How to Become a Registered Nurse: ADN vs BSN, the NCLEX and Your First RN Job

Ask ten registered nurses how they got their license and you'll hear ten different stories. One went straight from high school into a four-year BSN. Another worked as a CNA for six years, then did an evening ADN program while raising two kids. A third had a biology degree, hated her lab job, and finished an accelerated program in 15 months. All three sit the same exam and hold the same license, and all three can work the same shift on the same unit.

That's the good news about becoming an RN in the United States: there's more than one door in. The harder part is picking the door that fits your money, your time and where you want your career to go. This guide walks through every realistic route, what each one costs in time and money, how the NCLEX-RN works, and what to do in the months between graduation and your first paycheck.

What a registered nurse does

Registered nurses assess patients, plan and coordinate their care, give medications and treatments, watch for changes and step in when something goes wrong. They teach patients and families and supervise LPNs and CNAs. RNs are the ones who notice that a post-op patient's heart rate has crept up over four hours and call the surgeon before it becomes an emergency. That clinical judgment is the core of the job, and it's the main thing that separates RN practice from LPN and CNA roles.

RNs work almost everywhere care happens: hospitals, emergency departments, operating rooms, nursing homes, home health, schools, clinics, prisons, insurance companies and public health departments. They're also the largest single group of healthcare workers in the country, which is why RN jobs show up in every state and nearly every city.

The three main paths to an RN license

Every route ends with the same exam, the NCLEX-RN, and the same state license. What differs is the degree you earn along the way.

Associate Degree in Nursing (ADN)

The ADN is the most common starting point for working adults. Community college programs are usually much cheaper than universities, and many offer evening or weekend cohorts. The catch is that "two years" rarely means two years. Most programs want anatomy and physiology, microbiology, English, psychology and math done first. Popular programs are also competitive, and some use waitlists or point systems. Plan on two and a half to three years from your first prerequisite to graduation.

Bachelor of Science in Nursing (BSN)

A BSN covers everything an ADN does and adds more research, leadership, community health and public health coursework. Many hospitals, especially Magnet-designated ones and large academic medical centers, prefer or require a BSN for new hires. Others hire ADN nurses on the condition that they finish a BSN within a few years. If you're 18 and choosing a college major, the BSN is usually the stronger long-term choice.

Accelerated BSN

If you already have a bachelor's degree, an accelerated program gives you credit for your general education and packs the nursing content into roughly a year to a year and a half. It's intense: think full-time classes and clinicals with little room for a job. But it's the fastest route to a BSN for career changers.

Bridge programs: LPN-to-RN and RN-to-BSN

If you're already an LPN, an LPN-to-RN bridge gives you credit for what you know and can shorten the ADN by a semester or more. Once you're an RN with an ADN, RN-to-BSN programs are widely available online. Many let you work full time while you finish, and many employers help pay for them. We cover the LPN route in detail in our guide to becoming an LPN.

Step-by-step: from zero to licensed RN

Step 1: Finish your prerequisites

Look up the exact prerequisite list for the two or three programs you're most likely to apply to, because they're not identical. Grades in science prerequisites matter a lot in competitive programs, so it's worth retaking a C in anatomy if the program uses GPA for ranking. Many programs also require an entrance exam, most often the ATI TEAS or the HESI A2. Study for it. A strong score can be the tiebreaker.

Step 2: Apply strategically

Apply to more than one program. Community college programs often admit once or twice a year, and missing a deadline can cost you six months. Have your transcripts, entrance exam scores, immunization records and background check ready ahead of time.

Step 3: Get through nursing school

Nursing school mixes classroom theory, skills labs and clinical rotations in real hospitals and care facilities. Clinicals are where you'll figure out what you like. Plenty of students walk in sure they want pediatrics and walk out in love with the ICU. Treat every rotation like a long job interview. Nurse managers remember the students who were curious, on time and helpful, and many first jobs come from clinical sites.

If you can, work as a CNA or patient care technician during school. You'll earn money, get comfortable with patients, and build relationships inside a hospital that may hire you as a new grad. Our CNA guide explains how to get certified quickly.

