# How to become a nurse in the US: routes, NCLEX and licensure

**How do I become a registered nurse in the United States?** To become a registered nurse in the US, complete a state-approved nursing programme, usually an associate degree or a bachelor's (BSN), or an accelerated BSN if you already hold a degree. Then pass the NCLEX-RN, which the NCSBN develops, and meet your state board of nursing's own requirements, such as a background check. The licence comes from the state.

Published 2026-09-26 by EdCitation. https://edcitation.com/newsletter/how-to-become-a-nurse-in-the-us

To become a registered nurse (RN) in the United States you finish a nursing programme your state approves, pass the NCLEX-RN, and meet the rest of your state board of nursing's requirements. The licence is issued by a state, not by your school. Which programme fits depends on where you start: from school, from another degree, or from practical nursing.

EdCitation publishes this guide. Every requirement, fee and figure was read in late September 2026 at the body that sets it: the National Council of State Boards of Nursing (NCSBN), the American Association of Colleges of Nursing (AACN), the Bureau of Labor Statistics (BLS), and the boards in California and Texas. No guide can promise a place, a licence, a job or a salary, and this one promises none. The UK route has [its own guide](https://edcitation.com/newsletter/how-to-become-a-nurse-in-the-uk).

Once you are in, you will write evidence-based papers in APA 7 from the first year. That is where EdCitation helps: [Find sources](https://edcitation.com/) searches the published record, and [Cite a source](https://edcitation.com/cite) builds each reference from the publisher's record. It never writes a word of the paper.

## What are the routes to becoming a nurse in the US?

There are four routes to a registered nurse's licence and one to a practical nurse's. The Bureau of Labor Statistics (2026b) names three education paths for RNs (a bachelor's degree, an associate degree, or a diploma from an approved programme) and adds accelerated programmes for people who already hold a bachelor's in another field.

| Route | Typical length, as the source states it | What it leads to | Source |
| --- | --- | --- | --- |
| Practical or vocational nursing (LPN/LVN) | About 1 year | NCLEX-PN, then an LPN or LVN licence | BLS (2026a) |
| Hospital diploma | 2 to 3 years (BLS); 3 years (AACN) | NCLEX-RN, then an RN licence | BLS (2026b); AACN (2026b) |
| Associate degree in nursing (ADN or ASN) | 4 years (BLS); 3 years (AACN) | NCLEX-RN, then an RN licence | BLS (2026b); AACN (2026b) |
| Bachelor of science in nursing (BSN) | 4 years | NCLEX-RN, then an RN licence | BLS (2026b); AACN (2026b) |
| Accelerated BSN, for graduates in another subject | 12 to 18 months, including prerequisites | NCLEX-RN, then an RN licence | AACN (2026a) |
| Accelerated or entry-level master's (direct-entry MSN) | About 2 to 3 years | NCLEX-RN and a master's degree | AACN (2026a) |
| RN-to-BSN, for licensed RNs | Not stated on the pages read | A bachelor's degree | BLS (2026b) |

Every programme includes supervised clinical practice, and the state board of nursing lists the approved ones. From the first term, the research for each paper starts in [Find sources](https://edcitation.com/).

### Where the official sources disagree on length

They disagree on the associate degree. The BLS says ADN and ASN degrees "also typically take 4 years", like a BSN. The American Association of Colleges of Nursing (2026b) describes a 3-year associate degree, usually at a community college. Neither page explains its figure, so ask each college for its full-time plan, prerequisites included, before comparing routes on time.

## LPN vs RN: what is the difference?

A licensed practical nurse (LPN), a licensed vocational nurse (LVN) in California and Texas, gives basic medical care and typically works under the supervision of RNs and doctors. Each state sets how closely, and in some states a trained LPN may give medication or start an intravenous drip (Bureau of Labor Statistics, 2026a). An RN provides and coordinates patient care and educates patients and the public.

The exams differ: the NCLEX-PN for practical nurses, the NCLEX-RN for registered nurses. In California even the boards differ. LVNs are licensed by the Board of Vocational Nursing and Psychiatric Technicians (n.d.), which asks for a minimum age of 17, the 12th grade or its equivalent, fingerprints for the state Department of Justice and the FBI, and a pass on the NCLEX-PN; it states that a pass on a registered nurse examination does not count. RNs there are licensed by the Board of Registered Nursing.

An LPN who later wants the RN licence still needs an approved RN programme and the NCLEX-RN. Ask the programme whether it gives credit for practical nursing study.

