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FAQs About the Next Generation NCLEX (NGN)

Student nurses preparing to test after April 1st are understandably nervous as they are the first to encounter the new NGN exam. The purpose of this article is to explain what makes the NGN different. This should help you prepare for the exam better. Nursing Students NCLEX Article

• Next Generation Nclex

Updated: Feb 15   Published Jan 18, 2023

Why is the NCLEX changing?

The National Council of State Boards of Nursing (NCSBN) developed and reviews the national NCLEX exam every three years. Reasons that led to the revision of the NCLEX include:

• increased technology. 
• higher acuity patients.
• recognition that new grads need increased clinical judgment to practice safely.

The primary impetus for the new exam is the third bullet point, clinical judgment. New grads need clinical judgment and critical thinking skills. Can testing measure critical thinking ability? According to the NCSBN, NGN test items (test questions) better evaluate clinical judgment.

Never before has the exam been based on a clinical judgment model that measures critical thinking. What matters is not just information. It's the application of knowledge. These new items are based on NCSBN's Clinical Judgment Measurement Model (NCJMM) ( 1 ) . which reflects the nursing process (assess, plan, implement, evaluate).

NGN items based on the NCCJMM measure the test taker's ability to:

• recognize cues.
• analyze cues.
• prioritize hypotheses.
• generate solutions.
• take action.
• evaluate outcomes.

What is different about the NGN?

The revised exam retains much of the traditional format, but significant changes exist. In addition to testing for clinical judgment, changes include:

• partial credit scoring ( 1 ) .  Partial credit scoring is good news for test-takers. The NGN gives partial credit for some select-all-that-apply (SATA) items.
• a shift towards case studies. Case studies are less didactic and more applicable to real-life situations. Throughout the NGN case study exam portion, clinical judgment is assessed.
• inclusion of bowtie-type questions. Bowties cover all six aspects of the NCJMM. Read more on bowtie NCLEX questions .

What type of test questions should I expect?

According to the NCSBN ( 1 ) , the new question types include:

• extended multiple responses (SATA, Select N, multiple group response).
• drag and drop.
• cloze or drop-down (choose a word or phrase from a drop-down list to complete a blank).
• highlight (read a section and highlight specific findings). 
• matrix/Grid (multiple responses).
• Bowtie items. When written out on the screen, it resembles a bowtie. The bowtie layout shows antecedents on the left side, with outcomes on the right side. Test takers match the antecedents with outcomes.

Is the NGN harder?

The NGN will not necessarily be more challenging for all candidates. There is a decided emphasis on critical thinking, which is new. 

Whether it's harder depends on the test taker's ability to think critically. When faced with a large amount of information, can the test-taker recognize what is essential?

Why do I get different test questions than my classmates?

NCSBN uses computer-adaptive testing (CAT). CAT is not new. CAT algorithms adapt questions to past answers and estimate ability by analyzing previous responses. 

Exams are unique. Candidates receive a slightly more challenging or less challenging question based on their last answer. 

• Incorrect answers lead to easier questions.
• Correct answers lead to harder questions.

How many questions are on the NGN?

According to the NCSBN (1)

• the minimum number of questions is 85 (includes 15 non-scored questions).
• the maximum number of questions is 150 (includes 15 non-scored questions)
• non-scored questions are dispersed throughout the test.
• non-scored questions are not labeled as such.
• the total test time is 5 hours.
• the test keeps giving questions until there's a 95 percent certainty of passing.
• the test shuts off if you have answered the maximum number of questions or run out of time.
• if you run out of time, you can still pass if your total responses are above the passing standard and you've answered the minimum number of questions.

How can I prepare for the NGN?

Practicing questions similar to NGN questions is the best approach. 

There are many review sources available. When purchasing a test review product, use a reputable company that specializes in NCLEX review. 

When studying, take the time to understand the material thoroughly. Effective NGN preparation involves more than memorizing information because what matters most is how the knowledge is applied.

• Practice as many NGN-type questions as possible. Practice is active, as compared to reading, which is passive.
• Choose questions that provide rationales and performance tracking.
• Use quizzes.
• Use self-assessment tests.

During the test:

• review all choices before selecting an answer.
• reread the stem if necessary. Don't rush. The time limit is five hours.

What are the NGN case studies like?

According to NCSBN, every candidate receives a minimum of three case studies, each with six questions, for a total of 18 questions from case studies ( 1 ) .

Test-takers receive an unfolding clinical scenario. The six questions associated with each scenario are sequential. Each question builds on the previous question ( 4 ) .

The case study information is always available during the questions, so there is no need to memorize the initial case study information.

The bolded bulleted words are six steps from NCSBN's NCJMM ( 4 ) .

• Recognize cues in the scenario. Cues are signs and trends that a problem exists. Cues include abnormal vital signs, assessment findings, chief complaints, patient history, lab values out of range, and more.
• Analyze the cues . Think- what is the most pertinent clinical information? What data stands out? Ignore information that is not relevant. As an example, let's say the most prevalent and significant cues are cardiac in nature.
• Prioritize hypotheses . What condition or explanation is most likely? The patient may have multiple problems, but which problem represents the highest risk? You may determine the patient is at the highest risk for myocardial infarction.
• Generate solutions . What outcomes are needed, and how can you achieve them? There will be multiple potential interventions. Some may be strictly nursing interventions; others may require an order.
• Take action . Address and prioritize your actions. From the options, you may choose to start an IV, monitor the heart rhythm, obtain an EKG, and administer morphine.  
• Evaluate the outcomes . As an example, evaluate if giving morphine helped with the chest pain.

Good luck to the next generation of nursing students. Go in with confidence and positivity and visualize yourself writing RN after your name!

1. Betts, J., Muntean, W., Doyoung, K. Shu-Chuan Kao, S. Next Generation NCLEX®: Test Design in Next Generation. From NCLEX News. Winter 2022 edition. https://www.NCSBN.org/public-files/NGN_Winter22_English_Final.pdf Retrieved January 15, 2023. 

2. How different is NGN NCLEX? Educator Blog. December 1, 2022. https://atitesting.com/educator/blog/knowledge/2022/12/01/different-from-current-NCLEX Retrieved January 15, 2023. 

3. NGN Case Study. From Next Generation NCLEX News. Summer 2020. https://NCSBN.org/public-files/NGN_Spring20_Eng_02.pdf Retrieved January 15, 2023. 

4. Nurse FAQs for Educators. https://www.NCSBN.org/exams/next-generation-NCLEX/NGN+FAQS/ngn-faqs-for-educators.page Retrieved January 15, 2023.

About Nurse Beth, MSN

Hi! Nice to meet you! I especially love helping new nurses. I am currently a nurse writer with a background in Staff Development, Telemetry and ICU.

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I am using Archer/Klimek and various other sources to prepare for the NCLEX. My scores on NextGen questions are ALWAYS 30% higher than my peers compared to the classic questions. Basically, all of the information seems to be there just waiting for you to evaluate it - which is, of course - the point. People need to relax about NextGen - they are actually pretty entertaining! It's like being presented with a puzzle and trying to figure out how to pull at the pieces together. (And I don't even LIKE puzzles.. ? )

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Next Generation NCLEX

The NCLEX exam, short for National Council Licensure Examination , is the licensing exam that nurse graduates must pass in order to legally practice nursing in the United States, Canada, and Australia.

Practical (or vocational) nurse graduates must pass the NCLEX-PN exam, and registered nurse graduates must pass the NCLEX-RN exam.

If you’re a nursing student who expects to graduate in the spring of 2023 or later, there are huge changes taking place with the NCLEX exam that you’ll want to know about.

Next Generation NCLEX (NGN)

The National Council of State Boards of Nursing (NCSBN) plans to release a new format of NCLEX called the Next Generation NCLEX , or NGN for short.

When Will The Next Generation NCLEX Go Into Effect?

The NCSBN plans to release the new Next Generation NCLEX format on April 1, 2023. So, unless the release date changes, those of you graduating in spring 2023 or later will likely get the new format.

What is the Next Generation NCLEX? What’s Changing?

All exam details are subject to change before the actual release date. However, one of the big changes that you’ll find on the Next Generation NCLEX is a shift toward case studies (also called scenarios) to help assess the critical thinking ability of test takers.

What’s a case study? It’s a created scenario that could happen in the real world of nursing that assesses the test taker’s ability to handle a particular nursing situation. The test taker is given information about a patient, their diagnosis, current assessment findings, medications, lab results, and a presenting problem.

Based on this information, the testing candidate will be asked several questions on how the nurse would response or deal with the situation. This type of question requires much more critical thinking and nursing knowledge, and it assess whether the person will be able to deliver good, quality patient care.

There will be approximately three case studies with 6 questions each, for a total of 18 items [3], in addition to other types of questions.

There will also be five new item types on the Next Generation NCLEX, including the following:

Extended Multiple Response – Although multiple response items such as SATA questions are on the current NCLEX, “Extended Multiple Response” will expand on the number of options for each question.

