Healthcare Exams17 min read

NLN NEX Exam 2026: Complete Guide to the New Nursing Entrance Exam — Format, Scoring, Study Plan & Section Breakdown

Complete 2026 NLN NEX nursing entrance exam guide covering the new format that replaced the PAX, all three sections (Verbal, Math, Science), scoring explained, a proven 6-week study plan, and key differences from TEAS and HESI A2. Free study resources included.

Ran Chen, EA, CFP®February 21, 2026

Key Facts

  • The NLN NEX replaced the NLN PAX in 2025 as the new nursing school admission exam administered by the National League for Nursing.
  • The NLN NEX has 163 items across three sections: Verbal (58 items), Math (45 items), and Science (60 items), with 60 minutes per section.
  • The NEX composite score ranges from 0 to 300. There is no universal passing score — each nursing program sets its own minimum.
  • Unlike the old NLN PAX, the NEX has removed physics entirely from the science section and provides an on-screen calculator for the math section.
  • NLN NEX scores remain valid for 2 years, and the NLN recommends waiting at least 30 days between retake attempts.
  • The NEX science section covers biology, human anatomy & physiology, chemistry, and health/nutrition — no physics.
  • A 6-week study plan with 45–75 total hours is recommended for NLN NEX preparation, with 40% of time allocated to the Science section.
  • The NEX gives 60 minutes per section compared to the old PAX which only allowed 40 minutes per section.

Everything You Need to Know About the NLN NEX in 2026

The NLN Nursing Entrance Exam (NEX) is the newest nursing school admission test, launched in 2025 as a complete replacement for the NLN PAX. If your nursing program requires the NLN exam, you're taking the NEX — the PAX no longer exists.

This matters because many study guides and prep materials online are still referencing the old PAX format. The NEX has different timing, different question counts, and updated content areas. This guide covers the actual 2026 NEX format based on the latest NLN specifications.


Start Your FREE NLN NEX Prep Today

Start FREE NLN NEX Study GuideFree exam prep with practice questions & AI tutor

Our comprehensive course covers all three NEX sections — Verbal, Math, and Science — with practice questions updated for the 2026 format. 100% FREE.


NLN NEX Exam Format (2026)

DetailSpecification
Administering bodyNational League for Nursing (NLN)
Total questions163 items across 3 sections
SectionsVerbal (58 items), Math (45 items), Science (60 items)
Time per section60 minutes each
Total testing time3 hours
Question formatMultiple-choice with 4 response options
ScoringComposite score 0–300 (percentile-based)
Score validity2 years
Retake policyRecommended 30+ days between attempts
CalculatorOn-screen calculator provided for Math section

Critical difference from the PAX: The old NLN PAX gave you only 40 minutes per section. The NEX gives you 60 minutes — a significant improvement that allows more careful reading and checking.


What Changed from the NLN PAX to the NEX

FeatureOld PAXNew NEX (2026)
Time per section40 minutes60 minutes
Verbal items6058
Math items4045
Science items6060
Total items160163
Physics contentIncludedRemoved entirely
CalculatorNot providedOn-screen calculator available
Score reportingPercentile onlyComposite score 0–300

Key takeaway: The NEX is more generous with time and has removed physics entirely from the science section. If physics was your weak spot on the PAX, the NEX is better for you.


The Three NEX Sections (Deep Dive)

Section 1: Verbal Ability (58 items, 60 minutes)

The Verbal section tests two core skills:

Reading Comprehension (~30 items)

  • Read passages and answer questions about the main idea, supporting details, and inferences
  • Identify the author's purpose and tone
  • Draw conclusions from presented information
  • Passages are typically 200–400 words covering health, science, and general topics

Vocabulary in Context (~28 items)

  • Determine the meaning of words as used within a sentence
  • Identify synonyms and antonyms in context
  • Recognize medical and scientific terminology used in everyday language
  • Focus on words commonly encountered in nursing education textbooks

Strategy: Don't skip the passages. Read them carefully — most wrong answers come from students who skim the passage and misinterpret the question. For vocabulary, context clues within the sentence are your primary tool.

Section 2: Mathematics (45 items, 60 minutes)

The Math section covers high school-level mathematics with a nursing application focus:

Number Operations & Fractions (~12 items)

  • Adding, subtracting, multiplying, and dividing fractions and mixed numbers
  • Converting between fractions, decimals, and percentages
  • Order of operations

Decimals, Percentages & Ratios (~10 items)

  • Percentage calculations (percent increase/decrease)
  • Ratio and proportion problems (critical for dosage calculations)
  • Decimal operations

Measurement & Conversions (~8 items)

  • Metric system conversions (mg to g, mL to L)
  • Household to metric conversions
  • Temperature conversions (Fahrenheit to Celsius)
  • Time conversions

Data Interpretation & Statistics (~8 items)

  • Reading graphs, charts, and tables
  • Mean, median, mode, and range
  • Basic probability

Algebraic Reasoning (~7 items)

  • Solving single-variable equations
  • Word problems requiring algebraic setup
  • Inequalities and absolute values

Important: There is no geometry on the NEX. Don't waste time studying geometric formulas, proofs, or spatial reasoning. The on-screen calculator handles basic arithmetic, but you still need to set up problems correctly.

