Highlights from the 2016 NCLEX-RN Test Plan

Every 3 years, the National Council of State Boards of Nursing (those folks who invented the NCLEX) publishes their NCLEX-RN Test Plan. This document (and webinar) is chock full of useful information about the exam including its structure, content, question types, scoring, and much more.

But at 61 pages, it’s not exactly a beach read. You may be asking yourself, “Do I really need to go through the entire thing?!” Keep reading and I’ll let you in on what you really need to focus on.

1. Section III is a ‘must read’

If you only have time to review one section of the test plan, make it this one. Section III—aptly titled “Detailed Test Plan”—is the bulk of the document that outlines the content areas that will be on the exam.

You can think of “content” as what you will be expected to know—and do— in your day-to-day clinical practice as a nurse. For example, page 12 of the Test Plan notes that you must “recognize the client’s right to refuse treatments/procedures.” The NCLEX may have a question similar to the one below to test you on that content.

The nurse is caring for a patient who needs a diuretic to alleviate the symptoms of heart failure. The patient refuses, saying the last time she took that medication she had “ringing in her ears.” Which is the most appropriate response for the nurse to make?

1.       “You have to take the medication. Doctor’s orders.”

2.       “I will speak to the provider who ordered this medication to see if there is an alternative that won’t cause ringing in the ears.”

3.       “If you don’t take this medication, you won’t get better.”

4.       “You can’t refuse medications.”

Hint: the answer is #2 because you recognize that the patient has a right to refuse treatments but you are also looking for an alternative solution.


Doing lots of practice questions will help you become familiar with the type of content that will be on the real exam.  Because you don’t want to look like this when you’re taking the NCLEX:

2. How NCLEX content is distributed

In 2014, 2,744 new RNs answered lots of questions to make sure that the NCLEX questions are relevant to your actual clinical practice. This RN Practice Analysis is usually conducted every 3 years and guides how content will be distributed on the exam.

Section II of the Test Plan covers this in more detail but here’s the breakdown for 2016:

Safe and Effective Care Environment

·         Management of Care                                                   17-23%

·         Safety and Infection Control                                      9-15%

Health Promotion and Maintenance                      6-12%

Psychosocial Integrity                                                  6-12%

Physiological Integrity 

·         Basic Care and Comfort                                             12-18%

·         Pharmacological and Parenteral  Therapies         12-18%

·         Reduction of Risk Potential                                      9-15%

·         Physiological Adaptation                                          11-17%

Broken record here, but practice questions will really help you appreciate the distribution of content you’ll see on the actual test.

3. The Ins and Outs of the NCLEX

OK, so now that you know the what, let’s talk about the how.

Section IV of the Test Plan will let you in on lots of stealthy information including the length of the exam (hint: 75-265 items), the passing standard, whether or not you should guess at questions (you shouldn’t), scoring method, question types and more.

It’s nice to have an idea of what you’re getting yourself in to before you sit down to take the test.

Be a know-it-all

Whether you decide to read the Test Plan cover to cover, or just focus on the highlights here, you’ll be glad you reviewed it. Understanding how the exam works, and knowing exactly what to expect, will definitely help ease some of your anxiety (as you’re studying and on test day).

Have you had a chance to review the Test Plan yet? What sections were most helpful to you? Share your thoughts in the comments!