Date of Award

3-2025

Document Type

DNP Project

College

School of Nursing

Degree Name

Doctor of Nursing Practice (DNP)

Department

Nursing

First Advisor

Melinda Nwanganga

Abstract

Background

Success in the National Council Licensure Examination (NCLEX-RN) on the first attempt is essential for continued program accreditation, sustainability, and maintaining the national nurse workforce. Admission policies and assessment methods contribute to student enrollment and success. This Doctor of Nursing Practice (DNP) project evaluated the admission requirements of cognate and overall GPAs and assessment requirements of Health Education System Incorporated (HESI) scores in the School of Nursing to determine the best predictors of the first-time NCLEX-RN pass rates. This project aimed to determine whether the use of admission requirements in the School of Nursing Bachelor of Science in Nursing (BSN) prelicensure program predicted HESI scores and indirectly predicted successfully passing the NCLEX-RN on the first attempt. This project also analyzed the student performance results on the NCLEX-RN to that of their performance on the HESI assessment exam.

Methodology

This DNP project utilized a retrospective quantitative research design. Data were collected from student records within the Pre-Licensure Nursing program at a private university in the midwestern United States. The study analyzed admission criteria, including cognate grade point averages (GPAs), overall GPAs, and HESI assessment scores. Statistical methods, such as correlation and regression analyses, were employed to evaluate the predictive relationship between these admission criteria, HESI scores, and first-time NCLEX-RN pass rates. The project also examined the association between HESI assessment performance and NCLEX-RN outcomes to identify potential predictors of student success. Ethical considerations were upheld through data anonymization and institutional review board (IRB) approval.

Results

Admission cognate and overall GPA were identified as positive predictors of HESI scores. While cognates did not individually predict HESI passing scores, BIOL 221 and ENG 215 demonstrated trends nearing statistical significance. The Pearson Chi- Square Association test revealed a strong association between achieving a first-time passing score on the HESI and successfully passing the NCLEX-RN on the first attempt. Furthermore, HESI and NCLEX-RN test scores were highly aligned across all eight categories of care, with notable outliers observed in two categories.

Conclusion

This project highlights the significant role of admission criteria, particularly admission GPA and cognate GPA, in predicting HESI scores and indirectly predicting NCLEX-RN first-time pass rates. While individual cognates, such as BIOL 221 and ENGL 215, approached statistical significance, they could not independently predict HESI or NCLEX-RN success, revealing a potential gap in curriculum alignment with these assessments. The positive association between HESI scores and NCLEX-RN outcomes supports the validity of HESI as a predictor of first-time NCLEX-RN success. The findings suggest the need for curriculum review, particularly for cognate courses, to align content with the NCLEX-RN test plan blueprint. Incorporating NCLEX-RN simulated quizzes, mentorship programs, and active learning strategies can further enhance student learning and outcomes. Addressing disparities identified in specific HESI and NCLEX-RN performance categories through student surveys and curriculum adjustments can strengthen program effectiveness and sustainability, ultimately supporting the goal of preparing nursing students for first-time NCLEX-RN success.

Subject Area

Nursing; National Council Licensure Examination for Registered Nurses

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