Extended Drag and Drop – These question types require you to drag a response into one of the blank answer spaces, and test takers will now have to determine whether they should use some or all of the options available.

Cloze (Drop-Down) – these are the drop-down options that allow you to select a correct response, and there can now be multiple drop-down boxes in a Cloze question type.

Enhanced Hot Spot – this enhanced item type allows you to select (or highlight) the relevant words or phrases from a sample medical record that correspond to the question.

Matrix / Grid – this item type features rows and columns with options that the candidate must select.

Next Generation NCLEX Scoring Changes

If any of that NCLEX news makes you nervous, I have some good news: the Next Generation NCLEX is also changing their scoring model to a polytomous scoring model, which means that you can now get partial credit on some questions with multiple inputs. This is different from the regular NCLEX model, which marked questions as “full credit” or “no credit” only.

And yes, this does include those dreaded “select all that apply” (SATA) questions!

The Next Generation NCLEX will use three different scoring models, depending on the question type [2]:

0/1 scoring means you earn a point for each correct option selected, and zero points when you select an incorrect option. The points are then added together for a total question score. This scoring type is used on questions such as multiple choice, matrix multiple choice, multiple response where you select a specified number of answers (select N), drop-down cloze, drop-down table, and bowtie questions.

+/- scoring means that you can earn a point when you select a correct option, but lose a point when you select an incorrect option. This method is used with select all that apply multiple response questions, matrix multiple response, and MR grouping questions.

Rationale scoring means that you only earn points when you select a response that reflects a proper understanding of the rationale of the question. In this format, you will select the paired options that logically follow (Example: A leads to B). Both options must be selected correctly to earn a point.

How Many Questions are on the Next Generation NCLEX?

Each candidate will receive a minimum of 85 and a maximum of 150 questions on the exam. However, 15 of those questions are pretest questions that are not scored, so test takers can expect between 70-135 questions that are actually scored on the Next Generation NCLEX exam [3].

The exact number of questions a test taker will receive varies because the NCLEX uses Computerized Adaptive Testing (CAT), which continues to provide questions of different difficulty levels based on the test taker’s previous responses.

The test taker will continue to receive questions until the computer can determine with 95% confidence that the individual either passed or failed the exam. The exam will also stop once time is up or the person reaches the maximum number of questions (135).

How Long Do I Have to Complete the Next Generation NCLEX Exam?

You will have 5 hours to complete the Next Generation NCLEX exam.

Can You Use a Calculator on NCLEX?

NCLEX currently allows you to use a provided calculator on the test screen, and this will likely continue for the Next Generation NCLEX.

Don’t Be Intimidated by the Next Generation NCLEX (NGN)

I know that some of you are stressed out about this new NCLEX format, but I don’t think you should worry about it at all.

Unlike the meme below, the NCSBN is not some evil organization with an agenda to torture nursing students with the fear of forever failing NCLEX. Instead, these individuals are professionals who want to ensure that you’re equipped with the proper knowledge so that you can offer great care and succeed in practice.

They have a very strict process whereby nursing instructors actually develop questions. Then those questions are peer-reviewed by actual nurses in practice, and they even pretest questions and gather statistics to ensure that the exam is accurate and ready to administer.

So this isn’t something slapped together on a whim by people who know nothing about the nursing profession. It is a long, reviewed process that is continually improved based on feedback and statistics.

How Should Nursing Students Prepare for the Next Generation NCLEX (NGN)?

So how should you prepare for the Next Generation NCLEX right now as a nursing student? First, so many people are asking, “What’s changing with NCLEX?” It’s great to know what’s coming and how the questions will be formatted, and I do think practicing some questions in similar NCLEX format can be helpful.

(For the record, the NCSBN even offers a mock NCLEX exam with actual questions from previous exams that you can take at NCLEX.com for a fee if you want to practice before the actual test.)

However, I wouldn’t spend too much time stressing about the new NCLEX format changes.

If you really want to succeed on NCLEX, you need to ask this question, ”What is NOT going to change about NCLEX?” And what’s not changing is the fact that they are trying to ensure that you know enough about nursing to think critically and make the right clinical decisions so that you can provide safe and effective patient care.

So your study strategy needs to have that focus from day one. How do you do that? I would still offer the same advice that I offered in my recent NCLEX Study Plan video.

1. Start studying as early as possible . I started studying hard during the break before my last semester.

2. Prioritize your weak areas . I talked about how you can assess your strengths and weaknesses through software and so forth.

3. Practice many NCLEX-style questions . I would practice 90-100 questions almost every day.

4. Go back and review questions and topics you keep missing . Look at the pathophysiology of diseases on questions you missed. Look up medications and their mechanism of action, and so forth. Go back and study those important details.

5. Switch between review lectures , textbooks, and notes when you are not practicing questions to help you understand the content in different ways. Your brain will appreciate the switch to different studying formats. In other words, when you are tired of reading, watch a lecture that covers similar topics.

In my review lectures , I always try to help you to understand not just the way something is done, but the “why” something is done. I spend time trying to explain the patho and rationale behind things so that you’ll understand it more deeply and be able to think critically on exams and in real-life nursing practice.

That’s the key to really passing NCLEX. They want you to know enough about nursing to think critically and make the right clinical decisions.

And if you put in the time to understanding those things, it doesn’t matter whether you get a drag and drop, hot spot question, select all that apply, or whatever. You’ll have the knowledge in your head, and you will be able to sift through and choose the correct option(s).

Final Thoughts on Next Generation NCLEX

In conclusion, don’t waste time worrying about the changes coming in Next Generation NCLEX . Instead, stay the course and put in the time studying and practicing questions, and you’re going to do great!

Even if you do fail your first time around, you have the opportunity to take it again, so go into the exam with confidence!

References:

1. https://www.ncsbn.org/11436.htm

2. https://www.ncsbn.org/15991.htm

3. https://www.ncsbn.org/16013.htm

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Bootcamp's questions are exactly like real NCLEX. I was surprised to see the similarity in the topics and the wording of the questions between Bootcamp and the real thing. I also really liked how user-friendly it is to navigate, it makes it very easy to start studying. The video breakdowns for questions are also top notch!

NGN case studies with video rationales

I passed my NCLEX Next Gen on my first attempt using only NCLEX Bootcamp. I stumbled upon them via a YouTube ad and felt a sense of confidence in their format and content through that alone. Even better, their pricing was so manageable for me. Which was something I did not come across often while searching for reviews to purchase. The case studies with video explanations were amazing and the study schedule helped keep me on track. I’m so happy I chose Bootcamp!

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I just found out I recently passed my NCLEX using NCLEX Bootcamp. It was one of the best programs I have used because of its similarity to the NCLEX itself and how in depth the explanations were! I am grateful for this program and I’m proud to say I am officially an RN.

I recommend everyone to try NCLEX Bootcamp!

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NCLEX Bootcamp provides the best preparation I could have used! It offers the best guidance using the targets, the question tagging system provides a great framework to progress and work from and the question bank provides excellent preparation as it is so similar to the ‘real deal’.  When sitting the NCLEX I actually felt like it was another Bootcamp test! I passed the exam at 85 questions and walked out feeling extremely confident that I had passed, all thanks to Bootcamp. I am committed to sharing that this program alone is enough.

As an RN of 35 years in Australia it provided a wonderful opportunity to refresh my knowledge base, learn new information and experience the expectation and knowledge requirements of a US RN! I can’t thank the program creators enough! NCLEX Bootcamp is the BEST!

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Bootcamp was the only resource I used for the NCLEX and I passed on my first try! It was extremely helpful for the Next Gen questions and was formatted very similarly to what I saw on the actual exam. Bootcamp’s questions really solidified my ability to prioritize and identify safety concerns. I’m very thankful because I was able to pass without spending a fortune on resources. Thanks Bootcamp!

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I took my first attempt in July 2023 and I failed. I was so devastated and wasn’t sure what I did wrong. A friend of mine recommended NCLEX Bootcamp to me and I loved it the moment I joined. The case studies really helped me a lot, it helped me break down each questions and what they were looking for. The video rationales and the key important facts at the end of each questions really help you focus on what’s important and what you need to know and remember for each content. I buckled down for a good month and I passed my NCLEX on the second attempt thanks to NCLEX Bootcamp. I loved it better than any other source out there! Highly recommend 10/10!

NCLEX Bootcamp literally saved my life. I would review content and then use the Bootcamp’s test bank to test my knowledge in that specific area. Their Next Gen questions were so similar to the actual NCLEX, I felt so at ease when I took my exam. I don’t think I would’ve passed if it wasn’t for  Bootcamp. I can’t say thank you enough. I am now officially a registered nurse.

