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How to become a U.S. nurse if you trained abroad

Five steps lead from a nursing education abroad to a U.S. registered nurse license: choose a state board, have your credentials reviewed, pass the NCLEX-RN, receive the license and sort out your visa. The order and the details depend on the state. Every fact below links to its public source, read on Nov. 3, 2026.

This page is general information, not legal or immigration advice. Rules and fees change. Check the source linked under each step before you act.

Step 1. Choose the state board that will license you

In the U.S., a nursing regulatory body (a state board of nursing) grants the license. NCSBN lists 58 U.S. members: 50 states, the District of Columbia and four U.S. territories. California, Louisiana and West Virginia each have two boards, one for registered nurses and one for practical or vocational nurses.

Each board sets its own eligibility requirements for the exam. NCSBN does not keep a list of them, so you ask the board where you want to be licensed.

What the U.S. expects
One state board that you apply to first. Its requirements decide what you submit.
How it differs
Licensing is by state board, not by one national body, and the boards do not all ask for the same things.
The bridge
Pick the state first, then read its board page before you pay for anything else.

Sources, read on Nov. 3, 2026:

Step 2. Have your education and license credentials reviewed

Many boards ask an outside service to review nursing education from another country. CGFNS International runs one such credentials evaluation service. Its page says the service verifies the academic and licensing credentials of nurses and other health professionals for public safety. Ask your board which service it accepts and what it wants in the report.

What the U.S. expects
A review of your education and any licenses you have held, done by a service the board accepts.
How it differs
Each board decides what review it requires, so what one board accepts another may not.
The bridge
Ask the board early which documents it needs and who must send them.

Sources, read on Nov. 3, 2026:

Step 3. Apply, register and get your authorization to test

Registration for the NCLEX has two parts. First you apply to your board for licensure. Second you register with Pearson, which handles payment and scheduling. After the board declares you eligible and you have registered, you receive an Authorization to Test (ATT) by email. You need the ATT to book a test date, and you must test within its validity dates. NCSBN says the average ATT is valid for about 90 days. Your board sets the validity period, so read the dates on your ATT.

Fees: NCSBN lists a registration fee of USD 200 for candidates seeking U.S. licensure, plus USD 150 for an international scheduling fee. NCSBN also states that the registration fee becomes USD 350 on Feb. 1, 2027. Your board charges its own licensing fee on top. Read the fee page for the current figures.

You can take the NCLEX at a Pearson test center in or outside the U.S. NCSBN lists international test centers in places that include India, Kenya and the Philippines.

What the U.S. expects
Two separate registrations, the board's and Pearson's, in that order, and a test date inside the ATT window.
How it differs
Eligibility comes from the board, not from the testing company. Booking before you have an ATT is not possible.
The bridge
Plan your study so the exam falls well inside the ATT dates, because a missed window means registering and paying again.

Sources, read on Nov. 3, 2026:

Step 4. Take the NCLEX-RN

The NCLEX-RN is the licensing exam written by NCSBN. It uses computerized adaptive testing: after each answer the computer re-estimates your ability and picks the next item. You cannot skip an item or go back to change an answer. The exam stops when the computer is 95% certain that you are clearly above or clearly below the passing standard, or when you reach the maximum length or run out of time. The number of items you receive does not tell you whether you passed.

The exam includes the Next Generation NCLEX item types, which launched on April 1, 2023. The current RN test plan is effective April 1, 2026, through March 31, 2029. NCSBN reviews the passing standard every three years.

Your board sends the official result, usually within six weeks. Where the board takes part in the Quick Results Service, an unofficial result is available two business days after the exam for a fee. If you do not pass, you can retake the exam after 45 days, up to eight times a year, and some boards set stricter limits. A candidate who does not pass receives a Candidate Performance Report.

What the U.S. expects
A scenario-based exam that tests entry-level clinical judgment, with questions chosen for you one at a time.
How it differs
Each candidate receives items chosen one at a time, and you cannot skip an item or go back to change an answer.
The bridge
Practice the exam's own item types and the six clinical judgment steps until choosing the safest action first is a habit. This is the part Florence Academy teaches.

Sources, read on Nov. 3, 2026:

Step 5. Receive the license and sort out your visa

The board issues the license. Florence does not, and neither does the testing company.

A visa is a separate process from licensure. Working as a nurse in the U.S. generally needs an employment-based visa or a green card, and the rules depend on the visa type and your country. The F-1 student visa is only the route for studying in the U.S. Here are the F-1 basics in plain words, from USCIS. To study full time in the U.S. you generally need a student visa. The F-1 visa is for academic students at a school certified by the Student and Exchange Visitor Program. The school must be approved, you must be enrolled full time, you must show English proficiency or enroll in courses that lead to it, and you must have enough money for the whole course of study. F-1 students may not work off campus during the first academic year. After that they may be eligible for Curricular Practical Training (CPT) or Optional Practical Training (OPT). Off-campus work related to the field of study must be authorized before it starts, by the school's Designated School Official (DSO) for CPT, and by USCIS for OPT.

If you plan to work as a nurse on an occupational visa, CGFNS says a registered nurse must complete VisaScreen first. VisaScreen checks that your education is comparable to that of a U.S. graduate, that every license you held is valid and without restrictions, that you passed an approved English proficiency exam, and that you passed the NCLEX-RN or the TruMerit Nurse Qualifying Exam. CGFNS notes that the approved English tests and scores changed for tests taken after May 12, 2026, so read its page before you book a test.

What the U.S. expects
A license from the board and, separately, permission from the U.S. government to be in the country and to work.
How it differs
Passing the exam does not give you a visa, and a visa does not give you a license. They run on different timelines.
The bridge
Treat the license and the visa as two tracks from day one, and ask the school, the board or an immigration attorney about the visa rather than a study course.

Sources, read on Nov. 3, 2026:

Where Florence Academy fits

Florence Academy helps with step 4: preparing for the NCLEX-RN with live classes, a question bank and a daily plan. Florence Academy does not promise an exam result, a license, a visa or a job. A study estimate is a study estimate, not a prediction of your NCLEX result.

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