Taking the NCLEX truthfully involves and requires a significant amount of preparation. That being the case, it is no surprise that taking the exam intimidates prospective overseas nurses and nursing students. Even so, being familiar with and knowing what to expect from NCLEX is an advantage when taking the said exam.
Using the NCLEX test plan as a study tool enables one to review content areas covered in the exam. Hence, they can be one step closer to passing their NCLEX. With the introduction and upcoming of the Next Generation NCLEX (NGN), the current NCLEX Test Plan of 2019 has been updated and improved in the new Test Plan of 2023. However, because of the NGN, the two have few notable differences.Â
About the NCLEX Test Plan
Developed by the NCSBN, the NCLEX Test Plan provides detailed information regarding the content areas included in the NCLEX. Every three years, this document gets updated to ensure that the test plan reflects fair, comprehensive, and current nursing competency. In addition, the test plan provides a framework for client needs that is universal in its structure for defining entry-level nurse competency.
As it outlines critical concepts and specifies fundamental processes to nursing practice, it serves as a guide for candidates preparing for their exams. Furthermore, it also helps exam authors direct exam item development and facilitates exam item classification.
NCLEX: Test Plan 2019 vs. Test Plan 2023
Not much has changed from the 2019 NCLEX-RN Test Plan; however, it has various noteworthy additions that improve the test plan further.
Clinical Judgment
The new test plan for the NCLEX-RN 2023 presents a highlighted fundamental process that is highly relevant and important in delivering safe and effective nursing care. This process is called clinical judgment, derived from years of research and study by the NCSBN to understand and isolate factors contributing to nursing clinical judgment. These isolated factors were the basis for developing exam items for the NCLEX.
Clinical judgment is the new addition to the integrated processes fundamental to nursing practice. It is a multi-step iterative process that employs critical thinking and decision-making that generates solutions that deliver safe client care. Moreover, case studies or stand-alone items represent clinical judgment content in the NCLEX.
Distribution of Content Percentages
There are no changes to the overall content included in the NCLEX-RN. It remains to contain the four primary Client Needs, two of which are further divided into subcategories. However, there’s a minimal adjustment to the distribution of content in the 2023 test plan compared to the 2019 test plan.
Table 1: 2019 NCLEX-RN and 2023 NCLEX-RN Test Plan Content Distribution Comparison
The Client Needs categories and subcategories include clinical judgment processes that come as 18 case studies and about 10% stand-alone items.
Examination Length
In the 2019 test plan, the stated exam length can range from 75-145 items, including 15 unscored pretest items. Meanwhile, the 2023 test plan elaborates that a candidate can take a maximum of 150 items during the duration of the examination. They must be able to answer a minimum of 85 items; 52 items from the content areas in their respective percentages, 18 case studies, and 15 unscored pretest items.
Scoring the NCLEX
The scoring of items in the 2019 test plan does not have partial credit, whereas the 2023 test plan employs partial credit scoring for items with more than one key. Partial credit scoring will involve 3 methods: plus/minus, zero/one, and rationale scoring.
NCLEX Terminology
In the 2023 Test Plan, there are updates with the Order and Prescription terminologies.
Order: Intervention, remedy, or treatment as directed by an authorized primary health care provider.
Prescription: Intervention as it relates to medication directed explicitly by an authorized primary health care provider.
Summing up
The NCSBN develops the test plan to serve multiple uses: guide exam candidates and test item developers. Moreover, it contains detailed information about the content areas tested in the NCLEX and an overview of the administration of the exam, scoring, and more. Every three years, NCSBN updates the test plan to ensure that the test plan is consistent with what is current in the nursing practice.
As a result, updates like this are bound to have some revisions, and with the NGN’s launch in April, the test plan has had additions accordingly. For example, the latest NCLEX-RN Test Plan of 2023 introduces a new integrated process called Clinical Judgment. Alongside clinical judgment, new additions and revisions such as distribution of content areas, exam length, exam scoring, and updated terminologies are also significant.
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