Understanding the Next Generation NCLEX (NGN)

The NCSBN introduced the Next Generation NCLEX to better assess clinical judgment skills. Here's what changed:

New Question Types

1. Extended Multiple Response

Select all that apply questions with partial credit scoring.

2. Extended Drag and Drop

Organize information in priority order or match items.

3. Cloze (Drop-Down)

Complete sentences by selecting the correct option from drop-down menus.

4. Enhanced Hot Spot

Click on specific areas of images or charts.

5. Matrix/Grid

Make multiple selections across rows and columns.

6. Bow-Tie (Case Study)

The most complex NGN item type, testing all six clinical judgment skills.

The Clinical Judgment Measurement Model

NGN questions assess these six cognitive skills:

1. Recognize Cues - What's relevant?
2. Analyze Cues - What does it mean?
3. Prioritize Hypotheses - What's most important?
4. Generate Solutions - What can we do?
5. Take Action - What will we do?
6. Evaluate Outcomes - Did it work?

How to Prepare

• Practice with NGN-style questions regularly
• Focus on case studies and clinical scenarios
• Develop systematic approaches to complex problems
• Review lab values and assessment findings

Our NCLEX prep guide includes extensive NGN practice questions!