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I’m a four-time NCLEX taker. I graduated in 2020 and struggled to pass my test along with struggles from personal and health reasons. I had tried Archer, Kaplan, and UWorld (three times) and couldn't pass the test. My fourth attempt was in December 2023 and I passed using only NCLEX Bootcamp as a resource. And I would say that it was enough for me to pass the test with just that alone. The rationales and the videos that thoroughly goes with you through every question and each choices helped me understand content more clearly whether you get the answer right or wrong. PLUS the added prep for the Next Gen NCLEX is big with Bootcamp! I most highly recommend NCLEX Bootcamp! Good luck Future RNs!

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Bootcamp helped me understand the material that I was my weaker in and gave me the ability to review all areas of content prevalent in the NCLEX. I felt confident going into my exam with the help of each practice question. The questions I got wrong provided an amazing explanation that broke down the question and key points of the topic. I also appreciated the option to create personalized tests made up of questions that I felt the need to focus on.

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At first, I was terrified to take the NGN. But with the help of this program, I was given familiarity with the approach. Bootcamp is definitely a well-structured resource and a great assessor as it suggests the topics you should focus on under the Subject Breakdown. I also love the NCLEX Question of the Day! For someone like me who is working and could not consistently have the time to sit for long hours and answer, at least you can try one question – might only be 1 but the rationales are very informative! The case studies were amazing and surely my most favorite! I have practiced all of them and gained critical knowledge in making step-by-step decisions on how to handle a patient holistically as a safe nurse. The videos were full of techniques which I applied during my actual exam!

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Bootcamp helped me out so much on my NCLEX. I passed on the first try with 85 questions. I printed the study calendar and did that for 30 days. To me, the NCLEX felt like I was working the Bootcamp case studies. I felt very confident in the all my case studies which was 7 of them with 5 bowties. Because, of Bootcamp, I was able to pass on the first attempt. Thank you Bootcamp family.

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NCLEX Bootcamp's questions are similar to NCLEX. I passed with 100 questions only using Bootcamp. When sitting for the NCLEX, I felt like it was just another Bootcamp practice test.

Bootcamp was an amazing resource! I really enjoyed the format of the case studies to critically think through the patient’s chart. I felt like it really helped prepare me for the NCLEX.

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Preparing for the NCLEX® can feel overwhelming - I know, I've been there.

Stop me if this sounds familiar...

• You feel overwhelmed by how much you have to learn in such a short amount of time, it's like drinking water from a firehose…
• You don't have the time to learn all of it, and can't decide what's important to study and what's not...
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NCLEX Bootcamp is an online resource that will fully prepare you for the NCLEX-RN®. We have 1,900+ high-yield questions based on the real NCLEX®, 250+ Next Gen case study questions with video explanations, Readiness Exams that predict your chances of passing, a Next Gen NCLEX® Strategy Course , Bootcamp AI to instantly clarify any concept, a 4.9+ star-rated mobile app, and an NCLEX® Pass Guarantee.

The Next Gen NCLEX® is an updated test , and you need to prepare with an updated question bank . NCLEX Bootcamp is the only nursing resource created specifically for the Next Gen NCLEX®.

The Next Gen change means that the test now requires clinical judgment , and you can’t develop clinical judgment just by reading explanations alone. Instead, our video case walkthroughs and our Next Gen strategy course teach you how to think like a nurse and how to prioritize , which are the most important skills you need for NCLEX® success. Our question bank gives you plenty of opportunity to practice those skills .

NCLEX Bootcamp is made by a small team of passionate nurse educators who are committed to creating the best NCLEX ® prep tool – period . We come from all different clinical specialties and teaching backgrounds, but we are all masters - or doctorally-prepared nurses who share a common desire to help teach clinical judgment to future nurses (like you!).

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Our question bank is designed to help students prepare for the NCLEX-RN® exam. However, the NCLEX-PN ® exam will test highly similar content with only minor differences. To see a recent example of how one of our students passed the NCLEX-PN® exam after studying with NCLEX Bootcamp, check out Charmadora's post in our Facebook group: https://www.facebook.com/groups/nclexbootcampstudentgroup/posts/2442554832599502/

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NCLEX Practice Questions Test Bank for Free

Welcome to our collection of free NCLEX practice questions to help you achieve success on your NCLEX- RN exam! This updated guide for 2024 includes 1,000+ practice questions, a primer on the NCLEX-RN exam, frequently asked questions about the NCLEX, question types, the NCLEX-RN test plan, and test-taking tips and strategies.

Table of Contents

Nclex-rn practice questions test bank, what is nclex.

• What is Next Generation NCLEX (NGN)? 

Safe and Effective Care Environment

• Health Promotion and Maintenance 
• Psychosocial Integrity 

Physiological Integrity

Clinical judgment, integrated processes, item writers for nclex, computer adaptive test (cat), 95% confidence interval rule, maximum-length exam, run-out-of-time (r.o.o.t.) rule, zero/one (0/1) scoring, plus/minus (+/-) scoring, rationale scoring, pretest items, testing time, unfolding case study, stand-alone items, multiple response select all that apply.

• Multiple Response Select N 

Multiple Response Grouping

• Highlight in Text 

Highlight in Table

Matrix multiple response, matrix multiple choice.

• Drag and Drop Cloze 

Drag and Drop Rationale

Drop down cloze, drop down rationale, drop down in table, chart or exhibit questions, graphic option, select all that apply or multiple-response, fill-in-the-blank, ordered-response, how to register for the nclex, nclex-rn resources, want more practice questions, recommended resources.

Looking for the complete collection of practice questions? For more NCLEX practice questions, please visit our Nursing Test Bank here .

We have included more than 1,000+ NCLEX practice questions covering different nursing topics for this nursing test bank ! We’ve made a significant effort to provide you with the most challenging questions along with insightful rationales for each question to reinforce learning .

We recommend you do all practice questions before you take the actual exam. Doing so will help reduce your test anxiety and help identify nursing topics you need to review. To make the most of the practice exams, try to minimize mistakes to less than 15 questions and take your time answering the questions, especially when reading the rationales.

Quiz Guidelines

Before you start, here are some examination guidelines and reminders you must read:

• Practice Exams : Engage with our Practice Exams to hone your skills in a supportive, low-pressure environment. These exams provide immediate feedback and explanations, helping you grasp core concepts, identify improvement areas, and build confidence in your knowledge and abilities.
• You’re given 2 minutes per item.
• For Challenge Exams, click on the “Start Quiz” button to start the quiz.
• Complete the quiz : Ensure that you answer the entire quiz. Only after you’ve answered every item will the score and rationales be shown.
• Learn from the rationales : After each quiz, click on the “View Questions” button to understand the explanation for each answer.
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Included NCLEX-RN question sets for this nursing test bank are as follows. Please click on the links below and you’ll be redirected to the quiz page:

NEW UPDATE: Introducing Challenge Exams and Practice Exams

Engage with these new modes to enhance your learning journey, each tailored to meet different needs and propel you towards academic achievement.

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Test your mastery with these Challenge Exams :

Build your confidence and grasp core concepts with these Practice Exams :

The National Council Licensing Examination (NCLEX) is a comprehensive test administered by the National Council of State Boards of Nursing (NCSBN). It assesses whether candidates possess the necessary knowledge and skills to provide safe and effective nursing care at the entry level. The NCLEX is available in two versions: the NCLEX-RN for registered nurses and the NCLEX-PN for practical/vocational nurses.

The NCSBN, composed of nursing regulatory bodies from all 50 states in the US, the District of Columbia, and four US territories, is responsible for safeguarding the public by ensuring safe nursing care. It sets the standards and guidelines for nursing licensure and develops the NCLEX examinations.

Becoming a registered nurse (RN) requires meeting specific licensure requirements determined by the licensing authorities in each jurisdiction governed by the NCSBN. One of these requirements is passing the NCLEX-RN, which evaluates the competencies necessary for practicing safely and effectively as an entry-level RN. The NCLEX-RN is used by member boards of nursing and many Canadian nursing regulatory bodies to inform their licensure decisions.

What is Next Generation NCLEX (NGN)?

The Next Generation NCLEX (NGN) is currently in effect this April 2023 for RN and LPN /LVN candidates. The change in the NCLEX is driven by the need to adapt to the increasing complexity of client care, advancements in healthcare practice, and the demand for safe clinical decision-making. The NGN aims to address the declining ability of new nursing graduates to make safe clinical decisions by integrating clinical judgment as a key competency. The NGN test format will remain adaptive but with fewer test items. Candidates will encounter Unfolding Case Studies and Stand-Alone Items , scored using partial credit with three different scoring rules. These changes in the NGN aim to assess critical thinking and the ability to make safe clinical judgments during various phases of client care.

