What to Expect from NGN Questions and the Next Generation NCLEX

The Next Generation NCLEX (NGN) was introduced in 2023 to better evaluate clinical judgment and real-world decision-making in new nurses. The exam now includes Next Generation NCLEX questions and new question formats designed to test how well candidates analyze patient scenarios and prioritize care. Understanding these changes can help you prepare effectively and approach NGN questions with confidence.

The NCLEX changed in 2023, which means anyone preparing for the exam today must understand the new question format. It could make the difference between passing the test on your first try and taking it again.

In 2023, the NCLEX was updated to the Next Generation NCLEX. Due to this, you may have questions about the changes, their reason, and how the new NGN questions work. So to help you better understand what to expect, we’ve answered all your questions about the Next Generation NCLEX.

The goal of these updates is to better reflect the real clinical decisions nurses make every day in practice.

What Is Next Generation NCLEX?

NCSBN constantly strives to test the knowledge and skills of future nurses in the best possible way. This ensures that practicing nurses are competent to provide adequate and safe care to their clients.

Increasing healthcare demand requires nurses to undergo more thorough testing. Hence, a new and improved NCLEX was introduced: the Next Generation NCLEX (NGN).

One of the goals of these new NGN questions is to help you develop your critical thinking and clinical decision-making skills. For better preparation for the exam, let’s have an overview of what you can expect.

When Did the Next Generation NCLEX Start?

The NCSBN launched the Next Generation NCLEX on April 1st, 2023. If you entered nursing school in the fall of 2021 or later, you will test through NGN.

What Are NGN Questions?

New NGN question types measure entry-level nursing competency and clinical judgment. NCSBN has introduced five new NGN question types for the Next Generation NCLEX, which are as follows:

Extended Multiple Response

This item allows you to choose one or more options simultaneously. It is similar to the previous multiple-response questions but can have more options and partial scoring.

Extended Drag and Drop

This item type allows you to move or place the response options into specific answer spaces. It is similar to the previously ordered response questions, but you don’t have to use all the given response options. At times, there may be more response options than answer spaces.

Cloze

This type of question allows you to select one option from a drop-down list. There may even be more than one drop-down list in a question. These drop-down lists may be words or phrases in sentences, charts, or tables.

Enhanced Hot Spot

In this type of question, you can highlight words or phrases to select your answer. You can select or deselect the highlighted parts by clicking on the words or phrases.

The question will ask you to read a portion of a client’s medical record, including a nursing note, lab values, medical history, medication record, and so forth. After that, you must select the words or phrases that answer the question.

Matrix and Grid

This item allows you to select one or more answer options for each row and/or column. The column options may be indicated/ not indicated, risk factor/ not risk factor, effective/ ineffective/ unrelated, and anticipated/not anticipated. This question aims to determine your ability to make safe clinical decisions.

Changes in the Number of Questions in Next Generation NCLEX

Along with introducing new NGN question types, the Next Generation NCLEX also changed the number of questions. The minimum number of questions you have to answer is 85 (70 scored and 15 unscored), and the maximum number of questions is 150 (135 scored and 15 unscored).

Changes in Scoring in Next Generation NCLEX

The Next Generation NCLEX introduced a new scoring methodology called Polytomous scoring (partial credit). The NCLEX previously scored each item type as all correct or all incorrect.

But with NGN questions, you may get partial credit for partially correct responses. Here is a breakdown of the rules for the current scoring model:

0/1 Scoring Rule

The answer is either correct or incorrect. One point will be awarded if you answer the question correctly, and zero points for wrong answers. The multiple-choice questions are the best example of this rule of scoring.

+/- Scoring Rule

You get points by selecting the correct options and lose points by choosing the incorrect options. In a particular question, the total point value is the sum of all right options selected minus the number of incorrect options selected. This rule is applied to multi-point items, where you are free to choose as many or as few options that apply to the item.

Examples of these items are “select all that apply” and “multiple response items.” The minimum score that you can get for a question is zero.

Rationales Scoring Rule

This scoring rule is applied to options that test paired information, i.e., concepts that require justification through rationale. When caring for a particular patient, you must perform “Y” to assist with “Z.”

You must select the correct options for Y and Z to receive an entire point. You will not receive any points if you answer even one piece incorrectly.

The Things That Did Not Change About the NGN

Even though the NGN has new question formats and scoring methods, some core components of the exam remain the same as in previous versions. Students need to understand what stays the same to help manage anxiety as they prepare for the exam.

• Allotted Time: Like before, you will have 5 hours to complete the NCLEX-RN or NCLEX-PN exam.
• Method of Delivery: The test continues to be in variable-length Computer Adaptive Testing (CAT) format.
• Candidate Performance Report (CPR): You still get a performance report, but the report’s content may change slightly depending on whether you pass or fail.

Understanding Next Generation NCLEX Questions, NCLEX NGN Format

Change of any kind can be anxiety-provoking. However, you need not worry! Even if the types and number of NCLEX questions have changed, you will still be tested over the same nursing content. So, if you work hard and practice these new NGN NCLEX question types, you will easily pass the NGN on your first go!

So, work hard, plan well, and study effectively.

Frequently Asked Questions

Is the Next Generation NCLEX Harder Than the Previous NCLEX?

This exam helps measure a nurse’s clinical judgment. Because of this, it’s not meant to be necessarily harder. The content isn’t that dissimilar from the original.

What’s different is that the questions focus more on how well a person applies their nursing skills to different situations with patients. It’s extremely important that students prepare using NGN-style questions, so they can better understand this new way out and be prepared for it.

How Should You Study for NGN Questions?

Everybody studies differently, but it’s important that preparing for this exam is about more than just memorizing facts. For example, it’s important to practice different ways to analyze patient scenarios. You should also prepare yourself for identifying different top concerns and determining the best course of action.

Many NCLEX prep resources include NGN-style practice questions. Using one or two of these tools won’t best prepare you, which is why you want to use everything for the best possible exam results.

Are NGN Practice Questions Available Online?

Yes. Many nursing education platforms and NCLEX prep companies offer practice questions.

Depending on the school you attend, these questions might even be part of your coursework. When you review sample questions in advance, you’re better equipped to understand how clinical scenarios present on the test. You’ll also have a better understanding of Next Generation NCLEX scoring.

Can You Get Questions Wrong on NCLEX and Still Pass?

Yes. The NCLEX uses Computer Adaptive Testing (CAT). Test questions adjust based on your overall performance.

Just because you get a few questions wrong doesn’t mean you automatically fail the exam. It looks for overall competency, instead of those capable of achieving a perfect score without anything incorrect.

How Long Should You Spend Studying for the NCLEX?

This depends on each person’s learning style and overall schedule. Many students find it advantageous to take a few weeks and review core nursing concepts while practicing sample questions. What matters is to practice consistently and have strong test-taking strategies in place.

Understanding the Next Generation NCLEX Questions

Change of any kind can be anxiety-provoking. However, Archer Review has the tools needed to help you pass your exam, including access to a video library and over 3,100 in-depth NCLEX practice questions and Next Generation NCLEX questions.

Even if the types and number of NCLEX questions have changed, you will still be tested over the same nursing content. So if you work hard and practice these new NGN question types and Next Generation NCLEX questions, you will easily pass the NGN on your first go. The same approach applies when learning how to pass USMLE Step 1 in 2026 — strategy and consistency matter.

Work hard, plan well, and study effectively. Contact us today and learn how you can pass your NCLEX exam on the first try!