I am a English RN who took the NCLEX. Depending on where you want to work in the USA, you may need to take the CGFNS exam first, but you need to find out from the Board of Nursing in the State that you are interested, to find out if you need to take it. For example, in Minnesota you need to take the CGFNS exam before the NCLEX. In Florida, you only need to take the NCLEX. Unlike in England, where you take your final exam, then register, in the USA everyone takes a final, then your are eligable to practice, when you recieve your certificate from the board of nursing. The pass mark is about 75-80%, so you need to know your stuff. Nursing in the USA can be very different from the UK, depending on where you practice. I would imagine that the ICU and CCU settings are simiilar, but for example when working in the UK, I never once listened to someones lungs and heart, however here you are expected to know about lung sounds, and how to act on them. You are more independant here. The USA is a exciting place to work for a nurse, and far more rewarding money wise than in the UK. If you are thinking of taking the NCLEX then I suggest you study hard and obtain some USA nursing books. I believe that this website has links to the boards of nursing, so you can look them up. Applying for the NCLEX does cost money, and I think totals about 150 pounds, so that is not too bad. Good luck, if you need anymore information you can always email me, and I will be gald to help. Emma.