In summary, the following are the key changes between the previous NCLEX format and the Next Generation NCLEX (NGN): 

• Same adaptive test format but reduced number of items. The Next Generation NCLEX (NGN) will retain the adaptive test format, similar to the current NCLEX, but with fewer test items. Candidates will answer between 85 and 150 items, with 15 as pretest or unscored items. 
• Case studies. All candidates will encounter three (3) Unfolding Case Studies, each consisting of six test items (a total of 18 items). Clinical situation information will be presented to candidates in a medical record format resembling a table-like structure. These situations are designed to assess their ability to think critically and make safe clinical decisions across different phases of client care. In addition to the case studies, some candidates may have Stand-Alone Items for their NGN exam.
• New NGN item types. The NGN exam will feature new item types, which include questions in unfolding cases and stand-alone items, highlight, cloze, matrix, bow-tie, drag and drop, and extended multiple responses. 
• Scoring differences. NGN test items will be scored differently compared to the current NCLEX. They will utilize partial credit scoring with three different scoring rules: the 0/1 scoring rule, the +/- scoring rule, and the rationale scoring rule. These are explained further below. 

NCLEX-RN Test Plan

The NCLEX test plan is a content guideline to determine the distribution of test questions. NCSBN uses the “Client Needs” categories to ensure the NCLEX covers a full spectrum of nursing activities. It is a summary of the content and scope of the NCLEX to serve as a guide for candidates preparing for the exam and to direct item writers in the development of items.  Additionally, to assess the knowledge, skills, abilities, and clinical judgment necessary for entry-level nursing practice, the NCLEX-RN Test Plan utilizes Bloom’s taxonomy for the cognitive domain. This taxonomy provides a foundation for writing and coding examination items, focusing on application-level or higher-level cognitive abilities that require advanced thought processing.

The content of the NCLEX-RN is organized into four major Client Needs categories: Safe and Effective Care Environment, Health Promotion and Maintenance, Psychosocial Integrity, and Physiological Integrity. Some of these categories are divided further into subcategories. Below is the NCLEX-RN test plan effective as of April 2023 until March 2026: 

There are two subcategories under Safe and Effective Care Environment.

• Management of Care category includes content that tests the nurse’s knowledge and ability to direct nursing care that enhances the care delivery setting to protect clients, significant others, and healthcare personnel. 
• Safety and Infection Control category includes content that tests the nurse’s ability required to protect clients, families, and healthcare personnel from health and environmental hazards. 

Health Promotion and Maintenance

Health Promotion and Maintenance category includes content that tests the nurse’s ability to provide and direct nursing care to the client that incorporates knowledge of expected growth and development, preventing and early detection of health problems, and strategies to achieve optimal health. 

Psychosocial Integrity

The Psychosocial Integrity category is content related to the promotion and support for the emotional, mental, and social well-being of the client experiencing stressful events and clients with acute or chronic mental illness . 

In the Physiological Integrity category are items that test the nurse’s ability to promote physical health and wellness by providing care and comfort, reducing risk potential, and managing health alterations. There are four subcategories under Physiological Integrity. 

• Basic Care and Comfort are content to test the nurse’s ability to provide comfort and assistance to the client in performing activities of daily living . 
• Pharmacological and Parenteral Therapies category includes content to test the nurse’s ability to administer medications and parenteral therapies (IV therapy, blood administration, and blood products). 
• Reduction of Risk Potential category includes content to test the nurse’s ability to prevent complications or health problems related to the client’s condition or prescribed treatments or procedures. 
• Physiological Adaptation category includes questions that test the nurse’s ability to provide care to clients with acute, chronic, or life-threatening conditions. 

Clinical judgment is a central component of the NCLEX-RN Test Plan, reflecting the evolving demands and complexity of nursing practice. Nurses must engage in an iterative, multi-step process that utilizes nursing knowledge to observe and assess situations, identify client concerns, and generate evidence-based solutions to ensure safe client care. Clinical judgment questions are represented through Unfolding Case Studies or individual Stand-Alone Items , with case studies addressing each step of clinical judgment. The following are the six clinical judgment cognitive skills: 

• Recognize cues “What matters most?” Identifying relevant and important information from various sources, such as medical history, laboratory studies, and vital signs.
• Analyze cues “What could it mean?” Organizing and connecting recognized cues to the client’s clinical presentation.
• Prioritize hypotheses “Where do I start?”   Evaluating and prioritizing hypotheses based on urgency, likelihood, risk, difficulty, time constraints, and other factors.
• Generate solutions “What can I do?” Identifying expected outcomes and using hypotheses to define a set of interventions aligned with the expected outcomes.
• Take action “What will I do?” Implementing the highest-priority solution(s) identified.
• Evaluate outcomes “Did it help?” Comparing observed outcomes to expected outcomes to assess the effectiveness of interventions.

Additionally, In contrast to the nursing process or ADPIE , the NCSBN focuses on AAPIE ( assessment , analysis, planning, intervention, evaluation), wherein nursing diagnosis is not tested at the current NGN because it is not considered a universal language used in health care or the nursing profession. In nursing practice and for the NGN, students must use their pathophysiology knowledge to analyze client assessments and connect them with common conditions in healthcare settings. 

Integral to nursing practice, several processes are integrated throughout the Client Needs categories and subcategories:

• Caring. In an atmosphere of mutual respect and trust, nurses interact with clients, providing encouragement, hope, support, and compassion to help achieve desired outcomes .
• Clinical Judgment . An observed outcome of critical thinking and decision-making, clinical judgment (discussed above) is a dynamic and iterative process. It involves using nursing knowledge to observe and assess situations, prioritize client concerns, generate evidence-based solutions, and deliver safe client care.
• Communication and Documentation. Verbal and nonverbal interactions between nurses, clients, significant others, and the healthcare team. Accurate and comprehensive documentation ensures adherence to practice standards and accountability in care provision.
• Culture and Spirituality. Recognizing and considering the unique preferences, standards of care, and legal considerations of clients (individuals, families, groups, and populations) in the context of their culture and spirituality.
• Nursing Process. A systematic approach to client care encompassing assessment, analysis, planning, implementation, and evaluation.
• Teaching/Learning. Facilitating acquiring knowledge, skills, and abilities that promote behavioral change.

Who writes questions for the NCLEX? The NCSBN sets the criteria and selection process for item writers who are registered nurses. Many of them are nursing educators with an advanced degrees in nursing, so if you’ve completed an accredited nursing program, you have already taken several tests written by nurses with backgrounds similar to those who write for the NCLEX.

The NCLEX-RN is a crucial step for registered nurse (RN) candidates seeking licensure. Administered through computerized adaptive testing ( CAT ), this examination utilizes computer technology and measurement theory to create a personalized and accurate assessment of each candidate’s knowledge and skills. 

The CAT system employed in the NCLEX-RN ensures that each candidate receives a unique examination tailored to their abilities. As the test progresses, the computer selects items from a large item pool based on the candidate’s previous answers. These items are classified according to the test plan categories, difficulty levels, and clinical judgment steps. The CAT system continually recalculates the candidate’s ability estimate and selects subsequent items accordingly, creating an exam that aligns with the NCLEX-RN Test Plan requirements. This dynamic approach allows candidates to demonstrate their competence effectively.

Additionally, unlike traditional fixed-length exams, which assign the same items to all candidates, CAT selects items based on the candidate’s ability, resulting in a more accurate assessment. The CAT scoring algorithm estimates the candidate’s ability by considering all previous answers and the difficulty level of those items. By administering items that challenge the candidate appropriately, the exam gathers maximum information about their ability.

Pass or Fail Decisions: How to Pass the NCLEX?

Passing the NCLEX-RN requires you, the candidate, to meet a specific passing standard established by the NCSBN Board of Directors (BOD). The passing standard represents the minimum ability level necessary for safe and effective entry-level nursing practice. The BOD reevaluates this standard every three years, considering various factors such as a standard-setting exercise conducted by experts and psychometricians, historical data on candidate performance, and information on the educational readiness of aspiring nurses. Once the passing standard is set, it is uniformly applied to all candidates during the scoring process. The NCSBN indicates that these three rules govern pass-or-fail decisions: the 95% Confidence Interval Rule , Maximum-Length Exam Rule , and Run-Out-Of-Time Rule .

In this scenario, the computer stops administering test questions when it is 95% certain that your ability is clearly above the passing standard or clearly below the passing standard. 

When your ability is close to the passing standard, the CAT gives you items until the maximum number of items is reached. At this point, the computer disregards the 95% confidence rule and decides whether you pass or fail by your final ability estimate. If your final ability estimate is above the passing standard, you pass; if it is below, you fail. 

In the event that a candidate runs out of time before completing the maximum number of items and the computer has not reached a 95% certainty regarding the candidate’s pass or fail status, alternative criteria come into play.

• If the candidate has not answered the minimum required number of items, the candidate will automatically fail.
• If the candidate has answered at least the minimum required number of items, the final ability estimate will be determined based on all the responses given before the exam time expires. If the score meets or exceeds the passing standard, the candidate will pass. Otherwise, the candidate will fail.

New Scoring System in the Next Generation NCLEX

The Next Generation NCLEX (NGN) incorporates different item formats, and for items that have multiple correct answers, partial credit scoring is implemented . Unlike the previous exam format, where items are scored as either all correct or all incorrect, the NGN will use polytomous scoring models to evaluate partial understanding. For example, in the previous version of NCLEX (multiple response) SATA (select-all-that-apply) items, only endorsing all the correct options results in a correct score. However, the new approach will acknowledge partial understanding, allowing differentiation between candidates with different numbers of correct options. This change will provide a more accurate assessment of candidates’ knowledge, skills, and abilities.

