A retrospective study was initiated to determine: (1) the predictive relationship between demographic and academic variables and NCLEX-RN success; and (2) if there were significant differences between urban and rural nursing students that could account for an increased percentage of rural NCLEX-RN failures. A convenience sample was comprised of 398 graduates in 2005-2008, of an associate degree nursing program in the Midwest. Student age group, campus enrolled, Anatomy and Physiology GPA, number of practical nursing terms attempted, Practical Nursing GPA, and the number of associate degree nursing terms attempted were analyzed for predictive value of first-attempt NCLEX-RN success.

Descriptive analyses indicated urban and rural students were homogenous in nature. Means, standard deviations and the independent means t -test of significance determined there were no significant differences between urban and rural nursing students. A logistic regression analysis predicted 87.4% of the students who would pass the NCLEX-RN on the first attempt. Campus and the practical nursing core GPA were found to be significant predictors of NCLEX-RN success. Rural students were found to have less than a 30% chance of probability of passing the NCLEX-RN on the first attempt, compared to urban students, who had a 70% chance of passing the exam. Student age group, number of PN terms, Anatomy and Physiology GPA and the number of ADN terms were not significant predictors. The study supported the relationship between GPA and NCLEX-RN success, and the need to analyze environmental variables that influence success.