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Taking the IBLCE Exam: Top 10 Questions (& Answers!)

I’ve been asked — and answered — many, many questions about the IBLCE Exam. Here are my responses to the top ten questions I am asked most often.

What is the passing score for the IBLCE Exam?
Since 1985, the passing score has varied from year to year based on IBLCE’s statistical analysis of the exam items. For example, for the April 2016 exam, the passing score was 128 out of 175, or about 73 percent. It seems that each year, about 85 percent of IBLCE exam-takers pass the exam. (You can see several years’ worth of “test analysis reports” on the IBLCE website.)

How long will it take for me to get my test results?
Historically, it has taken about three to four months for results to arrive. Since it has moved to twice-a-year testing, the IBLCE says that April exam-takers will receive their results by the end of June; the October exam-takers will receive them by the end of December.

Why does it take so long to get test results?
I don’t work for the IBLCE, so I cannot say with certainty but I assume it is because the organization has a statistician analyze the results and figure out which questions will get thrown out. I know the delay is frustrating!

How will I know what I got wrong on the IBLCE Exam?
You will never know the exact items that you missed, but IBLCE will send you a breakdown of your score by topic and chronological area. You’ll get to see which subjects you scored better in and which were harder for you.

How many questions are on the IBLCE Exam?
There are 175 questions on the IBLCE Exam. Those 175 questions are given in two parts, one consisting of text-only questions, and the other referencing images (usually a clinical photo, but graphs, line drawings, and other images are all “fair game”). For the April 2016, 85 of the 175 items referenced images. For the 2015 exam, 100 of the 175 items referenced images. There’s no way to know exactly how many items will be image-based on future exams, but we know it will be a substantive number of items.

How hard are the questions?
There’s an old joke about a kid who comes out of an exam room. His friend approaches him and says, “Were the test questions hard?” The boy responds, “Uh, no, the questions weren’t all that hard; it was the answers I had trouble with!” Some people do feel that way about the IBLCE Exam! But seriously, opinions vary. Just keep in mind that the questions are not simple recall; they require the test-taker to apply information, which is more difficult than simply recalling it.

Can I take the exam in Spanish?
Absolutely. The exam is available in several different languages. Be sure to request the specific language you want when you sign up for the exam. (Consider: Even if you routinely provide clinical care in English, taking your exam in your native language may be a good idea.)

Is there a penalty for guessing if I don’t know the answer?
No. Go ahead and guess! You might be right! (But do try to use strategies that enable you to eliminate one or more options before you guess,.)

 Are there pictures on the exam?
Definitely! Sometimes, there are 100 or more; sometimes, there are fewer. But be prepared. These images could be clinical photos, drawings, charts, graphs—all of these are considered image-based.

I am a bad test-taker. What can I do?
Consider yourself in good company! I am a “recovering” bad test-taker, and you can learn from my experience. I have helped about 5,000 people to pass the IBLCE exam, and that book is chock full of the strategies I’ve recommended to them.

While these are the top ten questions I hear about the exam, I know they’re not the only ones people have. What are you wondering about the exam? What do you want to know? Comment below, and I’ll do my best to answer!

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  1. KJ

    Do you know of anyone who has ever passed the exam after submitting a hand grade request after the results have come out? Just wondering if I should waste my time or not. I got 128 right passing was 132.

    • Marie Biancuzzo

      Yes, I have known of many people who have failed and requested a hand-scoring of their exam. Over many years. Many. They have achieved the same score after paying for the hand-scoring. There’s probably someone out there who has gotten a “different” score, but I’ve never heard from such a person. Many, many have failed by as little as one point. Please contact my office for help with your next attempt. We have helped many people who have failed, My team and I have spent many hours on the phone trying to get a good “history” and pointing them towards some next steps to pass. Send mail to and we will likely get back to you within 2 business days, usually sooner, if we can. Between the COVID and the holidays, we have somewhat irregular staffing, but you’re also welcome to call us at 703-787-9894; if we can’t answer, leave us a message. We are here to help you. To get started, you might want to read a few of my blog posts on failure. Here’s a post from while ago, but everything in the post still holds true.

  2. KJ

    Thank You! I will contact your office after the holidays! I did go ahead and submit a hand grade request. Its not cheap, but I’m still in denial. It takes 8-10 weeks, I will likely not pass so I also applied for April 2021. I’m not sure why IBLCE even offers this as an option if its rare for anyone to pass this way. It all boils down to money!!

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