How the NCLEX exam questions are structured, especially with the new Next Gen NCLEX (NGN) format:

 how the NCLEX exam questions are structured, especially with the new Next Gen NCLEX (NGN) format:

1. Traditional Question Types (Still Used)

These are common in the old NCLEX and still appear in NGN:

 • Multiple Choice (MCQ)

Choose one correct answer from four options.

 • Select All That Apply (SATA)

Choose all correct answers — can be 2, 3, or even all options. No partial credit.

 • Ordered Response

Arrange steps in the correct order (e.g., CPR steps, medication administration process).

 • Hot Spot

Click on the correct area in an image (like where to place a stethoscope).

 • Fill-in-the-Blank (Calculation)

Type your answer (e.g., dosage, IV drip rate).

2. Next Gen NCLEX (NGN) Question Types

These were added to test Clinical Judgment more deeply.

Each case has a patient scenario (called a case study), followed by several questions related to that case.

NGN Case Studies

 • Each case study includes:

 • Patient background (name, age, diagnosis, meds, vitals, labs, etc.)

 • Around 6 questions per case

New NGN Question Types:

 • Cloze (Drop-Down Menus)

You select answers from drop-down options within a sentence (like filling in blanks).

 • Matrix/Grid

You select options in a table format (like “Yes/No” for multiple symptoms).

 • Highlight Text

You highlight relevant information from the case (e.g., an important cue from the nurse’s notes).

 • Highlight Table

Click/highlight important rows in a lab report or chart (e.g., abnormal values).

 • Drag-and-Drop

Drag nursing actions into categories (e.g., “Appropriate,” “Unnecessary,” or “Immediate Priority”).

 • Extended Multiple Response

Like SATA, but allows more than 5–6 choices.

 • Extended Drag and Drop

Put actions in a timeline or organize data across columns (e.g., “Assessment,” “Intervention,” “Evaluation”).

Each NGN Question Tests One of These 6 Steps of Clinical Judgment:

 1. Recognize Cues

 2. Analyze Cues

 3. Prioritize Hypotheses

 4. Generate Solutions

 5. Take Action

 6. Evaluate Outcomes

Example Flow:

Case Study:

Patient admitted with chest pain. History: hypertension, diabetes. Vitals: BP 90/60, HR 112, ECG shows ST elevation.

Q1 (Recognize Cues): Which data is most concerning?

Q2 (Analyze Cues): What does the ST elevation mean?

Q3 (Prioritize Hypotheses): Which condition is most likely?

Q4 (Generate Solutions): What action should the nurse take?

Q5 (Take Action): Choose the best 2 immediate interventions.

Q6 (Evaluate Outcomes): How do you know the patient is improving?

Summary:

 • You’ll answer both traditional and NGN-style questions.

 • NGN focuses more on realistic decision-making and safety.

 • There’s no partial credit unless stated (most are all-or-nothing).