Predictive Validity of Standardized Exit Exams for Next Generation NCLEX-PN Outcomes: A Multiprogram Analysis of Exam Scores and Institutional Policies

Background: The 2023 Next Generation NCLEX-PN® (NGN-PN) introduced significant changes in content and methodology, necessitating revalidation of standardized exit exams as predictors of licensure success in practical nursing programs. Purpose: This multiprogram study examined the predictive validity of the HESI Exit Exam (E2) on first-time NGN-PN pass rates (FTPR) and the influence of institutional E2 policies on student outcomes. Methods: Data from 404 practical nursing students across 9 U.S. programs were analyzed alongside institutional E2 policies. Results: Achieving E2 benchmarks of ≥850 or ≥900 strongly predicted first-time pass NGN-PN rates (98.5%–98.8%), with passing students scoring nearly 190 points higher than failing peers. While no individual E2 policy was directly linked to passing the NGN-PN on the first attempt, policies such as requiring minimum scores, multiple attempts, practice testing, and structured remediation significantly increased benchmark score attainment. Conclusion: These results affirm E2 benchmarks as reliable predictors of NGN-PN readiness and highlight policy approaches that indirectly support licensure success. Incorporating evidence-based testing and remediation strategies may enhance student preparedness and strengthen program outcomes in the evolving NGN assessment landscape.