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For nurses sitting the registered-nurse licensure.
Strategy, CAT mechanics, and content tracks for the RN exam.
The HESI Fundamentals exam is an Elsevier-proctored specialty test taken during your Fundamentals of Nursing course — not the HESI A2 admissions exam or the RN Exit Exam. It tests the nursing process, patient safety, infection control, meds, and basic care in NCLEX format. Most programs require a scaled 800–850 to pass.
The HESI Exit Exam is Elsevier's comprehensive end-of-program nursing assessment — not the HESI A2 admissions test. It spans Med-Surg, Pediatrics, Maternity, Mental Health, Pharmacology, and Leadership, predicts NCLEX-RN readiness, and most programs benchmark 850–900 on the 0–1,500 scale.
NCLEX pharmacology tests nursing actions around drugs — what to assess, hold, and teach, and how to spot toxicity — not pharmacokinetics. 'Pharmacological and Parenteral Therapies' is 13–19% of the NCLEX-RN. High-yield classes include anticoagulants, insulins, antihypertensives, and narrow-window drugs. Since 2023, NGN tests pharm through clinical cases.
NCLEX practice questions build the format, timing, and clinical-judgment skills the exam tests — including the six NGN item types. Free sources like NCSBN Learning Extension and Testavia help, but not all free banks include NGN content. Most RN candidates do 1,500–2,500 questions before testing.
Next Generation NCLEX (NGN) launched April 1, 2023 for NCLEX-RN and PN. NGN items are built on the Clinical Judgment Measurement Model — a six-function framework for clinical reasoning. Item types include unfolding case studies, bow-tie, trend, highlight, matrix, and cloze, some with partial credit. All current candidates take NGN.
Mental health NCLEX questions fall under Psychosocial Integrity (6–12% of the NCLEX-RN): therapeutic communication, psychiatric disorders, crisis intervention, and substance use. The most-tested skill is therapeutic communication — the response that opens dialogue and avoids advice, false reassurance, or 'why' questions.
More than 40 U.S. states participate in the Nurse Licensure Compact (NLC), letting RNs and LPNs practice across member states on one multistate license. California and New York are notable non-members. The compact only applies if your HOME state is a member — verify the current list at nursecompact.com.