An Investigation of Predictors of Nclex-Rn Outcomes on the First-Attempt Among Standardized Tests

Abstract

Nursing shortage is one of the critical issues in the United States. In order to meet increased demands for qualified RNs and prevent negative effects on graduates, nursing programs, stakeholders, and society from graduates’ NCLEX-RN failure, it is important to support nursing students to succeed on the NCLEX-RN. By utilizing effective NCLEX-RN predictors, students at risk for NCLEX-RN failure can be identified, and early remediation can be provided to support them. This study was to investigate effective predictors of NCLEX-RN outcomes on the first-attempt among standardized tests (adult medical-surgical, fundamentals for nursing, pharmacology, maternal-newborn, nursing care of children, mental health, community health, and leadership and management) conducted throughout the nursing program. NCLEX-RN outcomes and individual adjusted scores on the standardized tests of 151 participants, who were composed of 118 graduates who passed the NCLEX-RN on the first-attempt and 33 graduates who failed the NCLEX-RN on the first-attempt, were analyzed by a t-test and logistic regression. The investigation found that there were significant statistical differences between the two groups with NCLEX-RN success and failure in the individual adjusted scores on the adult medical-surgical, pharmacology, maternal-newborn, mental-health, community health, and leadership and management standardized tests. Only in individual adjusted scores on the fundamental and nursing care of children standardized tests, there were no significant statistical differences between the two groups. In addition, the result of logistic regression indicated that the overall regression models were significant in predicting both NCLEX-RN success and failure. Adult medical-surgical, pharmacology, and community health standardized tests were central in the prediction of both NCLEX-RN success and failure; however, a much lower percentage of NCLEX-RN failure than success was classified. It can be concluded that the adult medical-surgical, pharmacology, and community health standardized tests were less effective to predict NCLEX-RN failure than NCLEX-RN success. It is recommended to use different standardized test products as variables, have a larger sample size of those who fail the NCLEX-RN, have a more diverse group of participants, and continue longitudinal and replicated studies for future studies.