Next Generation NCLEX-RN® Test Plan 2023

To become a registered nurse in the US and Canada, you must pass the NCLEX-RN®. The exam, created by the National Council of State Boards of Nursing® (NCSBN®), is intended to evaluate a candidate's knowledge and abilities regarding entry-level nursing practice. The exam is built around a four-category NCLEX-RN test plan, or blueprint. Therefore, it's critical that you get to know the test plan's content and use it as a guide for your study plan. To help you get started, this article provides concise summaries of each category and subcategory.

NCLEX-RN Test Plan Structure

The NCLEX Examination Committee (NEC) reviews and approves the NCLEX-RN test plan, which includes a content distribution blueprint. This blueprint will be key as you develop your study plan. For example, you’re more likely to receive more questions on physiological adaptation than on basic care and comfort. The relative weight of each client needs category is detailed in the outline below. The test plan's general structure is as follows:

  • Client Needs
  • Integrated Processes
  • Clinical Judgment
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Client Needs Categories

The Client Needs categories are used as a framework for the NCLEX-RN to define the knowledge and skills nurses require to care for a diverse population of clients in various settings. Client Needs is divided into four main categories, two of which are further divided into subcategories.

Client Needs % of Items
Safe and Effective Care Environment
  • Management of Care
  • Safety and Infection Control
  • 15–21%
  • 10–16%
Health Promotion and Maintenance 6–12%
Psychosocial Integrity 6–12%
Physiological Integrity
  • Basic Care and Comfort
  • Pharmacological and Parenteral Therapies
  • Reduction of Risk Potential
  • Physiological Adaptation
  • 6–12%
  • 13–19%
  • 9–15%
  • 11–17%

Safe and Effective Care Environment

The NCLEX-RN's Safe and Effective Care Environment category carries a 25–37% weighting. It's designed to ensure that RNs can provide safe treatment to patients in a variety of settings and is broken down into the two following sub-categories:

  • Management of Care (15-21%) — Nurses with strong management of care skills can prioritize patient needs, delegate tasks to other healthcare professionals, and collaborate with interdisciplinary teams to develop and implement care plans. This category also covers the management of healthcare resources, including time, personnel, and supplies, to ensure that patient care is delivered efficiently and effectively.
  • Safety and Infection Control (10-16%) — Refers to the steps taken by medical personnel to stop the transmission of infections to patients, employees, and visitors. These precautions include spotting possible risks, putting infection control policies and procedures in place, utilizing personal protective equipment (PPE), keeping oneself clean, and handling and disposing of hazardous materials with care.

Health Promotion and Maintenance

The NCLEX-RN category—Health Promotion and Maintenance—is weighted at 6–12%. This category focuses on activities and interventions that assist people, families, and communities in preserving and enhancing their general health and well-being. This entails:

  • Promoting healthy lifestyles
  • Preventing illness and injury
  • Managing chronic health conditions
  • Educating patients about healthy behaviors
  • Promoting regular health screenings and vaccinations
  • Identifying and addressing health concerns early

Maintaining optimal health, preventing or managing chronic diseases, and enhancing patients' overall quality of life are the key objectives for healthcare practitioners. In practice, this can mean assisting patients and their families with the management of a chronic illness like diabetes or heart disease or instructing patients on good nutrition, or quitting smoking.

Psychosocial Integrity

The NCLEX-RN's Psychosocial Integrity category carries a 6–12% weighting. Candidates will be assessed on their knowledge and abilities in relation to treating patients with mental health and psychosocial problems. Healthcare providers must offer patients holistic care that takes into account both their physical and emotional requirements. Important subjects consist of:

  • Therapeutic communication
  • Coping mechanisms
  • Mental health disorders
  • Substance abuse
  • Grief and loss
  • Family dynamics

This category provides a framework for understanding the social and emotional aspects that affect a patient's health and well-being. Healthcare workers must be able to provide compassionate care, recognize and address patients' emotional needs, and interact with patients and their families in a clear and effective manner. This can be done in practice by recognizing the warning signs of suicide or self-harm, taking into account the adverse effects of psychotropic medications, and putting the proper safety measures in place.