Three methods are used to assign partial credit for these items: plus/minus scoring, zero/one scoring, and rationale scoring. Understanding the scoring models is crucial for NCLEX-RN takers to know how their answers are evaluated and how scores are determined.

The 0/1 scoring rule is used for multiple-choice items. Choosing the correct option earns one point while selecting an incorrect option gives a score of zero. This rule applies to single response items, including the example multiple-choice item.

The +/– scoring rule measures a candidate’s ability to identify relevant information. It assigns points for correct options and deducts points for incorrect options. It is used for multi-point items, and the total score is calculated by adding correct options and subtracting incorrect ones. The lowest possible score is zero. This rule is applied to NGN question types such as multiple-response and select all that apply.

The rationale scoring rule is used for questions that assess paired information. To earn a score of one point, both answer options must be correct. If either option is incorrect, the score is 0.

How Many Questions Are on the NCLEX?

All RN candidates must answer a minimum of 85 items , while a maximum of 150 items be administered during the five-hour time allotment. Each NCLEX-RN exam includes 15 pretest items (unscored), which are indistinguishable from operational (scored) items.

To ensure the effectiveness of computerized adaptive testing (CAT) in the NCLEX, the difficulty level of each item needs to be determined beforehand. This is achieved by administering these items as pretest items to a large group of NCLEX candidates. Since the difficulty of pretest items is initially unknown, they are not part of your score and are not considered when evaluating a candidate’s ability or determining pass-fail outcomes. Once a sufficient number of responses are collected, the pretest items undergo statistical analysis and calibration. If they meet the required NCLEX statistical standards, they can be used as operational items in future exams. Therefore, candidates must approach every item with their best effort, regardless of whether it is a pretest or an operational item.

The length of the NCLEX-RN examination varies for each candidate based on their responses, but there is a five-hour time limit for the exam, including all breaks. To ensure completion within the allotted time, candidates must maintain a reasonable pace, spending approximately one to two minutes per item . It’s important to note that the length of the examination does not determine pass or fail outcomes; candidates can succeed or fail regardless of the examination’s duration.

Case Studies in NGN

The Next Generation NCLEX (NGN) has introduced case studies that present practical clinical scenarios and include test items aligned with six cognitive abilities of the clinical judgment model. The scenario can occur in various settings, and the client’s outcome can vary, including improvement, stability, or decline with complications. Laboratory results, if included, are presented in a table, and abnormal values are highlighted with an “L” or “H”. There are two types of case studies: Unfolding Case Study with six test items assessing specific skills and Stand-Alone Items with a single test item independent of a case study.

An Unfolding Case Study presents a realistic client situation with evolving data resembling a medical record. It includes multiple phases over time, reflecting changes in the client’s condition. The case study evaluates all six cognitive skills of the clinical judgment model through six questions. Each test-taker receives three (3) unfolding case studies, totaling 18 items across those cases. 

Stand-Alone Items are case studies with a single question, with the item presented as a bow-tie or a trend question type. Candidates who take more than the minimum number of items on the NCLEX receive around six to seven stand-alone cases. 

Question Types in the NCLEX-RN

The different question types for the NCLEX-RN include the following: 

Extended Multiple Response

In Extended Multiple Response item types, test-takers can choose one or more options in Multiple Response Select All That Apply, select a specific number of items in Multiple Response Select N, or choose options from different groupings presented in a table in Multiple Response Grouping, with scoring rules based on the selected type. Extended multiple response may include the following formats:

The Multiple Response Select All That Apply item type allows test-takers to choose one or more answer options. It uses the +/- Scoring Rule, where selecting correct information earns points (+1), and selecting incorrect information results in points deducted (-1). The maximum points achievable are equal to the number of correct options, and the minimum score is 0, with no negative scores. The item must have a minimum of five options and can have up to ten options, with the possibility of all ten options being correct.

Multiple Response Select N

The Multiple Response Select N item type informs the test-taker about the specific number of items (N) that can be selected. The question provides a range of options, with a minimum of five and a maximum of ten options. It uses the 0/1 Scoring Rule, where each correct response earns 1 point, while any incorrect response results in 0 points.

The Multiple Response Grouping utilizes a table to present options, with a minimum of two and a maximum of five groupings. Each grouping consists of a minimum of two and a maximum of four options, ensuring an equal number of options within each grouping. Test-takers are required to select at least one option from each grouping. The item follows the +/- Scoring Rule, meaning there is no negative score per grouping. The total score for the item is determined by summing the points earned within each grouping. The maximum score achievable equals the number of keys (N).

For this NGN item type, the test-taker is presented with information and must highlight specific parts of the information provided.  Highlight question type include the following formats:

Highlight in Text

It involves a paragraph of information where the test-taker must select (highlight) specific parts of the text based on the question’s requirements. The item can include a maximum of ten options for selection and uses the +/- Scoring Rule. 

The Highlight in Table item type involves a table of information. The candidate is tasked with selecting (highlighting) specific parts of the text within the table based on the question’s prompt. The item can include a maximum of ten options for selection. The table has two columns, including a header, and can have up to five rows. This item type uses the +/- Scoring Rule. 

Matrix/Grid

In the Matrix NGN item type, test-takers are presented with a grid-like structure to which they must respond. There are two variations: Matrix Multiple Response, where each column can have multiple correct responses, and Matrix Multiple Choice, where test-takers select one answer option per row. Extended multiple response may include the following formats:

The Matrix Multiple Response item type consists of response columns, where each column can have multiple correct responses. The item can have between two and ten columns and four to seven rows. In each column, at least one response option must be selected, but it is possible to select one or more responses per column. The item follows the +/- Scoring Rule, with no negative score per column. The total score for the item is determined by summing the points earned within each column. The maximum score achievable is equal to the number of keys (N).

The item includes a minimum of four rows and a maximum of ten rows. It can have either two or three options/columns. Test-takers are allowed to select one answer option per row. The item follows the 0/1 scoring rule, where the test-taker earns 1 point for each correct response and 0 points for incorrect responses. The total score for the item is obtained by summing the scores over the rows. The maximum score achievable is equal to the number of rows.

Drag and Drop

In the Drag and Drop NGN question type, test-takers are presented with options to drag and drop into specific targets. There are two variations: Drag and Drop Cloze, where options are placed in response targets to complete sentences and Drag and Drop Rationale, where options are matched to causes and effects. Drag and drop may include the following formats:

Drag and Drop Cloze

The Drag and Drop Cloze item type includes a range of four to ten options. It can have one or more response targets where the options are dragged to. The item must have a minimum of one sentence with one target per sentence and up to five sentences, each with one target per sentence. The item follows the 0/1 Scoring Rule, where a correct response earns 1 point and incorrect responses earn 0 points. The total score is obtained by summing the scores across all targets, with the maximum score achievable being the number of targets.

The Drag and Drop Rationale type involves one sentence with one cause and one effect or one sentence with one cause and two effects. The sentence can be a single dyad (one sentence with two targets) or a single triad (one sentence with three targets). Each drag & drop target can have three to five options. The item follows the Rationale Scoring Rule where both answer options must be correct to earn a point. 

The Drop Down question type in NGN includes three variations: Drop Down Cloze, Drop Down Rationale, and Drop Down in Table. Drop down may include the following formats:

The Drop Down Cloze item type presents one or two sentences of information that require completion using drop-down options. Each drop-down can contain three to five options. The item must have a minimum of one sentence with one drop-down per sentence and can include up to five sentences, each with one drop-down. The item follows the 0/1 Scoring Rule, where the score is calculated by summing the correct responses across all drop-downs. The maximum score achievable is equal to the number of drop-downs.

The Drop Down Rationale item type presents either one sentence with one cause and one effect or one sentence with one cause and two effects. Each drop-down can contain three to five options. The scoring follows the Rationale Scoring Rule, where X and Y must be correct to earn one point. The maximum points that can be earned are 1 point for a dyad (one sentence with two targets) and 2 points for a triad (one sentence with three targets).

The Drop Down in Table item type presents a table of information with drop-down options located in various parts of the table. The item must have a minimum of three columns and three rows and a maximum of five columns and four rows. One column serves as the header column. Each row contains one drop-down. The item follows the 0/1 Scoring Rule, where the score is calculated by summing the correct responses across all drop-downs. The maximum score achievable is equal to the number of drop-downs.

The Bow-tie item type is visually designed to resemble a bow-tie shape. It consists of five options on the left side, five options on the right side, and four options in the middle well of the bow-tie. The item addresses all of the cognitive skills within a single item. The Bow-tie item follows the 0/1 scoring rule. The left and right wells have two answer options each, while the middle well has one answer option, resulting in a maximum possible score of 5 points. Each correct response earns 1 point, while incorrect responses earn 0 points.

