NCLEX Prep That Works: Train Better Nurses with Simulation
The NCLEX (National Council Licensure Examination) turns a nursing graduate into a licensed nurse. Every RN and LPN in the U.S. and Canada must pass it.
Traditional NCLEX prep has always had its place. It builds the foundation through textbooks, lectures, review guides, and practice questions. At Lumeto, we’re seeing that technology can take that prep further.
In this article, we’ll explain what NCLEX prep looks like today and how simulation sharpens clinical judgment. We will also discuss why forward-thinking educators combine both to help their students succeed.
What Is NCLEX Prep?
The NCLEX (National Council Licensure Examination) is a nationwide licensing exam that every nursing graduate must pass to practice in the U.S., Canada, and even Australia.
There are two versions of the NCLEX:
- NCLEX-RN: This one’s for students aiming to become Registered Nurses. It’s designed for associate’s or bachelor’s degree graduates. The test probes complex decision-making, management of care, and advanced nursing judgment. Students are expected to think critically and lead when necessary.
- NCLEX-PN: This one’s for Practical or Vocational Nurses. It focuses more on hands-on care, like monitoring patients, assisting with daily living, and recognizing common conditions. Students are expected to work under supervision, so the exam leans more toward coordination than leadership.
While both exams test essential nursing skills—like safety, infection control, and psychosocial support- they differ in depth. The NCLEX-RN exam expects a wider scope, while the PN exam sticks to foundational care.
Most students spend a few months preparing. They study the content and take practice exams to familiarize themselves with the test format.
Simulation is also becoming a core part of that prep. To meet this need, Lumeto has created InvolveXR, an immersive VR training platform for healthcare education. We designed it to give nursing students a safe, repeatable way to practice critical thinking in realistic clinical situations. The platform is built to align with the Next Generation NCLEX (NGN).
We’ve integrated the NCSBN Clinical Judgment Measurement Model (NCJMM) into our assessments. That means students’ decision-making structure in InvolveXR mirrors the one used in the NCLEX. On Lumeto’s InvolveXR, students build the exact skills they’ll be tested on.
What Does an NCLEX Prep Course Typically Include?
An NCLEX prep course includes study materials, practice systems, and active learning methods. Let’s break down:
Review Books and Study Guides
Most students start with the foundation books as they condense everything they learned in school into high-yield summaries. Think bullet points, topic-based outlines, and focused breakdowns of critical areas—like med-surg, pediatrics, OB, mental health, and pharmacology.
They can also find full-length practice questions with rationales that explain why each answer is right or wrong. Two of the most popular resources are Saunders Comprehensive Review and Lippincott Q&A Review.
These books also train students to think in patterns. Frameworks like ABCs (Airway, Breathing, Circulation) or infection control precautions show up repeatedly on the test. These guides help reinforce those systems so they become second nature under pressure.
Online Courses and Qbanks
Online courses walk students through content review, test strategies, and practice questions over several days or weeks. Some students choose them independently, while others get access through nursing school.
In fact, many schools now build NCLEX prep directly into the curriculum for senior students, using these platforms to support review in the final semester.
Most courses include Qbanks—question banks with thousands of practice items. These mimic the real exam format, including alternate styles like:
- Select-all-that-apply (SATA),
- Case studies,
- Next Gen-style questions.
Practice Exams
Practice exams and test plans are some of the most realistic ways to prepare for the NCLEX experience. By taking full-length tests, 75 questions, 100, or even more, students get a feel for sitting through a high-stakes, computer-adaptive exam.
These exams build mental endurance, time management, and focus when every question feels high-pressure.
Flashcards and Note-Taking Systems
Flashcards are a popular method for memorizing high-yield facts. Some students use index cards, while others use apps to create digital decks they can review anytime.
Flashcards work best for content that’s repetition-heavy. Examples include:
- Common medication side effects
- Normal lab values (like potassium, BUN, or hematocrit)
- Developmental milestones in pediatric care
- Key infection control precautions (like contact vs. airborne isolation)
- Priority frameworks like Maslow’s or the nursing process
Simulation-Based Training
Simulation is becoming a powerful addition to NCLEX prep. It allows students to practice nursing practically. The simulation training can take different forms:
- High-fidelity manikins
- Standardized patients
- Screen-based simulations
- Virtual simulation software
A 2023 study in the Journal of Nursing Education found that simulation helps strengthen clinical judgment, the core skill tested on the Next Generation NCLEX. It even showed potential to boost NCLEX pass rates.
