New Questions on the Next Gen NCLEX (NGN)

nursing students taking the NCLEX exam with next gen NCLEX questions

Jump to Sections

  1. What is the Next Generation NCLEX?
  2. How are NGN questions scored?
  3. What are the Next Gen NCLEX questions?

Are you planning on taking the National Council Licensure Examination (NCLEX) exam this year or later?

As of April 2023, the National Council Licensure Examination (NCLEX) is known as the Next Gen NCLEX (NGN). The NGN’s biggest changes include new question types and a different scoring system.

These next gen NCLEX questions range from Matrix Multiple Response, Bow Tie, Cloze drop-down, to Trend.

Questions have a new scoring method (polytomous) to allow partial credit. All questions will be either correct or incorrect, but some will allow test-takers to earn partial credit.

What is the Next Generation NCLEX (NGN)?

The NGN is a result of changing demands in the nursing profession. As a result, the NCSBN re-evaluates the NCLEX exam every three years to ensure those who pass are ready for nursing.

This new NCLEX rolled out in April 2023, and no doubt will change again in the future.

How are NGN questions scored?

Standard questions from the old NCLEX (including fill-in-the-blanks, multiple choice, select all that apply, and hot spot) will continue to be worth one point. However, multiple-response questions will receive partial scoring.

In the new NGN-style questions, partial credit is now given in three different ways: +- scoring, Dyad scoring, and Triad scoring.

+/- Scoring lets test-takers earn one point for each correct response, but lose one point for each incorrect response. If the total score is negative, the final score is reduced to zero. In this system, points are not deleted for incorrect responses.

In the dyad scoring system, test-takers get one point if both answers in a paired set are correct. With the triad scoring system, they get one point for each correct answer. If all three are correct, test-takers get two points. 

Find out how to study for the NCLEX exam here.

What are the Next Gen NCLEX questions?

Questions (items) are standalone items or unfolding (case studies).

Case studies reflect real-world scenarios based on the six functions of clinical judgment in the Clinical Judgment Measurement Model. Stand-alone items are similar to case study questions, but are not a part of them. They are introduced after the minimum number of items.

These new question types (as both case studies and standalones) include:

Drag-and-Drop Cloze

Test-takers can choose a response to drag a choice to, but there might be more than one answer that could be correct. You can either drag the choice back to the list or remove it from the question entirely.

Drop Down Cloze

This includes a paragraph with one or more drop‐down options from which to complete the paragraph, each option having three to five possible answers.

Drag-and-Drop Rationale

This question is made up of one sentence with one cause, one effect, or two causes. Test-takers can select a choice on top of a target and remove it by either dragging it back to the choice list or just removing it.

This can be a dyad (two sentences with one target) or a triad (three sentences with one target).

Drop Down Rationale & Table

This question type includes one sentence with one cause, one effect and another effect. The answer can be a dyad (one sentence with two drop‐downs) or a triad (one sentence with three drop-downs each).

Read our guide on which NCLEX questions to prioritize on your testing day. 

Matrix Multiple Choice & Response

These questions have four to ten rows with two or three options. Each row must have one response selected. A test-taker can only continue to the next question once responding to all rows.

Multiple Response Select N

This differs from other multiple response item types in that the test-taker may not select all but is limited to a certain number of keys.

Multiple Response Grouping

The multiple-choice question has a table with two to five groupings, each with two to four options. The number of options is the same for all groupings, so test-takers must select at least one option from each grouping.

Highlight Text & Table

Test-takers must select parts of the text to determine what is critical for the action. Responses are tokenized, and there can be no more than ten options. Test-takers can choose and deselect options as they see fit.


This question type tests knowledge of the NCJMM, which is a series of steps for measuring clinical judgment.

Prep for the Next Gen NCLEX Questions Here

The New NCLEX exam, Next Gen NCLEX (NGN), is coming soon. The most significant changes include new question types and a scoring system that considers not just your correct answers, but also the ones you got wrong.

It requires a lot of preparation. But with the right study tools, you can claim back your time and understand nursing concepts with ease.

SimpleNursing equips you with lecture series, question banks, adaptive exams, study guides, and much more. 

Ace the new NCLEX, starting with a free trial today.