge that you will overcome.
Now that you’ve taken the exam once, you have more insight into its structure and content.
“Preparing for it a second time is simpler than you think,” Flores-Harris says.
It’s best to schedule your retake exam sooner rather than later because the longer you wait, the less likely it is that your desired date and time will be available. But this doesn’t mean you have to choose the soonest available date. Give yourself adequate time to prepare.
If you fail the exam, you will receive a Candidate Performance Report from your state board.
“This report will list the eight content areas of the NCLEX blueprint and provide an above, near, or below passing standard rating for each category based on your performance,” Flores-Harris says.
It can be a great resource to help you determine the subjects you need to focus on the most, optimizing study time.
“Address the ‘below passing’ standard areas first, followed by the ‘near passing standard areas,'” Flores-Harris says. “You should not address the ‘above’ categories at this point in your preparation.”
To help break it down even further, Flores-Harris says to “take note of the percentage makeup of the test for each category and address the areas that make up the highest percentage first.”
Next, reevaluate your study habits to determine which ones worked and which didn’t. Be honest with yourself through this process.
Some people have great success with certain approaches, such as group study, while others find it distracting and unproductive. Some have great success with flashcards; others find that they don’t help them truly understand a subject. The techniques that work best will be unique to each person.
Using a test-prepping resource can help you stay organized. Chanel and Rosen found success with UWorld, a test-prep resource that provides practice tests and other study tools.
Now that you have evaluated your areas of improvement and thought about your study strategy, plan how many hours per week you will study.
Get granular about which topics you will cover each week and write down your plan in a calendar or planner. Breaking the content you need to cover into chunks will make it more manageable.
“I made a schedule where I studied a different topic every day,” Chanel says. “Following my study schedule, whatever topic I had planned for that day, I would do all the practice questions covering that topic and make sure to comprehend the concept.”
Chanel allocated two-and-a-half weeks for preparation. But you might find you need more time to prepare depending on how many topics you need to refresh yourself on.
And when mapping out your schedule, don’t forget to factor in time to maintain a healthy diet and exercise routine.
[the] NCLEX,” Flores-Harris says. “Exercise throughout your preparation to improve cardiovascular circulation which improves your brain function.”
When exam day comes, avoid last-minute cramming. It does little to help you retain information and can heighten your anxiety about the NCLEX, negatively affecting your performance.
Instead, close your books and make yourself a healthy breakfast. “Protein and complex carbohydrates are best. Avoid lots of sugar to avoid a sugar coma,” Flores-Harris says.
You may also benefit from mindfulness activities. Consider verbalizing or writing down self-affirmations, breathing exercises, meditation, or any practice that relaxes you and boosts your confidence.
Try not to speculate on your performance as you’re taking the exam. For some, the format of the NCLEX (e.g., that it chooses questions based on your most recent answers and shuts off if you answer too many incorrectly) causes test-takers to become panicky and distracted.
“The hardest part of the exam for me was not knowing if the next question would be my last. My biggest advice would be to focus on each question individually and not ‘what is coming next?'” Rosen says.
“Read each question slowly, think about what you know about that topic, and then answer to the best of your ability,” she says. “You have the knowledge! You know the information! Don’t second guess yourself.”
“Also, remember to breathe and take your time. The exam gives you plenty of time, so there is no need to rush,” Chanel adds.
Creating a concrete plan of action to pass the nursing exam makes test preparation for the NCLEX less daunting. Just like any other obstacle in life, preparing for the NCLEX is done one step at a time.
When in doubt, remember what you’re working so hard for. “Once you successfully pass the NCLEX, get ready for a challenging but rewarding career as a nurse,” Chanel says.
Maria Flores-Harris is an executive director of nursing at the education and test-prep company Kaplan. She earned a master’s in nursing, specializing as a geriatric nurse practitioner, from Clemson University and a doctor of nursing practice in educational leadership from American Sentinel University.
Shannon Rosen graduated from Nova Southeastern University, passed the NCLEX in May 2022, and is an operating room nurse at Naples Community Hospital in Florida. Find her on TikTok, where you can watch a heart-warming video of her and her dad reacting to finding out she passed the NCLEX.
Kristyn Chanel graduated from Chamberlain University and passed the NCLEX in May 2022. She is now a pediatric ER nurse at a hospital in Houston, Texas. She can be found here on TikTok, where you can find a clip of her surprising family and friends at graduation with the news she passed the NCLEX.
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