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A big Next Gen NCLEX change that got everyone talking

Oct 4, 2023, 17:48 PM
<2-min. read> The new version of the NCLEX (the Next Generation NCLEX) is different from the previous version — particularly in regard to reference ranges.

What's the big deal regarding reference ranges on the Next Generation NCLEX?

Next Gen NCLEX - What is a reference rangeDoes the Next Generation NCLEX (NGN) — AKA the new version of the NCLEX  include reference ranges?

This was one of the top questions asked of Jason Schwartz, Director of Outreach at the National Council of State Boards of Nursing (NCSBN), during a special edition of “The ATI Talk” in September 2022 that focused on the subject. Addressing the thousands of nurse educators in attendance, Schwartz keyed in primarily on one aspect of the new version of the exam: the inclusion of 3 case studies that every candidate now answers.


As he walked the more than 1,300 attendees through a case study, he illustrated how it moved through the 6 cognitive functions outlined in the NCSBN’s Clinical Judgment Measurement Model. One of the example questions (referred to as item types in the testing profession) displayed reference ranges for several lab results.


Why NGN includes reference ranges 

Educators were caught off-guard in seeing the reference ranges. The previous version of the NCLEX required students to memorize this data to check whether candidates could immediately recognize when a lab value was off in reviewing test results.

But that memorization is no longer required.

The new version of the NCLEX includes reference ranges when referring to lab values.

“It’s a nice friendly change,” Schwartz said.

Schwarz explained that nurses in the real world no longer need to pull this information from memory; reference ranges are generally included when lab results are presented. And the NCSBN wanted the new version of the NCLEX to more accurately reflect such changes in a nurse’s job.

“One of the things we’re doing [on the NGN],” Schwartz explained, “we’re trying to get much more real life.” And real-life nurses are presented with reference ranges when they review a client’s lab results. “Therefore,” Schwartz said, “ the exam [does] too.”


Educators also wondered whether all the questions on the Next Generation NCLEX included reference ranges. Specifically, do knowledge questions also offer this information?

In developing the new version of the exam, Schwartz said, “We had to think a lot about that. What we decided was, if we only provided [reference ranges] in the case study, then your graduates — when they got to a case study — would frantically write down all these reference ranges, because they might [think they would] need them later on in the test,” Jason explained. “That just seem[ed] silly to us.”

Therefore, the Next Gen NCLEX provides reference ranges for all questions — with 1 small exception.

“You could come to an item that says the nurse is working with a client who has a slightly elevated potassium level,” Schwartz illustrated. “Well, we may not tell you the level or the reference range,” he said. The exam will simply expect the candidate to have an understanding of what is meant by “slightly elevated potassium.”

“The point is,” he continued, “[students] don't need to memorize reference ranges for the rest of the test. We just … crossed that off the list.” 

Watch the full edition of “The ATI Talk” to see Schwartz’s detailed description about the Next Generation NCLEX.

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