Becoming a registered nurse requires completing an approved nursing program, passing the national licensing exam (NCLEX-RN), and applying for a state license. The entire process takes between two and four years depending on the degree you choose, and the career pays a median salary of $93,600 per year.
Choose Between Two Degree Paths
You can qualify to sit for the licensing exam with either an Associate Degree in Nursing (ADN) or a Bachelor of Science in Nursing (BSN). Both make you eligible to become a registered nurse, but they differ in time, cost, and long-term career flexibility.
An ADN is a two-year program typically offered at community colleges, though some accelerated versions finish in 18 months. The curriculum covers prerequisites like chemistry, anatomy, biology, and psychology, then moves into nursing-specific coursework: fundamentals, medical-surgical nursing, pediatric nursing, psychiatric nursing, and community health.
A BSN is a four-year undergraduate program at a college or university. It covers the same clinical patient care skills as an ADN but adds coursework in nursing theory, public health, ethics, and pathophysiology. Many hospitals now prefer or require a BSN for hiring, and you’ll need one if you ever want to pursue a graduate degree in nursing or move into leadership roles.
If you already hold a bachelor’s degree in another field, accelerated BSN programs offer the fastest route to licensure. These programs compress the nursing curriculum into 11 to 18 months of full-time, intensive study with no breaks between sessions. Admission standards are high, typically requiring a minimum 3.0 GPA, and students are encouraged not to work during the program given its pace.
Complete Your Prerequisites
Before you can enter a nursing program, you’ll need to finish a set of science and general education courses. While exact requirements vary by school, most programs expect the following:
- Anatomy and Physiology I and II: Two sequential courses, each at least 3 semester credits.
- Chemistry with lab: General Chemistry I or Inorganic Chemistry as a 4-credit course. Chemistry courses designed for non-science majors are typically not accepted, and Organic Chemistry or Biochemistry won’t substitute.
- Microbiology: Medical Microbiology is acceptable at most schools.
- Statistics: Courses taken in the social sciences generally count.
- Nutrition: Human Nutrition or Nutrition Science is preferred.
- Developmental Psychology: Must cover the full lifespan. Introductory, general, abnormal, or age-specific psychology courses won’t satisfy this requirement.
Most programs require a minimum grade of C in every prerequisite course. Competitive programs often look for a B average or higher, especially in the sciences. If your grades are borderline, retaking a course before applying can strengthen your chances.
Pass a Nursing Entrance Exam
Many nursing schools require either the TEAS or the HESI A2 as part of the admissions process. The TEAS tests reading, math, science, and English language usage. The HESI A2 covers math, reading, vocabulary and grammar, anatomy and physiology, and sometimes additional sections depending on the school. Passing requirements vary by program, with some setting minimum scores for each section and others evaluating your overall performance. Check with your specific school to know which exam they accept and what score you need.
What Happens During Nursing School
Nursing programs combine classroom instruction with supervised clinical rotations in hospitals, clinics, and community health settings. There is no single national standard for how many clinical hours you must complete. The American Association of Colleges of Nursing does not set a required number for entry-level programs, but many state boards of nursing have their own minimums, and individual schools often exceed them. Expect to spend significant time in clinical settings during your final year, practicing skills like medication administration, patient assessment, wound care, and charting under the supervision of licensed nurses and instructors.
Clinical rotations typically cycle through different specialties: medical-surgical units, labor and delivery, pediatrics, mental health, and community health. This gives you a broad foundation and helps you identify which area of nursing interests you most.
Pick an Accredited Program
Before enrolling anywhere, confirm the program holds nursing-specific accreditation from either CCNE (Commission on Collegiate Nursing Education) or ACEN (Accreditation Commission for Education in Nursing). This matters for practical reasons: accreditation is typically required for federal financial aid, scholarships, and employer tuition assistance. It also ensures your credits will transfer if you later pursue a BSN or a graduate degree. An unaccredited program can leave you unable to advance your education or, in some cases, sit for the licensing exam in certain states.
Pass the NCLEX-RN
After graduating from your nursing program, you’ll take the NCLEX-RN to earn your license. The exam uses computerized adaptive testing, meaning each question you answer determines the difficulty of the next one. Answer correctly and the questions get harder; answer incorrectly and they get easier. The computer continues until it has enough data to determine whether you’re above or below the competency standard.
You’ll face between 70 and 135 questions. The current version, called the Next Generation NCLEX, uses several question formats beyond traditional multiple choice: extended multiple choice where more than one answer may be correct, matrix grids where you match findings to clinical scenarios, drag-and-drop ordering, drop-down menus, and cloze items where you fill in responses based on a case study narrative. Some questions use straightforward right-or-wrong scoring, while others use a plus/minus model where incorrect selections cost you a point.
The exam covers the full scope of nursing practice, so your best preparation is solid performance throughout your program. Most graduates also use a dedicated NCLEX review course or question bank in the weeks leading up to the test.
Apply for Your State License
Once you pass the NCLEX-RN, you apply for licensure through your state’s board of nursing. Every state requires a criminal background check as part of this process. You must disclose all convictions, including misdemeanors, felonies, no-contest pleas, and even convictions that were later expunged or set aside. The board reviews each case individually.
Offenses most likely to create problems are those considered substantially related to nursing practice: assaultive or abusive conduct, theft or fraud, failure to comply with mandatory reporting requirements, and sex offenses requiring registration. Having a past conviction doesn’t automatically disqualify you, though. Boards evaluate the nature and severity of the offense, how long ago it occurred, and evidence of rehabilitation. If you have concerns about your background, contact your state board before investing in a nursing program so you understand what you’re facing.
Currently, 43 states and jurisdictions participate in the Nurse Licensure Compact. If you live in one of these states and meet the requirements, you can obtain a multistate license that lets you practice in any other compact state without applying for a separate license. This is especially valuable if you live near a state border or want to do travel nursing.
Salary and Job Outlook
Registered nurses earned a median annual wage of $93,600 as of May 2024, according to the Bureau of Labor Statistics. Employment is projected to grow 5 percent from 2024 to 2034, faster than the average for all occupations. Demand is driven by an aging population, increased prevalence of chronic conditions, and ongoing retirements among the current nursing workforce. Your earning potential varies significantly by setting, specialty, and location. Nurses in metropolitan areas, critical care units, and operating rooms generally earn above the median, while those in outpatient clinics or rural settings may earn less.