How to Pass the NCLEX-RN®: The Osmosis Ultimate Guide
Published on May 6, 2020. Updated on Jun 20, 2024.
Discover all that you need to know about the NCLEX-RN® exam, including lots of information about Next Generation NCLEX-RN®, question types, the grading system, how to apply—and most importantly, how to pass!
Congratulations on graduating from nursing school! Passing all those rigorous exams and grueling clinicals shows your dedication and skill. There is just one more critical step standing between you and your Registered Nursing license, and Osmosis is here to help you through it.
The NCLEX-RN Exam
What is the NCLEX-RN®?
NCLEX® stands for the National Council Licensure Examination®. Nursing school graduates take this test to pass national and state requirements and receive their nursing license.
Who takes the NCLEX-RN?
The NCLEX-RN® is taken by all graduates of approved nursing programs who want to get their registered nursing (RN) license (both domestic and international). This exam measures the competencies needed to provide safe and effective patient care as an entry-level nurse.
On the other hand, the NCLEX-PN® focuses more on collecting client information and supporting care plans. To take the NCLEX-PN® you typically must graduate from a vocational or practical school of nursing.When did the NCLEX-RN® start?
The exam started in 1982 in the US; Canada first adopted the test in 2012, and it went into effect for live testing in 2015. The National Council of State Boards of Nurses® (NCSBN®) owns, develops, and administers the NCLEX-RN®. Each state’s nursing board accepts the results of the NCLEX® in order to bestow a state nursing license.
Didn’t the NCLEX® just change?
It sure did! Every few years the NCSBN® updates the NCLEX® to ensure it is the most relevant and up-to-date exam possible. After years of research, a significant update was made to the NCLEX®, called Next Generation NCLEX® or NGN for short. This new exam went live on April 1, 2023, and this guide contains all of the updated information you need to know about it!How do I take the NCLEX-RN®?
The NCLEX-RN® is taken on a computer through Pearson VUE® testing centers. The exam uses Computer Adaptive Technology (more on that below). The NCLEX-RN® tests theoretical knowledge, practical skills, and clinical judgment ability for each student who wants to enter the nursing profession. The test is designed to ensure that every new nurse is minimally competent to practice as an RN.
This standardization helps ensure client safety and the maintenance of ethical practices across the country.
Where and when do I take the NCLEX-RN?
Nursing students take the NCLEX at Pearson VUE testing centers. The exam is offered year-round.
- US domestic testing centers
- Any state within the U.S. and American Samoa, Guam, Northern Mariana Islands, the U.S. Virgin Islands, and Puerto Rico
- Canada domestic testing centers
- Any Canadian province/territory and the mainland U.S. (not including territories)
- International testing centers
- Testing centers are available internationally in a number of countries. Visit the NCSBN® website for the most up-to-date list.
How do I register for the NCLEX-RN?
To register, the first step is to contact your state or province Nursing Regulatory Board® (NRB®) for an application. There is a fee associated with submitting your application.
The second step is to register with the test administrator, Pearson VUE®. You can do this online or over the phone. Then, you’ll schedule your test through Pearson VUE®.NCLEX-RN exam fees
The NCLEX® exam comes with associated fees, which you will need to pay before you can take the exam. You can pay by debit, credit, or prepaid card, or, in some cases, your institution will take care of the fees.
For more information on how much you’ll have to pay, check out these instructions on the NCSBN's Application & Registration page.What topics does the NCLEX-RN cover?
Exam content is based on overall client needs. It's broken down into Client Needs categories of Safe and Effective Care Environment, Health Promotion and Maintenance, Psychosocial Integrity, and Physiological Integrity. In addition, there are integrated processes that are fundamental to the practice of nursing and are integrated throughout all of the client needs categories. The integrated processes are caring, clinical judgment (more on this later), communication and documentation, culture and spirituality, nursing process, and teaching/learning. We'll cover the Client Needs categories and clinical judgment more in-depth below. Since clients and environments vary across a wide spectrum, expect a wide range of questions and we’ll go more in-depth on the question distribution and content areas below.
Did I hear that the NCLEX-RN® is changing?
Yes! The NCSBN® continuously reviews and updates the questions and content of the exam to make sure that they are keeping up with current medical understanding, trends, and challenges. When nursing practices change, the relevant questions will be reviewed and revised as needed.
