• Objective type - single response
• SATA / Multiple response
• Hotspot ( Identification of specific area)
• Fill in the blanks
• Drag and drop

Also 3 types of alternate format on four option multiple choice questions

• Exhibit questions ( Use information from chart given/exhibit to answer )
• Audio items ( Listen to sound & select answer.)
• Graphic questions

                                      NGN - QUESTIONS

• Extended Multiple Response

• Extended Drag and Drop

• Cloze (Click or drag answer options to fill in the blank

• Highlight Text

• Matrix/Grid

• Bowtie

• Trend

Extended Multiple Response

Extended multiple response NGN item types require candidates to select one or more answer choices. Select all that apply (SATA), select N, and multiple response grouping items fall into this category.

Multiple response items are similar to the current NCLEX but have been extended in that candidates may choose one or more answer options. Extended multiple response questions have more options available and utilize partial credit scoring. The NGN includes three extended multiple response question types:

• SATA (Select All That Apply)
• Select N Item Type (N equals a pre-set number of selections required)
• Multiple Response Grouping (2 to 5 groupings with 2 to 4 options, like several SATA questions in a table format)

Extended Drag and Drop

Drag and drop NGN item types require candidates to drag and drop one or more answer choices from a box of options into answer key boxes placed in sentences (ie, Cloze) or into a separate multiple response answer key box (ie, Extended Drag and Drop).

Drag and drop items are like current NCLEX ordered response questions that allow candidates to drag response options from a list into the appropriate answer spaces. However, in the extended version, the candidate may not have as many answer spaces as response options, meaning they have leftover responses. The NGN has two types of extended drag and drop question types:

• Cloze (minimum of 4 and maximum of 10 items on a provided list must be dragged and dropped to one or more response targets)
• Rationale (contains 1 sentence with 1 cause and 1 effect or 1 sentence with 1 cause and 2 effects, and appropriate responses must be dragged and dropped from the list provided)

Drop-Down

Drop-down NGN item types require candidates to fill in blanks using drop-down lists of options. Drop-down answer choices can be used in a Cloze format (eg, sentence, passage, rationale statement) or within a table in the answer key.

These question types have candidates select one option from a drop-down list of words or phrases within sentences, tables and charts. Each question may include more than one drop-down list. The NGN has three types of drop-down question types:

• Cloze (1 or more drop-down options to complete a paragraph, with 3 to 5 options per drop-down per sentence and 1 to 5 drop-down lists per paragraph)
• Rationale (contains 1 sentence with 1 cause and 1 effect or 1 sentence with 1 cause and 2 effects, and appropriate responses must be selected from the drop-down list provided)
• Table (same as Drop-Down Rationale question types only in table format)

Enhanced hotspot/ Highlight

Highlight NGN item types require candidates to read a sentence or passage and select words or phrases within the text to answer the question. When the cursor hovers over a block of text that may be an option, the text will turn light yellow, and once selected, it will turn a darker shade of yellow.

             Matrix/Grid

Matrix/Grid item types require candidates to select one or more options for each row or column. Square buttons indicate that candidates can select more than one answer from the list of choices; radio buttons indicate that only one answer can be selected from the list of choices. Requires selecting one or more answer options for each row and/or column to measure multiple aspects of the clinical scenario. These question types provide a scenario and client information, and candidates must make judgments about the findings by checking the appropriate boxes in the matrix. The NGN has two matrix question types:

• Multiple Choice (contains 4 to 10 rows, with 2 to 3 options/columns, and each row must have 1 response option selected before continuing to the next row)
• Multiple Response (contains 2 to 10 columns with 4 to 7 rows, and each column must have 1 response option selected before continuing to the next column)

Standalone Items: Bowtie and Trend

                     These question types are new to the NGN and require candidates to use the information received in Case Studies to answer the question. They include 6-question sets, progressing from recognizing and analyzing findings to making clinical judgments to providing appropriate care and evaluating the client’s response. The NGN has two standalone items:

Bowtie

It addresses all 6 of the NCSBN Clinical Judgment Measurement Model in one question, requiring candidates to drag and drop items from a series of targets to move forward.

Bowtie item types are unique because they assess all 6 steps of the NCJMM in one item. Candidates must read a scenario then drag and drop 5 answer choices into the correct location in the answer key. This item type gets its name because the answer key is shaped like a bow tie.

The way the patient information, actions, and parameters are set up in these questions appears like a bowtie, hence the name bowtie question. Here's an example of a bowtie question:

The nurse on the medical-surgical floor is caring for a 56 year old male client.

The nurse reviews the vital signs and prepares the plan of care for the client.

Instructions: Complete the diagram by dragging 2 appropriate actions to take, the potential condition, and 2 parameters to monitor to assess progress by the client.

From the example bowtie question above, you would toggle between the vital signs and nurses' notes to obtain the important information. The blood pressure (BP), heart rate (HR), respiratory rate (RR), O2 sat, and pain are all abnormal cues. Then from the nurses' notes, the client is complaining of crushing chest pain (8/10) also radiating down his left arm, which is again an abnormal cue.

