Saunders Comprehensive Review for the NCLEX-RN Examination Review

Saunders Comprehensive Review for the NCLEX-RN Examination is still the most complete NCLEX content review in print, and whether to buy it today comes down to your exam date. If you test this year, buy the 9th edition now: $75.99 list for 1,144 pages and more than 5,700 practice questions. If you test in 2027, wait seven weeks and pay $2.00 more for the 10th edition, which lands on 9 November 2026 with more than 6,000 questions written to the test plan the exam currently runs on.

Both dates are on the publisher's own store. The 9th edition was published on 15 July 2022, and the 10th edition, ISBN 9780443128219, is on pre-order at $77.99 for release on 9 November 2026.

No NCLEX book roundup we can find mentions that release date, which means none of them tell you the one thing that changes what you should do today. What is not in question is the book itself: if you are rebuilding nursing content from the ground up and want one source to do it from, this is the one to own.

Summary Table

The 9th edition on the publisher's own store. Source: us.elsevierhealth.com, captured September 2026.

Saunders Comprehensive Review Overview

Saunders is the book almost every nursing student is told to buy, and the reason is scope. At 1,144 pages it tries to cover every content area the NCLEX-RN can ask about, then attaches a question to nearly every idea it teaches. Most other NCLEX review books pick one job. This one takes both.

The teaching frame is the Pyramid system that students recognize even when they have never opened the book. Pyramid Points icons mark content likely to appear on the exam, Pyramid Alerts in red flag the nursing concepts to remember, and two Priority Concepts per chapter tie the material to nursing care rather than to memorization.

What Elsevier states you get in the 9th edition:

• 1,144 pages of content review across every NCLEX-RN content area, with 270 illustrations in full color
• More than 5,700 practice questions split between the book and the Evolve companion website
• A test-taking strategy for every question, plus rationales for the correct answer and for each wrong one
• Priority Nursing Action boxes that walk through the steps to take in situations requiring prioritization
• A 75-question comprehensive exam in the book, weighted to match the content percentages of the test plan
• Evolve questions filterable by content area, cognitive level, client needs area, integrated process, health problem, clinical judgment and priority concept
• Audio review summaries on Evolve covering pharmacology, acid-base balance, and fluids and electrolytes
• Alternate item formats including multiple response, ordered response, fill-in-the-blank, hot spot, chart and exhibit, video and audio questions

One correction worth making, because it turns up in most roundups including our own earlier NCLEX book comparison: this book is not 1,000 pages and it is not vaguely "$50 to $70". Elsevier states 1,144 pages, and its own store lists $75.99 for the print book and $63.99 for the eBook, with both discounted often enough that the sale price is the one most people pay.

Saunders Comprehensive Review For 2026

The content review earns the price, and the question bank is real

Most print NCLEX books are either a content book with a few questions bolted on or a question book with thin explanations. Saunders is the rare one where both halves are usable. More than 5,700 questions is more than HESI counts on its companion site by a factor of four, and the rationales explain the distractors rather than restating the correct answer.

The filters on Evolve are the part students underuse. Sorting questions by client needs area or by cognitive level lets you practice the thing the test plan actually weights rather than whatever chapter you happen to be on. Sorting by clinical judgment does the same for the reasoning skills the Next Generation format tests.

At $75.99 for 1,144 pages you are paying 6.6 cents a page, or 1.3 cents a question. Nothing else we review in print gets close on volume for the money.

The edition problem, in dates

Here is the part no other review states. NCSBN updates the NCLEX test plan every three years, and the 2026 RN Test Plan took effect on 1 April 2026 and runs to 31 March 2029. The Saunders edition on sale today went to print on 15 July 2022, three years and eight months before that plan took effect.

Saunders edition dates against the test plan the exam currently runs on. Read September 2026.

Be clear about what that does and does not mean. Nursing content does not expire in four years, and the 9th edition is not a pre-NGN relic: it was the edition that added Next Generation NCLEX style questions and the Clinical Judgment boxes built on the six cognitive skills of the NCSBN Clinical Judgment Measurement Model. Fluid and electrolyte balance is the same as it was in 2022.

What a new test plan moves is the weighting of the client needs categories and the emphasis given to item types. Our NCLEX study guide sets out the 2026 weightings as question counts, which is the quickest way to check any book's chapter balance against the exam you will sit. Elsevier sells each edition on being current with the plan, and the 10th edition's own description claims exactly that. So the honest position is that the 9th edition is good material written to a plan the exam has since replaced, and the publisher is seven weeks from shipping the version written to the plan you will sit.

What the 10th edition changes, and what it costs

The upgrade is modest and worth knowing precisely, because $2.00 is the entire price difference.

What Elsevier states for each edition, from its own product pages. Read September 2026.

Three of those changes matter more than the question count. Questions in the 10th edition carry reference ranges the way real practice and the real exam do, so you read a lab value and decide rather than recall a number you were handed. The 75-question in-book exam becomes an 85-question pre-test and post-test on Evolve, each generating an individualized study calendar, which is the first time Saunders has tried to schedule your prep for you. And five more NGN standalone and unfolding case studies land on Evolve, which is the format most students report finding hardest.

