Choosing a nursing career path involves understanding the different types of nursing licenses and the exams required to obtain them. The two main nursing licensure exams in the United States are the NCLEX-PN (for Licensed Practical Nurses/Licensed Vocational Nurses) and the NCLEX-RN (for Registered Nurses).
This guide explains the key differences between these exams, the nursing roles they lead to, and how to decide which path is right for your career goals.
Understanding LPN/LVN vs RN
Licensed Practical Nurse (LPN) / Licensed Vocational Nurse (LVN)
LPNs (called LVNs in Texas and California) provide basic nursing care under the supervision of registered nurses and physicians. They:
- Complete a practical nursing program (typically 12-18 months)
- Must pass the NCLEX-PN exam
- Work under RN or physician supervision
- Perform basic patient care tasks
- Administer medications in most states
- Work in nursing homes, clinics, hospitals, and home health
Registered Nurse (RN)
RNs have a broader scope of practice and more autonomy. They:
- Complete an associate degree (ADN) or bachelor’s degree (BSN) nursing program
- Must pass the NCLEX-RN exam
- Can practice more independently
- Develop nursing care plans
- Supervise LPNs and unlicensed personnel
- Work in all healthcare settings
- Have pathways to advanced practice roles (NP, CRNA, etc.)
NCLEX-PN vs NCLEX-RN: Exam Comparison
Exam Structure
| Feature | NCLEX-PN | NCLEX-RN |
|---|---|---|
| Minimum Questions | 85 | 85 |
| Maximum Questions | 150 | 150 |
| Time Limit | 5 hours | 5 hours |
| Case Studies (NGN) | 3 | 3 |
| Testing Format | CAT | CAT |
| Exam Fee | $200 | $200 |
Content Differences
While both exams test similar content categories, the depth and complexity differ:
NCLEX-PN Test Plan Categories:
- Safe and Effective Care Environment (26-32%)
- Health Promotion and Maintenance (6-12%)
- Psychosocial Integrity (9-15%)
- Physiological Integrity (45-55%)
NCLEX-RN Test Plan Categories:
- Safe and Effective Care Environment (21-27%)
- Health Promotion and Maintenance (6-12%)
- Psychosocial Integrity (6-12%)
- Physiological Integrity (49-63%)
Scope of Practice Differences on the Exam
The key difference is that NCLEX-RN questions involve a broader scope of practice:
NCLEX-RN includes:
- More complex patient scenarios
- Leadership, delegation, and management questions
- Supervision of other healthcare workers
- Advanced assessment skills
- More independent decision-making
NCLEX-PN focuses on:
- Reinforcing the established plan of care
- Working under supervision
- Stable, predictable patient situations
- Basic nursing interventions
- Recognizing when to report to supervising nurse
Educational Requirements
For NCLEX-PN Eligibility:
- High school diploma or GED
- Completion of state-approved practical nursing program
- Programs typically 12-18 months
- Available at community colleges and vocational schools
For NCLEX-RN Eligibility:
- High school diploma or GED
- Completion of state-approved RN nursing program
- Associate Degree in Nursing (ADN): 2-3 years
- Bachelor of Science in Nursing (BSN): 4 years
Career Comparisons
Salary Differences
According to the U.S. Bureau of Labor Statistics (2024):
- LPN/LVN Median Salary: $59,730/year ($28.72/hour)
- RN Median Salary: $93,600/year ($45.00/hour)
Job Settings
LPNs commonly work in:
- Nursing homes and long-term care facilities
- Physician offices
- Home health care
- Hospitals (in some regions)
- Rehabilitation facilities
RNs work in:
- Hospitals (all departments)
- Outpatient clinics
- Schools
- Home health
- Public health
- Research
- And many more settings
Career Advancement
LPN Career Paths:
- LPN to RN bridge programs
- Specialized LPN roles
- Supervisory positions in long-term care
RN Career Paths:
- BSN completion (for ADN nurses)
- Specialty certifications
- Advanced Practice Nursing (NP, CNS, CRNA, CNM)
- Leadership and management
- Education
- Research
Which Path Should You Choose?
Consider LPN/LVN If:
- You want to start working in healthcare quickly
- You have limited time or resources for education
- You’re interested in long-term care settings
- You want to “test” nursing before committing to more schooling
- You plan to continue to RN later (LPN-to-RN bridge programs exist)
Consider RN If:
- You want a broader scope of practice
- You’re interested in hospital nursing or specialty areas
- You want higher earning potential
- You’re considering advanced practice roles
- You can invest 2-4 years in education
LPN to RN: Bridging Programs
If you start as an LPN, you’re not locked in. Many nurses use the LPN as a stepping stone:
- LPN-to-RN programs: Typically 1-2 years
- Advantages: Earn while you learn, build experience
- Considerations: Working while in school is demanding
Preparation Is Similar
Whether you’re preparing for NCLEX-PN or NCLEX-RN, the strategies are similar:
- Understand the NGN format and clinical judgment model
- Practice with NCLEX-style questions
- Focus on understanding, not just memorizing
- Master prioritization and delegation (for RN)
- Take CAT simulation exams
Both exams now use the Next Generation NCLEX format with case studies and clinical judgment questions.
Conclusion
Both LPNs/LVNs and RNs are essential members of the healthcare team. The right choice depends on your goals, resources, and timeline. Whether you choose NCLEX-PN or NCLEX-RN, proper preparation is key to passing your exam and starting your nursing career.
