03/4/2022
Are you dreaming of gaining your registered nurse license? Now maybe the ideal time to pursue that dream! Registered nurses are now in high demand across the country. According to the US Bureau of Labor Statistics, the annual growth for RNs is expected to hit nine percent annually for the next eight years.
Know what this means? Completing the RN licensing process opens you to a broad range of career opportunities, cutting across management, education, and administration roles.
This guide shines a light on the process, including the prerequisites for ASNs/BSNs, the RN course curriculum, the ins and outs of preparing for NCLEX-RN, and more.
Four types of nurses require a license: Licensed Nursing Assistants (LNAs), Registered Nurses (RNs), Licensed Practical Nurses (LPNs), and Advanced Practice Registered Nurses (APRNs).
Accreditation establishes parity for high-performing schools, ensuring similar standards and criteria apply nationwide. The two most popular accreditation agencies for nursing include the Accreditation Commission for Education in Nursing (ACEN) and the American Association of College of Nursing (AACN).
State-accredited nursing students are eligible for federal government financial aid and transferred credits to another accredited school. Additionally, certified schools enable nursing students to take NCLEX-RN.
To view accreditation records for your nursing school, visit the US Department of Education’s Office of Postsecondary Education (OPE) ‘s database.
To become licensed, nursing students must pass a rigorous curriculum with a strong focus on anatomy, nutrition, and other human sciences. Therefore, some nursing school prerequisites include but are not limited to anatomy, physiology, biology, chemical, psychology, and nutrition.
Other necessary nursing courses include Nursing Fundamentals, Ethics in Nursing, and Clinical Study. Nursing Fundamentals is typically a first-semester program that offers an overview of the nursing profession, including a primer on how healthcare works. Ethics in Nursing covers theory and ethical issues around health equity, conflicts of interest, and professional conduct in a hospital or health clinic setting.
Lastly, Clinical Study is full hands-on training with a required number of fieldwork hours under the supervision of a nurse in a health facility. The process begins with a preceptor review before progressing into simulations and a caseload. Expect patient diagnosis, clinical rotations, and work managing care plans.
Remember, these are standard courses. Coursework varies according to school and program. Please check with your nursing program for all courses and the number of credits.
The minimum high school GPA required to get into a nursing program depends on the nursing school. However, expect to have a minimum 3.0 high school GPA.
The number of years required to become a registered nurse depends on the nursing degree.
A Practical Nursing Diploma (PN) to become a licensed practical nurse (LPN) takes one to two years to finish, depending on the school and program.
An Associates Degree in Nursing (ASN) is a two-year program.
A Bachelor’s Degree in Nursing (BSN) is a traditional four-year program. However, accelerated BSN programs allow prospects to become nurses in 18 months.
LPN-BSN or RN-BSN programs also exist for LPN or ASN holders looking for a bachelor’s degree.
Lastly, a Master of Science in Nursing (MSN) and Doctor of Nursing Practice program will require that you spend 6+ years in nursing school. The number of years is subject to change based on specialty.
However, all nursing students must graduate from an accredited college or university and successfully pass the National Council Licensure Examination (NCLEX) to become an RN regardless of licensure and degrees.
Coursework in RN programs offers a mix of prerequisites such as English and the social sciences and basic intros to anatomy, chemical, biochemistry, and related subjects.
Here’s an example of a study sample plan for a BSN degree at the University of Pennsylvania’s Penn Nursing College.
Upgrading to BSN opens up a world of possibilities, affording greater autonomy and the ability to enter into administrative, educational, and managerial roles.
Additionally, the American Association of Colleges of Nursing (AACN) confirms that BSN-accredited nurses have a higher probability of favorable patient outcomes, more superb care quality, and lower patient mortality rates.
New York even issued a 2017 ‘BSN in 10’ law, which requires all ASN-earning RN’s to earn a Bachelor’s Degree within ten years of obtaining their license.
The NCLEX is a nurse licensure exam that the National Council of State Boards of Nursing (NCSBN) administers. A candidate who passes the test gains a license to practice nursing in the US, Canada, and Australia. This assessment covers medical, pediatric, psychiatric, obstetric, surgical, and other topics discussed throughout nursing school.