The Trend item type presents information in a medical record or flow sheet format that spans over time, requiring the test-taker to analyze information across different points in time. The item addresses multiple cognitive skills within a single item. It can utilize any NGN item type except for the bow-tie. The scoring rule for the Trend item depends on the specific item type used.

Multiple-Choice Questions

Many questions on the NCLEX are in multiple-choice format. This traditional text-based question will provide you data about the client’s situation, and you can only select one correct answer from the given four options. Multiple-choice questions may vary and include: audio clips, graphics, exhibits, or charts.

A chart or exhibit is presented along with a problem. You’ll be provided with three tabs or buttons that you need to click to obtain the information needed to answer the question. Select the correct choice among four multiple-choice answer options. 

In this format, four multiple-choice answer options are pictures rather than text. Each option is preceded by a circle that you need to click to represent your answer.

In an audio question format, you’ll be required to listen to a sound to answer the question. You’ll need to use the headset provided and click on the sound icon for it to play. You’ll be able to listen to the sound as many times as necessary. Choose the correct choice from among four multiple-choice answer options. 

For the video question format, you must view an animation or a video clip to answer the following question. Select the correct choice among four multiple-choice answer options. 

Multiple-response or select all that apply (SATA) alternate format question requires you to choose all correct answer options that relate to the information asked by the question. There are usually more than four possible answer options. No partial credit is given in scoring these items (i.e., selecting only 3 out of the 5 correct choices), so you must select all correct answers for the item to be counted as correct. 

Tips when answering Select All That Apply Questions

• You’ll know it’s a multiple-response or SATA question because you’ll explicitly be instructed to “Select all that apply.”
• Treat each answer choice as a True or False by rewording the question and proceed to answer each option by responding with a “yes” or “no”. Go down the list of answer options one by one and ask yourself if it’s a correct answer.
• Consider each choice as a possible answer separate to other choices. Never group or assume they are linked together.

The fill-in-the-blank question format is usually used for medication calculation, IV flow rate calculation, or determining the intake-output of a client. You’ll be asked to perform a calculation in this question format and type in your answer in the blank space provided. 

Tips when answering Fill-in-the-Blank

• Always follow the specific directions as noted on the screen. 
• There will be an on-screen calculator on the computer for you to use. 
• Do not put any words, units of measurements, commas, or spaces with your answer, type only the number. Only the number goes into the box.
• Rounding an answer should be done at the end of the calculation or as what the question specified, and if necessary, type in the decimal point. 

In an ordered-response question format, you’ll be asked to use the computer mouse to drag and drop your nursing actions in order or priority. Based on the information presented, determine what you’ll do first, second, third, and so forth. Directions are provided with the question. 

Tips when answering Ordered-Response questions

• Questions are usually about nursing procedures. Imagine yourself performing the procedure to help you answer these questions.
• You’ll have to place the options in correct order by clicking an option and dragging it on the box on the right. You can rearrange them before you hit submit for your final answer.

A picture or graphic will be presented along with a question. This could contain a chart, a table, or an illustration where you’ll be asked to point or click on a specific area. Figures may also appear along with a multiple-choice question. Be as precise as possible when marking the location. 

Tips when answering Hotspot questions

• Mostly used to evaluate your knowledge of anatomy, physiology, and pathophysiology.
• Locate anatomical landmarks to help you select the location needed by the item.

So you’ve finally decided to take the NCLEX, the next step is registration or application for the exam. The following are the steps on how to register for the NCLEX, including some tips:

• Application to the Nursing Regulatory Board (NRB). The initial step in the registration process is to submit your application to the state board of nursing in the state in which you intend to obtain licensure. Inquire with your board of nursing regarding the specific registration process as requirements may vary from state to state.
• Registration with Pearson VUE. Once you have received the confirmation from the board of nursing that you have met all of their state requirements, proceed, register, and pay the fee to take the NCLEX with Pearson VUE . Follow the registration instructions and complete the forms precisely and accurately.
• Authorization to Test. If you were made eligible by the licensure board, you will receive an Authorization to Test (ATT) form from Pearson VUE. You must test within the validity dates (an average of 90 days) on the ATT. There are no extensions or you’ll have to register and pay the fee again. Your ATT contains critical information like your test authorization number, validity date, and candidate identification number.
• Schedule your Exam Appointment. The next step is to schedule a testing date, time, and location at Pearson VUE. The NCLEX will take place at a testing center , you can make an exam appointment online or by telephone. You will receive a confirmation via email of your appointment with the date and time you choose including the directions to the testing center. * Changing Your Exam Appointment. You can change your appointment to test via Pearson VUE or by calling the candidate services. Rules for scheduling, rescheduling, and unscheduling are explained further here . Failing to arrive for the examination or failure to cancel your appointment to test without providing notice will forfeit your examination fee and you’ll have to register and pay again. 
• On Exam Day. Arrive at the testing center on your exam appointment date at least 30 minutes before the schedule. You must have your ATT and acceptable identification (driver’s license, passport, etc) that is valid, not expired, and contains your photo and signature.
• Processing Results. You will receive your official results from the board of nursing after six weeks.

Important list and resources you need to know if you’re taking the NCLEX: 

• 2023 NCLEX Candidate Bulletin. This resource is a comprehensive guide for the NCLEX, providing essential information and contact details for candidates. It covers registration procedures, test fees, scheduling, testing accommodations, exam rules, and what to bring to the test site. The guide also includes details on the check-in process, breaks, technical issues, and the testing environment. It explains the results reporting process and retake-policy and provides information on the content, development, and test plans of the NCLEX. Additionally, it discusses the passing standard, item formats, and decision rules for passing or failing the exam.
• Sample Questions and Exam Preview. Get a headstart on your exam preparation with these sample test packs by the NCSBN. 
• Candidate Tutorial. With the new item types, we highly recommend testing how the Next Generation NCLEX (NGN) works. This tutorial guides you on interacting with different question types in your NCLEX exam. It provides a representative sample of items you may encounter during the test, allowing you to practice their functionality.

Please visit our Nursing Test Bank page if you’re looking to answer more practice questions from different topics and different question formats.

Recommended books and resources for your NCLEX success:

Disclosure: Included below are affiliate links from Amazon at no additional cost from you. We may earn a small commission from your purchase. For more information, check out our privacy policy .

Saunders Comprehensive Review for the NCLEX-RN Saunders Comprehensive Review for the NCLEX-RN Examination is often referred to as the best nursing exam review book ever. More than 5,700 practice questions are available in the text. Detailed test-taking strategies are provided for each question, with hints for analyzing and uncovering the correct answer option.

Strategies for Student Success on the Next Generation NCLEX® (NGN) Test Items Next Generation NCLEX®-style practice questions of all types are illustrated through stand-alone case studies and unfolding case studies. NCSBN Clinical Judgment Measurement Model (NCJMM) is included throughout with case scenarios that integrate the six clinical judgment cognitive skills.

Saunders Q & A Review for the NCLEX-RN® Examination This edition contains over 6,000 practice questions with each question containing a test-taking strategy and justifications for correct and incorrect answers to enhance review. Questions are organized according to the most recent NCLEX-RN test blueprint Client Needs and Integrated Processes. Questions are written at higher cognitive levels (applying, analyzing, synthesizing, evaluating, and creating) than those on the test itself.

NCLEX-RN Prep Plus by Kaplan The NCLEX-RN Prep Plus from Kaplan employs expert critical thinking techniques and targeted sample questions. This edition identifies seven types of NGN questions and explains in detail how to approach and answer each type. In addition, it provides 10 critical thinking pathways for analyzing exam questions.

Illustrated Study Guide for the NCLEX-RN® Exam The 10th edition of the Illustrated Study Guide for the NCLEX-RN Exam, 10th Edition. This study guide gives you a robust, visual, less-intimidating way to remember key facts. 2,500 review questions are now included on the Evolve companion website. 25 additional illustrations and mnemonics make the book more appealing than ever.

NCLEX RN Examination Prep Flashcards (2023 Edition) NCLEX RN Exam Review FlashCards Study Guide with Practice Test Questions [Full-Color Cards] from Test Prep Books. These flashcards are ready for use, allowing you to begin studying immediately. Each flash card is color-coded for easy subject identification.

179 thoughts on “NCLEX Practice Questions Test Bank for Free”

How much are you charging for it?

Thanks for being generous

Thank you for your kindness & generosity. This is a big help for us, especially those with financial constraints.

How much for this

Thanks Matt Vera for your utmost effort in helping nurses to pass the exam

You’re most welcome! Good luck on your exams!

Hello Matt do you still have the Test Bank questions for 2021. If you do can I have them please and thank you.

Hi Winnie, Please visit our

Thanks heaps! Matt..

The site is very useful.

