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The test plan is reviewed and approved by the NCLEX®
Exam Committee (NEC) every three years.
Multiple resources are used, including the recent practice analysis of licensed practical/vocational nurses
(LPN/VNs), and expert opinions of the NEC, NCSBN staff and nursing regulatory bodies (NRBs) to ensure that
the test plan is consistent with nurse practice acts. Following the endorsement of proposed revisions by
the NEC, the test plan document is presented for approval to the Delegate Assembly, which is the decisionmaking body of NCSBN.
The test plan serves a variety of purposes. It is used to guide candidates preparing for the examination, to
direct item writers in the development of items, and to facilitate the classification of examination items. This
document offers a comprehensive listing of content for each client needs category and subcategory outlined
in the test plan. Sample items are provided at the end of each category, which are specific to the client needs
category in that section. There is an item writing guide along with sample case scenarios, which provide
nurse educators with hands-on experience in writing NCLEX-style test items.

Entry into the practice of nursing is regulated by the licensing authorities within each of the NCSBN nursing
regulatory bodies (state, commonwealth and territorial boards of nursing). To ensure public protection, each
jurisdiction requires candidates for licensure to meet set requirements that include passing an examination
that measures the competencies needed to perform safely and effectively as a licensed practical/vocational
nurse (LPN/VN). NCSBN develops a licensure examination, the National Council Licensure Exam for
Practical Nurses (NCLEX-PN®), which is used by U.S. members to assist in making licensure decisions.
Several steps occur in the development of the NCLEX-PN Test Plan. The first step is conducting a practice
analysis that is used to collect data on the current practice of entry-level LPN/VNs (Report of Findings from
the 2018 LPN/VN Practice Analysis: Linking the NCLEX-PN® Exam to Practice, NCSBN, 2019). Twelve
thousand newly licensed practical/vocational nurses are asked about the frequency and priority of performing nursing care activities. Nursing care activities are then analyzed in relation to the frequency of performance, impact on maintaining client safety and client care settings where the activities are performed. This
analysis guides the development of a framework for entry-level nursing practice that incorporates specific
client needs, as well as processes that are fundamental to the practice of nursing. The next step is the
development of the NCLEX-PN Test Plan, which guides the selection of content and behaviors to be tested.
Variations in jurisdiction laws and regulations are considered in the development of the test plan.
The NCLEX-PN Test Plan provides a concise summary of the content and scope of the licensure examination.
It serves as a guide for examination development as well as candidate preparation. The NCLEX® assesses the knowledge, skills and abilities that are essential for the entry-level LPN/VN to use in order to meet the needs
of clients requiring the promotion, maintenance and restoration of health. The following sections describe
beliefs about people and nursing that are integral to the examination, cognitive abilities that will be tested in
the examination and specific components of the NCLEX-PN Test Plan.

Client Needs
Percentage of Items from Each
Category/Subcategory
Safe and Effective Care Environment
„ Coordinated Care 18–24%
„ Safety and Infection Control 10–16%
Health Promotion and Maintenance 6–12%
Psychosocial Integrity 9–15%
Physiological Integrity
„ Basic Care and Comfort 7–13%
„ Pharmacological Therapies 10–16%
„ Reduction of Risk Potential 9–15%
„ Physiological Adaptation 7–13%

