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What You Need to Know about the Next Gen NCLEX-RN

Nursing students are known for being dedicated and enthusiastic about their future profession. Second-career nurses, especially, often have a next-level commitment to learning and a passion for helping people. 

Nursing school programs can leverage these qualities to deliver massive amounts of information about physiology, anatomy, epidemiology, and nursing theory to students who are eager and ready to put their new knowledge into practice. 

But before a nurse can begin nursing practice, there is one final hurdle to clear. To apply for any state or multi-state nursing license, every registered nurse (RN) candidate must pass the Next Generation NCLEX-RN exam.

Let’s take a look at the way this test has changed in the last several years as well as how you can prepare to pass the test the first time you take it. 


What is the NCLEX examination? 

The National Council Licensure Examination (NCLEX-RN) is the licensure examination that all registered nurses (RNs) need to prepare for and pass. It is a challenging, comprehensive assessment meant to determine whether you have the basic knowledge required to safely begin your nursing practice. In 2023, the examination was administered 358,998 times, and the pass rate was 69.66%.

The NCLEX-RN uses computerized adaptive testing (CAT) technology to score your results. The system uses a set of unscored questions to determine a basic understanding of your nursing knowledge, skills, and abilities. The computer then uses that information to decide which questions to ask you next. Every time you answer a new question, the computer updates its estimate of your ability. 

CAT scoring is meant to ensure that each question you receive is challenging and targeted to your specific potential. Once the computer is 95% certain that your knowledge level is clearly above or clearly below the passing standard, the test ends. 


What kinds of questions are on the NCLEX-RN?

For every question or question set in the examination, there is a situation describing a health care scenario. Often, there is a chart or graph with additional details. Test takers must use the information provided to choose the correct answer out of four possible choices. 

Additional question types include “hot spot” questions that require the test taker to identify a certain area on an image and click that spot. There are also “drag and drop” questions that ask you to drag answers and arrange them in a specific order, and audio questions that require listening to an audio clip to get the information that you need to find an answer. 


Why is the NCLEX-RN an important part of nursing?

The NCLEX-RN sets the standard for what nurses are expected to have learned through their nursing education. It also creates an industry expectation for new nurses to adhere to and gives nurse educators a clear target in their curriculum planning. 

Your comprehension of nursing theory and current best practices is crucial for performing well on the NCLEX-RN—but it’s also critical for the work of being a nurse. 

The test is meant to assess your understanding of a large amount of knowledge. Categories include:

  • Providing a safe and effective health care environment
  • Health promotion and maintenance 
  • Physiological integrity
  • Psychosocial integrity


What changed in April 2023? 

The Next Gen NCLEX, which is also called the NGN, refers to an updated, “enhanced” version of the NCLEX. There are new question types and a new scoring system in this new NCLEX format. 

In April 2023, the NCLEX-RN began including next-generation features to assess nursing candidates' clinical reasoning skills. These changes to the examination were the product of years of research and were over a decade in the making. 

Research showed that clinical decision-making was the most important skill required for every nursing task, and the Next Gen test was designed specifically to assess a test-taker’s abilities to “think like a nurse” and solve complex patient care problems. 

The updated format tests your understanding of contingencies—how certain information plays into other information—as well as critical reasoning skills and clinical judgment. Another notable change is that test-takers can now earn partial credit for some answers. 

These adaptations have yet to hurt test scores—in fact, test-takers in April-June of 2023 had some of the highest pass rates of the last several years. This could be because partial credit scoring on the new question types means that question sets are no longer “all right” or “all wrong.” 

Several types of new questions made their debut as part of the next-generation project, including: 


Matrix Multiple Response 

A matrix question set is displayed in columns and rows. There is brief description or case study, followed by four to ten rows that contain several answer choices each. Test takers must select one response in each row before proceeding to the next question. 


Cloze Drop-Down 

These questions present a piece of information alongside additional context. The question then offers a drop-down menu of multiple-choice options. 



Trend questions present client scenarios on an electronic health record, presented alongside findings collected over a limited period of time. The findings are followed by a question or question set about nursing interventions or what the client might need. 



Bow-tie questions require test-takers to analyze a sample health record to determine the health condition a patient may be experiencing, actions to take, and parameters to monitor. (The completed answer set will include two actions to take, one possible health condition, and two parameters to monitor, creating a “bow-tie” shape.) 


How can you prepare for the Next Gen NCLEX? 

A quality nursing education will prepare you to pass the NGN NCLEX-RN. That doesn’t mean that the instructors will simply “teach for the test” without regard to the other information you need to have. But it does mean that faculty will spend significant time reviewing different question types and demonstrating how to study well for a CAT-scored, timed exam. 

Beyond choosing a high-quality nursing program, nursing candidates will want to take additional steps to be as prepared for the examination as possible These steps may include:

  • Meeting one-on-one with faculty to discuss the new question formats, going over strategies for each
  • Forming or contributing to an online study group that shares materials like practice tests and study guides 
  • Dedicating at least one evening per month to taking practice examinations, tracking your progress to ensure your score is improving with each test


How Marymount’s ABSN prepares you to excel in nursing 

If you want to change careers, consider Marymount’s ABSN program, where test prep for the Next Gen NCLEX is built into the curriculum. Marymount’s ABSN students had a 95% pass rate in 2023 —high above the Virginia state average of 85% and the national pass rate of around 70%. 

Marymount University has been a national nursing education leader for over 50 years. We cultivate strong partnerships with clinical sites to constantly refine the curriculum so you can build the most relevant skills. You’ll also be able to complete your nursing education much faster than a traditional BSN, finishing with your degree in as little as 16 months. 

At Marymount, your advisors, clinical placement support team and faculty are passionate about nursing and committed to your success. Learn more about the only Accelerated Bachelor of Science in Nursing offered by Marymount University by clicking here

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