The NCLEX-RN works on a computerized adaptive testing (CAT) model, adjusting each question’s difficulty to the applicant’s perceived ability, which the software determines according to the number of preceding questions answered correctly. There are a minimum of 75 questions and a maximum of 265, comprising multiple-choice, fill-in-the-blank, drag and drop, and other formats.
The NCLEX has varying costs in the US, Canada, and Australia. Candidates seeking American, Canadian, and Australian licensure pay USD 200, CAD 360, and USD 200, respectively.
The NCLEX-RN covers all subjects learned during nursing school, broken down into eight nursing subfields.
Management of Care — 20%
This section covers topics like Advanced Directives, Advocacy, Case Management, Client Rights, Concepts of Management, Confidentiality, Continuity of Care, Quality Improvement, Delegation, Establishing Priorities, Ethical Practice, Informed Consent, Legal Responsibilities, Referrals, and Supervision.
Pharmacological and Parenteral Therapies — 15%
This section tests your knowledge of the following: Adverse Effects, Contraindications, Blood and Blood Products, Central Venous Access Devices, Chemotherapy, Expected Effects, Intravenous Therapy, Medication Administration, Pharmacological Pain Management, Total Parenteral Nutrition, and Dosage Calculations.
Physiological Adaptation — 14%
This section covers Alterations in the Body Systems, Fluid and Electrolyte Imbalances, Hemodynamics, Medical Emergencies, Pathophysiology, and Unexpected Response to Therapies.
Reduction of Risk Potential — 12%
This section covers Diagnostic Tests, Laboratory Values, Potential for Complications from Surgical Procedures, and Health Alterations and Therapeutic Procedures.
Safety and Infection Control — 12%
This section covers Accident Prevention, Error Prevention, Hazardous Materials, Surgical Asepsis, Standard Precautions, and Use of Restraints.
Health Promotion and Maintenance — 9%
This section covers Aging Process, Ante/Intra/Postpartum and Newborn Care, Developmental Stages and Transitions, Disease Prevention, Health Screening, Lifestyle Choices, Physical Assessment Techniques, Health Promotion Programs, High-Risk Behaviors, and Self-Care.
Psychosocial Integrity — 9%
This section covers Coping Mechanisms, Grief and Loss, Mental Health Concepts, Spiritual Influence on Health, Sensory/Perceptual Alterations, Stress Management, Support Systems, Therapeutic Communication, Chemical Dependency, Behavioral Interventions, Crisis Intervention, Coping Mechanisms, End of Life Care, and Family Dynamics.
Basic Care and Comfort — 9%
This section covers Assistive Devices, Elimination, Mobility, Non-pharmacological Comfort Interventions, Nutrition, Oral Hydration, Personal Hygiene, and Rest and Sleep.
Candidates have to wait for six weeks after the test to confirm their results. Should you pass, you may start practicing as an RN with a temporary license before receiving the permanent certificate.
On the other hand, applicants who fail the examination can retake 45 days later for a total of up to 8 times in a single year.
Note that test-takers can pay $7.95 for unofficial results through the Quick Results program to receive test results faster. However, these are estimated scores and not the official final scores required for licensure.
NCLEX-RN exam pass rates vary according to the school. The National Council of State Boards of Nursing pegged the 2020 NCLEX-RN pass rate at 86.5%. For repeat RN test takers, this percentage drops to 42.94%.
Here are the NCLEX pass rates by state in 2020.
