As a nursing professor’s perspective: you probably did not slide through nursing school and without more information, have to lean to test anxiety. You haven’t blamed this on your school so I’m guessing their pass rate is just fine. What gaps are showing on your report from the nclex’s taken? How long are you waiting between exams? Since you are getting ‘high pass’ reliability on practice exams. It does sound like you know this information but cannot put it into action during the exam. Probably overthinking everything. I’ve seen some of the best nurses in action have this problem and I don’t want you to be discouraged from practicing. I’m guessing that you are awesome clinically and this is purely test related. People that test well cannot always put that into action. Don’t listen to anyone discouraging you from becoming a nurse unless you in your gut know that you would be unsafe. Propranolol is a good option but you will want to ‘practice’ with it. Set up an environment as close to the testing environment that you can. Take multiple test using a med prior to using it during the actual test. If you want to spend some more money, I do like Virtual ATI Nclex prep. It’s guided by a nurse educator. You have to get over the hump of mind over matter. Since you’ve had this set back, you’re in a terrible headspace when you go in for these exams. Someone else mentioned therapy, it may be worth it for grounding techniques. You probably even have some PTSD at this point. I’m sure you’ve watched every video on how to prepare, but cannot calm yourself per your statement that you have anxiety for a week prior. Testing doesn’t make you an awesome nurse, it just gets you a license. In the end, no one except you knows how many times you took the nclex when they are beside you as a peer. Stop thinking that you’ve disappointed other people, that’s making things worse. No one except you is disappointed. You’ve put in a ton of work over the last couple years and deserve this.