What’s New in the Next Generation NCLEX (NGN)?

Just like other healthcare professions, nursing education is always changing to make sure we’re up to date with best practices and providing the highest quality care. A big part of a nurse’s journey is tackling the NCLEX (National Council Licensure Examination), and as of last year, this exam was revamped to become the new Next Generation NCLEX (NGN) exam. 

Here at Blueprint Nursing, we’re all about connecting our community with the skills and information they need to rock it as confident nurses. So, in this blog post, we’re going to walk you through the new changes on the NGN to help you prepare for exam day. 

Let’s begin by taking a look at why some changes were made to the exam, and how they are to your benefit as a healthcare professional!

All About the Next Generation NCLEX (NGN)

Why did the NCLEX change in 2023?

The National Council of State Boards of Nursing (NCSBN) revamped the NCLEX to stay in sync with the latest changes in nursing. They found that the choices nurses make every day require serious clinical judgment, and new nurses might find that a bit tricky. 

Enter the NGN, rolling in to take things up a notch. This exam was designed to truly assess how sharp your clinical judgment and decision-making skills are. 

While changes like these can feel intimidating, they’re ultimately made to help you as a new RN! This exam is better designed to help you work through real-world scenarios you’ll soon be seeing in clinical practice. I know it might feel scary but you’ve got this (and we’re here to help you succeed)!

Can you still take the old version of the NCLEX? 

No, all tests administered after April 1, 2023, will be the NGN. It’s the only licensing exam for nursing students upon graduation from nursing school. 

3 Things That are New About the NGN 

Now let’s take a look at what’s different about the new exam. The three major changes are: 

1. There’s more emphasis on clinical judgment.

The NCSBN found that clinical judgment is linked to 46% of all tasks performed by entry-level nurses. So, almost half of what you’ll be expected to do on a daily basis requires clinical judgment! 

The NCSBN’s goal with this exam change is to ensure you, as a new nurse, can make decisions appropriately while maintaining client safety. 

This new exam style will allow you to read (and work through) real-world scenarios, then put your knowledge into practice by answering questions related to them. 

2. Now you can get partial credit.

Great news! There’s a new scoring system that’s to your benefit! You can now get… (drumroll please) partial credit! The previous version of the NCLEX scored items as either correct or incorrect. This new scoring system allows you to receive some credit, even if the answer is not fully correct. 

Here’s some ways you can get partial credit: 

  • +/- scores: You can receive 1 point for correct answers and subtract 1 point for incorrect answers. If the total score is negative, the final score would be a 0. 
  • 0/1 scores: You’ll receive 1 point for correct answers, but no points will be subtracted for incorrect answers. 
  • Rationale scores: You’ll receive an “all or nothing” score for units within an item, meaning it’s entirely correct or incorrect. 

3. There’s six new item types on a split-screen.

The days of only multiple-choice questions being on the exam are behind us! New item types have been added to the NGN. 

A few of the styles described below involve case studies. When completing these item types, you’ll be provided with tabs to click through. These tabs contain different parts of the client’s medical records. You’ll have the opportunity to read about things like the client’s current status, medications, lab work, and assessments. When reading below about the different types of items, keep those tabs in mind! 

For a full breakdown of the NCLEX question types, check out our other post, Types of NCLEX Questions: The Ultimate Guide

The new question types are as follows: 

1. Extended drag-and-drop items 

You’ll be asked to drag and drop items. For example, you may have an answer bank with multiple options. From that answer bank, you must choose one answer to fill the blank in a sentence. Another example is that you may be asked to match items from two columns with one another. 

2. Drop-down items 

Remember those medical record tabs we discussed earlier? You’ll see those for these questions! After reviewing the tabs, you’ll be asked to respond with the appropriate nursing actions from as many as six responses in a drop-down menu. 

3. Matrix-grid items 

Think of this as a checklist! The matrix grid will provide boxes you’ll be asked to check based on client data and clinical findings within their medical record tabs. For example, you’ll be asked to determine from a list of nursing interventions which are indicated and which are not for a hypothetical client. Then you’ll choose by clicking the corresponding items within the matrix grid.

4. Hot spot items 

Get ready to see those case studies with medical record tabs again (check out our YouTube channel for practice examples)! After reviewing the client’s medical records, you’ll be asked to highlight words or phrases presented within those information tabs.

5. Extended multiple-choice items 

These include select-all-that-apply (SATA), multiple responses and select a specified number (MR-N), and multiple-response groupings (think of these as several small SATA within a table format).

6. Bow-tie and trend questions

The name sounds a little daunting, but I promise it’s not! Think of a bow-tie question as three drag-and-drop questions combined into one significant question. You’ll likely see a diagram with three columns in it. From there, you’ll select from an answer bank, placing your selections in the appropriate columns.For example, after reviewing a client’s medical record tabs, you’re asked to select the condition this client may have, nursing interventions to take, and what to monitor.

FAQs About the NGN

Is the NGN harder than earlier versions of the exam? 

It’s difficult to say whether the NGN is tougher than the previous version, as the difficulty level is relative to each student taking the exam. 

Should you study differently for the NGN? 

If I could recommend a way to study for the NGN, I would say keep in mind you’re going to be asked to apply what you’ve learned. Case studies are a fantastic way to test your knowledge and test your clinical judgment! 

While certain aspects of nursing require memory recall, the NGN is looking to see how you apply your knowledge. What decisions will you make when you’re working as a nurse? And how will you ensure you’re maintaining client safety? 

Keep those things in mind while you’re preparing for the exam. 

Final Thoughts

The NGN is different from the NCLEX in three major ways: there is more of an emphasis on clinical judgment, now you get partial credit for your responses, and there are six new item types on the exam. 

If you’re worried about preparing for the NGN, please know there is help available for you. Be sure to check out Blueprint Nursing’s resources, designed to help you on your NCLEX journey! And believe in yourself. I know you’ve got this!

Looking for more (free!) content to help you pass the NCLEX-RN on the first try? Check out these other posts on the Blueprint Nursing blog:

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