The NCLEX-RN test plan you will sit in 2027 is the 2026 NCLEX-RN test plan. NCLEX.com lists it as effective from April 1, 2026, through March 31, 2029, so there is no separate 2027 version to wait for.
The 2026 plan also kept the structure of the 2023 plan that launched with the Next Generation NCLEX: the same eight Client Needs categories, the same percentage ranges, the same 85 to 150 items and the same three clinical judgment case studies. This guide walks through the RN blueprint category by category, shows exactly which tasks NCSBN added or reworded, and explains the one thing that does change in 2027: the registration fee.
Which NCLEX-RN test plan applies in 2027?
The 2026 plan, for the whole year. NCSBN rewrites the NCLEX-RN test plan on a three-year cycle: the 2026 NCLEX-RN Test Plan says the NCLEX Examination Committee reviews and approves it every three years, and NCSBN's Delegate Assembly then adopts it. The current cycle started on April 1, 2026, so 2027 sits in its middle.
Each plan rests on a practice analysis, a survey of what newly licensed nurses actually do at work. For the 2026 plan, NCSBN's 2024 RN Practice Analysis asked nearly 24,000 newly licensed RNs how often they perform each nursing activity, how important it is and how much clinical judgment it needs. Those answers set the content and the weights.
Check your own date below. The plan that replaces this one has not been published, and NCSBN has not said what it will contain.
The NCLEX-PN runs on the same cycle and dates, but with its own categories and percentages, so do not mix PN and RN numbers.
NCLEX-RN test plan categories and percentages
The NCLEX-RN test plan sorts every scored item into four Client Needs categories. Two of them split into subcategories, which gives eight content areas, each with a published range. NCSBN's distribution chart in the plan also shows one value inside each range, and those values add up to 100%.
Two numbers stand out. Physiological Integrity, the four subcategories about the body, adds up to 51% of the chart. And Management of Care, at 15–21%, is the largest single area: it is where the RN's job of directing care (delegation, prioritization, handoff, consent) gets tested.
The plan says one exam's mix can differ from these figures by up to 3% in each category, because exam length varies. Clinical judgment is measured on top of the eight areas, through 18 case-study items and about 10% stand-alone items.
What the percentages mean in items
At the 85-item minimum, the plan says 52 items come from the eight content areas "in the stated percentages." Applying NCSBN's chart values to those 52 items gives a rough sense of scale:
| Content area | Published range | About this many of the 52 items |
|---|---|---|
| Management of CareSafe and Effective Care Environment | 15–21% | 9 |
| Safety and Infection Prevention and ControlSafe and Effective Care Environment | 10–16% | 7 |
| Health Promotion and MaintenanceNo subcategories | 6–12% | 5 |
| Psychosocial IntegrityNo subcategories | 6–12% | 5 |
| Basic Care and ComfortPhysiological Integrity | 6–12% | 5 |
| Pharmacological and Parenteral TherapiesPhysiological Integrity | 13–19% | 8 |
| Reduction of Risk PotentialPhysiological Integrity | 9–15% | 6 |
| Physiological AdaptationPhysiological Integrity | 11–17% | 7 |
The last column is our arithmetic (chart value × 52, rounded), not an NCSBN figure. A real exam will not match it item for item, and a longer exam adds more items in roughly the same proportions.
What each NCLEX-RN category covers
Each content area in the plan opens with a list of activity statements: the tasks the 2024 practice analysis found newly licensed RNs perform. They are the best checklist you have of what can appear. A few examples from each category:
Management of Care (15–21%). Delegate and supervise care provided by LPN/VNs, assistive personnel and other RNs; prioritize care based on acuity; give and receive handoff; receive, verify and carry out provider orders; verify consent; report conditions required by law, such as abuse or communicable diseases.
Safety and Infection Prevention and Control (10–16%). Infection prevention and isolation, correct client identification, restraints, allergies, handling hazardous materials, documenting errors and near misses, and escalating unsafe practice by staff.
Health Promotion and Maintenance (6–12%). Care and education across the lifespan, with separate statements for newborns to age 2, ages 3 to 17, adults 18 to 64 and adults 65 and over. Also prenatal, labor and postpartum care, targeted screening, comprehensive health assessment and readiness to learn.
Psychosocial Integrity (6–12%). Therapeutic communication, abuse and neglect, substance misuse and withdrawal, potential for violence, grief and end-of-life care, and care for clients with depression, dementia or eating disorders.
