The “NEW” Next Generation NCLEX (What is the new NCLEX format?) 😩

NGN nclex changes

What is Next Generation NCLEX (NGN)?

  • Quick NGN Facts
    • WHAT: 5 new question NCLEX question formats
    • WHEN is the NCLEX Changing?: April 2023
    • WHY: better measure new grad nurse clinical judgement

Essentially, the NCSBN or the National Council State Boards of Nursing (who administers the NCLEX) is planning to include a variety of 5 new question types (explained below) that better measure clinical judgment into the NCLEX beginning of 2023.

Right now is 2020. This is planning on happening in 2023 so you’ve got some time. If you’re in school right now, chances are you won’t be exposed to the new NCLEX on test day.

You might, however, see some of these exam items on your exam as the NCSBN begins to test some of these question types, but they will not be scored.

Why NGN?

The Next Generation NCLEX project began in about 2012 when the NCSBN said, “Hey, are we doing everything that we can to prepare new nurses to enter the floor?” And they said, “well, no, we’re not.  We need to help them think a little bit differently and feel more clinically prepared.”

With that, it was determined that creating new questions types might improve their ability to gauge readiness to work on the hospital floor.

As of the latest update, there are 5 new question types.

What Kind of New NCLEX Question Formats will be on the NEXTGEN?

The 5 new NCLEX question types include:

  • Extended Multiple Response
  • Extended Drag and Drop
  • Cloze (drop down)
  • Enhanced Hot Spot
  • Matrix (grid)

Essentially, three of the “new” NCLEX question types already exist and the new format is just adjusting delivery (multiple response, drag and drop, hot spot).

Extended Multiple Response

Essentially, these are select all that apply questions (SATA) questions with additional answer options.

extended multiple response nclex questions

So basically you’re given a, a STEM or a question and you’re asked to select all the answers that all the items or all the answers that answer that question. So they’re just adding a few more options to SATA questions. Now here’s the good thing . . . they’re planning to use partial credit scoring. So that’s huge.

Extended Drag and Drop

So extended drag and drop is an alternate format question type on the NCLEX. These extended drag and drops are different because not all of the options will be required to be used in the answer.

extended drag and drop new nclex

So it’s almost like a select all that apply, drag and drop. It’s really nothing more than that. It’s just that you’re dragging it over rather than clicking a button. So in some cases, there might be more boxes available, than there are correct answers. And so you just have to select which ones actually apply to the patient for this new NCLEX question.

Cloze (dropdown)

Given a sentence and it’s almost like a fill-in-the-blank, but instead of fill-in-the-blank, it’s a dropdown. So you’re given a sentence of the nurses evaluating a patient with pneumonia.  You hover over the first dropdown and you select your answer and then you hover over the second and you select your answer. It’s truly nothing more than that.

cloze new nclex ngn

It’s just selecting the appropriate dropdowns in any given sentence or within tables on a chart.

Enhanced Hot Spot

These seem kind of interesting in that you’re, for example, given a report, a written report from an offgoing nurse, and inside that report there’s a couple pieces of information that you have to identify as important or things that you need to take action on.

cloze highlighting nclex

So you’re given this report, this written report or a med chart or something like that, or a lab value and you have to select within there by like highlighting the phrase that requires the most immediate action.  This is a great way to test nursing priorities.

Matrix (grid)

You’re going to see an Excel spreadsheet and you’ll have different columns. One column will be patient data or actions that the nurse would take. And then the other three columns will be or correct answer options. And you would have to select one of the columns for each of these rows.

matrix nclex questions

In all honesty – these seem like an exciting new NCLEX question type.


Now is this intimidating? Yeah, it be a little bit intimidating for nursing students knowing that this is quite a bit different than just a four answer options, but we got your back.

To help remove the test anxiety around the NCLEX, we developed SIMCLEX which is a computer adaptive NCLEX simulator that replicates the adaptive nature of the NCLEX . . . you can take a SIMCLEX today.

Take a SIMCLEX Now

simclex screenshot

But at the same time, this is almost like when you are able to give an oral report or an essay answer option instead of selecting the right answer. I remember when I took anatomy and physiology, our professor would give us like a hundred-question test and they would give us two essays. I loved the two essay parts because I was able to explain everything that I knew versus having to select one right answer option. And maybe I’d read the question wrong. So this is almost like that. It’s almost giving you a chance to show more of what you know and I believe that a lot of these truly are going in the right direction for preparing nurses to deal with all that we see on the floor versus selecting a right answer option.

There’s a lot of times in nursing, there’s not really a right answer, it’s just the best answer for that time for that patient. So I do believe that this is in the right direction. Don’t get too concerned about this. If you’re taking the NCLEX this year or next year, if you’re taking it in 2022, maybe start becoming familiar with it. If you’re taking it in 2023 or beyond. I think that by that point, all the tech is going to be rolled out. All the testing’s going to be done where you would actually need to understand what’s going on here. We will have many resources coming for you to help you take these questions as it gets closer.

Try out our Test Taking Course for additional help on how to uncover the why behind the what, the most important information, and in a way that you can go out and implement. All right guys, we love you. Now go out and be your best self today. Happy nursing.

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