NCLEX-RN Exam 2026: Format, Test Plan, NGN and Fees

What is the NCLEX-RN?

The National Council Licensure Examination for Registered Nurses, written by NCSBN and used by every US state and territory, as well as Canada and Australia, to decide whether a nursing graduate is safe to practise as an entry-level RN.

You do not apply to NCSBN for a licence. You apply to your state's board of nursing (the nursing regulatory body, or NRB), register for the exam with Pearson VUE, and the board sends you an Authorization to Test (ATT) when you are eligible. The ATT has a validity window set by the board, and you must test inside it.

The exam tests clinical judgment more than recall. Since April 2023 it has been the Next Generation NCLEX (NGN), built around the NCSBN Clinical Judgment Measurement Model, and since April 2026 it follows the 2026 NCLEX-RN Test Plan, which kept the 2023 percentages and renamed "Safety and Infection Control" to "Safety and Infection Prevention and Control".

The real exam, with where each fact comes from
Who sets it	The National Council of State Boards of Nursing (NCSBN), for the nursing regulatory body (NRB) that will license you; Pearson VUE delivers itPublished by the ownerNCSBN, 2026 NCLEX Examination Candidate Bulletin (PDF)
Format	Computerized adaptive test: each answer changes which item comes nextPublished by the ownerNCSBN, NCLEX-RN Test Plan effective April 2026 (PDF)
Length	85 to 150 items. A minimum-length exam is 52 content items, 18 items in 3 clinical judgment case studies and 15 unscored pretest itemsPublished by the ownerNCSBN, NCLEX-RN Test Plan effective April 2026 (PDF)
Time	5 hours, including the tutorial and every breakPublished by the ownerNCSBN, 2026 NCLEX Examination Candidate Bulletin (PDF)
Passing standard	0.00 logits, in force through 31 March 2029. Not a percentPublished by the ownerNCSBN, "Passing Standard"
Test plan	2026 NCLEX-RN Test Plan, 1 April 2026 to 31 March 2029Published by the ownerNCSBN, "2026 NCLEX-RN Test Plan"
Fee	US$200 for every registration, including retakes; US$350 for registrations from 1 February 2027Published by the ownerNCSBN, "NCLEX Fee Changes Feb. 1"
Retakes	At least 45 test-free days between attempts, up to 8 a year; some boards set stricter limitsPublished by the ownerNCSBN, 2026 NCLEX Examination Candidate Bulletin (PDF)

What is on the NCLEX-RN test plan?

Four Client Needs categories split into eight subcategories, each with a published percentage range. Management of Care (15-21%) and Pharmacological and Parenteral Therapies (13-19%) are the largest.

The 2026 NCLEX-RN Test Plan Client Needs ranges, with the questions each gets in our 85-question mock
Client Needs subcategory	Category	2026 Test Plan range	Questions in our mock
Management of Care	Safe and Effective Care Environment	15-21%	15
Safety and Infection Prevention and Control	Safe and Effective Care Environment	10-16%	11
Health Promotion and Maintenance	Health Promotion and Maintenance	6-12%	8
Psychosocial Integrity	Psychosocial Integrity	6-12%	7
Basic Care and Comfort	Physiological Integrity	6-12%	8
Pharmacological and Parenteral Therapies	Physiological Integrity	13-19%	14
Reduction of Risk Potential	Physiological Integrity	9-15%	10
Physiological Adaptation	Physiological Integrity	11-17%	12

Running through every category are the integrated processes: the nursing process (clinical judgment), caring, communication and documentation, teaching and learning, and culture and spirituality. That is why a pharmacology question can really be a teaching question, and a delegation question can really be a safety question.

Each subcategory has its own topic page with a free drill: management of care and safety, pharmacology, prioritization and physiological adaptation, basic care, comfort and reduction of risk, and health promotion and psychosocial integrity.

Practise every Client Needs area

The free mock shows your weakest area. The Pass Pack adds two more 85-question mocks and four drills for each of the eight areas.

The NCLEX-RN Pass Pack gives you 3 full mocks on the real clock, 32 drills of 12 questions for the sections that cost you points, and a predictor that turns your mocks into the odds of reaching your target. One payment, no subscription, and your free score stays free.

Prep courses for these tests usually cost $19 to $129. The NCLEX-RN Pass Pack is US$39 (£29), once.

See the NCLEX-RN Pass Pack How our questions are built and checked

3
timed mocks: 32
topic drills: 1
score predictor

What are the Next Generation NCLEX question types?

Besides classic multiple choice, the NGN uses multiple response, matrix, drop-down, drag-and-drop, highlight and bowtie items. On a minimum-length exam, 18 items come as three case studies of six items, one for each step of the Clinical Judgment Measurement Model.

NGN item formats (from NCSBN's list) and whether our practice test uses them
Format	What you do	In our practice test
Multiple choice	Pick the one best option	Yes, every question
Multiple response (select all that apply, select N)	Pick every option that is correct, or exactly the number asked	Described here, not imitated
Matrix multiple choice and matrix multiple response	A grid: for each row (a finding or an action), mark the column it belongs to	Described here, not imitated
Drop-down cloze and drop-down table	Complete sentences or a table by choosing from drop-down lists	Described here, not imitated
Drag-and-drop cloze and rationale	Drag words or phrases into a sentence, often "the client is at risk for ___ as shown by ___"	Described here, not imitated
Highlight text and highlight table	Click the parts of a nurse's note or table that show a cue	Described here, not imitated
Bowtie (stand-alone)	Pick the condition in the middle, two actions on one side and two parameters to monitor on the other	Described here, not imitated

The six steps of the NCSBN Clinical Judgment Measurement Model, one per case-study item
Step	Name	What the item asks
1	Recognize cues	Which findings in the chart matter?
2	Analyze cues	What do those findings point to, and which conditions fit them?
3	Prioritize hypotheses	Which condition is most likely or most dangerous right now?
4	Generate solutions	What outcomes do you want, and which actions would get there?
5	Take action	Which actions do you take first, and which do you avoid?
6	Evaluate outcomes	Which findings show the care worked, or did not?