| State | Pass Percentage (%) |
| Alabama | 87.5 |
| Alaska | 88.5 |
| Arizona | 91.4 |
| Arkansas | 83.4 |
| California | 90.9 |
| Colorado | 90.7 |
| Connecticut | 89.5 |
| Delaware | 93.6 |
| District Of Columbia | 94.8 |
| Florida | 68.8 |
| Georgia | 88.8 |
| Hawaii | 91.3 |
| Idaho | 89.2 |
| Illinois | 86.7 |
| Indiana | 87.7 |
| Iowa | 86.6 |
| Kansas | 86.1 |
| Kentucky | 88.8 |
| Louisiana | 92.8 |
| Maine | 89.1 |
| Maryland | 87.4 |
| Massachusetts | 89.8 |
| Michigan | 89.0 |
| Minnesota | 83.8 |
| Mississippi | 88.5 |
| Missouri | 90.0 |
| Montana | 89.1 |
| Nebraska | 90.1 |
| Nevada | 93.2 |
| New Hampshire | 96.2 |
| New Jersey | 87.6 |
| New Mexico | 85.7 |
| New York | 83.2 |
| North Carolina | 92.0 |
| North Dakota | 91.6 |
| Ohio | 84.4 |
| Oklahoma | 85.3 |
| Oregon | 90.1 |
| Pennsylvania | 91.7 |
| Rhode Island | 87.8 |
| South Carolina | 90.4 |
| South Dakota | 92.4 |
| Tennessee | 91.7 |
| Texas | 90.7 |
| Utah | 88.7 |
| Vermont | 87.7 |
| Virginia | 87.0 |
| Washington | 90.6 |
| West Virginia | 90.2 |
| Wisconsin | 88.7 |
| Wyoming | 80.8 |
Check out NCSBN records for information on NCLEX pass rates by year dating back to 1983-1994.
The Nurse Licensure Compact (NLC) is a policy that allows nurses with a multi-state license to practice nursing in participating states. This arrangement makes it easier for nurses to work as travel nurses or move freely without a state-specific licensing exam.
As of this writing, 39 states belong to the NLC map. Non-participating states include California, Nevada, Oregon, Washington, Minnesota, Illinois, New York, and Connecticut.
Jobs Outlook. The Bureau of Labor Statistics Employment Projections (2020-2030) report that registered nursing is expected to see 9 percentage growth each year, resulting in roughly 194,500 openings annually. Considering these projections, owning an RN license offers a near guarantee of gainful employment for years to come.
Higher Learning Opportunities. Becoming an RN opens the door to specialization in numerous areas. For example, RNs can earn an MSN, which may work as clinical nurse specialists (CNS) and certified registered nurse anesthetists (CRNA). There’s also the option to work in health policy, nurse education, and other educational and managerial roles.
Competitive Salaries. Registered nurses enjoy competitive salaries. According to the Occupational Outlook Handbook, registered nurses earn a median annual wage of $75,330 (2020). Note that this figure varies by state, specialization, and other factors.
For more perspective, the top-paying states for registered nurses are California, Hawaii, Massachusetts, Oregon, and Alaska.
An LPN program incorporates learnings from the first year of nursing school, with licensure granted after completing an Associates Degree in Nursing (ADN) program. They earn lower salaries, have less autonomy than RNs, and perform limited tasks under their direct supervision.
On the other hand, RNs make more and pursue advanced education, management, and leadership roles.
Luckily, many LPN to RN bridge programs are available to help working LPN students become registered nurses. However, pursuing this path will expose you to additional required clinical hours and required RN prerequisites.
Competency levels are the main difference. RNs have proven to show a basic level of competency. In contrast, certified nurses are formally recognized as having advanced proficiency in a subject area or multiple subject areas like acute and critical care.
We recommend the following criteria when selecting an RN school.
Accreditation is the No. 1 criteria when evaluating an RN program. Look for nursing schools accredited by the Commission on Collegiate Nursing Education (CCNE) and the National League for Nursing Accreditation Commission (NLNAC). This metric ensures education is held to a high standard and comparable with other similarly-accredited institutions.
Note employers are selective when it comes to choosing nurses. Most, if not all, will look for recent graduates from an accredited program.
The No. 1 RN program cost is tuition, followed by hidden costs such as books, room & board, supplies, and miscellaneous expenses such as test fees. Tuition costs vary by state, program, and whether or not it is a public or private school.
Thankfully, there are plenty of scholarships and grants to go around. Look to obtain free money in scholarships and grants before considering federal or private loans. Like any school program, applying for federal student loans requires filling out the Free Application for Federal Student Aid (FAFSA).
Refer to the last five to ten years’ worth of data evaluating the nursing school’s pass rate. Look for a minimum of 95%. Anything less than that may be a severe ground for concern.
We agree that becoming a registered nurse is worth your efforts. The potential for a high salary, specializations, a healthy job outlook, and the prestige of registered nurses are all excellent reasons for joining this rewarding and exciting field.
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