The NCLEX® test plans are updated every three years and reflect any major changes to the exam. It's highly recommended that you review the NCSBN® test plan in-depth before taking the exam.
The next significant change came in April 2023 with the launch of Next Generation NCLEX® (NGN®). This exam update is in response to studies showing a lack of critical thinking skills among novice nurses. This test emphasizes critical thinking and clinical judgment abilities over rote memorization of tasks and information and is based on the Clinical Judgment Measurement Model (CJMM). There are new question types, such as case studies, where six sequential questions that follow the six steps of the CJMM are asked based on one scenario and client chart. This means that truly learning material for the long term will be much more important than cramming right before the exam.
What is the NCLEX-RN CAT exam?
The NCLEX-RN® employs Computer Adaptive Technology (CAT), which means that the computer recalibrates the exam after each question you answer. This helps ensure that the exam is specific to your level of ability and is unique to each test-taker.
Each time you answer a question correctly, the computer chooses the next question out of its question bank that you’ll have a 50% chance of answering correctly. This means that the better you perform, the more difficult the questions will get. You shouldn’t read too much into the level of challenge you’re experiencing though. The exam also randomly generates 15 non-scored questions of varying levels of difficulty. These are sample questions that may be used on future NCLEX-RN® exams.
At the end of your exam, you must reach a certain passing level determined by the NCSBN®, as this will demonstrate that you are minimally competent to begin practicing as a nurse.How is the NCLEX-RN CAT exam different from a regular one?
In a fixed-length test, each student is given exactly the same questions to complete in the same amount of time, creating a consistent experience across the board. However, each test-taker is different. In a fixed-length exam, students of high abilities must answer all easy questions, and low-ability students will find themselves guessing at the difficult items.
CAT exams allow flexibility in the testing environment by targeting each student’s ability level and adapting to it. This provides a much more accurate reflection of each student’s particular abilities across a range of topics. Since the nursing practice demands such a range of knowledge, this type of testing is particularly suited for the NCLEX-RN exam.
NCLEX-RN exam preparation
How do you prepare for the NCLEX-RN®?
The first thing to do after you graduate from school is to take a little bit of time to rest and recuperate. Nursing school is demanding, and you’re probably undernourished both physically and emotionally.
Give yourself a week or two to rest and recuperate (R&R). Sleep in, eat well, and get some exercise and fresh air. It also helps to reconnect with friends and family who haven't seen you during long days of studying and working through school.
This R&R time includes your brain, too! The NCLEX-RN® exam may take a month or two to prepare for, so practice managing your anxiety and try not to worry. When you’re prepared, you’ll feel much more calm and comfortable going into the test center come exam day.
After this mini-break, sit down and plan out your study schedule. Set your test date for a month or two out so that you give yourself enough study time. Each student is different, but the general recommendation is to spend about three hours a day reviewing your study material.
How much should I study?
As you’re probably aware after observing your peers at school, every student has different study habits and needs. There are always those students who seem to be able to breeze through exams with minimal studying.
The rest of us, however, need time and a plan. These vary widely as well, of course, but we’ve gathered some tips from students who’ve taken the test and experts who study these things. In addition to the advice below, you can check out our recorded webinar on How to Build Study Habits that Last.
Step 1: Organize
The very first thing to do is get organized. If it’s been awhile since you graduated from nursing school, your study space may have gathered dust, junk, or have been repurposed altogether. Create a clean, orderly, and above all quiet space. Make it comfortable, because you may be spending upwards of three to four hours a day studying.
Step 2: Plan ahead
Get out your calendar and figure out how much time you have between now and your test date. Create a schedule that you can realistically stick to: which days will you be able to dedicate to studying? Do you have work or family obligations you’ll need to attend to? When will you take time to relax? Also, plan out when you’ll take the practice exams; consider taking one early to gauge where your strengths lie, then sprinkle in a practice test here and there, with one of those being at least two weeks before you take the test.
Step 3: Find a partner
One of the best ways to learn is by teaching the material to someone else. Demonstrating material helps you master it in a way that passive reading and studying can’t. Schedule some reciprocal study sessions where you and your study partner can take turns explaining concepts and answering questions. These kinds of sessions can also go really far in bolstering your confidence, which is a big part of exam success.