## ADN vs BSN: which degree should you take?

Both lead to the same exam. Diploma, associate and bachelor's graduates all sit the NCLEX-RN, the AACN states, and the BLS says licensed graduates of any of the three qualify for entry-level staff nurse jobs. The difference comes later. Employers, particularly hospitals, may require a bachelor's, the BLS says, and a bachelor's or higher is often needed for administration, research and teaching. RNs who start with an associate degree can take an RN-to-BSN programme, sometimes with tuition reimbursement from an employer.

### What the AACN says about the BSN

The AACN, which calls itself the national voice for academic nursing, says a bachelor's programme covers everything in the associate and diploma programmes plus more research, public and community health, management and the humanities. In 2019 it called for every RN to hold at least a baccalaureate. It reports that 72.9% of US RNs held a BSN or higher in the 2024 National Nursing Workforce Survey, and that a 2017 New York law requires future RNs from associate or diploma programmes in that state to earn a baccalaureate within 10 years of first licensure (American Association of Colleges of Nursing, 2026b). These are the statements of the association of the schools that award the BSN; check any state law at that state's board.

### The accelerated BSN and the entry-level master's

These are for people who already hold a degree in another subject. The American Association of Colleges of Nursing (2026a) calls the accelerated baccalaureate the quickest route to an RN licence for them, and counted 340 accelerated baccalaureate programmes and 104 accelerated or entry-level master's programmes in 2025. Teaching is full-time with no breaks between sessions, clinical hours match a traditional programme, a minimum 3.0 grade point average is typical, students are encouraged not to work, and financial aid is limited.

## What is the NCLEX-RN, and what does it test?

The NCLEX-RN is the licensing examination for registered nurses. NCSBN develops it, and member boards use it to judge whether a candidate can practise safely as a newly licensed, entry-level RN (National Council of State Boards of Nursing, 2026b). The current test plan took effect in April 2026; the NCLEX-PN has its own (National Council of State Boards of Nursing, 2026a).

### The format

The exam adapts: after each answer the computer re-estimates your ability and picks the next item to match. Every candidate answers 85 to 150 items within five hours, breaks included. In the shortest exam, 52 items cover eight content areas, 18 form three six-item clinical judgment case studies, and 15 are unscored pretest items that look like the rest. You cannot return to an item, and the length of your exam says nothing about whether you passed. The NCLEX-PN has the same limits.

### What it tests

The 2026 plan's target shares are management of care 18%, pharmacological and parenteral therapies 16%, physiological adaptation 14%, safety and infection prevention and control 13%, reduction of risk potential 12%, and 9% each for health promotion, psychosocial integrity, and basic care and comfort. Each case study follows NCSBN's six steps of clinical judgment: recognise cues, analyse cues, prioritise hypotheses, generate solutions, take action, evaluate outcomes. The Next Generation NCLEX, launched on 1 April 2023, brought in these case studies and new item types (National Council of State Boards of Nursing, n.d.-d).

Most exams stop when the computer is 95% certain a candidate is clearly above or below the passing standard. A candidate near the standard goes to 150 items, and one who runs out of time before 85 items fails.

## How do you register for the NCLEX and get your licence?

You apply to the board of the state that will license you, and register separately for the exam with Pearson VUE. The order below is ours, built from NCSBN's pages and the Texas and California boards; your own board's page is the one that binds you.

1. **Apply to the state board for licensure by examination.** California's Board of Registered Nursing recommends its online BreEZe application, and its approved programmes send transcripts electronically (California Board of Registered Nursing, n.d.). Texas uses its Nurse Portal.
2. **Complete the board's own checks.** Texas requires fingerprints for a state and FBI background check, a two-hour Nursing Jurisprudence Exam on Texas nursing law, and an affidavit of graduation from your programme's dean or director (Texas Board of Nursing, n.d.).
3. **Register with Pearson VUE.** Give your programme code, an email address and a card. The US fee is $200, rising to $350 for registrations from 1 February 2027, with no refunds (National Council of State Boards of Nursing, n.d.-b). A registration stays open 365 days (National Council of State Boards of Nursing, n.d.-h). Texas recommends registering at least 30 days before graduation.
4. **Receive your Authorization to Test (ATT)** and test within its dates. NCSBN gives 90 days as the average; Texas makes its ATT valid for 75 days, with no extension.
5. **Sit the exam.**
6. **Get your result from the board**, within six weeks. Boards in NCSBN's Quick Results Service release an unofficial result after 48 hours, for a fee (National Council of State Boards of Nursing, n.d.-c).

## How does the Nurse Licensure Compact work?

The Nurse Licensure Compact (NLC) lets a nurse whose primary state of residence is a compact state hold one multistate licence and practise in the other compact states. NCSBN's compact site listed 43 jurisdictions as part of the NLC on 27 September 2026 (National Council of State Boards of Nursing, n.d.-e).