Basic Care and Comfort (6–12%). Activities of daily living, elimination, tube feedings, skin and tissue integrity, sleep, pain and nonpharmacological comfort.
Pharmacological and Parenteral Therapies (13–19%). Dosage calculations, IV infusions, blood products, central venous access devices, parenteral nutrition, titration to ordered parameters, controlled substances and high-risk medications.
Reduction of Risk Potential (9–15%). Vital sign trends, diagnostic results, point-of-care testing, procedures with moderate sedation, and inserting or removing urinary catheters, nasal or oral gastrointestinal tubes and peripheral IV lines.
Physiological Adaptation (11–17%). Ventilators, chest tubes and drains, telemetry, pacing devices, arterial lines, dialysis, fluid and electrolyte imbalances, and emergency care.
What changed in the 2026 NCLEX-RN test plan
Very little, and NCSBN said so before adopting it. Its summary of the proposed 2026 plans lists five points: the overall format was retained, edits were minor and made "for currency and clarity," the Client Needs percentages were retained, one category was renamed, and new activity statements were added. If you are searching for NCLEX-RN changes, that is the whole official list.
The rename is the one you will notice: Safety and Infection Control is now Safety and Infection Prevention and Control, with the same 10–16% weight.
To see the rest, we compared every activity statement in the 2023 RN plan with the 2026 plan, ignoring punctuation, spacing and capitalization.
149
activity statements in the 2026 RN plan (146 in 2023)
NCSBN RN test plans, Prepia comparison
128
worded exactly as in 2023
NCSBN RN test plans, Prepia comparison
18
reworded
NCSBN RN test plans, Prepia comparison
3
new; none removed
NCSBN RN test plans, Prepia comparison
Most of the 18 rewordings are housekeeping: "substance abuse" became "substance misuse," "preventative" became "preventive," and "health care personnel" became "staff." Pharmacological and Parenteral Therapies did not change at all. These are the changes worth your study time:
| 2023 plan | 2026 plan | Category |
|---|---|---|
| Not in the plan | Perform care for clients to support unbiased treatment and equal access to care, regardless of culture/ethnicity, sexual orientation, gender identity and/or gender expression | Management of Care (new) |
| Not in the plan | Maintain client dignity and privacy during care | Basic Care and Comfort (new) |
| Not in the plan | Monitor and maintain internal monitoring devices (e.g., intracranial pressure monitor, intrauterine pressure catheter) | Physiological Adaptation (new) |
| Perform testing within scope of practice (e.g., electrocardiogram, glucose monitoring) | Perform testing within scope of practice (e.g., electrocardiogram, point-of-care testing, fetal monitoring) | Reduction of Risk Potential |
| Maintain client confidentiality and privacy | Maintain client confidentiality and privacy (e.g., social media, disclosure of information) | Management of Care |
| Practice and advocate for cost effective care | Practice and advocate for quality and cost-effective care | Management of Care |
| Promote staff safety | Promote staff and workplace safety | Safety and Infection Prevention and Control |
The new internal monitoring statement is the most clinical addition. If your review book only covers intracranial pressure as a sign to watch for, add the device itself: what an ICP monitor or intrauterine pressure catheter measures and how the nurse maintains it.
How long is the NCLEX-RN, and how does it end?
Between 85 and 150 items, within five hours that include every break. The 2026 plan breaks the 85-item minimum into 52 content-area items, 18 case-study items and 15 unscored pretest items, which look exactly like scored ones.
The NCLEX-RN is a computerized adaptive test. After each answer, it re-estimates your ability and picks the next item to be challenging for you. It usually stops once it is 95% certain you are clearly above or below the passing standard; otherwise it runs to 150 items or until time runs out. The length of your exam says nothing about whether you passed. The RN standard is 0.00 logits, which NCLEX.com says holds through March 31, 2029.
You cannot go back. Once you confirm an answer and select Next, that item is closed, and every item must be answered.
Clinical judgment case studies
The case studies are the Next Generation NCLEX part of the exam, introduced on April 1, 2023 and unchanged in the 2026 plan. Each one follows a single client whose information unfolds over six items, one for each step of NCSBN's Clinical Judgment Measurement Model:
Some items give partial credit when more than one answer is correct. The NCLEX candidate tutorial on NCLEX.com shows every item format, so work through it before test day.
Try two NCLEX-RN-style questions
These are original practice items written by Prepia for the two largest RN content areas, Management of Care and Pharmacological and Parenteral Therapies. They are not NCSBN items.