Step 4: Read the NCLEX® test plan
The NCSBN® publishes an in-depth test plan every three years. It’s in your best interest to carefully read through the plan to get an idea of what to expect come test day. The test plan lays out content distribution in a detailed way and even gives sample exam items that give an excellent sneak peek into the test. The test plan also has very thoughtful things to say about the values and beliefs underlying the exam. This is an essential step that you should take early on and revisit throughout your studying.
Step 5: Make use of study resources on Osmosis
When studying for the NCLEX®, Osmosis is one of the most powerful tools at your disposal. We have hundreds of fun, easy-to-understand videos that help nursing concepts truly stick, with new videos added all the time. Be sure to check out our webinar on How to Use Osmosis’s New Nursing Library for an overview of all the nursing videos available for you to use! Our Medication Tables cover more than 140 of the most common medication classifications. And we even have a library of over 3,000 NCLEX®-style questions in a variety of question styles designed to test your knowledge and get you in the mindset for test day. Learn more by watching the How to Use the Osmosis Nursing Quiz Builder recorded webinar.
Step 6: Take a brain break before the actual exam
Don’t break your brain just before you sit down to take the test! It’s important to rest your noggin, allow the knowledge to sink in, and lower your stress level. Creating this detailed schedule will reduce the need for cramming right before your test day. Give yourself a day or two off before the exam. Go for a hike, or shopping, or to the beach—whatever you do to relax and take your mind off of things. Don’t worry, all of your hard work will not disappear in 24 short hours. Go into testing day refreshed and ready!
What else can I do to optimize my studying for the NCLEX-RN?
Here are a few other tips and tricks that candidates have used to pass the NCLEX-RN successfully.
Visualization
Picture the scenario the exam item describes. Place yourself in the setting with the client.
Mnemonics
There’s value in memorizing some of the material by rote. Creating handy ways to remember facts and processes can help.
Study guides and prep courses
There's plenty of study material and test practice online and these resources can be helpful.
Reword the question
The NCLEX-RN® is testing your ability to apply your knowledge. Take a moment to be certain you understand exactly what is being asked.
Eliminate wrong answers
Go through the responses and discard any that you know are obviously wrong. This will help you focus on analyzing the remaining responses for the best possible answer. And remember, sometimes NCLEX® is asking which answer is BEST, meaning there may be some truth to all answers.
What are "integrated processes" on the NCLEX-RN?
The concept of integrated processes underpins the whole exam. These processes are the building blocks of the nursing practice. They will be an essential part of each exam.
The following six processes make up this underlying exam philosophy:
Caring
Nurses demonstrate respect and concern for clients in order to build a collaborative and trusting environment.
Clinical Judgment
Clinical judgment is vital to nursing practice and is the outcome of critical thinking and decision making. Think of it this way, your clients have needs and those needs must be met through clinical decision-making. The way to get there is through clinical judgment. This is a very important part of NGN as many of the new questions are based upon the steps of the Clinical Judgment Measurement Model, also called the CJMM. Those steps are on layer 3 of the CJMM and are recognize cues, analyze cues, prioritize hypotheses, generate solutions, take actions, and evaluate outcomes.
|
Communication and documentation
Clear, open communication between the client, the client’s family, and caregivers is an essential part of the nursing process. Nurses must keep accurate medical records that precisely reflect treatment even during stressful or confusing situations.
Culture and spirituality
Effective nursing considers the beliefs, identity, and uniqueness of each individual being cared for.
Nursing process
While there are several versions of the nursing process, at Osmosis, we use five steps, which you can remember using the acronym, “ADPIE:” Assessment, Diagnosis, Planning, Implementation, Evaluation.Teaching/Learning
Nurses are expected to continue learning throughout their careers, as well as educate their patients and their families. With Osmosis, you're set up for life-long learning, and you'll find that our videos can be an excellent resource for clients looking to understand their illnesses in a visual way.
How long is the NCLEX-RN?
The test is long, and part of preparing for it will include working on the mental endurance that it takes to focus for hours at a time.
The test itself ranges between a minimum of 85 questions and a maximum of 150. There’s no way to predict which number your test will encompass, so don’t read too much into getting the minimum or maximum number. However, do be prepared for the test to take between three to five hours to complete. The test will automatically end when the CAT has determined that you have reached a passing or non-passing score or the maximum time of five hours.What is the NCLEX-RN exam structure?
