Using NCLEX to
Prepare for the Canadian Nursing Entrance Test?

If you are thinking of using NCLEX preparation materials to prepare for the nursing entrance exam in Canada you might want to reconsider that strategy.

The nursing entrance tests for the US and Canada are different tests. They are not prepared nor delivered in the same way. Additionally the two countries have significant differences in social, legal, and government policy for delivery of health care.

• Community health nursing theory is not required for entry level practice in the US. In Canada, however, community health nursing competencies are required for entry level practice. Therefore community health nursing theory is tested on the Canadian nursing entrance exam but not on the US nursing entrance exam.


Canadian nurses are required to have knowledge of the publicly funded universal health care system and this is tested on the Canadian nursing entrance exam.
• The US has a privately funded and managed health care system whereas in Canada health care is designed as a universal health care system and is publicly funded.


• Canada places more emphasis on the nurse's role in health promotion. There are 27 nursing competencies in the health and wellness category (possibly up to 31% of exam questions) whereas NCLEX questions indicate 12% or less health promotion content.


See this explanation of the critical thinking as applied to questions on the Canadian nursing entrance exam (CRNE).
• Canada emphasizes the therapeutic nurse patient relationship. There are 14 nursing competencies in the nurse client partnership category. By contrast in the US nursing entrance test, there is no category that indicates this is on the US nursing entrance exam.

Jump to the NCLEX exam blueprint of client needs.

• the US nursing entrance exam has a higher emphasis on pathology and physiology. The Canadian Registered Nurse exam has a higher emphasis on critical thinking and application of knowledge. Up to 80% of the question on the CRNE will test your ability to apply nursing theory and think critically. Questions testing straight knowledge recall or comprehension will be only about 20% of the exam.

What does the CRNE cover?

The Canadian Registered Nurse Exam is based on 148 identified competencies that make up the content domain for the nursing entrance test.

These entry level competencies are divided into 4 categories and each category is given a different weight on the exam:

Competency Category	number	percentage on the CRNE
Professional Practice	14	14-24%
Nurse-Client Partnership	28	9-19%
Nursing Practice: Health and Wellness	27	21-31%
Changes in Health	79	40-50%

This competency profile shows that a significant portion (up to 43%) of the Canadian Registered Nurse Exam can be from the first two competency categories of Profession Practice and Nurse Client Relationship. This means that 86 questions can be testing these competencies.

These two categories of competencies are about the nature of professional practice and how to establish a professional relationship with clients and colleagues in the Canadian Health Care system.

There will be 200 operational question on the CRNE that will count towards your mark. There will also be experimental questions on the Canadian Registered Nurse Exam that will not be counted towards your mark. These are questions that are being tested and developed for use on future exams. However, you will not know which questions these are.

What does the NCLEX cover?

According to the National Council of State Boards of Nursing, the NCLEX exam covers the following "categories of client needs":

Safe, Effective Care Environment (13- 19%)

• Management of Care (8-14%)
• Safety and Infection Control

Health Promotion and Maintenance (6 -12%)

• Growth and Development Through the Life Span
• Prevention and Early Detection of Disease

Psychosocial Integrity

• Coping and Adaptation (6 -12%)
• Psychosocial Adaptation (6-12%)

Physiological Integrity

• Basic Care and Comfort (6-12%)
• Pharmacological and Parenteral Therapies (13-19%)
• Reduction of Risk Potential (13-19%)
• Physiological Adaptation (11-17%)

The Canadian Registered nurse exam is based on a national competency framework. There is no national competency framework for the NCLEX exam.

Make sure you are studying the right things for the nursing entrance exam you want to pass.

View the table of comparison of the NCLEX and CRNE.

More information about the Canadian Registered Nurse Exam

Read about the Substantially Equivalent Competency Assessment (SEC) now being used in British Columbian, Alberta and some other provinces.

View the blueprint for the Canadian nursing entrance exam (CRNE)