At Lumeto, we’ve seen this firsthand. When students enter a virtual scenario using InvolveXR, they’re challenged to “think like a nurse” in real time.
This reflection is where the real learning happens. A student might finish a scenario and say, “I should’ve checked mental status when I saw that low blood sugar—I won’t forget that next time.”
Here’s a video from one of our sessions, where Dr. Andres E. Arboleda-Morejon, Associate Professor of Internal Medicine at the University of Texas Rio Grande Valley, experienced Lumeto for the first time during the Difficult Airway Management Session at CHEST AGM’22:
Real-world examples show how simulation is already transforming NCLEX prep. One notable case is a project from Toronto Metropolitan University (TMU).
Alumni nurse Halyna Yurkiv, in partnership with Lumeto, developed a VR-based simulation program that trains nursing students to respond to respiratory distress emergencies.
Benefits of Structured NCLEX RN Preparation
Here are some of the biggest benefits of a structured, multi-faceted prep approach:
Higher First-Time Pass Rates
When prep is intentional and starts early, students walk into the exam more confident and ready. The national average for first-time NCLEX-RN pass rates in the U.S. typically falls between 85% and 90%. That’s solid, but structured prep can help schools go even higher.
Take Florida A&M University, for example. After strengthening their NCLEX strategy, revising the curriculum to match the test plan, and offering more support, they boosted their pass rate to 93%. That’s an 11-point jump in just one year.
Greater Student Confidence
Both research and lived experience show that clinical simulation builds self-assurance in nursing students. When learners practice decision-making through simulation, they start trusting their clinical instincts.
One simulation review summed it up well: “Simulation is a useful tool in increasing nursing students’ self-confidence to perform clinical tasks and make clinical judgments.” And that confidence follows them into the testing center.
Confident students are less likely to second-guess answers or freeze under pressure. They’ve already seen tough scenarios and have already made hard choices. So when the NCLEX throws a case at them, it’s already familiar.
VR software like Lumeto makes these realistic scenarios accessible, without the need for a physical simulation center or specialized equipment. Students can practice clinical judgment in a repeatable, low-risk environment, anytime.
Here’s a student taking on a scenario of medication administration through a syringe. If they have already practiced the procedure in such an environment, they are more likely to be prepared when it’s needed in reality:
Higher Program Reputation
When a school maintains high pass rates year after year, it signals quality. It shows that the curriculum, instruction, and clinical training align with real-world expectations.
Many state boards of nursing require schools to keep pass rates near or above the national average. High NCLEX outcomes can also help secure accreditation, attract applicants, and unlock access to grants or funding opportunities.
Enhanced Clinical Judgment
A structured prep program that uses case-based learning and simulation helps students sharpen that thinking. They get repeated chances to analyze patient scenarios, spot subtle red flags, and make the right clinical calls.
In real-world terms, this means recognizing early signs of deterioration, knowing when to escalate care, or choosing the safest intervention for a complex patient. The more students practice those decisions, the more natural they become.
A systematic review on simulation in nursing education supports this. It found that students who engage in simulation consistently build stronger clinical judgment and decision-making skills than those who study passively.
Traditional NCLEX Prep vs. Simulation-Enhanced Prep
Traditional NCLEX-RN builds a solid academic foundation. But as the exam and the medical requirements evolve, incorporating practice tests and simulation brings a new layer of readiness. Schools that integrate both approaches (traditional study plus simulation) report better student engagement, fewer knowledge gaps, and stronger performance on mock exams and clinicals.
Here’s how the two approaches compare side by side:
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Aspect
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Traditional NCLEX Prep
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Simulation-Enhanced NCLEX Prep
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How Educators and Trainers Can Support NCLEX Preparation
Here’s how educators and trainers can strengthen NCLEX outcomes from day one:
Building a Curriculum that Mirrors the NCLEX Test Plan
The NCSBN provides detailed NCLEX-RN and NCLEX-PN Test Plans, updated every three years. These plans break down everything from content categories to question distribution. Faculty should review them regularly and align the course content to match.
