New item types on the Next Gen NCLEX

The Next Generation NCLEX consists of new item types designed to assess a student’s clinical judgment skills.

What are the new item types on the Next Gen NCLEX?

The most significant change to the test is the addition of unique new item types.

The NCSBN researched a variety of item types to determine which best measure clinical judgment. The organization settled on 12 for use with case studies and 2 for the use of stand-alone items.

  • Matrix multiple-choice
  • Matrix multiple-response
  • Multiple-response: Select all that apply
  • Multiple-response: Select N
  • Multiple-response: Grouping
  • Drag-and-drop: Cloze
  • Drag-and-drop: Rationale
  • Drop-down: Cloze
  • Drop-down: Rationale
  • Drop-down: Table
  • Highlight: Text
  • Highlight: Table

What are case study item types?

Case studies are an effective way to measure clinical judgment.

Case studies are real-world nursing scenarios that focus on the 6 clinical judgment functions of Layer 3 of the Clinical Judgment Measurement Model.

Learn more about case study questions

Stand-alone item types

These item types also assess clinical judgment.

Stand-alone items are individual questions that are not part of a case study but have a similar format. They are introduced after the minimum number of items.

Stand-alone items consist of two item types:

  • A bow-tie item
  • Trend item.
Learn more about stand-alone item types

Next Gen NCLEX tools, tips, & information

Bookmark this page. We are regularly releasing new blog posts, resources, and tools to help you prepare your students for the Next Generation NCLEX.

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