I trained outside the United States. Does that change the plan?

Usually yes. Reading load and item phrasing are a real and measurable cost in a second language, and they are teachable as technique rather than as clinical knowledge. NCSBN's 2025 figures show internationally educated candidates passing NCLEX-RN at 47.3% first time against 86.7% for US-educated candidates, so it is worth addressing directly rather than treating as a content gap.