Next you will look at actions to take. Based on the abnormal cues you would select administer oxygen at 2L/min by nasal cannula due to the chest pain and O2 sat of 88%. You would also select notify the healthcare provider (HCP) based on the chest pain and vital signs. You would then select request an electrocardiogram (ECG) based on the chest pain. You would leave behind insert a peripheral IV (PIV) and obtain a urine specimen because they would not be necessary for a client reporting chest pain.

Trend

For trend questions on the NGN, there will be a client scenario presented with findings over a designated period of time. You will also be given a multiple choice question (or two), or perhaps a multiple response question. These questions could ask about client needs, nursing interventions, or anticipated healthcare provider orders, among other things. Here is an example of an EHR attached to a trend question:

The nurse on the medical-surgical unit is caring for a 56-year-old client who was admitted after a motor vehicle collision (MVC). When reviewing the chart for this client, the following vital sign trends are collected.

As you can see in the 'chart' above, there are values recorded over a period of time. These changes in the values represent a trend, indicating that something is changing and an intervention of some type may be warranted. And that's where the actual questions come into play!

For trend questions, you will be expected to recognize certain cues, analyze those cues, figure out what the cues mean, come up with solutions or interventions, and evaluate client responses to interventions. In the simulated EHR above, there are distinct changes in the client's blood pressure, pulse, and respirations, and this requires careful consideration and some clinical decision-making. Let's look at a question related to the vital sign trend information above:

Which of the following interventions by the nurse are appropriate? Select all that apply.

A. Assess the client's pain level.

B. Collect a urine specimen.

C. Review the client's medications.

D. Notify the healthcare provider.

E. Review the client's medical history.

NCLEX RN

• Length of the exam

  With the introduction of Next Gen questions, the minimum length of the exam will be 85 questions (70 scored and 15 unscored) and the maximum 150 questions (135 scored and 15 unscored). “Within the minimum-length exam, there will be 52 stand-alone questions and 3 case studies (each case has six questions for a total of 18 questions) that will be scored and contribute to the pass/fail decision” (Next Generation NCLEX News, Winter 2022). However, candidates may receive up to two more unscored case studies (total of 5) as part of the pre-test questions.

  After the minimum-length exam, candidates have a 10% chance of receiving a clinical judgment stand-alone item administered alongside the traditional items until one of the stopping rules is applied and they pass or fail the exam.

NCLEX Rn

• When a candidate scores markedly( 95%) above or below passing standard with a minimum of 75 questions.
• When maximum time is used - 6hrs
• When maximum questions answered - 265

NCLEX Pn

• 95% certain that a candidate is clearly above/ below passing standard with minimum of 85 questions
• Maximum questions answered - 205
• Maximum time elapsed - 5 hrs

NCLEX RN / NCLEX PN

The passing score referred to as a logit.

Logit is a unit that compares each candidates capability to get difficult questions right. So the passing grade of NCLEX RN is 0.00 logit., NCLEX PN is -0.18

NGN- 

New Partial Credit NGN Scoring Models

Along with the introduction of new items, the NCSBN also introduced a new partial credit NGN scoring model. Depending on the item type used, the 0/1 scoring rule, +/- scoring rule, or rationales scoring rule may be applied. While the partial credit scoring rules may seem more challenging at first, this nuanced approach actually provides candidates more opportunity to accumulate points toward their final score.

In addition to the current item types found on the exam, the Next Generation NCLEX will introduce unfolding case studies and stand-alone clinical judgment items. Each case study includes a clinical scenario, supporting information, and six questions that require candidates to make multiple decisions. The items are presented in sequential order so candidates progress through all six steps of the NCJMM. Any of the traditional or new Next Generation Nclex item types, except for bowtie, can be used in the case studies.

NGN scoring models.

The Next Generation NCLEX introduces a new scoring methodology known as polytomous (partial credit) scoring. 

0/1 Scoring Rule

The answer is either correct or incorrect. Candidates get one point for answering correctly and zero points if they answer incorrectly. 

+/- Scoring Rule

Candidates earn points by selecting the correct options, but they lose points by selecting incorrect options. The score for this question is tallied by adding up the correct option points, then subtracting the incorrect option points.

Rationales Scoring Rule

The rationale scoring rule is applied to questions assessing relational or paired information. Because the question is assessing a candidate's knowledge of the concept, both answer options must be correct to earn a score of one point.

• Quick result service (As per NRB regulations )
• Official results ( approx 6 wks after exam )
• Complete the formalities of license in state board of nursing & be a licensed RN/PN.

NCLEX RN /NCLEX PN

MOCK EXAM (1) 100 100

MOCK EXAM (2) 100 100

ASSESSMENT EXAM (1) 100 100

ASSESSMENT EXAM(2) 100 100