NCSBN and State Boards of Nursing: RN Licensure and Exams

• NCSBN does not license nurses itself. Each state, the District of Columbia and the US territories have their own board of nursing (some states have separate RN and LPN/VN boards), and each keeps its own register of licensed nurses.
• Registered nurses (RN), licensed by a state board after passing the NCLEX-RN.
• Licensed practical nurses and licensed vocational nurses (LPN/VN), licensed after passing the NCLEX-PN.
• Advanced practice registered nurses (APRNs), licensed by state boards under separate rules; internationally educated nurses usually start as RNs.
• Nursys, run by NCSBN, is the national database boards use to verify licenses and discipline across participating states.
• The Nurse Licensure Compact lets nurses whose primary state of residence is a compact state hold one multistate license; the compact's website lists 43 participating jurisdictions.

• Graduation from a nursing program comparable to a board-approved US RN program, verified by a credentials review agency the board accepts (NCSBN's uniform licensure requirements).
• A nursing program approved by the body that approves nursing programs in your country.
• Verification of your nursing license or authorization to practice in your country of origin, sent directly by the licensing authority. Some boards, such as Texas, want verification from every country or state where you have ever held a license.
• A pass on an English proficiency exam covering reading, speaking, writing and listening, unless you are exempt. Under federal rules, nurses educated in Australia, Canada (except Quebec), Ireland, New Zealand, the UK or the US are exempt; individual boards may set their own rules.
• State and federal fingerprint-based criminal background checks, plus self-disclosure of all misdemeanors, felonies and plea agreements.
• Disclosure of any substance use disorder in the last five years and any action taken against any professional license.
• Board-specific extras, for example the Texas Nursing Jurisprudence Exam, or New York's approved infection control and child abuse reporting coursework.
• Some boards set time limits. Texas, for example, says internationally educated first-time applicants must have worked as a nurse within the 4 years before applying or be within 4 years of graduating.

Check your route with the route finder

1. 1

   Choose a state board of nursing

   Pick the state where you plan to work, or one whose requirements you can meet. Read that board's page for internationally educated applicants before you pay for anything, because accepted evaluation agencies, English tests, scores and extra courses differ. If you change your mind later, Pearson VUE charges $50 to change your nursing regulatory body, and you may have to meet the new board's requirements from the start.
2. 2

   Order a credentials evaluation

   Most boards require a report from an approved credentials evaluation agency. TruMerit (formerly CGFNS) says its Credentials Evaluation Service Professional Report is accepted by all 50 state boards; Texas also lists ERES, Josef Silny & Associates and The Evaluation Company. Your school and licensing authority send documents directly to the agency, and missing or non-direct documents are the most common cause of delay.
3. 3

   Pass an accepted English test

   If your nursing education was not in English or not in an exempt country, take a test your board accepts and have the testing agency send the scores directly. Texas, for example, requires IELTS 6.5 overall with 7 in speaking or OET 360 speaking, 340 reading, 350 writing and 320 listening. Use the same test to meet the VisaScreen requirement if you will need a visa.
4. 4

   Apply to the board

   Submit the board's application for licensure by examination as an internationally educated applicant and pay the board's fee, which is set by each state (Texas charges $75 including the jurisprudence exam; New York charges $143 for licensure and first registration). Complete fingerprints as the board instructs; Texas has separate instructions for applicants without a US Social Security number.
5. 5

   Register with Pearson VUE

   Register for the NCLEX on the Pearson VUE website with the $200 registration fee, using your name exactly as it appears on your passport. You cannot hold two registrations at once, and a registration stays open for 365 days waiting for the board to make you eligible. The fee is not refundable.
6. 6

   Receive your Authorization to Test (ATT) and book

   When the board makes you eligible, Pearson VUE emails your ATT. NCLEX says the average ATT is valid for 90 days and the dates cannot be extended. First-time candidates are offered appointments within 30 days of asking; booking at an international center adds a $150 non-refundable scheduling fee plus any VAT.
7. 7

   Sit the NCLEX-RN

   You have up to five hours, including breaks. Testing outside the US requires a passport as ID. The exam is adaptive, so it stops when it is confident you are above or below the passing standard, between 85 and 150 questions.
8. 8

   Get your results and your license

   Unofficial Quick Results are available for $7.95 two business days after the exam in participating jurisdictions. Official results come only from your board, within six weeks. If you fail, you receive a Candidate Performance Report and must wait at least 45 days before retesting; some boards set longer waits.

