Include These Item Types in Your NCLEX® Practice Questions

• 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!