If you’re considering which item types to include in your NCLEX® practice questions, the answer is all of them. When studying, you can break the item types into two categories: NCLEX® Nex-Gen new item types and traditional NCLEX® item types. Always remember that patient safety is at the core of each answer. The Nex-Gen NCLEX®...
The Best NCLEX® prep advice often comes from nursing professors. Slone-NCLEX Professor Tanya Killian breaks down her top three tips for passing the exam. Most importantly, you’ll want to focus on the quality and quantity of your preparation leading into exam day. As a professor of nursing, I’m not sure there’s a question I have...
The NCLEX-RN® exam can feel daunting, but we’re here to help you pass with flying colors.
RN candidates will have to answer at least 85 questions in various item types, with three full case studies.
In 2023, with the introduction of the Nex-Gen NCLEX®, a clinical judgment section was introduced to the NCLEX-RN® exam.
The NCLEX-RN® exam can be terrifying, daunting, and overwhelming. But we’re here to help you feel comfortable, prepared, and ready to take that exam by the horns and pass with flying colors.
Let’s start with the details of the exam and what it entails.
NCLEX-RN® Exam Format and Updates
All registered nurse (RN) candidates will have a minimum of 85 questions in various item types, with three full case studies. The maximum number of questions an RN candidate can have is 150 with a variety of item types and three full case studies.
A candidate has up to five hours, including breaks, to take the NCLEX-RN® ... Read more
If you’re considering which item types to include in your NCLEX® practice questions, the answer is all of them.
When studying, you can break the item types into two categories: NCLEX® Nex-Gen new item types and traditional NCLEX® item types.
Always remember that patient safety is at the core of each answer.
The Nex-Gen NCLEX® has a variety of item types, and if you’re considering which item types to include in your NCLEX® practice questions, the answer is ALL of them! It is an important part of your exam preparation to ensure that you study all areas of the exam — and with all item types that are included in the NCLEX®.Let’s break down the items types you will see on exam day and that you should incorporate into your NCLEX® practice questions. We are going to split this into two sections. The first section will cover all the NCLEX® Nex-Gen (NGN) new item types, and the second will cover the traditional NCLEX® item types.
NCLEX® Practice Questions: New Next-Generation Item Types
Extended Multiple Response
Select All That Apply (SATA)
The tester will select one or more answer options.
There can be up to 10 right answers.
There will be between five and 10 options to choose from.
Select N (Specified Number)
The question will tell the tester the number of items (N) that should be selected.
There can be up to 10 right answers.
There will be five to 10 options to choose from.
Multiple Response Grouping
Options are presented on a table, and the table can have two to five groupings.
Each grouping has two to four options, and the number of options for each grouping will be the same.
The tester will select at least one option from each group.
Matrix/Grid
Multiple Response
This is another way to present a SATA item type.
The item type has response columns, and each response column could have multiple correct responses.
The question will have two to 10 columns and four to seven rows.
Each column must have one response option selected, but one or all options can be correct.
Multiple Choice
This item type will have one correct answer per row and is another way to present a multiple-choice question.
The item type will have four to 10 rows and have two to three columns.
Drag and Drop
Drag and Drop Cloze
Will have one to two sentences of information with drag and drop options the user will use to complete the sentence(s).
Drag and Drop Rationale
Will have one sentence with one cause and one effect OR one sentence with one cause and two effects.
Drop Down
Drop Down Cloze
Will have one to two sentences of information with one or more dropdown options from which to complete the sentence(s).
Drop Down Rationale
Includes one sentence with one cause and one effect OR one sentence with one cause and two effects.
Drop Down in Table
These item types will have a table of information with drop down options in different parts of the table.
Highlight
Highlight in Text
This item type will have a paragraph of information.
The tester will highlight parts of the text based on what the question is asking.
Highlight in Table
This item type will have a table of information.
The tester highlights part of the text within the table based on what the question is asking.
Bowtie
These questions will look like a bowtie.
Will have five options on the left side, five options on the right side of the bowtie (wells), and four options in the middle.
Unfolding Case Study
These types of questions will trend information.
They will give information over time in a medical record or flow sheet requiring evaluation.
All case-studies will have six parts or phases.
The tester will review the information and answer questions throughout each part or phase.