• NCLEX-RN: format

  A computerized adaptive test delivered by Pearson VUE. The 2026 NCLEX-RN Test Plan, effective April 1, 2026 to March 31, 2029, says every candidate answers at least 85 items and at most 150, within five hours. A minimum-length exam includes 52 scored content items, 18 items in three clinical judgment case studies and 15 unscored pretest items.

  Read the guide

• NCLEX-RN: content

  Items follow the Client Needs categories: Management of Care (15 to 21%), Safety and Infection Prevention and Control (10 to 16%), Health Promotion and Maintenance (6 to 12%), Psychosocial Integrity (6 to 12%), Basic Care and Comfort (6 to 12%), Pharmacological and Parenteral Therapies (13 to 19%), Reduction of Risk Potential (9 to 15%) and Physiological Adaptation (11 to 17%).

  Read the guide

• Next Generation NCLEX (NGN)

  Since April 1, 2023, the NCLEX has used the Clinical Judgment Measurement Model, with case studies of six items each that follow one client presentation, plus standalone clinical judgment items. Expect question types beyond multiple choice, and prepare with NCSBN's sample questions.

  Read the guide

• Where you can take it

  At Pearson VUE centers in the US and, for an extra $150, in the countries NCLEX lists: Australia, Brazil, France, Hong Kong, India, Israel, Japan, Jordan, Kenya, Malaysia, Mexico, Pakistan, the Philippines, Puerto Rico, South Africa, Spain, Taiwan, Türkiye and the United Kingdom. No Gulf country is on the current list.

• NCLEX-PN

  The exam for licensed practical and vocational nurses, also adaptive and delivered by Pearson VUE. Internationally educated nurses whose education is comparable to a US RN program sit the NCLEX-RN, not the PN.

  Read the guide

• NCSBN's uniform requirements call for an English proficiency exam covering reading, speaking, writing and listening, except for applicants from countries where English is the native language whose nursing program was taught in English with English textbooks.
• Under the federal rules cited by NCSBN, nurses who graduated in Australia, Canada (except Quebec), Ireland, New Zealand, the UK or the US are exempt from the English requirement.
• Each board sets the tests and scores it accepts. Texas, for example, accepts TOEFL iBT (4.5 overall, 4.5 speaking, 3.5 in reading, listening and writing), IELTS (6.5 overall, 7 speaking), MET (58 overall, 59 speaking), OET (360 speaking, 340 reading, 350 writing, 320 listening) and PTE (55 overall, 76 speaking, 62 in reading, writing and listening).
• Texas stopped accepting the paper-based and computer-based TOEFL, the TSE and the TWE from September 1, 2026; check whether your board has made similar changes.
• The VisaScreen English requirement for immigration is separate from the board's. TruMerit's May 12, 2026 table uses the same RN scores as the Texas list above, and does not accept at-home test versions.
• Have the testing agency send scores directly to the board and the evaluation agency; applicant copies are usually refused.

Estimate your total cost

• Credentials evaluation: TruMerit says 70% of CES reports are issued within 7 business days once primary-source documents are validated; getting documents sent from your school and regulator usually takes longest.
• Board review: varies by state. Texas says it reviews retest applications within 15 business days of the last item; first applications depend on background check results.
• Authorization to Test: NCLEX says the average ATT is valid for 90 days and first-time candidates are offered a date within 30 days of asking.
• Results: Quick Results after two business days; official results from your board within six weeks.
• Retakes: at least 45 days between attempts under the NCSBN policy, longer in some states.