Nursing exam retains difficulty despite plummeting pass rates

“Both as a nurse, but also as a potential patient, I want nurses to be highly qualified,” said Linda Aiken, PhD, RN. “I don’t think anybody in the public is interested in lowering standards for nurses.”

Aiken is the founding director of the Center for Health Outcomes and Policy Research at the University of Pennsylvania School of Nursing. She was referring to National Council of State Boards of Nursing’s plan to keep the NCLEXRN exam the same, despite declining pass rates the past few years.

The percentage of U.S.educated test-takers who passed the exam on the first try fell from 88.2% in 2019 to 82.5% in 2021, with the decline continuing in 2022, which had an average pass rate of 80.9%.

The pass rate for all test-takers, which includes repeat candidates and those educated in other countries, fell from 72.8% in 2019 to 66.6% in 2022, according to MedPage Today. Percentages for last year were based on a data set that excluded the fourth quarter of 2022.

The 2021 pass rate for Georgia candidates taking the test for the first time was 87.6%, significantly higher than the national average of 82.5%. In total, 749 people took the NCLEX-RN in Georgia, with 656 passing their first try.

MedPage Today reported all its sources agreed the pandemic played a role in declining numbers. “Clinical placements were limited and sometimes eliminated from the curriculum” because of COVID-19, Dawn Kappel, director of marketing and communications for the NCSBN, told the website.

NCSBN evaluates pass rates every three years to determine if the questions are still relevant or need to be more difficult. If it believes the passing standard is “at a sufficient level that … if a candidate passes this exam, they are safe to practice as a nurse,” then they maintain the current standard, said Maria FloresHarris, DNP, MSN, BSN, RN, former executive director of nursing for Kaplan Test Prep in New York City who has since started her own consulting business, Academic Partners Consulting.

Last month, MedPage Today reported, NCSBN’s board of directors voted to keep the current standards, finding them an “appropriate as a measure of safe and effective entry-level nurse practice,” Jay Douglas, MSM, RN, the board’s president, who is also executive director of the Virginia Board of Nursing, said in a press release.