The unfolding case studies can use any question type and will test the user on all six clinical judgment categories.
NCLEX® Practice Questions: Traditional Item Types
Multiple Choice
Standard question format with one correct answer.
Multiple Choice – SATA
Select multiple correct answers.
Remember SATA questions can have only one option correct, or they may have all options as correct.
Hot Spot
Select specific areas on a graphic image.
For example: The nurse is caring for a client prescribed digoxin and is ordered to take the client’s apical pulse. Where on the above figure does the nurse place the stethoscope to listen? Click the correct area to assess the apical pulse.
Fill-in-the-Blank
Calculate and input numerical values.
These are dosage calculation questions.
Drag and Drop – Ordered Response
Arrange answers in a specific order.
Chart/Exhibit Item
Analyze data/information presented in charts or exhibits and answer questions from that information.
Audio Item
The tester will listen to audio clips and select answers based off of what they are hearing.
Graphics Item
The tester will answer questions based on graphical content provided.
The Bottom Line
Remember the NCLEX® is always going to test you on the same thing, whether or not can you practice nursing safely. The purpose of the exam is to ensure you are a safe, entry-level nurse who can provide safe patient care and not harm people. So, answer your NCLEX® practice questions (and the questions on exam day!) in that way. Ask yourself: which is the safest action? Is this a safe dose? Which action prevents harm? Who do you need to see first because they are at the greatest risk of harm? Keep safety at the center and you will pass the NCLEX® with flying colors!
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The Best NCLEX® prep advice often comes from nursing professors.
Slone-NCLEX Professor Tanya Killian breaks down her top three tips for passing the exam.
Most importantly, you’ll want to focus on the quality and quantity of your preparation leading into exam day.
As a professor of nursing, I’m not sure there's a question I have received more than, “What do I need to do to pass the NCLEX® exam?”I am sure you have asked yourself and others this exact question. Likely, you received all different answers. What I have found in my years as a nursing student, a nurse, and as a nursing professor is that the best NCLEX® prep involves remembering what the NCLEX® is, what it’s testing over, taking a lot of NCLEX®-style questions every day, and using a structured prep program, such as Slone NCLEX.
Best NCLEX® Prep Tip No. 1: Remember What the Test is About
First things first, remember what the NCLEX® is and what it is ultimately testing you over, which is one thing, SAFETY! The exam evaluates if you can be a safe practicing licensed nurse. So, when preparing for, and taking, the exam be sure to read each option and then pick the answer that is going to save your patient. So, if it’s a question about administering a blood pressure medication, make sure you are selecting answers that ensure patient safety. Assess if the dose being given is safe. Does the client have an allergy to that medication? Is the client stable enough to receive that medication, or is their blood pressure too low so you should hold that blood pressure medication? Always keeping in mind that safety is the priority.
Best NCLEX® Prep Tip No. 2: Practice, Practice, Practice
Next, take NCLEX®-style questions, and take a lot of them. When I was preparing to take the exam, I took more than 2,000 practice questions and I started reviewing questions during the last part of my final semester in nursing school. In one of the best NCLEX® prep tips I’ve received, a very wise professor told me not to wait to take the exam and to start preparing early. That way, the moment I received my authorization to test (ATT), I was all set. Follow this advice! Begin preparing six to eight weeks before you graduate and take your NCLEX® the moment you can. The more questions that you can take ahead of exam day, the better prepared you will be. Make sure you include a variety of questions that cover a variety of topics and feature a variety of item types. In 2023, the National Council State Board of Nursing developed a new NCLEX® that increased the testing of clinical judgement and added new item types for students to be evaluated with. This update was called the next-generation NCLEX® (NGN NCLEX®), so make sure when taking questions that you also find ones that are labeled NGN or next-generation.
Best NCLEX® Prep Tip No. 3: Use a Prep Program
Finally, use a prep program. I did, and it helped me prepare better than anything else. It is so hard to stay focused and organized after nursing school. A prep program like Slone NCLEX will help you remain structured and do what you need to do to be fully prepared.Find a prep program that provides you with a quality review and LOTS of questions. There’s no substitute for practice questions. You NEED them, so make sure you trial the preparation program’s questions, ensure their quality and check that the rationales help you understand the content.