Step 4: Apply for licensure and register for the NCLEX-RN

Near graduation you'll do two separate things: apply for licensure with your state board of nursing, and register for the NCLEX with Pearson VUE. The board has to declare you eligible before you can schedule the exam. Expect fingerprints, a background check and fees for both the board application and the exam. Your school will usually walk you through the timing.

Step 5: Pass the NCLEX-RN

Since April 2023 the exam has been the Next Generation NCLEX (NGN), which leans heavily on clinical judgment. You'll see case studies that unfold over several questions and new item types like matrix and highlight questions. It's computer adaptive. That means the difficulty adjusts to how you're doing, and the test can end anywhere between 85 and 150 questions, with up to five hours available.

Ending at 85 questions doesn't mean you failed, and running to 150 doesn't mean you passed. The test stops as soon as it's statistically confident either way. Most graduates study for four to eight weeks with a structured review course and thousands of practice questions. Focus your practice on reading the whole scenario and asking "what's the priority?" That's the skill NGN is built to measure.

Step 6: Receive your license and start applying

Some states post results within a couple of days through the board's website. Once your license shows as active on your state board's site or Nursys, you can legally work as an RN. Many new grads start applying for jobs before they test, listing "NCLEX scheduled for [date]" on their resume, and accept offers that depend on passing.

How much does it cost to become an RN?

Costs vary more by school type than by degree. Rough ranges:

• Community college ADN: often the most affordable route, especially for in-district students. Total tuition is commonly in the low five figures, and sometimes less.
• Public university BSN: four years of in-state tuition plus fees, housing and books.
• Private university BSN or ABSN: can run well into six figures. For-profit programs in particular deserve a careful look at NCLEX pass rates and total cost before you sign.

Don't forget the extras: uniforms, a stethoscope, background checks, drug screens, immunizations, the entrance exam, NCLEX review materials, the NCLEX fee and your state license fee. Look into hospital tuition-assistance programs, which sometimes cover school in exchange for a work commitment. Also look at federal loan-forgiveness options like the NURSE Corps program for nurses who work in high-need facilities.

Where new RNs work first

Medical-surgical units are the classic first job, and for good reason. You'll see a wide range of diagnoses, sharpen your time management and build a foundation that transfers anywhere. Telemetry, step-down, long-term care, rehab and home health also hire new graduates regularly. Some ICUs, emergency departments and labor and delivery units take new grads through structured residency programs, though competition for those spots is stiff.

If you can, choose a first employer with a formal nurse residency program. These programs usually last up to a year and pair extended orientation with classes and peer support. New nurses who go through one tend to stay longer and feel more confident. Our new grad nurse guide covers how to find and get into them.

What RNs earn

According to the U.S. Bureau of Labor Statistics, the median annual wage for registered nurses was roughly $93,600 in May 2024. That figure covers every setting and experience level. New graduates usually start below the median. Pay climbs with experience, certifications, night and weekend differentials, and specialty. Location matters even more: West Coast and Northeast states pay considerably more than parts of the South and Midwest, though living costs follow the same pattern.

For a deeper look at state-by-state differences, shift differentials, travel pay and how to negotiate, read our nurse salary guide. And when you're thinking further ahead, see our guide to the highest-paying nursing jobs.

Keeping your license active

An RN license isn't a one-time achievement. Most states require renewal every two years, along with continuing education hours that vary by state, and some require specific courses such as implicit bias, opioid prescribing awareness or human trafficking. Keep a folder of your CE certificates. Update your address with the board whenever you move. And if you live in a compact state, make sure you hold a multistate license so you can work across state lines. Our compact nursing license guide explains how that works.

Is becoming an RN worth it?

For most people who go in with clear eyes, yes. The work is physically and emotionally demanding, and your first year will test you. In exchange you get a license that's in demand in every state. The schedules can be unusually flexible, from three 12-hour shifts a week to per diem, travel and remote roles. You can switch specialties without going back to school. And there are real routes to six-figure pay through experience, advanced degrees or specialty work.

If you're already licensed or close to it, create a free profile on TheNurs.com and browse open RN jobs in your state. Hiring managers on the platform look specifically for new and experienced RNs, and applying costs you nothing.