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2026 NCLEX-RN Test Plan

Library

8 Client Needs categories, 149 activity statements, and the six steps of clinical judgment. Each card opens the study guide for its category, with a section for every activity statement.

ExamDragon is independent exam preparation. It is not affiliated with, endorsed by or reviewed by the National Council of State Boards of Nursing (NCSBN) or Pearson VUE. NCLEX, NCLEX-RN and NCSBN are registered trademarks of NCSBN, used only to name the examination. Every item and guide here is our own, written from NCSBN's published 2026 NCLEX-RN Test Plan. We never accept, use or discuss items from a real NCLEX: NCSBN's candidate rules forbid sharing them.

National Council Licensure Examination for Registered Nurses (NCLEX-RN)

How the exam is built

The Client Needs categories and their share of the exam, from the 2026 Test Plan

What each category is worth

NCSBN publishes a range for each category: the share of the exam it may take.

  1. Safe and Effective Care Environment · Management of Care25 activity statements15 to 21%
  2. Safe and Effective Care Environment · Safety and Infection Prevention and Control17 activity statements10 to 16%
  3. Health Promotion and Maintenance16 activity statements6 to 12%
  4. Psychosocial Integrity15 activity statements6 to 12%
  5. Physiological Integrity · Basic Care and Comfort16 activity statements6 to 12%
  6. Physiological Integrity · Pharmacological and Parenteral Therapies17 activity statements13 to 19%
  7. Physiological Integrity · Reduction of Risk Potential19 activity statements9 to 15%
  8. Physiological Integrity · Physiological Adaptation24 activity statements11 to 17%

Source: NCSBN, 2026 NCLEX-RN Test Plan.

The exam

Questions
85 to 150
Unscored pretest questions
15
Case studies
3 (18 items)
Time
5 hours

NCSBN, 2026 NCLEX-RN Test Plan.

What this covers

Every Client Needs category and activity statement of the 2026 Test Plan, the study guide section that teaches it, how many practice questions test it, and a free one-page study sheet per category.

Integrated process

Clinical judgment

Measured by three case studies of six items on every exam and by stand-alone items. Each case study item tests one step. In practice: 14 case studies; in the mock pool: 12.

  1. Recognize cuesPick out the information that matters from sources such as the history and vital signs.
  2. Analyze cuesLink the cues you have noticed to the way the client is presenting.
  3. Prioritize hypothesesWeigh the possible explanations and rank them by factors such as urgency, likelihood and risk.
  4. Generate solutionsSet the outcomes you expect and, guided by your hypotheses, choose interventions to reach them.
  5. Take actionCarry out the interventions that address the most urgent priority.
  6. Evaluate outcomesCheck whether what actually happened matches the outcomes you expected.
The NCSBN Clinical Judgment Measurement Model, in order; each step defined in our words.
Study guide: clinical judgment

Item formats and how they are scored

NCSBN gives partial credit where an item has more than one key, by three methods. Which method each format uses below follows NCSBN's own rule for when each applies.

  • Zero/one: a point for each right choice, nothing taken off for a wrong one.
  • Plus/minus: a point for each right choice, a point off for each wrong one, never below zero.
  • Rationale: a point only when both linked parts are right.
FormatWhat you do
Multiple ChoiceChoose the one best answer of four.zero/one
Multiple Response Select All That ApplyChoose every option that applies: one or more are right.plus/minus
Multiple Response Select NChoose exactly the number of options the item asks for.zero/one
Multiple Response GroupingFor each group (a body system, say), choose every option that applies.plus/minus
Matrix Multiple ChoiceFor each row, choose one column.zero/one
Matrix Multiple ResponseFor each row, choose every column that applies.plus/minus
Drop-Down ClozeComplete sentences by choosing a word or phrase from each list.zero/one
Drop-Down RationaleComplete a cause and effect sentence: the client's condition and what supports it.rationale
Drop-Down TableFor each row of a table, choose from its list.zero/one
Drag-and-Drop ClozePlace words or phrases into the blanks of a sentence.zero/one
Drag-and-Drop RationalePlace a condition and what supports it into a linked sentence.rationale
Highlight TextHighlight the parts of a record that answer the question.plus/minus
Highlight TableHighlight the cells of a table that answer the question.plus/minus
Bow-TieComplete a diagram: the condition the client most likely has, two actions to take and two parameters to monitor.zero/one
Ordered ResponsePut every step in the correct order.zero/one
CalculationType a number, rounded as the item asks.zero/one

Source: NCSBN, 2026 NCLEX-RN Test Plan and NCLEX FAQs. The categories, ranges, topics and steps are NCSBN's; the activity statements and step definitions are shown in our own words (read NCSBN's wording in the Test Plan); the guides and items are ours. Every source this path is built on.