From setback to success: A phenomenological study of NCLEX-RN repeat test-takers path to success

Abstract

Passing the National Council Licensure Examination for Registered Nurses (NCLEX-RN) represents a pivotal milestone for nursing graduates, yet a substantial number do not succeed on their first attempt. While existing literature primarily focuses on predicting at-risk students prior to graduation, less is known about the lived experiences of graduates who fail the exam and later pass. This phenomenological study explored the perspectives of nine BSN graduates who were unsuccessful on their first NCLEX-RN attempt but ultimately achieved licensure. Semi-structured interviews were conducted, transcribed, and analyzed using thematic analysis. Six themes emerged: (1) Key Changes in Preparation, (2) Emotional Impact, (3) Consequences of Not Passing, (4) Test-Day Stressors, (5) Mindset and Confidence-Building, and (6) Support Systems. All participants reported substantial adjustments in study strategies, including structured schedules, increased practice question volume, and targeted content review, which they perceived as the primary contributors to later success. Emotional responses to failure were profound, marked by embarrassment, self-doubt, and social withdrawal. More than half experienced tangible consequences such as delayed employment and financial strain, which often served as motivators for reattempting the exam. Test-day factors, including anxiety related to test-site procedures, weather, and fatigue, also influenced performance. Some participants emphasized the value of mindset shifts, positive self-talk, and anxiety-management techniques, while a smaller subset highlighted the importance of family, peer, or employer support. Findings suggest that NCLEX-RN remediation should extend beyond content review to include structured study planning, emotional support, and preparation for the testing environment. Nursing programs may enhance graduate success by providing early outreach, individualized study plans, and psychosocial support for those who do not pass on their first attempt.

Keywords

NCLEX-RN failure / Nursing education support / Phenomenology / Repeat test-takers

References

[1] Sheikoleslami RL, Princeton DM, Mihaila Hansen LI, et al. Examining Factors Associated with Attrition, Strategies for Retention Among Undergraduate Nursing Students, and Identified Research Gaps: A Scoping Review. Nursing Reports. 2025; 15(6): 182. PMid:40559473 https://doi.org/10.3390/nursrep15060182

[2] National Council of State Boards of Nursing. 2023 NCLEX Examination statistics. 2024. Available from: https://www.ncsbn.org/publications/2023_NCLEX_Examination_Statistics

[3] National Council of State Boards of Nursing. NCSBN launches Next Generation NCLEX exam. 2023. Available from: https://www.ncsbn.org/news/ncsbn-launches-next-generation-nclex-exam

[4] Mahmoud KF, Zhao J, Kyung Kim D, et al. Predictors of First-Time NCLEX-RN Pass Rate in Accelerated Bachelor of Science in Nursing Students. Journal of Nursing Education. 2024; 63(1): 10-16. PMid:38227325 https://doi.org/10.3928/01484834-20231112-04

[5] Kim HJ, Nikstaitis T, Park H, et al. Predictors and students’ perceptions of first attempt NCLEX RN success in a BS program. Journal of Nursing Education and Practice. 2019; 9(6): 32-41. https://doi.org/10.5430/jnep.v9n6p32

[6] Flowers M, Olenick M, Maltseva T, et al. Academic factors predicting NCLEX-RN success. Nursing Education Perspectives. 2022; 43(2): 112-114. PMid:35192289 https://doi.org/10.1097/01.NEP.0000000000000788

[7] Montegrico J. Standardized tests as predictors of NCLEX RN success. Philippine Journal of Nursing. 2021; 91(1): 22-31.

[8] Shah M, Fuller B, Gouveia C, et al. NCLEX-RN readiness: HESI Exit Exam validity and nursing program policies, Journal of Professional Nursing. 2022; 39: 131-138. PMid:35272820 https://doi.org/10.1016/j.profnurs.2022.01.010

[9] Rogers M, Koomey C, Fontenot R. Predictors of NCLEX RN failure in prelicensure nursing students. Nurse Educator Perspectives. 2025; 46(3): 143-148. PMid:40013917 https://doi.org/10.1097/01.NEP.0000000000001391

[10] Climer L, Shelton K, Young K, et al. Nursing school-ownership status as a predictor of first time NCLEX RN pass rates. Journal of Nursing Regulation. 2025; 16(1): 45-52. https://doi.org/10.1016/j.jnr.2025.03.002

[11] Odtom-Maryon T, Bailey L, Solmaz AD. The influences of nursing school characteristics on NCLEX-RN pass rates: A national study. Journal of Nursing Regulation. 2018; 9(3): 59-69. https://doi.org/10.1016/S2155-8256(18)30154-6

[12] Chery S, Larson E, Madden S, et al. The relationship of a predictable ability measurement examination and NCLEX-RN disposition. Nurse Educator. 2024; 49(5): 246-249. PMid:39110969 https://doi.org/10.1097/NNE.0000000000001710

[13] Neubauer BE, Witkop CT, Varpio L. How phenomenology can help us learn from the experiences of others. Perspectives on Medical Education. 2019; 8(2): 90-97. PMid:30953335 https://doi.org/10.1007/S40037-019-0509-2

[14] Gibson WJ, Brown A. Working with Qualitative Data. Sage Publications. 2009.

[15] Devkota S, Loftin C, Jeffreys H. The lived experience of new graduate nurses successfully completing NCLEX-RN. Journal of Nursing Education and Practice. 2022; 12(5): 41-46. https://doi.org/10.5430/jnep.v12n5p41

[16] Thompson CW. Retaining graduate nurses who experience NCLEX failure: Recommendations for supporting retest success. Nurse Leader. 2023; 21(2): 299-302. https://doi.org/10.1016/j.mnl.2022.11.013

[17] Spencer J. When New Graduate Nurses Fail the NCLEX: What Role Can the Hospital Play? Journal for Nurses in Staff Development. 2006; 22(4): 187-189. PMid:16885684 https://doi.org/10.1097/00124645-200607000-00006

[18] Kasprovich T, VandeVusse L. Registered nurses’ experiences of passing the NCLEX-RN after more than one attempt. Journal of Nursing Education. 2018; 57(10): 590-597. PMid:30277543 https://doi.org/10.3928/01484834-20180921-04

[19] Roa M, Shipman D, Hooten J, et al. The costs of NCLEX-RN failure. Nurse Education Today. 2011; 31(4): 373-377. PMid:20732732 https://doi.org/10.1016/j.nedt.2010.07.009

[20] Mingo S. Case study of a graduate nurse’s NCLEX-RN failure experience. International Journal for Human Caring. 2025; 29(2). https://doi.org/10.20467/IJHC-2023-0048

[21] Kramer M. Understanding NCLEX-RN Repeat Writers’ Learning Needs: A Pilot Developmental Design Research Study. The Journal of nursing education. 2025; 64(2): 121-124. PMid:39653066 https://doi.org/10.3928/01484834-20240724-01

[22] Bandura A. Self-efficacy: The exercise of control. W. H. Freeman. 1997.