Next Gen NCLEX (NGN) Questions: What you need to know (2024)

The Next Gen NCLEX (NGN) was recently launched in April 2023, but no worries, this is not a brand-new exam. With some slight changes to the existing NCLEX, the NGN has been in the works for a while—since the 2013-2014 NCSBN Strategic Practice Analysis, to be exact.

Still the NCLEX you know and have been prepping for, here’s everything you next to know about the NGN.

Changes to the NCLEX

The new NCLEX format for 2023 better measures an examinee’s clinical judgment and decision-making abilities. With that being said, the 2023 NCLEX is now longer in length, has different item types, and has slight changes in scoring questions.

The NGN will feature case studies with two to eight non-adaptive questions; these are where the new item types come in. With these questions, examinees have the opportunity to earn partial credit for their answers. We’ll go into more detail when we explain the new item types below.

How many questions are on the NCLEX®?

The 2023 NCLEX now ranges from 70-135 questions. On a minimum-length exam, there will be 70 scored items and 15 unscored items. Previously, exam questions ranged anywhere from 60-130 questions.

With a minimum-length exam, examinees can expect 52 stand-alone questions and three case studies. Each case study has six questions which adds up to a total of 18 questions.

What is the question format for the Next Generation NCLEX (NGN)?

The new NCLEX NGN question types are:

1. Extended multiple response: These are a part of the Clinical Judgment Measurement Model (NCJMM) which measures your decision-making abilities and clinical judgment skills. Essentially, they’re just questions with multiple possible answers.
2. Bow tie: Bow tie questions are also a part of the NCJMM. Examinees will read a clinical case and drag and drop their choices in a key shaped like a bow tie.
3. Drop-down (Cloze): Drop-down questions will allow you to pick from a list of answers to complete the passage. There will be multiple possible answers. There are also drop-down tables and rationale items!
4. Highlight: It’s exactly what you think—read a passage or sentence and highlight the answer.
5. Extended drag-and-drop: Answers will be some or all of the options; drag-and-drop your answers in the box.
6. Matrix: Pick one or more options in one column or row.
7. Trend: You’ll be presented with a client case for trend questions. They ask you to review and track the client’s needs, nursing interventions, and other healthcare orders over the course of a few questions.

The standard NCLEX questions are:

1. Fill in the blank
2. Multiple choice
3. Select all that apply

How many questions do you have to get right to pass the NCLEX®?

The exam time of 5 hours to complete the exam remains the same, but the NCLEX exam has computer-adaptive questions, so the number of questions will vary from person to person.

The minimum exam is 85 answered questions including your 15 practice questions. Overall, examinees will answer a total of at least 70 scored questions and may have up to 135 scored questions. You will keep receiving questions until the computer has 95% confidence you have passed or failed the exam.

How are NGN questions scored?

Next gen NCLEX questions follow three different scoring rules. These rules are rationale, +/- scoring, and 0/1 scoring.

1. 0/1 scoring: 0/1 scoring is used on questions that ask you to select x number of answers. You receive one point for a correct response, but zero points if the response is incorrect.
2. +/- scoring: This scoring rule is used on select all questions. You earn points for selecting correct information, but you will lose points for selecting incorrect information. The max number of points is the number of correct answers, and the minimum number of points is zero points for no correct answers.
3. Rationale scoring: Rationale scoring is cause and effect. This is broken down further in triad and dyad scoring. Both x (cause) and y (effect) must be correct to earn one point in dyad scoring. For triad scoring, you will earn one point for each correct answer. If all three are correct, you will earn two points.

How to pass the NCLEX

Everyone wants to pass NCLEX on their first attempt. NCLEX prep will take a good amount of studying and preparation. Like always, start your study scheduling, get your resources together (we’ll offer some below), and practice, practice, practice.

Familiarize yourself with the item types with practice quizzes and exams, review the NCLEX categories, and start looking at case study questions to best prepare.

To pass, you should also practice your test-taking strategies, plan your exam day accordingly, and, most importantly, avoid the top NCLEX exam day mistakes.

Resources to practice Next Gen NCLEX (NGN) questions

1. The official NCSBN website offers great resources and information for the Next Gen NCLEX. Sign up for their newsletter, check out sample questions, and download their NCLEX 2023 test plan to prepare for next-gen questions.
2. Nurse Sarah on Youtube has uploaded a few videos on everything you need to know about the NGN, how to create a study strategy, and case study practice questions to get you started!
3. Review the six clinical judgment steps with KeithRN to get ready for the NCJMM questions.
4. Practice your clinical judgment skills with case studies from Allnurses.com.
5. Master, review, and recall your NCLEX topics with the help of Picmonic. Picmonic’s vivid, memorable nursing mnemonics cover 1,200+ topics and over 13,000 key facts to help you prep for next-gen NCLEX questions. With daily-spaced repetition quizzes, NCLEX resources, and an app to study on the go, Picmonic covers all the bases and offers a pass guarantee for the Next Gen NCLEX®-RN.

Ready to start your NGN prep? Sign up for Picmonic today.

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