What are the NCLEX Changes in 2023?

nclex changes 2023

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The National Council Licensure Examination (NCLEX) is the final step in the academic process of becoming a nurse. Taken after graduation, this test evaluates if a nurse is ready to begin making life-and-death decisions that will affect patients. 

Nursing students should be aware that the NCLEX is undergoing a substantial change soon. While the exact date is not known, NCLEX changes are expected to occur sometime in 2023, and nursing students who are graduating in 2023 or beyond should know how the Next Generation NCLEX (NGN) will affect them and what they need to change in how they study.

Why is the NCLEX Changing?

The National Council of State Boards of Nursing (NCSBN) is responsible for creating the NCLEX and making sure that it correctly evaluates the competency of new nurses. Every three years, the NCSBN evaluates how well the NCLEX performs this evaluation, making changes if necessary.

While adjustments may be made every three years, the next gen NCLEX will be a larger-than-normal change, affecting both the NCLEX-PN and the NCLEX-RN.

What is Still the Same?

The next gen NCLEX will have many changes, but will also have many things that are in the NCLEX as of 2022. Understanding what is in the new NCLEX format that is unchanged from the current NCLEX is important, as not everything will be new.

Computer Adaptive Testing

On thing that will remain the same in the next gen NCLEX is that the test will still use computer adaptive testing. This means that the answer for each question will determine the difficulty of the next question you get. A correct answer will make the next question harder, while an incorrect answer will make it easier. The goal will be to achieve and maintain a certain level of difficulty so that the computer algorithm can evaluate your knowledge level.

Existing Question Types 

All of the old question types will still be used on the next gen NCLEX. The types of questions that you may see on the NCLEX include:

  • Multiple choice – The most common form of NCLEX question, multiple choice questions, provide multiple answers to a question from which you must select the correct one.
  • Select all that apply – Select all that apply questions are considered relatively difficult. For these questions you will need to select each of the answers that apply to the question.
  • Hot spot – While less common, hot spot questions will have you select a particular area in a graphic that answers the question.
  • Fill in the blank – Fill in the blank questions require you to enter a free text answer that must be correct. This will often be a number, such as a dose calculation.
  • Drag and drop – This question format will normally be used to have the test taker order the answers in the correct order, such as sequentially describing steps in a procedure.
  • Chart or graphics question – These questions will consist of an image as well as text. An example of this type of question could be a question asking you to name a heart rhythm based on its appearance.
  • Graphic answer multiple choice – This is the same as normal multiple choice questions, but uses graphics or images as answers instead of text. 
  • Audio or video – These questions will have you listen to a sound or watch a video then answer a question about the audio or video.

How is the NCLEX Changing?

While the next gen NCLEX will incorporate many of the existing NCLEX features, it will be different in many ways. Most of the NCLEX changes for 2023 will be things that are added to this new test.

Harder Question Content

One of the NCSBN’s findings when evaluating the NCLEX is that nurses are more often caring for patients that are critically ill than has traditionally been the case. This increased patient acuity means that new NCLEX questions will be more difficult, with increased focus on caring for more critically ill patients.

New Question Types

While all the existing NCLEX question types will be retained, there are multiple new question types in the next gen NCLEX that are significantly different from what nursing students have been accustomed to. Some of these new question types include:

  • Case scenario questions – NCLEX questions have traditionally been standalone questions, each question unrelated to the others. In the new NCLEX, 2-8 questions may all be derived from a single case. These cases will provide you with a patient record with several tabs and a split screen. The patient record will be on one side and questions will appear on the other, with multiple, non-adaptive questions for each case study.
  • Extended select all that apply – Longer select all that apply questions with as many as eight answers will be used. A significant difference with these questions, however, is that partial credit will be given for answers that are close to correct. 
  • Drop down answers – Essentially a cross between multiple choice and fill in the blank, these questions will provide a drop down list of possible answers to complete a sentence.
  • Extended drag-and-drop – This question type will be like the traditional drag-and-drop, except for the fact that there will be more answers than spaces, and some answers will need to be excluded.
  • Highlight text – These questions will be answered by highlighting an area of text from a given passage.
  • Matrix/grid – These will be like a select all that apply question, but with more than just a “select or don’t select” option. For example, there may be a list of eight different interventions for which you have to chose if they are anticipated, nonessential, or contraindicated based on the question stem.

Number of Scored Questions

While not hugely different, the new NCLEX will have 70-135 scored questions, not 60-130 like the old NCLEX. The new NCLEX will, however, still be 5 hours like the current version.

What do I Need to Do Differently for the Next Gen NCLEX?

Being prepared for different question types and harder questions will be vital when the NCLEX changes for 2023 go into effect. Reputable NCLEX preparation help, like the help that Simple Nursing provides, can enable you to be ready for what you will encounter. We encourage you to join the over 1,000,000 nursing students that have used our materials and go into your NCLEX with confidence.