NCLEX-PN vs NCLEX-RN: Key Differences

The NCLEX-PN and NCLEX-RN are the licensure exams for practical/vocational nurses and registered nurses, respectively. While both exams are developed by the National Council of State Boards of Nursing (NCSBN) and share some similarities, they differ significantly in content, complexity, and scope. Understanding these differences helps you prepare effectively for whichever exam you’re facing.

Quick Comparison

Feature	NCLEX-PN	NCLEX-RN
Full Name	National Council Licensure Examination for Practical Nurses	National Council Licensure Examination for Registered Nurses
Questions	85-150 items	85-150 items
Time Limit	5 hours	5 hours
Cost	$200	$200
Pass Rate (2024)	84-86% (first-time US)	87-89% (first-time US)
Format	CAT (Computer Adaptive Testing)	CAT (Computer Adaptive Testing)
Scope	LPN/LVN scope of practice	RN scope of practice

Exam Format

Both exams use Computer Adaptive Testing (CAT), which adjusts question difficulty based on your performance:

How CAT Works

1. Exam starts with a moderate-difficulty question
2. Correct answers lead to harder questions
3. Incorrect answers lead to easier questions
4. Algorithm determines your competency level
5. Exam ends when a pass/fail decision is made with 95% confidence

Question Range

Both exams have:

• Minimum: 85 questions (including 15 pretest items)
• Maximum: 150 questions
• Pretest items: 15 unscored questions testing future content

Finishing at the minimum (85 questions) can mean either a strong pass OR a clear fail—the number alone doesn’t indicate your result.

Time Management

Component	Time
Total exam time	5 hours
Tutorial	Up to 15 minutes (doesn’t count)
Optional breaks	2 breaks offered
Average per question	1-2 minutes recommended

Content Differences

NCLEX-PN Content Categories

The NCLEX-PN test plan focuses on practical nursing scope:

1. Safe and Effective Care Environment (26-32%)

• Coordinated care (13-19%)
• Safety and infection control (13-19%)

2. Health Promotion and Maintenance (6-12%)

• Growth and development
• Health screening
• Disease prevention

3. Psychosocial Integrity (9-15%)

• Coping mechanisms
• Mental health concepts
• Support systems

4. Physiological Integrity (49-59%)

• Basic care and comfort (9-15%)
• Pharmacology (10-16%)
• Reduction of risk potential (9-15%)
• Physiological adaptation (7-13%)

NCLEX-RN Content Categories

The NCLEX-RN test plan covers a broader scope:

1. Safe and Effective Care Environment (21-29%)

• Management of care (17-23%)
• Safety and infection control (9-15%)

2. Health Promotion and Maintenance (6-12%)

• Similar to PN but more depth

3. Psychosocial Integrity (6-12%)

• More complex scenarios
• Therapeutic communication

4. Physiological Integrity (49-67%)

• Basic care and comfort (6-12%)
• Pharmacology (13-19%)
• Reduction of risk potential (9-15%)
• Physiological adaptation (11-17%)

Key Content Differences

Topic	NCLEX-PN	NCLEX-RN
Care planning	Contributes to care plan	Develops/implements care plans
Delegation	Limited	Extensive (delegating to LPNs, CNAs)
Patient teaching	Reinforces teaching	Develops teaching plans
IV therapy	Basic maintenance	Complete IV management
Assessment	Focused/basic	Comprehensive
Critical care	Minimal	Significant
Leadership	Limited	Management/prioritization

Question Types

Standard Multiple Choice

Both exams primarily use multiple-choice questions with 4 options. However, the clinical scenarios differ in complexity.

NCLEX-PN Example:

A client is receiving a blood transfusion. Which finding should the LPN/LVN report to the RN immediately?

• A. Temperature of 98.8°F
• B. Urinary output of 50 mL/hour
• C. Complaints of back pain and chills
• D. Blood pressure of 132/84 mmHg

NCLEX-RN Example:

An RN is caring for four clients. Which client should the RN assess first?

• A. A postoperative client with a blood pressure of 88/56 mmHg
• B. A diabetic client with a blood glucose of 180 mg/dL
• C. A client with pneumonia and oxygen saturation of 93%
• D. A client with chest pain rated 3/10 after nitroglycerin

Next Generation NCLEX (NGN) Items

Both exams now include Next Generation NCLEX question types:

• Extended multiple response — Select all that apply with partial credit
• Matrix/grid — Multiple decisions in one item
• Highlight — Select text within a passage
• Cloze (drop-down) — Fill in blanks with options
• Drag and drop — Sequence events or match items
• Bowtie — Identify causes, actions, and parameters

Case Studies

NGN includes unfolding case studies with 6 questions following one patient through a clinical scenario. These test clinical judgment across the nursing process.