The activity statements used in the 2018 LPN/VN Practice Analysis: Linking the NCLEX-PN®
Exam to
Practice (NCSBN, 2019) preface each of the eight content categories and are identified throughout the test
plan by an asterisk (*). NCSBN performs an analysis of those activities used frequently and identified as
important by entry-level nurses to ensure client safety. This is called a practice analysis; it provides data to
support the NCLEX as a reliable, valid measure of competent, entry-level LPN/VN practice. The practice analysis is conducted every three years.
In addition to the practice analysis, NCSBN conducts a knowledge, skills and abilities (KSA) survey. The primary purpose of this study is to identify the knowledge needed by newly licensed practical/vocational nurses
in order to provide safe and effective care. Findings from both the 2018 LPN/VN Practice Analysis: Linking
the NCLEX-PN®
Exam to Practice (NCSBN, 2019) and the 2018 LPN/VN Nursing Knowledge Survey
(NCSBN, 2019) can be found at www.ncsbn.org/1235.htm. Both documents are used in the development of
the NCLEX-PN Test Plan as well as to inform item development.
All task statements in the 2020 NCLEX-PN®
Test Plan require the nurse to apply the fundamental principles
of clinical decision making and critical thinking to nursing practice. The test plan also makes the assumption
that the nurse integrates concepts from the following bodies of knowledge:
„ Social Sciences (psychology and sociology); and
„ Biological Sciences (anatomy, physiology, biology and microbiology) Collaboration with Interdisciplinary Team
„ Identify roles/responsibilities of health care team members
„ Identify need for nursing or interdisciplinary client care conference
„ Contribute to the development of and/or update the client plan of care
„ Contribute to planning interdisciplinary client care conferences
„ Participate as a member of an interdisciplinary team Concepts of Management and Supervision
„ Recognize and report staff conflict
„ Verify abilities of staff members to perform assigned tasks (e.g., job description, scope of practice, training, experience)
„ Provide input for performance evaluation of other staff
„ Participate in staff education (e.g., inservices, continued competency)
„ Use data from various credible sources in making clinical decisions
„ Serve as resource person to other staff
„ Monitor activities of assistive personnel
Confidentiality/Information Security
„ Identify staff actions that impact client confidentiality and intervene as needed (e.g., access to medical records, discussions at nurses station, change-of-shift reports)
„ Recognize staff member and client understanding of confidentiality requirements
„ Apply knowledge of facility regulations when accessing client records
„ Maintain client confidentiality*
„ Provide for privacy needs Continuity of Care
„ Follow up with client after discharge*
„ Participate in client discharge or transfer*
„ Provide follow-up for unresolved client care issues
„ Provide and receive report*
„ Record client information (e.g., medical record, referral/transfer form)
„ Use agency guidelines to guide client care (e.g., clinical pathways, care maps, care plans)
Establishing Priorities
„ Organize and prioritize care based on client needs*
„ Participate in planning client care based upon client needs (e.g., diagnosis, abilities, prescribed treatment)
„ Use effective time management skills
Ethical Practice
„ Identify ethical issues affecting staff or client
„ Inform client of ethical issues affecting client care
„ Intervene to promote ethical practice
„ Practice in a manner consistent with code of ethics for nurses*
„ Review client and staff member knowledge of ethical issues affecting client care Informed Consent
„ Identify appropriate person to provide informed consent for client (e.g., client, parent, legal guardian)
„ Participate in client consent process*
„ Describe informed consent requirements (e.g., purpose for procedure, risks of procedure)
„ Recognize that informed consent was obtained (e.g., completed consent form, client understanding of procedure)
Information Technology
„ Use information technology in client care*
„ Access data for client or staff through online databases and journals
„ Enter computer documentation accurately, completely and in a timely manner
Legal Responsibilities
„ Identify legal issues affecting staff and client (e.g., refusing treatment)
„ Verify and process health care provider orders*
„ Recognize self-limitations of task/assignments and seek assistance when needed*
„ Respond to the unsafe practice of a health care provider (e.g., intervene, report)*
„ Follow regulation/policy for reporting specific issues (e.g., abuse, neglect, gunshot wound,
communicable disease)*
„ Document client care
„ Provide care within the legal scope of practice*
Performance Improvement (Quality Improvement)
„ Identify impact of performance improvement/quality improvement activities on client care
outcomes
„ Participate in quality improvement (QI) activity (e.g., collecting data, serving on QI committee)*
„ Document performance improvement/quality improvement activities
„ Report identified performance improvement/quality improvement concerns to appropriate
personnel (e.g., nurse manager, risk manager)
„ Apply evidence-based practice when providing care*