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Nursing is the largest of the health care employment categories. There were 2,583,770 registered nurses working in the United States as of May 2009, according to the U.S. Department of Labor's Bureau of Labor Statistics. There were also 728,670 licensed practical nurses and licensed vocational nurses, who are licensed by the individual states, working in the United States. RNs, LPNs and LVNs all must take and pass a national licensure examination before they are licensed to practice in any state.
All 50 states and the District of Columbia require registered nurses to be licensed by the state board of nursing. Requirements may vary from state to state. There are three primary educational pathways that can prepare a registered nurse candidate for licensure. Candidates can earn a Bachelor of Science in Nursing from a traditional four-year college or university, or earn a two-year associate degree in nursing, or earn a diploma from a three-year professional nursing program at a teaching hospital. Each of these programs will prepare a candidate to sit for the National Council Licensure Examination for Registered Nurses, which is commonly referred to as the NCLEX-RN.
Licensed Practical Nurses
Licensed practical nurses, referred to in some states as licensed vocational nurses, are entry-level professional nurses who provide basic nursing care under the direct supervision of a registered nurse or physician. All 50 states and the District of Columbia require practical nurses to be licensed by the state board of nursing. Requirements may vary from state to state. Practical nurses can typically complete their training in one year through courses offered at local community colleges. Formal training programs will prepare a candidate to sit for the National Council Licensure Examination for Practical Nurses, which is commonly referred to as the NCLEX-PN.
There are many similarities between the NCLEX-PN and the NCLEX-RN. Both examinations were developed by the National Council of State Boards of Nursing and are administered through a national testing service. Candidates for either test must first apply for licensure with a state board of nursing. They must register and pay for the appropriate exam. They must receive acknowledgment of receipt of registration, authorization to test, and eligibility to test. A candidate must schedule the exam during the validity dates, and arrive at the testing site with her authorization to test letter and proper identification. Candidates will typically receive the results of their exam within a month of taking the exam.
Both the NCLEX-PN and the NCLEX-RN are organized into four categories of client needs, including Safe and Effective Care Environment, Health Promotion and Maintenance, Psychosocial Integrity, and Physiological Integrity. The percentage of test questions assigned to each category is different between the two exams. A significant difference between the two tests involves the focus on the delivery of nursing care. The NCLEX-PN focuses on the coordination of nursing care while the NCLEX-RN focuses on the management of nursing care. The NCLEX-RN tests for a far more extensive base of nursing knowledge than the NCLEX-PN. The NCLEX-PN lasts for a maximum of five hours. Candidates taking the NCLEX-PN must answer at least 85 items out of a maximum of 205 items. The NCLEX-RN lasts for a maximum of six hours. Candidates taking the NCLEX-RN must answer at least 75 items out of a maximum of 265 items.
- Bureau of Labor Statistics: Registered Nurses
- Bureau of Labor Statistics: Licensed Practical and Licensed Vocational Nurses
- National Council of State Boards of Nursing: The 8 Steps of the NCLEX (pdf)
- National Council of State Boards of Nursing: NCLEX-PN Test Plan (pdf)
- National Council of State Boards of Nursing: NCLEX-RN Test Plan (pdf)
Mike Parker is a full-time writer, publisher and independent businessman. His background includes a career as an investments broker with such NYSE member firms as Edward Jones & Company, AG Edwards & Sons and Dean Witter. He helped launch DiscoverCard as one of the company's first merchant sales reps.