The Bottom Line
The other piece that is important in preparing is to keep your mindset positive and believe in yourself! You’ve got this and we’ve got you!
The NCLEX-RN® exam can feel daunting, but we're here to help you pass with flying colors.
RN candidates will have to answer at least 85 questions in various item types, with three full case studies.
In 2023, with the introduction of the Nex-Gen NCLEX®, a clinical judgment section was introduced to the NCLEX-RN® exam.
The NCLEX-RN® exam can be terrifying, daunting, and overwhelming. But we're here to help you feel comfortable, prepared, and ready to take that exam by the horns and pass with flying colors. Let’s start with the details of the exam and what it entails.
NCLEX-RN® Exam Format and Updates
All registered nurse (RN) candidates will have a minimum of 85 questions in various item types, with three full case studies. The maximum number of questions an RN candidate can have is 150 with a variety of item types and three full case studies. A candidate has up to five hours, including breaks, to take the NCLEX-RN® exam. If you were granted additional time for accommodation in school, make sure you have the same accommodation for this exam. To request accommodation, you’ll have to go through your state’s nursing review board.The NCLEX® tests over specific categories. Its eight client need categories are:
Management of Care.
Safety and Infection Control.
Health Promotion and Maintenance.
Psychosocial Integrity.
Basic Care and Comfort.
Pharmacological and parenteral Therapies.
Reduction of Risk Potential.
Physiological Adaption.
In 2023, with the introduction of the Next-Gen NCLEX®, a clinical judgment section was introduced.Clinical judgment is a substantial portion of professional nursing and is the result of critical thinking and decision making. It is a process that first recognizes cues, then analyzes those cues, prioritizes hypotheses made from those cues, generates solutions to those hypotheses, takes action while prioritizing the most important client needs first, and finally, evaluates the outcomes of those actions. Another major change that coincided with the 2023 Next-Gen update was the introduction of new item types. The traditional item types are multiple choice, select all that apply, hot spot, fill-in-the-blank (numerical), drag and drop ordered response, chart/exhibit/graphics questions, and audio questions. The new item types seem a bit more complex, but that’s mostly because they are new and not as familiar as the traditional item types. The Next-Gen item types are extended multiple response, matrix grids, drag and drop, drop down, highlight, bowtie, and unfolding case studies. Slone NCLEX features all of these item types in its NCLEX® prep program. The exam is administered through computer-adaptive testing, meaning that the computer adjusts the difficulty of questions based on your answers to previous questions. Once a tester is above or below the passing standard at a certain level the test will shut off, the exam is scored, and a pass or fail is sent to the tester's nursing review board to be sent to the tester. Another change was updated scoring that now ensures partial credit is given to multiple part questions. There are four types of scoring models used in the NCLEX-RN® exam. There is partial credit scoring for items for which more than one key exists. There will be three methods for scoring items for partial credit: plus/minus, zero/one, and rationale scoring.
How to Study
All right, now that you understand what the NCLEX® is and what to expect, let’s talk about how you can study. The most important thing you can do is take as many NCLEX®-style questions as you can in various categories and item types. Your goal should be to take at least 200-400 questions per day until exam day. You should also use a prep program like Slone NCLEX to keep your preparation organized and structured. It is so hard to stay focused and maintain the rigor of nursing school with NCLEX® prep after you graduate, but it is needed for you to be successful. So, find a reputable prep program that provides quality questions, detailed rationales, and readiness exams to gauge your progression and exam readiness. And stick to it!When answering questions, remember that the entire purpose of the exam is to test your ability to be a SAFE practicing entry-level nurse. After reading questions on the exam, determining which possible answer ensures your client is SAFE, which promotes their safety, and how do I ensure they have safe outcomes? On the questions where you’re at a loss, look at the answer options and see if you can find a common denominator. Or, do all but one option seem negative? This can help you pick an option.
The Bottom Line
Before you start the exam, take three deep breaths. Deep breathing can help you improve focus, reduce anxiety, and help you manage the stress of the exam. If you begin getting worked up during the exam, pause and take a deep breath, it sounds simple, but it will be a huge help!Most importantly, believe in yourself. Remember that you’ve got this, you can do this and that we’ve got you!
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If you’re considering which item types to include in your NCLEX® practice questions, the answer is all of them.
