HealthApril 16, 2020

Preparing students for temporary changes in the process for taking the National Council of State Boards of Nursing NCLEX-RN Licensing Exam

By Diane M. Billings, RN, EdD, ANEF, FAAN Chancellor’s Professor Emeritus, Indiana University School of Nursing, Indianapolis

The current Covid-19 pandemic has required institutions and organizations to temporarily change policies and procedures to accommodate national guidelines for mitigating risk and maintaining health.

To this end the National Council of State Boards of Nursing (NCSBN) has made temporary changes in the NCLEX-RN licensing exam and procedures for taking the exam at exam sites.  This change is in effect from March 25, 2020 to July, 2020. (NCSBN, COVID-19 Impact to NCLEX Candidates).  This blog explains the changes and offers suggestions for preparing students who will be affected by these changes.

The exam sites

As of March, 25, 2020, Pearson Vue, the company that manages the licensing exam testing centers, will open selected sites in metropolitan areas in the United States and Canada for graduates to take the exam.  Those sites that will be open will accommodate limited numbers of test takers and observe local, state and federal guidelines for social distancing. The sites will be cleaned and disinfected between each test taker. These changes are in effect from March 24 through July, 2020.  For information about exam sites, go to

Preparing students to take the exam

In addition to advising students about these temporary changes, faculty can continue their plans to help all students prepare for the exam.  While most exam preparation plans can be followed as usual, some preparation strategies may need to be adapted for use in online environments or to accommodate social distancing.  Faculty should communicate with students about testing sites, where to check to determine if sites are open their area, and about changes in the exam procedures. Although the NCSBN has indicated that the testing experience should not be affected by the temporary changes, faculty who find that their students use the full number of test items available, should help students recognize their need to prepare for success with fewer items.  Faculty can also identify at-risk students who may be eligible to take the modified exam and ensure that they are sufficiently prepared. Faculty can also ensure that all students understand the importance of using study resources, participating in exam content reviews, and practicing effective test-taking strategies.

Preparing students for content review

To prepare for reviewing content and study skills, students can use exam review books which can be purchased online and online testing products.  Review books include large numbers of practice questions and students can use these to identify areas requiring additional study.  Students who are taking the exam during the time period of the temporary change in the minimum and maximum number of test questions on the exam can create for themselves a test with 60 to 130 questions to simulate the variety of questions and the amount of time in which to complete the test.

For those students who are using online testing products, faculty can advise students to follow the same study procedures such as using the broad base of questions to determine areas requiring further study. Lippincott® PassPoint allows students to take an adaptive exam with 60 to 130 questions, to set a time limit of 4 hours, and provide and provide a passing benchmark and data on strengths and weaknesses for further study. It’s a very authentic practice experience, even with these temporary exam parameters.

Schools that offer faculty-conducted content reviews can adapt these for use online.  Students who will be eligible for the changed format could also form study groups using online meeting software.

Preparing students to be effective test takers

Taking tests involves not only knowing the content, but also understanding techniques and strategies for understanding the format of the question and selecting the correct answer. Faculty can ensure that test-takers are familiar with the format for all test item types with particular attention to multiple response questions which are the most difficult for students and are scored as being either correct or incorrect. 

Review books and online testing products provide students with feedback for the correct and incorrect answers as well as information about each question such as content area, level of the cognitive domain, step of the nursing process.  Students can use this information to determine areas of strengths and weaknesses.

Equally important, the student should understand the structure of the question and the reason for their answer choice.  For each test item the student should be sure they understood what the stem of the question was asking; why each possible answer was correct or incorrect; and, why they chose the answer that they did.  Incorrect answer choices can occur because the student: 1) did not understand what the questions was asking 2) missed key words in the question; 3) did not understand the meaning of key words; 4) did not read all of the answer options; 5) did not understand the content; 6) changed the answer; or 7) was anxious, tired, not concentrating.   Students can make a grid for each test item they use for practice to determine a pattern of causes of incorrect responses.


The NCSBN has made temporary changes in the licensing exam.  The number of the test items has been reduced to a minimum of 60 and a maximum of 130 and the time limit for the exam is 4 hours. Not all exam sites will be open and faculty and students should check the Pearson Vue website for current information (see link below).  Faculty can advise students who will be taking the licensing exam under these changed circumstances by guiding students to review both the content and test-taking strategies.  A variety of resources are available, and students can use all of them while maintaining social distancing and following health practices.

Faculty must stay informed as changes in licensing exam procedures can continue to change.  Faculty should subscribe to NCSBN newsletters and bookmark the web sites of the NCSBN, State Boards of Nursing, Pearson Vue, and publishers’ practice and study resource websites to be able to provide current information and best study practices for their students.

References and resources for information about changes to the NCLEX-RN licensing exam.

National Council of State Boards of Nursing.  COVID-19 Impact to NCLEX Candidates.  Retrieved from

Pearson Vue

Wolters Kluwer