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The 2023 Next Gen NCLEX: What you Need to Know

*Original post released on 2/28/2023

The National Council of State Boards of Nursing (NCSBN) re-evaluates the NCLEX exam every three years for potential changes. The most recent changes having been made to the exam will take effect April 1st 2023 and remain in effect until 2026. What does this mean for new grad nurses about to take their board exams? There are some updates to keep in mind when studying for the exam so that you can be as successful as possible, passing with your first attempt! In this article we’ll discuss some of those new changes, how they may affect you, and how you should change your approach to preparing for this “Next Gen NCLEX” or NGN (if you plan on taking the exam between 2023 and 2026).

The NCLEX exam, in the past, has had a research section of questions (that don’t count for or against your overall score). Based on the data these questions have gathered over the past three years, the NCSBN has determined the focus of the NGN for the next testing period will be on enhancing clinical judgment and reducing med errors in new nursing graduates. Some of the new changes to this new version of the NCLEX include a new scoring model, alterations in question types, harder knowledge content, and a change in the range of possible questions administered during the exam.

With the new scoring model of the NGN, answers to questions aren’t simply correct or incorrect anymore. Some questions will allow for test takers to receive partial credit. As of yet, this change has not affected the “passing standard” set for overall passing of the NCLEX. How this new scoring model will impact the passing standard will be more apparent once test takers begin taking the NGN. The questions have had content redesigned to be more difficult to ensure better evaluation of clinical judgment and critical thinking. Additionally, the number of potential possible questions has been updated from a minimum of 60 and a maximum of 130 questions to a minimum of 70 and a maximum of 135 questions.

As for the question types, there has also been an adjustment. For example, cases/scenarios and questions/answers are going to be presented in a more structured manner – cases/scenarios present information on the left side of the computer screen while the proposed question and answer choices is presented on the right side of the computer screen. Furthermore, there are a few new question types: extended multiple response, extended drag and drop, cloze (drop down), matrix (grid), and enhanced hot spot questions. Let’s briefly describe the new question types:

  • Extended multiple response questions are similar to select all that apply questions, however these questions offer partial credit when some (not all) correct answers are selected.
  • Extended drag and drop questions are similar to their original drag and drop predecessors, however these questions may present additional answer options that might not be utilized. There will be more answer choices than required answers, meaning that you will be expected to know the content better instead of relying on the process of elimination to help you select your answer choices.
  • Cloze, or drop down, questions have test takers select their answer option from a drop down menu, however there now may be more than one drop down menu or answer list to select from.
  • Matrix, or grid, questions present a scenario with data and test takers are expected to check the appropriately correlating answer boxes within the matrix.
  • Enhanced hot spot questions have test takers select answers by highlighting the words/phrases that appropriately answer the question.

So why is there a change in the NCLEX board examination’s structure and content? Supposedly, the NCSBN believes that these changes will ensure the licensure of new graduate nurses with better clinical judgment and critical thinking skills. How will this impact preparation for the exam by students? The NCSBN has their own clinical judgment measurement model (NCJMM) which is similar to the nursing process but doesn’t replace it. Nursing programs are expected to utilize both the nursing process and the NCJMM to adjust their programs and students’ preparations for the NGN. As for individual students, they are encouraged to follow the changes their programs are making, continue studying using the nursing process, and focus on enhancing their clinical judgment and critical thinking. Truly work to learn and understand the materials rather than memorizing the content so you can apply it to case scenarios. The content will also be more difficult, so repetitive studying and preparation via practice with these new question types is highly recommended.

I hope this helps you understand the new changes being made to the NCLEX, or rather the Next Gen NCLEX or NGN, so you can test with confidence, excel, and obtain your licensure. You’ve got this! Now go practice and remember to think critically and use your best clinical judgment. Until next time, happy studying!


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