Every student comes into NCLEX prep with a different challenge. Some struggle with content gaps—maybe they never felt confident in maternity or psych nursing. Others hit a wall with test-taking strategies—they know the material, but second-guess themselves. That’s why support has to be flexible. And early.
Don’t wait until the final semester to bring in NCLEX-style questions. One of the most effective strategies is embedding practice questions into daily teaching. Instead of reviewing cardiac meds with a lecture, walk through a real clinical case and end it with a Next Gen-style question. Get students used to applying knowledge, not just recalling it.
Integrating Simulation Labs and Mock Exams
Simulation shouldn’t be a one-time event. If you want it to make a real impact on NCLEX readiness, it needs to be woven into the fabric of your curriculum.
In the first semester, students might work through single-patient scenarios focused on basic assessments. As they progress, you introduce more complex simulations—like caring for multiple patients, managing code situations, or ethical dilemmas under pressure.
According to NCSBN guidelines, schools that are new to simulation should start modestly. As faculty gain experience, they can increase simulation hours, even substituting up to 50% of traditional clinical time with high-quality simulation—if the setup meets national standards.
Some programs also run a mock NCLEX hospital day. Seniors rotate through stations featuring simulated patients with a variety of conditions. Each station tests their ability to assess, prioritize, and intervene, all under timed conditions. It’s like working an 8- or 12-hour shift in compressed form.
See an example video below where NYU students perform an ACLS (Advanced Cardiovascular Life Support) session inside Lumeto’s InvolveXR platform:
Offering Personalized Feedback and Review Sessions
One of the most effective ways to support NCLEX certification is through targeted feedback. Students don’t just need to know what they got wrong—they need help understanding why and how to improve.
Programs can use diagnostic tools like:
- NCLEX-style practice tests
- Course exam performance
- Simulation session evaluations
- Virtual reality simulations integrated with AI assessment tools
These data points help flag students who are struggling well before graduation. Some schools set up mentoring systems where each student meets with a faculty advisor to go over scores, review patterns, and build a personalized study plan focused on weak areas.
At Lumeto, we’ve built that feedback loop right into the platform.
Our ACE (Artificial Clinical Evaluator) uses AI to automatically assess learner performance during simulation. It tracks how well students execute clinical actions and maps those actions to critical thinking domains.
Educators also get access to robust debriefing tools. After each session, instructors can review the checklist, watch session replays, and give direct, scenario-specific feedback.
Here’s what that looks like on the instructor dashboard:
Upgrade Your NCLEX Prep Class with Lumeto’s Immersive Training
Throughout this guide, we’ve shown how traditional tools lay the groundwork, but simulation brings it to life. It challenges students to apply knowledge, think fast, and confidently make clinical decisions.
Lumeto’s InvolveXR platform is built to support your NCLEX prep class from the inside out. With VR-based scenarios aligned to the NCSBN Clinical Judgment Measurement Model, AI-powered assessment tools, and built-in debriefing features, educators can deliver modern, high-impact training.
Let Lumeto help you bring clinical judgment into focus—before your students step into the exam room. Book a demo today!
Frequently Asked Questions
How early should NCLEX prep begin in a nursing program?
While formal prep usually starts at least 5 to 6 months before graduation, students can begin building NCLEX-RN readiness as early as their first semester.
Can simulation help students who are retaking the NCLEX?
Yes. Simulation is especially useful for repeat test-takers who struggle with application and clinical reasoning. Practicing real-time decision-making in a controlled environment can help them identify gaps and rebuild confidence.
Can simulation be used for soft skills like communication and teamwork?
Absolutely. Many programs use VR-based simulations to assess nurse-patient communication, interprofessional collaboration, and ethics-based decision-making.
What’s the difference between Next Gen NCLEX (NGN) and the old format?
The Next Generation NCLEX (NGN) focuses more on clinical judgment than the older version. It includes case-based scenarios, matrix questions, and layered decision-making tasks that better reflect real nursing responsibilities.