top of page

8 Facts you should know about the Next Generation NCLEX

Updated: Apr 13

Over the past few years, the Next Generation NCLEX (NGN) has been the talk of the nursing world and it has brought feelings of excitement and anxiety to nurses.

Nursing educators and candidates would want to assure themselves that they are equipped for whatever is coming brought about by this change.

The Next Generation NCLEX was implemented worldwide last April 1, 2023. All NCLEX candidates will undergo the new exam format regardless of educational background or where you’re going to take the exam.

Let’s take a look at the important information we need to know about NGN:

1. They’re not changing the NCLEX entirely

The NGN doesn’t wander far from the existing NCLEX.

Majority of the minimum-length exam will still contain standard question formats such as the multiple response format where one has to choose 1 correct answer out of 4 options.

Keyword: ENHANCED. The Next Generation NCLEX is NCSBN’s enhanced examination designed to ask questions that go beyond assessing knowledge and skills, or what they like to call “BETTER QUESTIONS.” It is meant to determine the ability of nurses to use clinical judgment when faced with various clinical situations.


See the exam preview here:

2. New questions formats will be introduced

New question types were developed and approved by the NCSBN in order to better screen nurses entering practice. The candidate may encounter these questions as stand-alone items or in case studies. The items types are as follows:


  • This is built on the existing Select All That Apply (SATA) questions wherein more options are provided (around 10-12) and uses partial credit scoring.


  • This is built on the existing drag and drop questions, however more options are provided and they may or may not include all options in the answer.


  • This is built like a fill-in-the-blank question wherein answers are found in a drop down list and there can be more than one drop down list in an item. Also, the list can be found in sentences, charts and tables.


  • Candidates can select answers, which can be in the form of words, phrases and values, by highlighting information from the given situation which can be within a medical record (nurse’s notes, history, etc).


  • A group of questions presented in a grid of rows and columns wherein there can be 1 or more correct options per row. This assesses multiple aspect of the situation with a single question.


  • There will be a medical record presented where the candidate needs to review information that trends over time (e.g. from minutes, hours, days, etc.). Trend items address multiple steps of the NCSBN Clinical Judgment Measurement Model(NCJMM) and can feature any item response type.

3. There will be 3 case studies throughout the exam

Based from the released information from NCSBN, through the NGN, candidate’s clinical judgment are to be assessed through unfolding case studies followed by a series of questions designed to evaluate the individual’s ability to perform clinical decisions.

The candidate will encounter a total of three (3) case studies with six (6) items each throughout the exam, regardless of the maximum number of items he/she will answer.

See sample case studies here:

4. Nursing concepts will not change in the NGN

Taking care of a mother who gave birth in 2022 is no different from taking care of one who just gave birth in 2023. This analogy will help you understand that even if the NCLEX format is changing this year, the nursing concepts will still remain the same. That’s why you need to understand the fundamentals for you to be able to answer any type of question no matter how many times it’s reworded.

It’s inefficient to keep answering hundreds of practice questions everyday if you do not have a solid foundation of your basic nursing concepts. It’s even harder to make clinical reasoning and judgment if you don’t have a basis.

5. It involves more critical thinking than memorization

You don’t need to memorize everything to pass the NCLEX. Don’t listen to anyone who will tell you to read textbooks from cover to cover because it’s a waste of time.

The NCSBN developed the NCLEX to measure your clinical judgment and decision-making skills. They are looking for a nurses who use their nursing knowledge to generate the best possible evidence-based solutions to deliver safe client care, not just anyone who memorized all the signs and symptoms of a certain disease.