Thank you mam/sir

This is very helpful site. god bless🤗

Great website wish l knew about it before taking my nclex

Thank you so much for this free site. I found it just as helpful as Kaplan and Sanders which I paid for. I recommended this nurseslabs to some of my nurse friends preparing for the NCLEX. I used it to study and passed my NCLEX October 28. I will continue to use this as a reference. Once again Thank-You. A.Haynes RN

Hey Matt, I am impressed by your generosity. I couldn’t believe these were all free. In all fairness, there should be a tab for donations for the constant upkeep of the web. A very minimal way to show our gratitude.

Although I just started nursing school the i formation is mind blowing and very useful for me already. Thank you for your generosity. I will be using all the practice quizzes and test to prepare myself. Thank you again.

Thank you for this free nclex practice tests! May you have more blessings and success! I will take my exam next month.

Very informative and helpful

Thank you!You’re a big blessing to those who will take the exam.

I can’t thank you enough for this gift you have given us to use . God bless you.

Thank you so much Matt! This is helping me work toward my NCLEX with less pressure.

Thanks a lot can I get reading materials on PDF please

Thanks Matt Vera for ingenious effort.

You are heaven sent, Thank you Matt for helping us.

you guys all thank you so much for this massively hard work and huge success for all the nurses around the world .

Your efforts are immeasurable, you are not only helping nurses to pass their NCLEX exams but also increasing the number of qualified/competent nurses providing healthcare around the globe. We are grateful. I used this site to prepare for internal exams whilst I was in school and it really helped me. I’ll be writing NCLEX soon..

Planning to start this process, I think this will be so helpful to me. Thankyou very much

Thank you so much Nurse matt vera for this qbank,most beneficial, God bless you., if I may ask for some videos or pictures associated with the questions, will also help e.g lung sounds,abdominal sound etc thank you

I loved your blog and thanks for publishing this about NCLEX practice questions!! I am really happy to come across this exceptionally well written content. Thanks for sharing and look for more in future!! Keep doing this inspirational work and share with us.

My name is Daniel m Johnson from Tanzania I’m holding diploma in nursing and midwifery I’m looking for different nurse from different country so as we can share ideas and experience since I’m student I need to no much thing about nursing ….any one who is touched to please help me I wish to be came a good nurse and help different people from different society

What a wonderful thing to do for people! Thank you very much.

This very helpful to me, thank you.

You did a great job Matt…

This is so lovely

Very useful site. Thank you so much.

This is an amazing job Matt!! REALLY INCREDIBLE!!!

With all this I will certainly pass my NCLEX exams.

THANK YOU so so much Matt, this is great beyond measure.. I have been hook to this website. God will bless you and yours abundantly

You’re most welcome! :)

i just want to confirm for #39 it state pt need additional teaching so E should also be included to the answer cause it was contraindicated to MS right? . thank you :)

Yes, this has been corrected. Thank you! :)

Very informative and helpful. Thank you so much Sir/ madam

Thank you for providing regarding NCLEX preparation

Very informative. Thank you for update.

This is for sure the best nurse’s website ever. It really helped me a lot during my training.

Number 58 of NCLEX test 5 does not have the answers listed.

Hi Rebekah, this is now fixed. Thank you for letting us know!

This is very helpful

It’s very informative. Thanks

Thank you Matt Vera for providing information free of charge

Any advice of how well you can do on these question to build up your confidence?

Thanks a lot for great job. May the Lord Almighty shower His blessing upon you.

Thank you, this site is amazing. God bless you

Thanks alot.I,ve got a question What score ranges would be considered a Pass? I scored 69.33% overall. is that a Pass???

75% and above, from the analysis I got from a test after getting below 75

Thank you Nurse Matt. You deserve all the blessings! 🙏🏻😊

This is very helpful. Thank you Nurse Matt

Question 16 on practice test 9 asked about assessment during L sided CHF, yet the correct answer pertained to right sided HF. Just wanted to let you know…. Thanks for the practice questions! Appreciate all the work put into this.

Question 41 of NCLEX-RN Test 2 has two C choices. Thanks.

Hi, I like your questions, they’re very nice and challenging. Learning a lot from them.

I love this site.. Now all friends are learning serious from here

Thanks you guys are very generous

From Kenya, this site is so helpful,am learning a lot here.Thank you especially for the care plans.

Thank you so much

You Matt and your staff are such a blessing to us who will be taking the NCLEX RN exam. This site is very useful and helpful because it is very comprehensive and easy to understand. God bless and may tribe increase. Thank you so much

The site is very informative. I have learned a lot. Test questions are really amazing which I cannot find with other website. However, I got a low score, thus I need to further study especially on the areas wherein I got a below passing grade. I hope you will allow me. Thank you

thank you so much for creating this site for people like us. This excellent job. May God bless you in Jesus name —Amen

The Practice tests are awesome! The rationales are all well-explained which I love because it gives me more knowledge and insight. Thank you for creating this website free of charge.

Thank you so much. It was really helpful. I passed the exam. God bless real good.

Thank you Matt for the awesome and great website! its beyond compare. I want more practice test questions to hone my knowledge in Nursing practice, however, when I am trying to open one of the practice tests, I cant go through it. Could you please allow me? God bless

Thank you Matt for this practice test. Now I know my strength and weaknesses and will concentrate of the system that needs for further study. Can I practice more in practice test no 2? Please allow me to go trough with it. Kudos to you and your staff.

Hi this is what i got, im so nervous due to my nclex exam its gonna be this coming oct. Its doesnt say pass or not.

Your score 48% Categories Basic Care and Comfort 100% Health Promotion and Maintenance 53.85% Pharmacological and Parenteral Therapies 26.67% Physiological Adaptation 54.55% Psychosocial Integrity 100% Reduction of Risk Potential 36.36% Safety and Infection Control 100%

Thanks so much for this useful information. God bless you.

Thank you so much for all you do

The Practice tests are excellent. The rationales are all well-explained which I love because it gives me more knowledge and insight. Thank you for creating this website free of us. Remain blessed.

Like I am obsess with nurselab. A handy powerful tool, to keep you updated, thick and richly packed. You guys made reading so interesting and magnetic and very easy. Please do not stop. I recommend this to all nurses.

Love this. Thank you for sharing your generosity. I’ve been using this since I was still in college and I continue to use it until now.

Thank you so very much for this

I remain speechless but mostly grateful for your unconditional helpful assistance for this awesome richly throughout profound tool and opportunity given to me to increase my confidence, strengthen my knowledge, and be ready for my upcoming exam. Your questions and rationales are beyond my expectations. You are a God’ sent angel. Thank You. God Bless you. I will be forever grateful to you for making my dream come true! 🙌

This website can help me to review for NCLEX and it is for free! Thank you so much!

Amazing and really awesome job to you Matt and your entire team, may God replenish your source for giving us this for free. I have recommended to all my friends and family. Remain blessed and stay safe.

That’s very kind of you. Thank you so much! Bless you!

Your test questions have greatly helped me pass my NCLEX. I passed my NCLEX today and thank you to Nurseslabs. I came across this website by accident and I do not know how but it was divine intervention. I will definitely recommend Nurseslabs to my friends. The quality of the questions and rationales were very good and you would not think this is all for free the kind of work that came with it.

Kudos Nurseslabs and wishing all the future test takers all the best!

Wow Sam, congrats! What materials did you use other than nurseslabs? I’ve been answering nurseslabs also. My exam is on June. I hope I could also make it.

Thank you for this NCLEX sample test,as tool to determine areas i need to review/focus on for the proper exams.

This website can help me to review for NCLEX Thank you so much!

I just wanna ask why is that there are no more rationale posted after answering the question unlike before. Thanks by the way for the free and great Q & A bank. ❤

Sorry, we’re currently having some performance issues with that setup. Until we can resolve it, we have set each quiz to show results and rationales only after you have finished all the questions. Thank you for your understanding.

Hello, how do I get my score after taking the test to know if I am doing well or not

Hi, after you’re done answering all questions, the final item will direct you to the “Quiz Summary,” from there, click on the “Finish Quiz” button to get your final score.

Very great tool to study for the NCLEX. I passed my exam just by focusing on the questions and rationales provided here.

That’s great! Congratulations!

Thank you so much. It’s very helpful. God bless you…

Thank you for being generous. This is a big help.

I got 55/75.

Thank you so much for making this site.

Very helpful. Thank you and God bless…

Thank you so much, Nurse Matt for your generosity. Helping your fellow nurses and aspiring nurses to work abroad is such a selfless and noble act. God bless you and your team!

Thank you for your kind words, JB! Will pass on this message to the team. :) God bless!

The rationale after the question will really help us a lot specially when you are just using the question via online.

Hi Romel, we have temporarily changed this setting so that results and rationales will show only after you’ve finished the quiz. This is because we’re having some performance issues when using the previous setting. We’ll revert the changes once we’re sure the problem is resolved. Thanks for understanding!

I didn’t get my results after answering the 75 questions. Please why?

Hi Esther, did you click on the “Finish Quiz” button?

Thanks for all these questions where/how can i check my answers to these questions?