Physiological Integrity

The NCLEX-RN's Physiological Integrity category, which is broken down into four subcategories (see details below), is weighted at 33-57%. Examinees are required to show proficiency in terms of giving patients with physiological needs safe and effective care. Understanding how the human body functions, as well as the disruptive qualities of disease and injury, underpins this category.

Focuses on the fundamentals of nursing care, such as aiding with mobility, controlling discomfort, offering emotional support, and engaging in efficient communication.

Elaborates on how to administer medication in a safe and efficient manner. Includes pharmacology, pharmacokinetics, and pharmacology principles. Examinees must show that they can keep an eye out for negative drug reactions and put the right measures in place.

Covers the prevention of complications and adverse events such as falls, infections, and complications from surgeries or treatments, as well as how to keep an eye out for drug-related complications and put the right safety precautions in place.

Consists of treating patients who have either acute or long-term physiological abnormalities, such as changes to their vital signs, oxygenation, or fluid/electrolyte balance. This subcategory also covers the skills needed for competent care for patients with acute or chronic illnesses, such as respiratory distress, heart failure, and diabetes.

This category is used in practice in various ways, including bathing, feeding, and positioning a patient with physiological demands. Other uses include administering nutritional and oral hydration, parenteral and pharmaceutical therapy, and emergency care.

Integrated Processes

Nurses must understand how to prioritize patient care, recognize and address changes in patients' situations, and work well with the rest of the healthcare team. For instance, nurses might need to use information technology to assist with patient care and documentation or apply ethical and legal ideas in various situations. This requires an understanding of all four of the client's need categories. In light of this, Integrated Processes evaluate a candidate's capacity to practice clinical reasoning and critical thinking in all facets of nursing care. This category's core procedures are as follows:

Fostering mutual respect and trust as well as fostering a compassionate and cooperative environment.

Thinking critically, providing evidence-based solutions, and prioritizing concerns.

Collecting data, planning, implementing, and evaluating in order to approach client care scientifically.

Includes verbal and nonverbal (i.e., written/electronic records) interactions between nurses, clients, and other healthcare professionals.

Considers a patient’s reported or self-identified preferences and recognizes related legal considerations.

Nurturing a positive learning environment and establishing positive behavior changes.

Clinical Judgment

Clinical judgment refers to the ability of a nurse to use their knowledge, experience, and critical thinking skills to make informed decisions about a patient's care. It involves synthesizing information gathered from various sources, such as patient history, patient assessments, medical records, and lab data, and then applying that knowledge to develop a treatment plan and evaluate the outcomes of that plan.

To underscore the importance of clinical judgment and ensure all entry-level nurses have the clinical judgment skills necessary to provide safe and effective care, the NCSBN developed the Clinical Judgment Measurement Model (NCJMM) to provide a framework to better understand and assess candidates' clinical judgment. Tier three of the NCJMM is focused on six measurable steps in the clinical decision-making process.

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Administration of the NCLEX-RN

The NCSBN updates the NCLEX-RN test plan every three years to ensure that the exam continues to be a reliable and accurate measurement of an individual's competency to practice entry-level nursing. The final section of said test plan covers details regarding the administration of the exam—exam length, passing standard, scoring methods, and terminology. To learn more about these details, see the linked articles below.

There is a ton of NCLEX-related information. For this reason, we have compiled the most crucial data from across the internet on this page.

You can’t pass the NCLEX if you don’t sit for it. Find out if you qualify, how to sign up, and how much it will cost you to take the NCLEX.

The complex nature of NCLEX scoring can be intimidating. This page will explain how the NCLEX scoring system works, and what to expect when you receive your score.

Now that you are aware of the topics covered by the NCLEX-RN, it is time to create a thorough and efficient strategy. You can get started with this study guide.

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