There are four major categories and eight subcategories on the exam. The categories all fit under the framework entitled, “Client Needs”. Let’s take a closer look at these.
Category 1: Safe and Effective Care Management
This category includes two subcategories:
Management of Care
This subcategory includes activities that improve client care and decrease the amount of medical services needed through treatment coordination. This helps reduce duplication of treatment, therefore improving client outcomes and managing costs. Some important aspects of management of care include understanding advance directives, case management, and client rights. Other practices include ethical practices and demonstrated knowledge of legal responsibilities, confidentiality, and continuity of care.
Safety and Infection Control
Safety of nursing staff, as well as clients, will also be tested on the exam. This includes being able to demonstrate the ability to prevent the spread of pathogens, understanding of standard safety procedures, and accident prevention. Other activities that may appear on the test are the disposal of hazardous waste materials and surgical precautions.
Category 2: Health Promotion and Maintenance
The second main category of the exam is Health Promotion and Maintenance. This category examines the different health and medical needs of a person at all different stages of life. From newborn care, early childhood development, adolescence, and adulthood, humans encounter various health issues. The proficient RN will understand the medical needs of each stage in the aging process. Activities tested in the Health Promotion and Maintenance category include newborn care through geriatric treatments and all developmental stages in between.
Category 3: Psychosocial Integrity
This category includes processes by which a nurse cares for not only the physical, but also the mental, emotional, and social wellness of the people in their care. These processes include assessments of potential abuse or neglect, end-of-life care, support through grief or loss, and education on coping skills and aftercare. These skills are especially important for clients experiencing mental health crises or dealing with the aftermath of traumatic injuries. Nursing demands an understanding of how to interpret family dynamics and apply understanding of various cultures.
Category 4: Physiological Integrity
The Physiological Integrity category is broken down into four subcategories:
Basic care and comfort
Clients often need assistive devices to learn new ways of doing things or will need assistance with basic functions that they’ve been performing their whole lives. New issues around mobility, elimination, and personal hygiene will be addressed by nurses.
Pharmacological and parenteral therapies
Nurses administer medications as well as educate clients on how to self-administer. They will also evaluate the effectiveness and side effects of treatment and monitor for adverse effects. Other processes include identifying appropriate veins for intravenous medication, preparing dosages, and preparing clients for intravenous catheter insertion.
Reduction of risk potential
This process is critical for ensuring clients do not develop life-threatening complications related to medical treatment. The subcategory will include items related to reading laboratory reports and interpreting values, understanding diagnostic tests, and monitoring vital signs. Other important aspects include identifying possible complications and being able to respond to them.
Physiological adaptation
This aspect of meeting client needs revolves around providing care for clients with acute, chronic, or life-threatening medical issues. This complex subject includes dealing with alterations in body processes, dealing with health emergencies, responding to unexpected outcomes, and managing clients’ hemodynamics.
What is the question distribution of the NCLEX-RN?
Since each exam is different, the content distribution will also vary. The questions will generally fall under the following ranges:
1. Safe and Effective Care Management
Management of Care (15-21%)
Safety and Infection Control (10-16%)
2. Health Promotion and Maintenance (6-12%)
3. Psychosocial Integrity (6-12%)
4. Physiological Integrity
Basic Care and Comfort (6-12%)
Pharmacological and Parenteral Therapies (13-19%)
Reduction of Risk Potential (9-15%)
Physiological Adaptation (11-17%)
What types of questions are on the NCLEX-RN?
A large proportion of the test is multiple choice, but there are other question formats as well. Be prepared for:
Multiple-choice
Multiple response
Fill-in-the-blank calculation
Hot spots
Exhibit
Ordered response
Audio and graphics
All item types may include multimedia, such as charts, tables, graphics, and audio.
What types of questions are on the NCLEX-RN®?
With the launch of NGN in April 2023, there are still a good number of the traditional questions you are accustomed to, like multiple choice and multiple response (select all that apply), but there are also now some new question types.
The different types of questions may sound daunting but the exam will provide you instructions on how to answer each type. Take each question one at a time and keep in mind what you DO know! Let’s learn about question types you will find in case studies first.