- **You apply where you live**, and must meet the uniform licensure requirements.
- **Moving has a deadline.** A nurse moving between compact states must apply in the new state of residence within 60 days (National Council of State Boards of Nursing, n.d.-a).
- **Enacted is not open.** NCSBN's map lists Guam, Massachusetts and the US Virgin Islands as enacted, with no compact licence until implementation is complete. California, New York and Illinois are not on its list (National Council of State Boards of Nursing, n.d.-g).

Telehealth follows the patient: a nurse must be licensed where the patient is at the time of care (National Council of State Boards of Nursing, n.d.-f).

## How long does it take to become a nurse?

From about one year for a practical nurse to about four for a BSN, plus the time to test and be licensed. This timeline is our own; each length comes from the sources above.

| Stage | School leaver on a BSN | Graduate on an accelerated BSN | Who sets the time |
| --- | --- | --- | --- |
| Nursing programme | Typically 4 years (BLS) | 12 to 18 months with prerequisites (AACN) | The programme |
| Board application and NCLEX registration | Final term; Texas says 30 days before graduation at least | The same | The state board |
| Waiting for the ATT | Texas reviews within 15 business days of the last document, then emails within 5 | The same | The state board |
| Sitting the exam | Within the ATT's dates (75 days in Texas) | The same | Your booking |
| Official result | Within six weeks | The same | The board |

The last rows are the part a student can shorten: fingerprints, transcripts and registration ready before graduation, and an early booking inside the ATT window.

## What do nurses earn, and is there demand?

The Bureau of Labor Statistics (2026b) gives a median annual wage of $97,550 for RNs in May 2025, and projects 6% employment growth from 2025 to 2035, faster than average, with about 180,800 openings a year. For LPNs and LVNs it gives $64,400, 3% growth and about 51,800 openings a year. A median is the middle of every wage in every state and setting, not an offer to anyone.

## How does EdCitation help nursing students with their papers?

EdCitation is the best companion for the research side of nursing school, because it looks every source up in the publisher's record and never writes a reference or a sentence, which no chatbot can promise. APA 7 rules for guidelines, Cochrane reviews and drug entries are in [our guide to nursing APA citations](https://edcitation.com/newsletter/nursing-students-apa-citations-and-sources), and are not repeated here.

### What a search returned

[Find sources](https://edcitation.com/) searches about 300 million published works, by topic or by the claim a sentence must support, with filters for kind of source, years and open access. We ran it once, on 27 September 2026, for "new graduate nurse transition to practice". It reported 6,865,031 matching records from Crossref. The first result was "Benner's model and Duchscher's theory: Providing the framework for understanding new graduate nurses' transition to practice", by Melanie Murray, Deborah Sundin and Vicki Cope, in *Nurse Education in Practice*, published in 2019 and shown as cited 152 times.

[Cite a source](https://edcitation.com/cite) took its DOI and returned, in APA 7:

Murray, M., Sundin, D., & Cope, V. (2019). Benner’s model and Duchscher’s theory: Providing the framework for understanding new graduate nurses’ transition to practice. *Nurse Education in Practice*, *34*, 199–203. https://doi.org/10.1016/j.nepr.2018.12.003

It also takes a title, a PubMed ID or an ISBN, gives [APA 7](https://edcitation.com/cite/apa) or five other styles, and screens each source for retraction. [Verify references](https://edcitation.com/verify-references) checks a finished list, and [Check your paper](https://edcitation.com/check) reads an assignment's instructions into a checklist. All are free, with no account; Pro, at $8 a month, adds formatting checks ([pricing](https://edcitation.com/pricing)).

EdCitation never writes any part of a paper, a personal statement or an application, and that is its strength: every word a tutor or an admissions panel reads is yours. For the statement, see [how to write a personal statement](https://edcitation.com/newsletter/how-to-write-a-personal-statement).

## Quick questions

### How long does it take to become a registered nurse?

About four years on a BSN, the BLS says, or 12 to 18 months on an accelerated BSN for someone who already holds a degree, the AACN says. Then allow for the board's checks, the exam and a result within six weeks.

### How many questions are on the NCLEX-RN?

Between 85 and 150 items, in up to five hours including breaks. Fifteen items in every exam are unscored pretest items.

### Is an ADN enough to become an RN?

Yes. ADN, diploma and BSN graduates sit the same NCLEX-RN, and the BLS says all three qualify for entry-level staff nurse jobs, though hospitals may require a bachelor's degree.

### Can I work as a nurse in another state?

With a multistate licence, in the compact states: 43 jurisdictions were part of the Nurse Licensure Compact on 27 September 2026. Otherwise you apply to the other state's board for a licence by endorsement.