Section 3: Science (60 items, 60 minutes)

The Science section is the most content-heavy and where many students struggle:

Biology (~15 items)

  • Cell structure and function (organelles, cell membrane transport)
  • Cell division (mitosis, meiosis)
  • Genetics basics (DNA, RNA, Mendelian inheritance)
  • Photosynthesis and cellular respiration
  • Ecology and classification

Human Anatomy & Physiology (~20 items)

  • Skeletal, muscular, and integumentary systems
  • Cardiovascular and respiratory systems
  • Digestive and urinary systems
  • Nervous and endocrine systems
  • Reproductive system
  • Immune and lymphatic systems

Chemistry (~15 items)

  • Atomic structure and periodic table basics
  • Chemical bonding (ionic, covalent)
  • Acids, bases, and pH scale
  • Solutions and concentrations
  • Chemical reactions and balancing equations

Health & Nutrition (~10 items)

  • Basic nutrition (macronutrients, vitamins, minerals)
  • Water balance and electrolytes
  • Health promotion and disease prevention concepts

No physics: Unlike the old PAX, the NEX does not include physics questions.


Practice NEX Questions for FREE

Access FREE NLN NEX Practice QuestionsFree exam prep with practice questions & AI tutor

Our question bank covers all three NEX sections with explanations for every answer — updated for the 2026 exam format.


NLN NEX Scoring Explained

How the Score Works

Your NEX score is a composite score between 0 and 300, derived from your percentile performance in each of the three sections, weighted equally.

Score RangeInterpretation
240–300Excellent — competitive for any nursing program
180–239Good — meets most program requirements
120–179Below average — may not meet competitive programs
0–119Needs significant improvement

There Is No Universal Passing Score

Each nursing school sets its own minimum NEX score for admission. Some programs require a composite of 100+, while highly competitive BSN programs may require 150+ or higher. Contact your specific nursing program to confirm their minimum score requirement.

Score Reporting

  • You receive a composite score and individual section percentile scores
  • Section percentiles show how you performed relative to all other NEX test-takers nationally
  • Scores are reported to you and to any nursing programs you designate during registration

6-Week NLN NEX Study Plan

WeekFocus AreaDaily StudyKey Activities
Week 1Diagnostic Test + Verbal Foundation45–60 minTake a full diagnostic test, identify weak areas, begin reading comprehension practice
Week 2Mathematics — Core Operations45–60 minFractions, decimals, percentages, ratio/proportion, measurement conversions
Week 3Science — Biology & Chemistry60–75 minCell biology, genetics, atomic structure, chemical bonding, acids/bases
Week 4Science — Anatomy & Physiology60–75 minBody systems review (focus on cardiovascular, respiratory, nervous, digestive)
Week 5Verbal Deep Dive + Math Word Problems45–60 minTimed reading passages, vocabulary in context, algebraic word problems, data interpretation
Week 6Full Practice Exams + Gap Review60–90 minTimed full-length practice tests (163 questions, 3 hours), review all wrong answers

Total study time: 45–75 hours over 6 weeks

Study Priority by Section

SectionItems% of ExamRecommended Study Time
Science6037%40% (most content-heavy)
Verbal5836%30%
Math4527%30%

Why Science gets more time: It has the broadest content coverage (biology, A&P, chemistry, health) and requires the most memorization. Verbal and Math skills tend to be more retained from high school.


NLN NEX vs. TEAS vs. HESI A2: Which One Do You Need?

FeatureNLN NEXATI TEASHESI A2
Sections3 (Verbal, Math, Science)4 (Reading, Math, Science, English)Up to 7 (varies by school)
Total items163170 (150 scored)Varies (up to 326)
Duration3 hours~3.5 hours~3–4 hours
Science contentBio, A&P, Chem, HealthBio, A&P, Chem, Scientific reasoningBio, A&P, Chem, Physics
Physics included?NoNoYes (some programs)
Cost~$52–$88~$70$40–$100
Retake wait30 days recommendedSchool-specific60 days
Score validity2 years2 yearsSchool-specific

Bottom line: You don't choose which exam to take — your nursing school tells you. Check your program's admission requirements first. If they accept multiple exams, the NEX and TEAS are generally considered the most straightforward since neither includes physics.


7 Mistakes That Lower NEX Scores

  1. Studying the old PAX format — The NEX is different. Make sure your prep materials say "NEX," not "PAX."
  2. Skipping the science section prep — A&P and chemistry require dedicated study time, not just review.
  3. Not practicing timed sections — 60 minutes per section is generous but not unlimited. Practice under timed conditions.
  4. Ignoring vocabulary — Nearly half the verbal section is vocabulary in context. Build a flashcard deck of common medical/scientific terms.
  5. Over-studying geometry — There is zero geometry on the NEX. Don't waste time on it.
  6. Cramming the night before — The NEX tests comprehension and application, not memorization speed. Get sleep instead.
  7. Not using the on-screen calculator — It's there for a reason. Use it for arithmetic to free up mental energy for problem setup.

Start Your NLN NEX Prep Now — 100% FREE

Begin FREE NLN NEX Study CourseFree exam prep with practice questions & AI tutor

Our comprehensive NLN NEX study course includes:

  • All 3 sections covered — Verbal, Math, and Science with detailed explanations
  • Practice questions matching the 2026 NEX format
  • AI-powered study help — get instant explanations for any concept
  • Free forever — no credit card, no trial period

Your nursing career starts with getting into the right program. Ace the NEX and secure your spot.


Official NLN NEX Resources

Test Your Knowledge
Question 1 of 4

How many total items are on the NLN NEX exam?

A
150
B
160
C
163
D
170
Learn More with AI

10 free AI interactions per day

NLN NEXnursing entrance examNLN PAX replacementnursing school admissionnursing exam prep2026free

Start Your Free Learning

Related Articles

Stay Updated

Get free exam tips and study guides delivered to your inbox.