How to Become a Registered Nurse (RN) in the US
A step-by-step guide from choosing an ADN or BSN program through NCLEX-RN, state board licensure, your first nursing job, and ongoing license renewal.
US-trained nurses: This guide covers the standard pathway for students who complete a nursing program in the United States. Internationally educated nurses follow a different process — see Work as a Nurse in the USA instead of steps 1–7 below if you trained outside the US.
8 steps to become an RN in the United States
- Choose ADN or BSN — Compare timelines and costs in our ADN vs BSN guide. Both can lead to RN licensure after NCLEX-RN.
- Complete prerequisites — Most programs require anatomy & physiology, microbiology, psychology, statistics or college math, and English composition; chemistry only where required. Apply to state-approved nursing schools via the US nursing schools directory.
- Graduate from a state-approved program — Complete clinical hours and coursework. Your school verifies completion to the state board.
- Apply to your state board of nursing — Submit transcripts, fingerprints, background check, and fees. The board determines NCLEX eligibility.
- Register for NCLEX-RN — After board approval, register with Pearson VUE. You receive an Authorization to Test (ATT) before scheduling.
- Pass the NCLEX-RN — Prepare with your program review and NCLEX practice questions. The exam uses computerized adaptive testing focused on clinical judgment.
- Receive your RN license — Your state board issues licensure after passing NCLEX and meeting all requirements. Compact-state residents may qualify for multistate privilege — see NLC guide.
- Start your nursing career & maintain licensure — Apply for new-grad residency or staff roles. Renew on schedule and meet state CE requirements.
ADN vs BSN: which program first?
Both pathways lead to the same NCLEX-RN and RN license. ADN programs are shorter and often less expensive; BSN programs take longer but may improve hiring options at BSN-preferred employers and are required for most graduate nursing paths.
Compare timelines, cost, and career goals in our ADN vs BSN guide before applying.
NCLEX-RN registration and ATT
NCLEX registration is a two-part process. First, apply to your state board of nursing and meet eligibility requirements. After the board declares you eligible, register with Pearson VUE and pay the exam fee. NCSBN confirms that candidates must meet their nursing regulatory body’s requirements before receiving an Authorization to Test (ATT).
Your ATT includes a validity window — schedule your exam before it expires. Bring approved ID on test day. If you do not pass, review your board’s retake and remediation rules before re-registering.
Your first RN job
Many new graduates target hospital new-grad residency programs, long-term care, home health, clinics, or community settings. Employers may require BSN for some acute-care roles; ADN graduates are hired widely depending on local supply and setting.
Prepare a clinical-focused résumé, gather preceptor references, and research states that fit your salary and lifestyle goals. Compact-state residents may have broader multistate options — see the NLC guide.
License renewal and continuing education
RN licenses expire on a schedule set by each state board — often every two to four years. Renewal typically requires a fee, attestation of practice hours or employment, and in many states, continuing education (CE) credits.
Review nursing CE requirements by state before your first renewal deadline. If you move to a new state, you may need endorsement rather than simple renewal.
Timeline and cost overview
Timeline: ADN pathways often take 2–3 years including prerequisites; traditional BSN programs take about 4 years. Accelerated BSN programs for prior-degree holders may run 12–18 months.
Cost: Community college ADN programs are often the lowest-cost route. Private BSN programs can cost substantially more than public community college or state university routes, especially before financial aid. Budget for NCLEX fees, board application fees, and licensing costs.
Salary outlook: BLS reports a median RN annual wage of $93,600 (May 2024) with about 189,100 openings per year on average. See RN salary by state.
Internationally educated nurses
If you trained outside the US, your pathway differs — credential evaluation, English testing, and visa steps apply. Read the dedicated Work as a Nurse in the USA guide instead of following the US graduate steps above.
❓ FAQ
How long does it take to become an RN?
Most ADN pathways take about 2–3 years including prerequisites; traditional BSN programs take about 4 years. Accelerated BSN programs for prior-degree holders may take 12–18 months.
Can I become an RN without a BSN?
Yes. An ADN from a state-approved program qualifies you for NCLEX-RN and RN licensure in most states. Some employers prefer BSN hires, but ADN RNs work in many settings nationwide.
What is the NCLEX-RN pass requirement?
The NCLEX uses computerized adaptive testing. There is no fixed number of questions — the exam ends when the system determines with confidence that your ability is above or below the passing standard.
📎 Official sources
📎 Related guides
Disclaimer: Licensure requirements vary by state. Verify with your state board of nursing before applying.