The National Council Licensure Examination (NCLEX), the standardized test all aspiring nurses must pass to become licensed, is undergoing revisions. While the core structure of the exam remains largely unchanged, updates coming April 1st will focus on refining the evaluation of competencies and incorporating broader stakeholder input into the process of setting passing standards. These changes, though less extensive than the 2023 “Next Generation NCLEX” overhaul, signal a continued effort to ensure the exam accurately reflects the demands of modern nursing practice.
The NCLEX, administered by the National Council of State Boards of Nursing (NCSBN), exists in two versions – one for Registered Nurses (NCLEX-RN) and another for Practical/Vocational Nurses (NCLEX-PN). In 2025, approximately 330,000 candidates took the NCLEX-RN, and nearly 70,000 took the NCLEX-PN, according to the NCSBN. The upcoming adjustments build upon the significant changes implemented last year, which aimed to better assess clinical judgment and decision-making skills.
The 2023 “Next Generation NCLEX” redesign demonstrably impacted pass rates. The NCLEX-RN pass rate for first-time, U.S.-educated test-takers increased from 79.9% in 2022 to 88.6% in 2023, indicating the new format may be more effectively evaluating candidates’ abilities. The NCSBN regularly reviews the NCLEX-RN test plan, based on analysis of current RN practice and expert opinions, to maintain its relevance.
New Input on Passing Standards
One of the most significant changes for the 2026 NCLEX-RN framework is the introduction of a new element in the passing-standard review process: a survey of nurse educators, and employers. The results of this survey will now be considered by the NCSBN board of directors, alongside existing expert analysis and historical performance data, when determining the minimum competency level required for entry-level practice. This broadened input aims to ensure the passing standard aligns with the expectations of the profession.
Emphasis on Health Equity and Dignity
The 2026 NCLEX-RN test framework too reflects a growing emphasis on social responsibility and patient-centered care. “Health equity” has been added to the foundational principles guiding RN practice within the “beliefs” section of the exam. Language surrounding end-of-life care has been expanded, moving from “dignity in dying” in 2023 to “dignity throughout the lifespan including at the end of life” in 2026, signaling a more holistic approach to patient care.
Unbiased Care as a Core Competency
Within the “management of care” subcategory, the 2026 NCLEX-RN blueprint now explicitly requires nurses to “support unbiased treatment and equal access to care,” regardless of a patient’s culture, ethnicity, sexual orientation, or gender identity or expression. This addition underscores the importance of equitable healthcare delivery and the nurse’s role in advocating for all patients. The NCSBN emphasizes the need for nurses to provide culturally competent and inclusive care.
Focus on Patient Dignity and Privacy
Maintaining patient dignity and privacy is receiving increased attention. The 2026 NCLEX-RN blueprint adds a new activity statement to the “basic care and comfort” subcategory under “physiological integrity,” requiring nurses to prioritize these aspects during patient care – a requirement not present in the 2023 framework. This change reinforces the ethical obligations of nurses to respect patient autonomy and confidentiality.
Monitoring Advanced Medical Devices
Finally, the 2026 test plan includes a new activity statement within the “physiological adaptation” subcategory, requiring nurses to monitor and maintain internal monitoring devices, such as intracranial pressure monitors and intrauterine pressure catheters. This addition reflects the increasing complexity of medical technology and the need for nurses to be proficient in managing these devices.
These updates to the NCLEX-RN represent a continuing evolution of the exam to meet the changing needs of the nursing profession and the patients nurses serve. The NCSBN’s commitment to regular review and refinement ensures the NCLEX remains a relevant and reliable assessment of nursing competence. Future iterations of the exam will likely continue to incorporate advancements in healthcare and evolving best practices.
What are your thoughts on these changes to the NCLEX? Share your perspective in the comments below.
Disclaimer: This information is intended for general knowledge and informational purposes only, and does not constitute medical advice. This proves essential to consult with a qualified healthcare professional for any health concerns or before making any decisions related to your health or treatment.