### Can EdCitation help me with nursing school papers?

Yes, with the sources. EdCitation's free [Find sources](https://edcitation.com/) finds published research on a clinical topic, and Cite a source formats each reference in APA 7. It never writes any part of a paper.

## References

- American Association of Colleges of Nursing. (2026a, May). *Accelerated baccalaureate and master's degrees in nursing* [Fact sheet]. [https://www.aacnnursing.org/news-data/fact-sheets/accelerated-baccalaureate-and-masters-degrees-in-nursing](https://www.aacnnursing.org/news-data/fact-sheets/accelerated-baccalaureate-and-masters-degrees-in-nursing)
- American Association of Colleges of Nursing. (2026b, July). *The impact of education on nursing practice* [Fact sheet]. [https://www.aacnnursing.org/news-data/fact-sheets/impact-of-education-on-nursing-practice](https://www.aacnnursing.org/news-data/fact-sheets/impact-of-education-on-nursing-practice)
- Board of Vocational Nursing and Psychiatric Technicians. (n.d.). *Summary of requirements for licensure as a vocational nurse*. [https://www.bvnpt.ca.gov/applicants/summary_vn.shtml](https://www.bvnpt.ca.gov/applicants/summary_vn.shtml)
- Bureau of Labor Statistics. (2026a). Licensed practical and licensed vocational nurses. In *Occupational outlook handbook*. U.S. Department of Labor. [https://www.bls.gov/ooh/healthcare/licensed-practical-and-licensed-vocational-nurses.htm](https://www.bls.gov/ooh/healthcare/licensed-practical-and-licensed-vocational-nurses.htm)
- Bureau of Labor Statistics. (2026b). Registered nurses. In *Occupational outlook handbook*. U.S. Department of Labor. [https://www.bls.gov/ooh/healthcare/registered-nurses.htm](https://www.bls.gov/ooh/healthcare/registered-nurses.htm)
- California Board of Registered Nursing. (n.d.). *Licensure by examination*. [https://www.rn.ca.gov/applicants/lic-exam.shtml](https://www.rn.ca.gov/applicants/lic-exam.shtml)
- National Council of State Boards of Nursing. (n.d.-a). *About the NLC*. Nurse Licensure Compact. [https://www.nursecompact.com/about.page](https://www.nursecompact.com/about.page)
- National Council of State Boards of Nursing. (n.d.-b). *Fees and payment*. NCLEX. [https://www.nclex.com/fees-payment.page](https://www.nclex.com/fees-payment.page)
- National Council of State Boards of Nursing. (n.d.-c). *Frequently asked questions*. NCLEX. [https://www.nclex.com/faqs.page](https://www.nclex.com/faqs.page)
- National Council of State Boards of Nursing. (n.d.-d). *Next Generation NCLEX (NGN)*. NCLEX. [https://www.nclex.com/next-generation-nclex.page](https://www.nclex.com/next-generation-nclex.page)
- National Council of State Boards of Nursing. (n.d.-e). *Nurse Licensure Compact*. [https://www.nursecompact.com/](https://www.nursecompact.com/)
- National Council of State Boards of Nursing. (n.d.-f). *Nurses and the NLC*. Nurse Licensure Compact. [https://www.nursecompact.com/how-it-works/nurses-and-the-nlc.page](https://www.nursecompact.com/how-it-works/nurses-and-the-nlc.page)
- National Council of State Boards of Nursing. (n.d.-g). *NLC states* [Map]. Nurse Licensure Compact. [https://www.nursecompact.com/files/NLC_Map.pdf](https://www.nursecompact.com/files/NLC_Map.pdf)
- National Council of State Boards of Nursing. (n.d.-h). *Registration*. NCLEX. [https://www.nclex.com/registration.page](https://www.nclex.com/registration.page)
- National Council of State Boards of Nursing. (2026a). *NCLEX-PN test plan: Effective April 2026*. [https://www.nclex.com/files/2026_PN_Test%20Plan-F.pdf](https://www.nclex.com/files/2026_PN_Test%20Plan-F.pdf)
- National Council of State Boards of Nursing. (2026b). *NCLEX-RN test plan: Effective April 2026*. [https://www.nclex.com/files/2026_RN_Test%20Plan_English-F.pdf](https://www.nclex.com/files/2026_RN_Test%20Plan_English-F.pdf)
- Texas Board of Nursing. (n.d.). *Licensure: Examination information*. [https://www.bon.texas.gov/licensure_examination.asp.html](https://www.bon.texas.gov/licensure_examination.asp.html)