What does change in 2027: the registration fee
The NCLEX registration fee in the United States rises from $200 to $350 on February 1, 2027. NCSBN announced the change after its Delegate Assembly vote and called it the first adjustment since 2000. The fee depends on when you complete your registration, not when you test, and it applies to retakes too. The international scheduling fee ($150) and the $50 fees to change your nursing regulatory body or exam type stay the same, according to NCLEX.com.
One thing that is not coming in 2027, as far as anyone knows: an at-home NCLEX. NCSBN's NCLEX Online page says online testing is in development, is not launching in 2026, and has no announced date. Plan on a Pearson VUE test center.
How to study for the NCLEX-RN in 2027
Because the blueprint did not move, a good 2023-era NCLEX-RN review book still covers the right categories, weights and formats. Your job is to study from the right document and patch the small gaps.
- Download the 2026 NCLEX-RN test plan from NCLEX.com. The cover says "Effective April 2026." Use it as your master checklist of activity statements.
- Weight your time by the chart. Physiological Integrity is about half the exam, and Management of Care is the largest single area. Health Promotion and Psychosocial Integrity matter, but each is under a tenth of scored items.
- Add the three new statements to your notes: unbiased treatment and equal access to care, client dignity and privacy, and internal monitoring devices such as ICP monitors and intrauterine pressure catheters. Review point-of-care and fetal monitoring under testing within scope of practice.
- Practice whole case studies. Work six-item sets about one client, not only single questions, so you practice carrying cues forward.
- Take the official tutorial on NCLEX.com and try the sample items in the test plan's appendix before relying on any question bank.
- Pick your registration date with the February 1, 2027 fee change and the 365-day eligibility window in mind.
Frequently asked questions
Is there a new NCLEX-RN test plan for 2027?
No. The 2026 NCLEX-RN test plan is effective from April 1, 2026, through March 31, 2029, so an exam in 2027 uses the same categories, percentages and length as one in late 2026. NCSBN has not published the plan that will follow it.
What are the NCLEX-RN test plan percentages?
Management of Care 15–21%, Safety and Infection Prevention and Control 10–16%, Health Promotion and Maintenance 6–12%, Psychosocial Integrity 6–12%, Basic Care and Comfort 6–12%, Pharmacological and Parenteral Therapies 13–19%, Reduction of Risk Potential 9–15% and Physiological Adaptation 11–17%. The ranges are the same as in the 2023 plan.
What were the NCLEX-RN changes in 2026?
Safety and Infection Control was renamed Safety and Infection Prevention and Control, some activity statements were reworded, and three were added: unbiased treatment and equal access to care, client dignity and privacy during care, and internal monitoring devices. The format, length and percentages did not change.
Is the Next Generation NCLEX still in use?
Yes. The Next Generation NCLEX launched on April 1, 2023, and the 2026 plan keeps its clinical judgment measurement: three six-item case studies plus about 10% stand-alone clinical judgment items.
How many questions are on the NCLEX-RN?
Between 85 and 150 in a five-hour limit that includes breaks. At the minimum, 52 items come from the eight content areas, 18 from three case studies and 15 are unscored pretest items.
Can I still use a 2023 NCLEX-RN review book?
Mostly, yes. The categories, ranges, exam length and case-study format are the same, and 128 of the 149 activity statements in the 2026 plan are worded exactly as in 2023. Add the three new statements and the reworded ones from the 2026 plan.
Sources
- NCSBN — 2026 NCLEX-RN Test Plan (PDF), accessed October 2, 2026.
- NCSBN — 2023 NCLEX-RN Test Plan (PDF), accessed October 2, 2026.
- NCLEX.com — Test Plans, accessed October 2, 2026.
- NCSBN — 2026 NCLEX-RN and NCLEX-PN Test Plans: Summary of Proposed Changes (2025 Annual Meeting presentation, PDF), accessed October 2, 2026.
- NCSBN — NCLEX Fee Changes Feb. 1, accessed October 2, 2026.
- NCLEX.com — Fees & Payment, accessed October 2, 2026.
- NCLEX.com — Registration, accessed October 2, 2026.
- NCLEX.com — Passing Standard, accessed October 2, 2026.
- NCLEX.com — NCLEX Online, accessed October 2, 2026.
- NCLEX.com — Next Generation NCLEX (NGN), accessed October 2, 2026.