Case Study Question Types
Every NCLEX-RN test-taker will come across at least three case studies. In a case study, you will be presented with patient information, like in a chart or electronic health record. You will need to review that patient information and then answer the six questions that relate to the case study. These six questions will address each step of the Clinical Judgment Measurement Model and go in order from first to last (recognize cues, analyze cues, prioritize hypotheses, generate solutions, take actions, and evaluate outcomes). There can be a variety of question types in a case study such as drag-and-drop, drop down, multiple choice, multiple response, and highlight.
Drag-and-drop
In a drag-and-drop question you are taking a possible response, called a token, and dragging then dropping it into one or more target areas. There are two types of drag-and-drop questions.
Drag-and-drop cloze: Drag and then drop words or phrases into a sentence
Drag-and-drop rationale: You must complete the sentences or sentences by dragging and dropping one cause and one or two effects
Dropdown
In a drop-down question you must click the drop-down icon (also called a caret), which looks like this , to select the correct answer or answers. There are three types of drop-down questions.
Drop-down cloze: Choose the best option to complete the sentence or sentences
Drop-down rationale: Similar to the drag-and-drop rationale except for you must use the dropdown options instead of dragging your response from a list of possible responses
Drop-down table: Complete the information in a table by using the dropdown options
Multiple choice
This is the question type that everyone is probably familiar with. You must select the single best answer out of a few potential answers, but there are two variations.
Multiple choice: Click the radio button, which is a small circle, next to the single best answer to the question.
Matrix multiple choice: In this question type, you must click the radio button next to the single best answer in each row of the matrix
Multiple response
A multiple response question, also called a select all that apply, or SATA, is similar to a multiple choice except there can be more than one correct answer. Instead of radio buttons, on multiple response questions, you will see checkboxes that look like this ⬜.
Matrix multiple response: A matrix multiple response is similar to a matrix multiple choice, except now there can be more than one correct answer in a single row.
Multiple response select all that apply: This is like a multiple choice question except that there are at least five options and up to 10 options. Anywhere from one to all ten options can be the correct answers.
Multiple response select N: In this question type, there will be some instruction for how many answers to select. The language will be something like, “Select the 2 findings that…”. The computer will not let you move to the next question if you have selected either more or less answers than the instructions directed you to select.
Multiple response grouping: For this question type, possible answers will be placed into groupings. There will be at least two groupings but up to a maximum of 5 groupings. You must select at least one answer from each grouping.
Highlight
In a highlight question, you must highlight text to indicate the correct answer. The highlight areas are tokenized which means that the computer testing system will show you the options for highlighting and there can be a maximum of 10 tokenized areas. This eliminates the possibility of you getting it incorrect just because you included either too many or not enough words. The NCLEX® includes two types of highlight questions.
Highlight text: In this question type, you will highlight one or more sections of text to indicate the correct answer or answers. The text will come in paragraph form like from a nurse’s note or a history and physical report.
Highlight table: This question type is similar except you will highlight information in a table to indicate the correct answer. The table could be patient data such as laboratory results, an intake and output chart, or vital signs.
Standalone Question Types
Now, all of the previous question types can be found within a case study. These last two question types (bowtie and trend), on the other hand, are standalone questions. This means that they are testing the Clinical Judgment Measurement Model (CJMM) but are not within a case study.
Bowtie
A bowtie question addresses all six steps of the CJMM and functions a bit like a drag-and-drop question. You will read the question that contains some patient information. You will then select one potential condition from a list of potential conditions and drag it into the potential condition box, two actions to take from a list of potential actions to take, and two parameters to monitor from a list of potential parameters to monitor.
Trend
This last question type addresses multiple stems of the CJMM. You will review the patient information which shows changes over some period of time like minutes, hours, days, or months. This patient information can be nurse’s notes, history and physical, laboratory results, vital signs, admission notes, intake and output, progress notes, medications, diagnostic results, or a flow sheet. You then answer the corresponding question which can be any question type.
What should I expect on NCLEX-RN test day?
Well, expect some nerves. If you’re not feeling nervous, great! If you are, it’s totally normal—this test is a big step in your career. Try to get up early and, if you can, skip caffeine in the morning, as this can often add to your jitters. Eat a good breakfast with protein.
Get to your testing site early in order to check-in. This process includes providing biometrics like your signature, photo, and a palm vein scan.
The NCSBN® has strict rules for exam candidates around confidentiality and more. Make sure you review what you can and cannot bring, and all other guidelines provided by the board. You’re allowed to bring some personal items that you must leave in a locker outside of the testing room. You’ll be able to access some things during your breaks but remember that you cannot access any cell phones, other devices, or any test prep material.How is the NCLEX-RN test scored?