Difficulty Comparison

Why NCLEX-RN Is Considered Harder

1. Broader scope — Covers all RN responsibilities including those LPNs cannot perform
2. Complex decision-making — Prioritization, delegation, and management questions
3. Higher-level thinking — More analysis and synthesis required
4. Critical care content — ICU, emergency, complex patients
5. Independent judgment — RNs must make autonomous decisions

What Makes Both Exams Challenging

• Application-level questions (not just recall)
• Clinical judgment requirements
• Multiple “correct” answers where you choose the BEST one
• Time pressure with complex scenarios
• Test anxiety and high stakes

Pass Rates

Historical Pass Rates (First-Time, US-Educated)

Year	NCLEX-PN	NCLEX-RN
2024	84.56%	89.01%
2023	84.29%	87.62%
2022	80.96%	82.48%
2021	81.76%	86.05%

Pass rates dropped in 2022 when NGN items were introduced, then recovered as programs adapted their preparation methods.

Repeat Test-Taker Pass Rates

For those who don’t pass on the first attempt:

• NCLEX-PN repeat: ~60%
• NCLEX-RN repeat: ~50%

This underscores the importance of thorough preparation for your first attempt.

Preparation Strategies

For NCLEX-PN

1. Focus on practical nursing scope

   • What can LPNs do independently?
   • When must you report to the RN?
   • Basic nursing skills and procedures

2. Master foundational content

   • Vital signs and normal ranges
   • Medication administration basics
   • Infection control
   • Patient safety

3. Practice decision-making

   • Stable vs. unstable patients
   • Expected vs. unexpected findings
   • Priority actions within LPN scope

For NCLEX-RN

1. Prioritization is key

   • ABCs (Airway, Breathing, Circulation)
   • Maslow’s hierarchy
   • Nursing process
   • Acute vs. chronic conditions

2. Delegation questions

   • What can you delegate to LPNs?
   • What can you delegate to UAPs?
   • What must the RN do personally?

3. Complex patient scenarios

   • Multiple patients to manage
   • Critical thinking required
   • Independent decision-making

Study Resources for Both

Resource Type	Examples
Review courses	Kaplan, Hurst, ATI
Question banks	UWorld, Archer, Kaplan
Books	Saunders, Lippincott
Apps	NCLEX RN/PN Mastery, Nurse Achieve
Practice exams	Archer, BoardVitals

Note: Some links above are affiliate links. I may earn a commission if you purchase, at no cost to you.

Study Timeline

Timeline	Recommended Hours
3 months before	2-3 hours daily
1 month before	4-6 hours daily
Last week	Light review, practice questions

Practice Question Goals

• Minimum: 2,000-3,000 practice questions
• Ideal: 3,500-4,000+ questions
• Focus on: Understanding rationales, not just memorizing answers

Registration and Scheduling

Steps to Take Either Exam

1. Graduate from an accredited nursing program
2. Apply to your state board of nursing
3. Register with Pearson VUE ($200 fee)
4. Receive ATT (Authorization to Test)
5. Schedule exam at a Pearson VUE testing center
6. Take exam within ATT validity period (typically 90 days)

What to Bring

• Valid government-issued ID (must match registration exactly)
• ATT confirmation email (recommended but not required)
• Nothing else allowed in testing room

Test Day Tips

1. Arrive 30 minutes early
2. Eat a good meal beforehand
3. Dress in layers (temperature varies)
4. Stay calm—you’ve prepared for this
5. Take offered breaks if needed
6. Read each question carefully
7. Don’t second-guess constantly

Results

Quick Results

• Available 48 hours after exam (not all states)
• $7.95 fee through Pearson VUE
• “Unofficial” but highly accurate

Official Results

• Sent to state board (2-4 weeks)
• Board issues license number
• Check board website for license verification

If You Don’t Pass

Waiting Period

• 45-day waiting period between attempts
• Maximum attempts varies by state (some unlimited, some cap at 8)

Retake Strategy

1. Identify weak areas from your Candidate Performance Report
2. Focus study on weak content areas
3. More practice questions with rationale review
4. Consider a review course if self-study didn’t work
5. Address test anxiety if that was a factor

Transitioning from PN to RN

If you’ve passed NCLEX-PN and later complete an RN program:

• Your LPN pass doesn’t exempt you from NCLEX-RN
• You must take NCLEX-RN after completing RN education
• Previous nursing experience helps but doesn’t replace exam prep
• Focus on expanded RN scope content

Learn more: LVN to RN Bridge Programs

Summary

Both NCLEX-PN and NCLEX-RN are challenging but passable exams when you prepare properly. Key differences center on scope of practice—the PN exam tests practical nursing skills within a collaborative framework, while the RN exam tests broader clinical judgment and independent decision-making.

Next Steps

Ready to start preparing? Check out:

• Archer vs UWorld — Compare the top NCLEX question banks
• NCLEX Study Strategies — Proven techniques for passing
• 30-Day NCLEX Study Plan — Complete month-long preparation schedule
• NCLEX Exam Guide — Complete preparation resources
• RN License Requirements — State-by-state requirements
• LVN/LPN License Requirements — State-by-state requirements