Failed the NCLEX? Now What?

By Kathleen Colduvell RN, BSN, BA, CBC

The final hurdle to become a fully licensed Registered Nurse is the National Council Licensure Examination (NCLEX).

To some, this is a daunting feat requiring countless hours of preparation and thousands of sample questions. Others take lengthy review courses in conjunction with online study programs. According to the National Council of State Boards of Nursing (NCSBN) 84.57% of new graduates pass the NCLEX on their first attempt.

So what does that mean for the other 15%?

Nurses who’ve failed their boards on the first attempt -- as well as nursing experts -- explain that it takes commitment, perseverance, humility, and grace to overcome this hurdle. A shocking number of new graduates fail their boards on the first attempt, but it’s rarely discussed.

Interestingly, a large number of nurses have a coworker who failed the NCLEX. In fact, including internationally educated nurses and repeat test takers, the pass rate in 2016 was only 70.18% on the first attempt. According to statistics, this number is an increase from 69.87% in 2015.

Analyze your failure

It’s important for nurses to recognize why they failed, and for every nurse the reason will be different. Some fail due to personal responsibilities, including family. Others suffer from lack of preparation, difficulty with critical thinking and  multiple choice questions, the inability to focus during studying, or being distracted during testing.

Each of these can be overcome but require immediate and focused attention.

A study conducted in 2008 by the NCSBN concluded that for those who fail, it’s important to retake the NCLEXas soon as possible. It found that delaying the exam after graduation doesn’t increase the chance of failure. Rather, delaying after initially failing can increase the chance of failing a second time.

Once it’s been determined why you failed, think about what you need to do differently in order to change the outcome.

Enrolling in NCLEX prep courses can be helpful for those requiring personalized attention and in-person reviews. These courses are instructor-based and offer a money back guarantee. Review courses can increase confidence and help with critical thinking skills.

It’s important to take multiple practice tests and answer hundreds of questions in order to become increasingly familiar with the test format and questions. Some questions have multiple answers that may in fact be correct, but the NCLEX searches for the best possible answer. Sample online tests can be found through various websites or through NCLEX study books.

Take action!

After determining why you failed, it’s time to take action with this information. First, write down as many of the topics from the initial test that you can remember. These could include lab results, obstetrics, cardiology, or time management questions.

If there’s one area where you feel especially weak, spend some time reviewing content material related to this subject. Some experts suggest answering 50 questions per day with a specific focus on areas of weakness. 

Study guides containing review questions are a potential nurse’s best friend. Every day, regardless of outside factors, experts recommend at least 150-250 questions should be answered. The questions answered incorrectly should be reviewed and content material reexamined if there is still confusion. 

Lippincott's NCLEX Review Guide contains more than 3,000 sample questions with correct and incorrect answers and rationales, as well as a diskette containing an additional 100 questions. The book is separated into different clinical areas so that you can concentrate on your weak area and not spend too much time on areas where you’re more comfortable. 

Think positive thoughts 

Despite the hours of preparation, the most important advice any nurse can give is to stay positive and expect to pass. Failing the NCLEX on the first attempt doesn’t adversely affect one’s future nursing career. It’s important to not get stuck in a cycle of depression or self doubt after failure.

Don’t give up. Remember, you made it through nursing school, so you have the persistence to pass the state boards and earn your license to practice.


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