NGN Explained: The 6 New NCLEX Item Types
Bow-tie, matrix multiple-response, matrix multiple-choice, drag-and-drop cloze, drop-down rationale, extended multiple response. Walked through with examples.
The Next Generation NCLEX added six new item types in 2023. Most students see all of them on test day. Here's what each one is and how to attack it.
1. Bow-tie
Center is a clinical problem. Left side: 2 conditions to address. Right side: 4 actions to take. Bottom: 2 parameters to monitor. Drag the correct options to each position. Partial credit per correct item.
2. Matrix multiple-response
Grid with multiple categories. Select multiple options per row (e.g., which interventions appropriate for each problem). Partial credit per row.
3. Matrix multiple-choice
Grid with categories. Pick one option per row (e.g., is each finding 'expected' or 'unexpected'). Partial credit per row.
4. Drag-and-drop cloze
Fill-in-the-blank sentence. Drag word choices into blanks. Each blank has its own answer set. Partial credit per blank.
5. Drop-down rationale
Sentence with embedded dropdowns. Select from each dropdown to complete a clinical reasoning statement. Partial credit per dropdown.
6. Extended multiple response
Like SATA but with more options (often 6-10). Select all that apply. May allow partial credit (different from traditional SATA).
How NGN scoring works
Most NGN items allow partial credit, get some right, get partial credit. Different from traditional SATA where it's all-or-nothing. Don't leave answers blank.
How many to expect
10-15 NGN items typically, including at least one unfolding case study (3-6 items on one patient).
Frequently asked
Will I see all 6 item types?
Usually yes, at least one of most types. Distribution varies per candidate.
Partial credit on classic SATA?
No, classic SATA remains all-or-nothing. NGN multi-response formats allow partial credit.
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