Nurse Certification and Licensing
How are Nurses Licensed or Certified?
All nurses in the United States must take and pass a test before their state will issue a nursing license to them.
The test is the National Council Licensure Examination. The subjects covered are:
- Safe Effective Care - Management, Safety/Infection Control
- Health Promotion/Maintenance
- Psychosocial Integrity
- Physiologic Integrity
- Basic Care/Comfort
- Pharmacology - Risk Reduction
- Physiologic Adaptation
The questions will be in several formats: multiple choice, fill in the blank, ordered response, multiple response, and illustrated.
The NCLEX is a CAT test, Computer Adaptive Test. What that means is that the program containing and administering the exam adapts to
the person who is taking it according to their answers. The questions advance based on difficulty and the ability of the test taker.
When the program has determined the test taker has the competency required to pass, the test stops and the administers are notified.
The same happens in the event that the person being tested fails.
The allotted time to finish the test is six hours. In this time the tested individual may answer 75 to 265 questions.
It is entirely possible to pass the test with the minimum number of questions answered in the shortest time. A pass or fail
does not rely on number of questions answered, only on the number of correct answers to incorrect. There are 15 practice questions
that do not count towards a score.
In order to sit for the NCLEX most nursing schools recommend that students
apply to their state's board of nursing late in their senior year of registered
nurse training or in the last month of licensed practical nurse courses. A fee
will be charged for processing and an approval, Authorization to Test, will
be mailed. This authorization letter is valid for 30 days. If testing is not
scheduled with the 30 days, a new application must be mailed.
The state board of nursing will receive instant notification of a passing or failing grade from the NCLEX. If the test taker has passed,
their name will be entered on that state's registry with 48 hours. The board will then mail a hard copy of the license to the new nurse's
home. That license is valid unless the nurse does not renew the license in two years or it is revoked.
A license can be revoked for serious infractions of he nursing code of ethics, such as neglect, abuse, criminal behavior, or substance abuse.
Nurses that have a problem with substance abuse may surrender their license for a treatment program on a temporary basis. That license may be
re-issued or released from a suspended status is the nurse completes a rehabilitation program and submits clean drug test results.
Specific Nurse Certification and Licensing Info by State