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The Next Generation NCLEX (NGN): what to expect

NCLEX will be changing soon! Due to this, you may have questions about the changes, their reason, and the implementation time. So to help you better understand the exam's future, we've answered all your questions about the Next Generation NCLEX.

What is Next Generation NCLEX?

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

Increasing healthcare demand requires nurses to undergo more thorough testing. Hence, a new and improved NCLEX exam is coming, i.e., the Next Generation NCLEX (NGN). NGN will ask you innovative questions to help you develop your critical thinking and clinical decision-making skills. For better preparation for the exam, let's have an overview of the changes you can expect.

When will the Next generation of NCLEX start?

The NCSBN has confirmed that the Next Generation NCLEX will launch on 1 April 2023. Hence, If you have entered nursing school in Fall 2021 or later, you will be tested through NGN.

What new Item types will the Next generation NCLEX have?

Currently, students who have finished their exam questions and have sufficient time can take an additional Special Research Section of the NCLEX. This section aims to collect data on new item types, which measure entry-level nursing competency and clinical judgment. These are unscored questions and do not affect your NCLEX result scores. Based on the psychometric analysis of these question prototypes' performance, NCSBN has approved five new question types for the Next Generation NCLEX, which are as follows-

  1. Extended Multiple Response: This item will allow you to choose one or more options simultaneously. It is similar to the current multiple response questions but will have more options and partial scoring.
  2. Extended Drag and Drop: This item type will allow you to move or place the response options into specific answer spaces. It is similar to the current Ordered Response Questions on the NCLEX, but you don't have to use all the given response options. At times, there may be more response options than answer spaces.
  3. Cloze (Drop–Down): This type of question will allow 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.
  4. Enhanced Hot spot (Highlighting): 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, etc. After that, you must select the words or phrases that answer the question.
  5. Matrix/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 question types, Next generation NCLEX will also change 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 will be 150 (135 scored and 15 unscored).

Changes in scoring in Next Generation NCLEX:

The Next Generation NCLEX will introduce a new scoring methodology called Polytomous scoring (partial credit). Currently, the NCLEX scores each item type as all correct or all incorrect. But with NGN, you may get partial credit for partially correct responses. Here is a breakdown of the rules for the new scoring model:

  1. 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.
  2. +/- 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.
  3. 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 are not changing about the NGN:

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


Change of any kind can be anxiety-provoking. However, you need not worry about anything. Even if the types and number of questions change, you have to study the same topics. So If you work hard and practice these new item types, you will easily pass the NGN on your first go!

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