Learn All About Next-Gen NCLEX®

• On April 1, 2023, the NCSBN NCLEX® launched a major overhaul called the Next Generation NCLEX®, also known as Next-Gen NCLEX® or NGN. 
• The updated exam includes a clinical judgment model and new question item types. 
• However, the exam is still administered using computer-adaptive testing. 

You’ve probably heard the National Council of State Boards of Nursing (NCSBN) completed a major change to the National Council Licensure Examination (NCLEX®) in 2023. On April 1, 2023, the NCSBN NCLEX® launched a major overhaul called the Next Generation NCLEX®, also known as Next-Gen NCLEX® or NGN.  

The change resulted in several updates and additions, with the goal of improving test functionality and providing a better way to evaluate the tester’s clinical judgment and safety as an entry-level nurse. 

New additions to the 2023 NCLEX® included: 

• Incorporating the NCSBN Clinical Judgment Measurement Model (CJMM); 
• Adding new question item types; 
• Adding updated scoring; and 
• Increasing the total number of NCLEX® questions on the exam.  

What’s the Clinical Judgment Measurement Model? 

The clinical judgment model ensures that the tester can be a safe practicing nurse and is incorporated throughout the NCLEX® exam. The model also is being used in residency programs, preceptorships, and for new graduate orientation.  

Previously, the NCLEX® utilized the nursing process within the eight client need categories (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, and Physiological Adaptation).  

With the addition of the clinical judgment model, we have created this image to help you visualize the way it connects with the nursing process and what each means: 

Clinical judgment begins with recognizing cues, then analyzing those cues, prioritizing hypotheses based on those cues, generating solutions to those hypotheses, taking action while prioritizing the most important client needs first, and, finally, evaluating the outcomes of those actions. 

Exploring the Next-Gen NCLEX® Question Item Types 

But don’t forget about the new question item types that were added to the exam. The NGN NCLEX® will include three unfolding case studies in every exam. The tester will have to answer a series of questions via different item types. The case study will “unfold” and questions will apply to each of the new areas.  

There will also be bowtie questions; new multiple response item types that include Select All That Apply (SATA), select N, and multiple response group; and highlight questions that include highlight test and highlight table.  

Drag-and-drop questions that have the tester complete a sentence have also been added. Some questions will require you to complete one to three sentences, and others will be a rationale sentence that will be a cause-and-effect statement.  

Like drag and drop, there will also be drop-down questions where the tester will complete the sentence selecting from the drop-down options.  

Finally, there are now matrix grid questions where users will select answers in a matrix set. For more information on the new item types, reference our previous blog, “Include these Item Types in Your NCLEX® Practice Questions.”

The NCSBN NCLEX® also updated the scoring for all item types. This ensures partial credit for multiple-part questions, including SATA. There are now four types of scoring models used in the NCSBN NCLEX®-RN. Partial credit scoring is used for items with more than one key. There will be three methods for scoring items for partial credit: plus/minus, zero/one, and rationale scoring.  

• Traditional Scoring 
  • The “original” NCLEX® scoring type. 
  • This scoring type means you either get the question right or wrong, there is no partial credit.  
• 0/1 Scoring 
  • Partial Credit Scoring Type. 
  • With 0-1 scoring, the tester earns one point for each correct response picked and they earn zero points for each incorrect response picked. The total score for a multi-point item is the sum of all correct responses.  
• +/- Scoring 
  • Partial Credit Scoring. 
  •  The tester earns one point for each correct response picked and also will subtract one point for each incorrect response picked. The total score for a multi-point item is the sum of all positive and negative points. *Negative total scores are a 0, there are no negative scores.  
• Rationale Scoring 
  • The tester earns points when both responses in the pair are correct. This is applied to items that require a full understanding of paired information (e.g., cause/effect relationships). 

The maximum number of questions for the Next-Gen NCLEX® also increased. The new NCLEX® has 85-150 scored questions (including 15 unscored pretest questions). It was previously 75-145 on the old version. 

What Hasn’t Changed on the Next-Gen NCLEX® 

The NCLEX® continues to be administered using computer-adaptive testing. This means the computer re-estimates the candidate’s ability after each item is answered, based on the difficulty of the item and the candidate’s previous answers.  

The computer then selects the next item for the candidate that is most optimal based on their previous responses. This ensures that the next item is neither too easy nor too hard, and the examination can obtain maximum information about the candidate’s ability from the item. Candidates should find each item challenging because the items are targeted to their ability level. After each item is answered, the computer’s estimate of the candidate’s ability becomes more precise. 

The test also continues to be a pass/fail exam and remains timed with a five-hour limit. The exam will automatically shut off if the tester reaches the maximum time and/or maximum number of questions. The exam will then be scored, and a pass/fail result is given to the user.  

The Bottom Line 

Regardless of what has changed or what has remained the same, the NCLEX® still tests your abilities to be a safe practicing entry-level nurse. Preparation is key to passing the exam. Make sure you select a preparation like Slone NCLEX that will provide you with the structure, organization, and variety that mirrors the Next-Gen NCLEX®. Setting yourself up for success is what will make you the most confident on test day. Focus hard and prepare and you will do great! 

Begin your NCLEX® preparation journey with Slone NCLEX today.