After answering the last item of the quiz, you’ll be redirected to the quiz summary. From there, click on the “Finish Quiz” button to view your score and results. You can also click on the “View Questions” button to review your answers and read the rationales.

Hi, thanks for providing so much useful information and all the test banks!

In RN practice Quiz 1:75 questions, for question 70, wonder if the correct phrase would be “would you NOT expect”?

Hi Cecilia, thanks for letting us know. We have corrected the question. Thank you! 🥰

Thank you for allowing me to practice the nurseslabs questions. The rationales are well explained. Thank you!

Thank you Ruth. Hope you’ve learned a lot from our practice questions. 🥰

God bless you

My name is Samuel. I just started with the RN practice questions. Thank you for the opportunity.

Hi, thank you so much for your generosity. Using this to prepare for my NCLEX and find it very informative. I will keep you posted on how it goes on the D-day

Frequently throughout the quiz, ARDS is given as “Adult Respiratory Distress Syndrome” instead of “Acute Respiratory Distress Syndrome”. This needs to be corrected.

Hi Bella, thanks for bringing this up.

Technically both terms are correct since “adult respiratory distress syndrome” is an earlier name referred to “acute respiratory distress syndrome” to differentiate it from respiratory distress syndrome in neonates and children. For the sake of uniformity, we have edited them to “acute respiratory distress syndrome”. You can read more about it here: https://doi.org/10.1164/ajrccm.149.3.7509706

This is so kind a gesture, remain blessed .The information is very understandable and helpful

I just wanted to thank you for taking the time to generate this website, this is really helpful and is free. God bless you

Thank you for your support and guide toward my nclex preparation.

Thanks for your generosity. I hope to pass my NCCLEX just on the first attempt Grateful for all your help

thanks for the help

Hi Sir, kindly explain why this question – The client with hyperemesis gravidarum is at risk for developing: Metabolic Acidosis is the answer. Thank you.

Quite familiar with the content. Thanks for this selfless initiative.

It has been a nice experience.

I love these practical questions. So helpful.

Thanks very much this is a good help for all students

Thank you for mett this free test which i have passed yesterday afternoon so ,it is greatest pleasure which will help me

Thank you so much for this great initiative.

Thanks for being kind God bless you

thank you for your help and kindness. It’s difficult to go back to school after 22 years of practice as a RN to take the test where you must cover a vast knowledge, which you do not use in everyday working (depends on the special field you are working. so I really appreciate your effort and dedication.

Matt Vera and all those helping us through this free medium, May God richly bless you abundantly. And may all your good desires come through

Hello Vera, I would start by thanking you for the great job you’ve done by helping us in our preparation for the exams. secondly would wish to know wther you have audio clips for lung, heart and abdominal sounds. thank you in advance and if any kindly let mh know pls.

What should we be scoring on these practice questions to let us know that we’re ready for the NCLEX

Do you have LPN test also?

Hi, please visit NCLEX-PN Practice Questions & Test Bank (200 Questions)

Thank you so much Nurse Matt you just don’t know how nurseslabs helped me in my nursing career and i even recommended nurseslabs to some of my friends. God bless you😊

Hi Matt, Thank you for this, indeed very helpful practice questions. Just a query though it says here to limit wrong answers to 15 or less? So is that the passing mark ? about 75-80%

Yes, that is correct. :)

Thank you so much for the practice questions. I learned a lot and it helped me to understand why I was getting my answers wrong. I used Kaplan and Saunders but it wasn’t helping me. I feel more confident than ever to retake my boards.

thank you…. wish this help a lot to my daughter to passed please pray for her God bless!!!

hi Matt, can l still use these question banks to study for the new NGN questions

Hi nurse Matt, May I gave all the questions please, need to prepare study for exam after been off school over 30 years, realize it for not giving up not try again, thank you 🙏

Thank you so much Nurselabs! I passed my NCLEX-RN exam using only your practice 75 question per day questions bank. I have a tight budget and not able to purchased online review and I just focused in answering your practice questions in just 2 weeks!!! Thank you for helping nurses! God Bless you more!

I want to practices questions

Hello Thanks so much for your good heart and good wish for us to practice and pass the NCLEX. Well appreciated. Please after your update I can’t get the answers and rationale to the 75 questions. This will help me to know my ability and where am lagging behind. Please how can this be rectified Thanks Hope

Hi Hope, did you finished all of the questions for the quiz? Your score together with the correct answers and rationale will only show after you’ve completed the whole quiz.

Hello Vera I finished all 75 questions submitted but no answer or rationale came up. I tried upto 3 times same. Even my friend I shared your content with complained of same thing, answers not coming. Please what can we do to access the answers and rationale Thanks Hope

What particular quiz?

Hello, great resource! I am a nurse that wants to help student nurses reach their full potential as nurses and pass the nclex. I would like to utilize your tests and quizzes to help my students learn to critically think through the questions and learn how to put their nursing knowledge to use. Would you allow me to utilize your questions in my content?

Thank you for the kind words! It’s awesome to hear that you’re dedicated to helping student nurses thrive. 🌟

Absolutely, you’re more than welcome to utilize our tests and quizzes for your students! We believe in collaborative efforts to strengthen the nursing community. Just ensure to give appropriate credit when using the content.

Out of curiosity, are there specific areas or topics you find students struggle with the most when preparing for the NCLEX? Maybe we can work together to create even more targeted resources!

Best of luck with your mission to guide the next generation of nurses!

Hi, I am studying for med surg 1 and med surg 2 upcoming exam. Need to pass both exams.

Sounds like you’ve got a busy study schedule ahead! MedSurg can be challenging, but with the right resources and dedication, you’ve got this. If you need specific materials, tips, or just a morale boost, don’t hesitate to reach out. Else, you can do practice all MedSurg exams on our Nursing Test Banks . Rooting for you to ace both exams! 💪

thank you so much… a big help

Hi Glacier and what a nice name!

You’re welcome! Really glad to hear the NCLEX practice questions were a big help. If you’ve got any other areas you’re prepping for or need more practice with, just let me know. Here to support your journey!

Thanks a lot @nurseslabs for this initiative I really believe by the time I sit my exam I will be a great nurse than ever before. I am learning a lot from the questions and explanation.

Hey Charles, You’re very welcome! I’m thrilled to hear that you’re finding our initiative helpful in your journey to becoming a great nurse. Remember, continuous learning is a key part of nursing practice, and it’s fantastic to see your dedication to it. If you ever come across any challenging topics or have questions about specific nursing concepts, please don’t hesitate to reach out. We’re here to support you every step of the way. Keep up the excellent work, and you’ll do great on your exam! 📖🏥🌟

Much help for beginners like us

Thank you so much Nurseslabs, I made it!!! Your practice exams, especially the rationales helped me a LOT…thank you!!!

Wow, that’s awesome news! 🌟 Huge congrats on making it through – your hard work and dedication really paid off. It’s super cool to hear how our practice exams and rationales played a part in getting you across the finish line.

Remember, this is just the beginning of an amazing journey in nursing. The field’s always changing and growing, and so will you. Keep that enthusiasm and curiosity going strong!

If you ever need a hand or just want to share your journey as you dive into your nursing career, give us a shout. We’re always here to cheer you on and lend support.

Big congrats again and best of luck out there!

Thanks for the information

thanks for the guide

Thank you for your kindness.

Thank you very much!

Thanks a lot for this whole range of knowledge; it’s now upon me to work extra hard to be a better nurse outside there or help other nurses be better at service delivery.

Hi Evans, You’re so welcome! I’m glad to hear that the range of knowledge from the NCLEX practice questions is empowering you to aim for excellence in nursing. Remember, every bit of effort counts towards becoming not just a better nurse but also a great mentor to others in the field. If you need more resources or advice along the way, I’m here to help. Keep up the fantastic work!

Please how can I practice questions please 🙏

In practice exam 5 question 22 asks about hyperemesis…. wouldn’t that cause alkalosis (rather than acidosis), since its acid from the stomach that is leaving the body?

Can I. Have free practice questions? NGN questions?

Thank you for the opportunity to know about all the information posted here. I strongly believe I will pass the NCLEX-RN exam at my first attempt through these useful resources available here. Thanks

Thanks a lot Nurselabs for the free test banks! It’s all what I focused to practice and read every rationale in each questions given. I just recently took my NCLEX-RN exam last week and i was able to make it. Your website is what i embraced and felt much comfortable and trusted what is in there. Thanks for helping lots of NURSES! Highly recommended!

Hello Brenda, Congratulations on passing your NCLEX-RN exam! 🎉 That’s a fantastic achievement, and I’m so thrilled to hear that our test banks and rationales were a valuable part of your preparation. Thank you for trusting Nurseslabs and for your kind words—it means a lot to us.

If you have any tips for future test-takers or any other resources you found particularly helpful, we’d love to hear about them. Your feedback not only celebrates your success but also helps us continue to improve and assist other nursing students.

Thanks again for recommending us, and best of luck in your exciting nursing career!

THIS IS GREAT. THANK YOU FOR SHARING.

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