When studying, you can break the item types into two categories: NCLEX® Nex-Gen new item types and traditional NCLEX® item types.
Always remember that patient safety is at the core of each answer.
The Nex-Gen NCLEX® has a variety of item types, and if you’re considering which item types to include in your NCLEX® practice questions, the answer is ALL of them! It is an important part of your exam preparation to ensure that you study all areas of the exam — and with all item types that are included in the NCLEX®.Let’s break down the items types you will see on exam day and that you should incorporate into your NCLEX® practice questions. We are going to split this into two sections. The first section will cover all the NCLEX® Nex-Gen (NGN) new item types, and the second will cover the traditional NCLEX® item types.
NCLEX® Practice Questions: New Next-Generation Item Types
Extended Multiple Response
Select All That Apply (SATA)
The tester will select one or more answer options.
There can be up to 10 right answers.
There will be between five and 10 options to choose from.
Select N (Specified Number)
The question will tell the tester the number of items (N) that should be selected.
There can be up to 10 right answers.
There will be five to 10 options to choose from.
Multiple Response Grouping
Options are presented on a table, and the table can have two to five groupings.
Each grouping has two to four options, and the number of options for each grouping will be the same.
The tester will select at least one option from each group.
Matrix/Grid
Multiple Response
This is another way to present a SATA item type.
The item type has response columns, and each response column could have multiple correct responses.
The question will have two to 10 columns and four to seven rows.
Each column must have one response option selected, but one or all options can be correct.
Multiple Choice
This item type will have one correct answer per row and is another way to present a multiple-choice question.
The item type will have four to 10 rows and have two to three columns.
Drag and Drop
Drag and Drop Cloze
Will have one to two sentences of information with drag and drop options the user will use to complete the sentence(s).
Drag and Drop Rationale
Will have one sentence with one cause and one effect OR one sentence with one cause and two effects.
Drop Down
Drop Down Cloze
Will have one to two sentences of information with one or more dropdown options from which to complete the sentence(s).
Drop Down Rationale
Includes one sentence with one cause and one effect OR one sentence with one cause and two effects.
Drop Down in Table
These item types will have a table of information with drop down options in different parts of the table.
Highlight
Highlight in Text
This item type will have a paragraph of information.
The tester will highlight parts of the text based on what the question is asking.
Highlight in Table
This item type will have a table of information.
The tester highlights part of the text within the table based on what the question is asking.
Bowtie
These questions will look like a bowtie.
Will have five options on the left side, five options on the right side of the bowtie (wells), and four options in the middle.
Unfolding Case Study
These types of questions will trend information.
They will give information over time in a medical record or flow sheet requiring evaluation.
All case-studies will have six parts or phases.
The tester will review the information and answer questions throughout each part or phase.
The unfolding case studies can use any question type and will test the user on all six clinical judgment categories.
NCLEX® Practice Questions: Traditional Item Types
Multiple Choice
Standard question format with one correct answer.
Multiple Choice – SATA
Select multiple correct answers.
Remember SATA questions can have only one option correct, or they may have all options as correct.
Hot Spot
Select specific areas on a graphic image.
For example: The nurse is caring for a client prescribed digoxin and is ordered to take the client’s apical pulse. Where on the above figure does the nurse place the stethoscope to listen? Click the correct area to assess the apical pulse.
Fill-in-the-Blank
Calculate and input numerical values.
These are dosage calculation questions.
Drag and Drop – Ordered Response
Arrange answers in a specific order.
Chart/Exhibit Item
Analyze data/information presented in charts or exhibits and answer questions from that information.
Audio Item
The tester will listen to audio clips and select answers based off of what they are hearing.
Graphics Item
The tester will answer questions based on graphical content provided.
The Bottom Line
Remember the NCLEX® is always going to test you on the same thing, whether or not can you practice nursing safely. The purpose of the exam is to ensure you are a safe, entry-level nurse who can provide safe patient care and not harm people. So, answer your NCLEX® practice questions (and the questions on exam day!) in that way. Ask yourself: which is the safest action? Is this a safe dose? Which action prevents harm? Who do you need to see first because they are at the greatest risk of harm? Keep safety at the center and you will pass the NCLEX® with flying colors!
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