After completing their required training and education programs, prospective nursing students must sit for the National Council Licensure Examination. Registered nurses, who devise treatment plans and administer care, take the NCLEX-RN. Licensed practical or vocational nurses, who perform more basic care tasks under RN supervision, complete the NCLEX-PN. The National Council of State Boards of Nursing reported that out of all candidates who took the NCLEX in 2012, 79.51 percent of RN students passed, compared to 73.79 percent of LVN/LPN students. RNs who passed went on to earn an average of $67,930 annually as of May 2012, according to the U.S. Bureau of Labor Statistics, while LVN/LPNs earned $42,400.
Combined with other requirements that vary by state, individual state nursing boards use the results from the NCLEX to make licensure decisions. The overall licensure process is designed to ensure that nurses meet the standards for safe practice, no matter where they live or the type of educational program they completed. Students receive their test scores directly from their state board of nursing, rather than the test center. Students who fail the NCLEX have between 45 and 90 days to retake it as needed.
The NCLEX-RN and the NCLEX-PN are generally the same in terms of structure; the main exception is that RNs have six hours to complete their work, and LVN/LPNs only five. Students take exams on computers in Pearson VUE test centers, without the aid of any outside writing materials. The bulk of the test questions require students to apply their knowledge to specific work scenarios, as they are written at the application level or higher of Bloom's Taxonomy. Questions are computer-adaptive, taking into account students' answers as they progress through the exam and adjusting in difficulty accordingly.
Generally, the largest difference between the two exams is that the questions are aimed at the specific duties of each nursing profession: for RNs, creating care plans and evaluating patients, and for LPN/LVNs, collecting patient information and supporting care plans. Despite this difference, both the NCLEX-RN and the NCLEX-PN use the idea of client needs as a framework, such as the care environment and health promotion, as well as communication, documentation and other processes central to effective nursing. The largest amount of the NCLEX-RN, at 20 percent, discusses care management, while the NCLEX-PN devotes its highest percentage of content -- between 13 and 19 -- to coordinated health care.
Specific differences in the process of registering for the NCLEX are found across different states, rather than between RN and LPN/LVN candidates. The first general step for all students is applying for licensure through their state nursing board; after being approved, students receive a letter with a date range within which they can take the NCLEX. Students register for an exam date directly through Pearson VUE and can complete registration through the mail, over the phone or online, which includes paying a fee.