Becoming a registered nurse (RN) requires completing an approved nursing education program, passing the national licensing exam (NCLEX-RN), and obtaining a state license. The entire process takes two to four years depending on the degree path you choose, plus several weeks for testing and licensure paperwork.
Choose a Nursing Degree Program
You have two main entry points into nursing: an Associate Degree in Nursing (ADN) or a Bachelor of Science in Nursing (BSN). Both qualify you to sit for the NCLEX-RN and work as a registered nurse, but they differ in length, depth, and long-term career flexibility.
An ADN is a two-year program typically offered at community colleges, though some accelerated tracks finish in 18 months. The curriculum covers core clinical skills: nursing fundamentals, medical-surgical nursing, pediatric nursing, psychiatric nursing, and community health. You’ll take science prerequisites like anatomy, chemistry, biology, and microbiology alongside your nursing courses.
A BSN is a four-year 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, nursing ethics, and pathophysiology. Many hospitals, especially those seeking Magnet designation, prefer or require BSN-prepared nurses. If you already hold an ADN and want to advance, RN-to-BSN bridge programs let you complete the bachelor’s degree while working.
Meet Prerequisite and Admissions Requirements
Before you enter a nursing program, you’ll need to complete prerequisite courses, most of which are science-heavy. A typical list includes chemistry, biology, English composition, math (usually statistics or college algebra), and often a nutrition course. Many programs require a grade of C or higher in each prerequisite, and some schools won’t accept science courses older than ten years.
Most nursing programs also require a standardized entrance exam. The three most common are the TEAS (Test of Essential Academic Skills), the HESI A2, and the Kaplan Pre-Admission Test. These exams test reading, writing, math, and science knowledge. Scores are weighted in the admissions process alongside your GPA. At some schools, a composite score of 80 or above on the admissions exam earns significantly more points toward your application than a score that just meets the minimum threshold, so preparation matters.
Nursing programs are competitive. Meeting the minimum requirements doesn’t guarantee a spot, especially at community colleges where ADN programs often have long waitlists.
Complete Clinical Rotations
Every nursing program includes supervised clinical hours in real healthcare settings. These rotations are where you practice hands-on patient care: administering medications, monitoring vital signs, assisting with procedures, and documenting in medical records. You’ll rotate through different specialties including medical-surgical units, maternity, pediatrics, and mental health.
There’s no single national requirement for how many clinical hours you must complete. States and accrediting bodies leave the specifics to individual programs, though they expect a meaningful ratio of classroom to clinical time. A common guideline is three hours of clinical experience for every one hour of classroom instruction in a given subject. In practice, nursing students typically accumulate several hundred clinical hours before graduating.
Pass the NCLEX-RN Exam
After graduating from an approved nursing program, you must pass the NCLEX-RN to earn your license. The exam uses computerized adaptive testing, meaning it adjusts the difficulty of each question based on how you answered the previous one. The test ends when the computer has enough information to determine whether you’ve met the passing standard, so the number of questions varies from person to person.
The current version, called the Next Generation NCLEX, was introduced in 2023 and places heavier emphasis on clinical judgment. It includes five newer question types beyond traditional multiple choice: extended multiple response, drag-and-drop, drop-down (cloze), and matrix questions. A key change is partial credit scoring. You can earn points for partially correct answers rather than losing full credit for one wrong selection in a multi-part question.
Registration for the NCLEX costs $200, paid to Pearson VUE. Your state board of nursing will charge a separate licensure application fee on top of that.
Apply for State Licensure
Passing the NCLEX alone doesn’t make you a licensed nurse. You also need to apply through your state’s board of nursing, and every state requires a criminal background check as part of this process. The check includes both state and federal reviews using fingerprints. Private background checks are not accepted.
If you get fingerprinted electronically at a state police barracks or designated office, results typically come back within a week. Manual (ink-and-card) fingerprinting takes three to four weeks. No license will be issued until the background check has been reviewed, even if you’ve already passed the NCLEX. If the check reveals arrests or convictions, the board will request additional information and review your case individually before making a decision.
The total cost for fingerprinting and background checks varies by state but generally runs between $50 and $100. Combined with the NCLEX fee and state application fee, expect to spend roughly $300 to $500 on testing and licensure.
The Nurse Licensure Compact
If you live in a state that participates in the Nurse Licensure Compact (NLC), you can apply for a multistate license that lets you practice in any other compact state without getting a separate license. Over 40 states currently participate or have pending legislation. To qualify, you must declare your primary state of residence (verified by your driver’s license, voter registration, or tax documents), pass the NCLEX, complete a background check, hold a valid Social Security number, and have no felony convictions or active disciplinary actions against you.
If your state isn’t part of the compact, you’ll need to apply for a separate license in each state where you want to practice, a process called endorsement.
Keeping Your License Active
Once licensed, you’ll need to renew on a regular cycle, typically every two years, and meet continuing education requirements. These vary by state. Washington, for example, requires 8 hours of continuing education per renewal period (including 2 hours focused on health equity), 96 practice hours annually, and a one-time 6-hour training in suicide assessment. Other states set their own thresholds, but nearly all require some combination of continuing education hours and documented practice time.
Failing to meet renewal requirements means your license lapses, and practicing on a lapsed license is illegal. Most state boards send reminders well before your renewal deadline.
Requirements for Foreign-Educated Nurses
If you completed your nursing education outside the United States, the path includes additional steps. Most states require certification through CGFNS International before you can apply for licensure. The CGFNS Certification Program has three components: a credentials evaluation of your high school education, verification that you completed a registered nursing program, and confirmation of a current nursing license in your home country. All academic transcripts must be submitted in English directly from the institution, and your nursing license verification must be dated within the last three years.
You’ll also need to pass an approved English proficiency exam. Accepted tests include the TOEFL (minimum score of 81 on the internet-based version, with specific section minimums), IELTS Academic (6.5 overall with at least 7 on Speaking), and the OET (Grade B on Speaking, Grade C+ on Reading, Writing, and Listening), among others. Scores must come from an exam taken within one year of your CGFNS qualifying exam date, and at-home versions of these tests are not accepted. After completing CGFNS certification, you still need to pass the NCLEX-RN and go through the same state licensure process as domestically educated nurses.