The NCLEX-RN exam is written and overseen by the National Council of State Boards of Nursing (NCSBN), the organization responsible for setting nursing licensure standards across member states and territories. The NCSBN develops the NCLEX-RN through a detailed and research-based process designed to ensure that every question accurately measures the knowledge and clinical judgment required for safe entry-level nursing practice. To create the NCLEX-RN exam, the NCSBN works with a team of psychometricians, nurse educators, practicing registered nurses, and content experts who contribute to test design, item development, and ongoing exam evaluation.
The writing of NCLEX-RN exam questions begins with item development workshops, where qualified registered nurses are trained to write questions that reflect real clinical scenarios. These questions are then reviewed, revised, and validated by committees made up of nursing experts from different practice areas. Every NCLEX-RN question must align with the current NCLEX Test Plan, a document created by the NCSBN after conducting a large-scale job analysis survey of practicing nurses. This survey helps identify the most essential tasks and competencies required for safe patient care, ensuring the exam stays relevant to modern clinical practice.
The NCSBN also ensures that the NCLEX-RN remains fair, reliable, and legally defensible by using advanced psychometric methods. Before new items appear on the operational exam, they undergo pretesting to evaluate performance and difficulty. Only questions that meet strict statistical standards become part of the scored test. Additionally, the NCSBN continuously updates the NCLEX-RN to reflect changes in healthcare, clinical guidelines, and nursing responsibilities.
In summary, the NCLEX-RN exam is written by the NCSBN with input from experienced nurses, educators, and testing specialists, ensuring that every candidate is evaluated using high-quality, evidence-based, and practice-relevant exam questions.