By: Mariah Taylor – Becker’s Hospital Review
Many nurse leaders expressed surprise that the National Council Licensure Examination pass rate declined earlier this year, but most said the one-year drop is not cause for concern.
In the first quarter of 2025, the NCLEX pass rate for registered nurses dropped to 71.6%, compared to 79.1% in the same period in 2024.
The decline affected U.S.-educated and internationally educated nurses, as well as both first-time and repeat test takers, according to a June report from the National Council of State Boards of Nursing.
Declining pass rates is not new. In 2023, state nursing boards revised the NCLEX to counteract years of declining pass rates among U.S.-educated, first-time test takers. The new test was designed to better measure nurses’ clinical judgment and critical thinking skills. In the first year of the new test’s launch, pass rates rose from 70.4% in mid-2022 to 81.4% in mid-2023.Test developers attributed the higher pass rate to increased transparency and outreach, while critics said the exam got easier.
But rates are declining again. Becker’s reached out to nursing leaders to gauge their reactions to the shift and what might be behind the drop.
Note: responses have been lightly edited for length and clarity.
Timothy Carrigan, PhD, RN. Regional Chief Nursing Officer of Illinois and Indiana at Trinity Health (Livonia, Mich.): My initial reaction is that I’m not overly surprised. We’re seeing a change in how new graduate nurses are prepared coming out of their undergraduate programs, and we largely believe this is a result of changes in curriculum during the COVID-19 pandemic. These students were being educated — some starting as far back as high school — during a time when all of us were adjusting to new methods of teaching and learning.
Lisa Gossett, MSN, RN. System Chief Nursing Officer and Chief Experience Officer at Premier Health (Dayton, Ohio): Honestly, [declining pass rates] hasn’t been my experience with our local schools. Our two primary feeder schools — one an associate degree program, the other a baccalaureate program — have consistently been above the Ohio average of 75% in recent years. So my first thought was, “Yay us!” but of course, it’s still distressing to hear.
I had a conversation with one of our key partners at Wright State University here in Dayton about some of the changes in how the NCLEX is administered. One of her theories is that the dip might be tied to some schools not being as proactive or upfront as they could have been in preparing students. The new format is more competency- and scenario-based, and I wonder if everyone was truly ready for that. Were students appropriately prepared for this style of exam? That’s the question.
Tim Plante, MSN, RN. Region Chief Nursing Officer of the Central Region of CommonSpirit Health (Chicago): [The declining rates are] concerning. When I think about what may have influenced that change, a few things come to mind.
First, nursing schools are seeing increased enrollment, which means more people are taking the test. With a larger and more diverse group of test-takers, you naturally get a wider range of skill levels.
Second, in the past year or two, the NCLEX changed its question format. While I’m not fully versed in the specifics, I’ve read about it and heard from students who are nervous about it. Schools had become very good at tracking and preparing students for the old format after years of experience. With the new format, they don’t yet have that same depth of familiarity, which may be affecting pass rates.
From my perspective as a system CNO, my main concern is that lower pass rates slow our ability to bring new graduates into the system. With an 8% fail rate, those nurses must wait about six weeks before retaking the exam. That delays their entry into practice.
Of course, people have always failed the NCLEX; some just aren’t strong test-takers. Our role is to support them, especially if they’re already part of our organization, with study resources and time to prepare.
Susan Reeves, EdD, RN. System Chief Nurse Executive at Dartmouth Health (Lebanon, N.H.): I have to admit [the NCLEX declining pass rates] surprised me. Our health system operates in New Hampshire and Vermont, and both states experienced high pass rates. New Hampshire actually has the highest pass rate in the country. So, hearing about an 8% national drop was surprising.
I always say nursing education comes down to two things: excellent faculty and quality clinical experiences.
There are two potential drivers behind the national dip. First, the introduction of the new “Next Gen” NCLEX. Whenever a format changes, pass rates often drop while faculty and students adjust. This new exam is heavily focused on clinical judgment, which requires different preparation and test-taking skills.
Second, we can’t discount the lingering impact of COVID-19. During the pandemic, students lost in-person learning opportunities and clinical placements. Those disruptions may still be affecting graduates who are now sitting for the exam. I think this is what I’d call a “COVID hangover” in education.
That said, I don’t find a one-year dip particularly alarming. I expect pass rates will recover as everyone adapts to the new exam format.
Carolyn Santora, MS, RN. Chief Nursing Officer And Chief Regulatory Officer at Stony Brook (N.Y.) University Hospital: [The NCLEX pass rates are] certainly being talked about — you see it in the literature and in the news. We’re fortunate, because I haven’t noticed that drop here. We hire new graduates under a permit. Almost 100% of those we hire pass, and many come from our own School of Nursing. While some schools have seen pass rates as low as 72%, our school maintained 96% last year.
The cause of the decline is probably because of the new exam format. This shift has been challenging for some programs. Stony Brook anticipated the change and adapted the curriculum to a case-based, critical thinking model. That preparation has been key to maintaining our pass rate. Because many of our hires are Stony Brook graduates, we haven’t seen the drop here, but nationally, it is an issue.
Helen Staples-Evans, DNP, RN. Senior Vice President of Patient Care Services and Chief Nursing Officer at Loma Linda (Calif.) University Health Hospitals: Over the past two years, our average NCLEX pass rate has risen to approximately 95%, with at least one cohort achieving a 100% pass rate. We have increased enrollment while simultaneously improving student outcomes. Loma Linda University Health is blessed with our own School of Nursing but also surrounded by a number of excellent nursing schools. This means that recruitment of new graduates is currently not a challenge.