Some NGN items earn partial credit. NCSBN uses three methods: plus/minus (a point for each right choice, minus one for each wrong one, never below zero), zero/one (a point for each right choice, nothing taken away) and rationale scoring (a point only when both linked parts are right). On select-all items scored plus/minus, guessing at extra options costs you.

Our engine renders single-answer questions only, so we do not imitate these screens. Our questions are written to the same six steps: many ask which cue matters, what it means, what to do first, or which finding shows the care worked. Practise the official NGN screens with the tutorial and samples NCSBN publishes, and use our mocks for the judgment behind them.

How does the NCLEX decide when to stop?

By one of three rules: the 95% confidence interval rule (it stops once it is 95% sure you are clearly above or below 0.00 logits), the maximum-length rule (at 150 items it uses your final ability estimate) or the run-out-of-time rule (if time runs out before the minimum number of items, you fail).

Stopping at 85 items does not mean you failed, and stopping at 150 does not mean you passed. It only means the computer reached certainty early, or needed every item. 15 items on every exam are unscored pretest items, mixed in with the rest, so treat every item as if it counts.

The full explanation of logits, the confidence rule and the -0.18 figure some sites quote is on NCLEX passing score.

How do I register for the NCLEX-RN?

Apply to your state board for licensure, register and pay US$200 with Pearson VUE, wait for your Authorization to Test, then schedule your exam at a Pearson VUE center inside the ATT window.

Apply for licensure with the board of nursing in the state where you want to practise, and complete what it asks (fingerprints, transcripts, fees).
Register for the NCLEX with Pearson VUE and pay the US$200 fee. From 1 February 2027 the fee is US$350; the date you register decides which fee you pay.
When the board makes you eligible, you receive your Authorization to Test (ATT) by email. Check its expiry date.
Schedule the exam with Pearson VUE as early as you can: popular dates fill up near graduation season.
On test day, bring the acceptable ID named in your registration. You have 5 hours in all, including the tutorial and every break.
Results: official results come only from your board. Many boards take part in Pearson VUE's Quick Results, unofficial results after two business days for US$7.95.

What happens if you fail the NCLEX-RN?

You get a Candidate Performance Report showing how you did in each area, and you can retake after at least 45 test-free days, up to 8 times a year, though some boards are stricter. Every retake means re-registering and paying the fee again.

The real cost of a fail is the time. A 45-day minimum wait, a new ATT and a new appointment usually push your licence back two months or more, and in many states a graduate nurse permit ends when you fail. A job offer that depends on your licence may not wait. Use the Candidate Performance Report to aim your study, then take a full timed mock before you rebook.

How should I prepare for the NCLEX-RN?

Take a full timed mock to find your weakest Client Needs areas, learn the prioritization rules and the high-yield pharmacology and lab values, drill your weak areas, and read every rationale.

High-yield adult lab ranges (typical reference ranges; laboratories vary slightly)
Test	Typical range	Why the NCLEX asks
Potassium	3.5 to 5.0 mEq/L	Below: weakness, flat T waves. Above: peaked T waves, arrhythmia
Sodium	135 to 145 mEq/L	Below 130: confusion and seizure risk
Calcium (total)	About 9.0 to 10.5 mg/dL	Low after thyroid or parathyroid surgery: tingling, Chvostek and Trousseau signs
Magnesium	About 1.3 to 2.1 mEq/L	Loss of reflexes is the first sign of toxicity during magnesium sulfate therapy
Fasting glucose	70 to 99 mg/dL	Under 70 mg/dL: treat hypoglycemia with 15 g of fast carbohydrate
Creatinine	About 0.6 to 1.2 mg/dL	A sudden rise suggests acute kidney injury
BUN	10 to 20 mg/dL	Rises with dehydration, bleeding into the gut and kidney failure
Hemoglobin	About 14 to 18 g/dL (men), 12 to 16 g/dL (women)	A fall with tachycardia and hypotension suggests bleeding

A week-by-week plan, the prioritization frameworks and the test-day habits are in how to pass the NCLEX, and the free NCLEX-RN practice test shows where you stand today.

Commercial question banks are worth knowing about too: UWorld's NCLEX-RN page listed 30-day access at about US$139 when we checked. Whichever you use, the rule is the same: questions are for finding gaps, and rationales are for closing them.

Frequently asked questions

How many questions are on the NCLEX-RN?

Between 85 and 150 items. 15 are unscored pretest items, and a minimum-length exam includes three six-item case studies.

How long is the NCLEX-RN?

Up to 5 hours, and that includes the tutorial and every break you take.

What is the NCLEX-RN passing score?

There is no percent. The passing standard is 0.00 logits, a measure of ability, in force through 31 March 2029.

How much does the NCLEX cost?

US$200 for each registration, including retakes. For registrations from 1 February 2027, it is US$350. Your board charges its own licensure fees too.

What changed in the 2026 NCLEX-RN Test Plan?

The Client Needs percentages stayed the same as 2023. "Safety and Infection Control" became "Safety and Infection Prevention and Control", and some activity statements were reworded or added.

Is LifeScore part of NCSBN?

No. LifeScore is not affiliated with NCSBN. Our practice tests are NCLEX-RN-style, with original questions.

Pass on your first attempt

Three full NCLEX-RN-style mocks, four drills for each Client Needs area and a rationale for every answer, for one payment.