Nurse licensure exams, the NCLEX-RN and the
NCLEX-PN, are high-stake exams for students, nursing
faculty, and college and university administrators. Failure
of the exam has financial as well as emotional consequences
for students. Some nursing employment opportunities
are eliminated by such failures, and those
who fail may experience a sense of low self-esteem.1
The licensure exam measures minimal level competence
and is not designed to be a curriculum evaluation tool;
however, faculties often use the school’s pass rate on
the licensure exam as one curriculum outcome. College
and university administrators are interested in marketing
high pass rates as a means to attract students into
their nursing programs.
Because of the value attributed to success on the licensure
exam, it is important for students and faculty to
have a means of determining students’ preparedness for
the licensure exam so that if remediation is indicated, it
can be initiated before graduation. Computerized testing
can provide immediate feedback regarding students’ risk
for failing the licensing exam. Further, computerized instruments
can serve as learning tools for those preparing
for the computerized licensing exams. Billings et al1
and Riner et al2 reviewed computerized NCLEX-RN
preparation programs and described commercially prepared
computerized instruments based on numerous criteria. Their publications were descriptive and not intended
to address the effectiveness of such instruments
in predicting students’ success or in preparing students
for the licensure examination.
Many authors have described factors related to
NCLEX success.3–7 Some also have studied the relationship
of scores on commercially available testing products to students’ success on the licensing exam.7–11 The
Mosby Assess Test has been found to be a moderate to
strong predictor of NCLEX-RN success.8,10,12 However,
the Mosby Assess Test is a paper-and-pencil exam and
results are not immediately available. Barkley et al9 studied
81 students from one baccalaureate school of nursing
and found a significant relationship between students
who passed the NCLEX-RN and their scores on
the Psychiatric, Obstetric, Pediatric, and Adult National
League for Nursing (NLN) achievement tests. But,
again, the NLN achievement tests were paper-and-pencil
tests and results were not immediately available. Ross
et al11 examined the usefulness of the Computer Assisted
Preparation for the NCLEX-RN (1992) in assessing students
at risk of failing the NCLEX-RN. Their findings
were based on 230 volunteer participants from one
baccalaureate school of nursing, and they concluded
“further research is necessary to establish evidence of the
validity on the Computer Assisted Preparation for the
NCLEX-RN in predicting NCLEX results.”11
The need exists to study the predictive accuracy of a
computerized exam that can provide immediate feedback.
Previous studies often focused on students from one type
of educational preparation, and from one geographic area.
Therefore, to broaden the inferential range, the sample
needed to include nursing students from different nursing
educational preparations and from different parts of the
country. This study was designed to measure the effectiveness
of a computerized instrument in determining registered
nurse (RN-associate degree, baccalaureate, and diploma)
and practical nurse (PN) students’ preparedness for the licensure
exam in the United States. Additionally, the effect
of monitoring or proctoring the administration of the test
was examined.