There are three different scenarios by which a candidate may pass the test, and four failing scenarios.
Scenario 1: 95% Confidence Interval
This is the most common completion scenario for NCLEX® test takers. In this scenario, the computer will end the exam when it has reached 95% certainty that the student’s ability is above or below the passing standard. At that point, the exam will conclude.
Scenario 2: Maximum-Length
If your ability comes very close to the passing standard without the computer attaining the 95% certainty, the test will continue being administered until the maximum number of questions have been answered. At the conclusion of the exam, the computer will determine whether the candidate has reached the passing standard or not. The pass or fail result will be determined on that result.
Scenario 3: Running out of time
The NCLEX-RN®’s third scenario is called ROOT, or the run-out-of-time rule. This scenario kicks in when the test reaches the end of the allotted five hours and the computer has not determined with a 95% certainty whether the test-taker has passed or failed. At this point, a few things are examined by the computer. If the student has not answered the minimum number of questions, the result is a fail. If the minimum threshold has been reached, the computer uses the last 60 questions to determine whether the passing standard has been reached or not. If yes, you pass! If no, sadly it will result in a failure.What is the NCLEX-RN® pass rate?
The good news is that the pass rate for first-time test takers is fairly high. Based on 2022 statistics, the overall pass percentage for first-time test takers educated in the United States was nearly 80%. However, the pass rate drops dramatically for repeat test takers, to about 43%.
What should I do after the NCLEX-RN®?
Really, all you can do right after the exam is wait. Many states offer a Quick Results option that will at least let you know if you pass or fail. This is not an official result and does not constitute a nursing license, but at least you can put your mind at ease.
The Quick Results are available for some after two business days have passed. Once you find out you’ve passed the exam, go celebrate! You’re going to be an RN!
What happens if I don’t pass the NCLEX-RN®?
If you don’t pass the exam on the first try, don’t panic: you wouldn’t be the first, and you can always retake the exam. You will receive a Candidate Performance Report (CPR) from the NCSBN® that shows how you performed on each section of the exam. This individualized report is a helpful guide for those who opt to retake the exam.
When you decide to retake the test, focus on the areas where you didn’t perform well to prepare. If at first you don’t succeed, try again. And don’t be too hard on yourself—the NCLEX-RN® is a huge challenge and working hard at it will make your ultimate success all the sweeter.How can Osmosis help me prepare for the NCLEX, and in my nursing career?
Osmosis is the ideal learning platform for visual learners. Our library of over 600 nursing videos explain tough concepts in nursing with clear, easy-to-understand animations. They include mnemonics and incorporate proven learning science concepts to help information stick for the long term.
As a nursing student, when you learn by Osmosis, you also get access to a library of over 3,000 NCLEX®-style practice questions designed to test your knowledge and get you ready for exam day. We also post free NCLEX® questions every week on our Instagram page for Nurses (@OsmosisNursing) and on the Osmosis Facebook page.
In addition, look for our webinars on topics you care about like how to answer NCLEX®-style questions and how to learn by taking quizzes!
Here's how Kayla, a Registered Nurse, continues to incorporate Osmosis in her practice:NCLEX-RN: Last things to consider
Graduating from nursing school is a feat unto itself. However, the nursing profession is one of the most important parts of integrated, effective, life-saving healthcare. The NCLEX-RN® helps our health care system ensure that clients will receive first-class care. Becoming an RN is a worthy goal and we congratulate you on choosing such a noble profession. Good luck on the exam and embarking on this special calling!
Contributors
Liz Lucas has been an RN since 2008 and has an Ed.D. with Emphasis in Nursing and Health Professions Education. Liz’s clinical background is in oncology, and she later transitioned into nursing academia where she taught in a pre-licensure nursing program for several years. Liz feels passionate about building a strong nursing workforce through increasing education accessibility and believes in the role of technology in that pursuit. At Osmosis, Liz manages the nursing assessment and scripting teams. Liz currently lives near Baltimore, MD with her husband, two sons, and dog.NCLEX-RN® and NCLEX-PN® are registered trademarks of the National Council of State Boards of Nursing, Inc (NCSBN®). Osmosis is not affiliated with NCSBN.