One thing that does not change: 1,144 pages in both. This is a revision, not a rewrite.

Saunders Pricing

Elsevier sells the 9th edition in two formats, and it discounts them constantly. Both prices below are the publisher's list, read on 17 September 2026, with the sale price that was running that day.

The eBook is the interesting line. At $44.79 on sale it is the cheapest route into the most complete NCLEX content review in print, and it reads on a phone during a commute, which 1,144 printed pages do not.

It comes with one condition that matters for the buy-now question. Elsevier's own eBook FAQ states that an access code "does not expire" but is "only valid for the edition you purchase" and "does not provide access to past nor future editions of the title". So an eBook bought in October is not upgradeable in November. You would be buying it twice.

Whichever you buy, budget for a question bank on top. A book cannot run adaptive practice, and adaptive practice is what the exam does. Our review methodology explains how we weigh a one-time purchase against a subscription.

Who Saunders Comprehensive Review Is Best For

• Students rebuilding content from scratch. If nursing school left real gaps, this is the one book that covers everything rather than assuming you know it
• Anyone who wants one source instead of five. Content, strategy, rationales and a question bank in a single purchase, with no subscription to cancel
• Students who learn by reading then testing. The structure rewards working a chapter and immediately drilling its questions
• Retakers who failed on content rather than nerves. The Evolve filters let you attack one client needs area at a time instead of restarting the whole book
• Students on a longer timeline. 1,144 pages is a two to three month commitment, not a two week one

When You Might Look Elsewhere

• You know the content and keep missing questions anyway. That is a strategy problem, and Kaplan NCLEX-RN Prep is built for it at $54.99, with 10 critical thinking pathways instead of a content bible
• You want questions, not chapters. Lippincott Q and A Review packs 43 practice tests into 1,152 pages, and NCLEX-RN Q and A Made Incredibly Easy prints 3,500 of its questions in the book, though its current edition dates from 2016
• You used HESI exams all through nursing school. HESI Comprehensive Review is 364 pages against 1,144, and the familiar format saves time even though it costs more per question
• You want adaptive practice and analytics. No book does this. UWorld and Archer Review do, and our pass probability calculator shows how the 85 to 150 item stop rule behaves once you are testing
• You have six weeks and no plan. Start with the NCLEX study plan generator and a question bank, then use Saunders as a reference for your weak areas rather than reading it cover to cover

Final Verdict

The decision is simpler than most reviews make it. Pick your exam date first. Testing this year means buying the 9th edition today, because seven weeks of waiting costs you seven weeks of studying, and the content is sound. Testing next year means pre-ordering the 10th, especially in eBook form, where the access code will not carry across editions.

Either way this is a content book, not a testing engine. Read it, then go and practice somewhere that adapts. Our NCLEX pass rate data shows how much distance separates first-time candidates from repeaters, and the NCLEX exam guide covers what the test plan expects before you spend anything.

Saunders Comprehensive Review FAQs

How much does Saunders Comprehensive Review cost?

Elsevier lists the 9th edition at $75.99 for the print book and $63.99 for the VitalSource eBook, verified on 17 September 2026, and both were discounted to $68.39 and $44.79 on the day we checked. Retailer prices vary, sometimes well below list on the print edition. The 10th edition is available to pre-order at $77.99 list.

Should I wait for the Saunders 10th edition?

It depends on your exam date. The 10th edition releases on 9 November 2026 with more than 6,000 questions, reference ranges on questions, five extra NGN case studies and an 85-question pre-test and post-test on Evolve, for $77.99. If you sit the exam before the new year, buy the 9th edition now and start studying. If you sit it in 2027, the wait costs $2.00 and buys the edition written for the current test plan.

Is Saunders enough to pass the NCLEX on its own?

It is enough content, and for some candidates it has been enough full stop, but it is not the standard plan. A book cannot run computerised adaptive testing, and the NCLEX stops somewhere between 85 and 150 items based on how you are performing. Most candidates pair a content book like this one with a digital question bank and sit adaptive practice tests before exam day.

Can you use Saunders for the Next Generation NCLEX?

Yes. The 9th edition was the one that added Next Generation NCLEX style questions along with Clinical Judgment boxes built on the six cognitive skills of the NCSBN Clinical Judgment Measurement Model, and its alternate item formats cover multiple response, ordered response, fill-in-the-blank, hot spot, chart and exhibit, video and audio items. The 10th edition adds five more standalone and unfolding case studies on top of that.

Does the Saunders eBook upgrade to the next edition?

No. Elsevier states that an eBook access code does not expire but is valid only for the edition you purchase, and gives no access to past or future editions of the title. If you buy the 9th edition eBook and then want the 10th, you pay for it again. That is the single strongest argument for deciding your edition before you check out rather than after.

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