Author Q&A: The NGN®! Is It Really Brand New?

A Note from Linda and Angela Silvestri

The NGN is ready to launch on April 1! This is a very exciting event. We hear from students all the time about their anxiety and fear about this “brand-new” exam. But is it really brand-new?

The NGN is not a “brand-new” exam. The NCSBN has always measured clinical judgment on the NCLEX. But now the exam is going to better measure clinical judgment using case studies and new NGN item types. The NGN consists of items currently on the test which have been on the test for many years now. In fact, most of the test items are traditional items. What’s new are case studies that mirror real-life clinical situations and their accompanying innovative item types. These are likely clinical situations that you have dealt with as a student and will most likely be familiar with.

We understand that it is hard not to be anxious about taking the NCLEX, but thinking about this test as brand-new can make this experience so much more stressful.  Don’t think of the test as brand-new. The new questions help nurses to think critically when providing care, and the questions focus on clinical judgment and decision-making. Partial credit is allowed for certain items, including those Select All That Apply questions that students find most difficult. The test also provides reference ranges for laboratory tests so there is no need to memorize lab values. The new approach will drive nursing programs to prepare students in a different way, representing the real world in nursing!

Next Generation NCLEX (NGN) Student FAQs

What does NGN stand for and what is the Next Generation NCLEX (NGN)?

NGN stands for Next Generation NCLEX® and this is the licensing exam that you have to take after graduation in order to become a registered nurse or a licensed practical or vocational nurse.

You can learn more about it on the National Council of State Boards of Nursing (NCSBN) website.

I heard the new NGN questions will be more difficult. Is that true?

The NGN asks better questions to help nurses think critically when providing care, and focuses on clinical judgment and decision-making. NGN item types present authentic clinical scenarios, mirroring situations seen in real-life practice, scenarios that you probably already encountered in clinical experiences in nursing school.

What types of questions will we have on the NGN?

You will be administered all of the types that are currently in the exam:

  • Multiple Choice
  • Multiple response (SATA)
  • Fill-in-the-blank
  • Ordered response (prioritizing)
  • Figure or Image
  • Chart/exhibit
  • Audio
  • Graphic option

Additional types:

  • Highlight
  • Drag and Drop
  • Drop Down
  • Matrix/Grid
  • Extended Multiple Response

What kinds of case studies will be on the NGN?

There will be unfolding case studies and stand-alone case studies. The unfolding case studies will be accompanied by 6 questions that measure each of the 6 cognitive skills. The stand-alone cases are of the Bowtie type or the Trend type. The Bowtie presents a clinical situation presented at one point in time and can measure all 6 cognitive skills in the one question. The Trend presents a clinical situation requiring a review of information over time and will measure 1 or more than 1 cognitive skills.

How many questions will we have on the NGN?

The minimum number of questions is 85 and of those 85 (70 scored items and 15 unscored items). The maximum number of questions is 150 (135 scored items and 15 unscored items).

What are the purpose of the unscored items?

NCSBN has a rigorous procedure for selecting test items that will be in the pool of questions for the NCLEX exam. They include these unscored question on your exam and perform a detailed item analysis to determine if they are valid and reliable test items. You will not know which test items are the unscored items but they will be administered within the first 85 questions.

Is it possible that I won’t have case study questions on my exam?

All test-takers will have 3 scored unfolding cases that will be administered among the first 85 questions. That will be 18 questions since each case will have 6 accompanying questions. The Bowtie and Trend questions will be administered after question 85 on the exam.

How many hours do we have to complete the exam?

Cognitive skills are the thinking skills and abilities that you need to make clinical judgments when caring for a client. The new NGN test items measure these cognitive skills more so that the traditional questions on the NCLEX. These cognitive skills are recognize cues, analyze cues, prioritize hypotheses, generate solutions, take actions, and evaluate outcomes.

Will there be a written portion of the exam?

There will not be an essay or written format for any of the questions.

I am overwhelmed thinking about everything I have learned in nursing school. How do we get ready for the exam?

Practice as many traditional and NGN questions as you can. Practice! Practice! Practice! And, be sure to read the rationales and test-taking strategies.

Use the Saunders Comprehensive Review books and the Q&A books and the Clinical Judgment and Test-Taking Strategies book.

You can learn more about the new NGN and the new item types on the Elsevier Student Life website, we recommend viewing the NGN item type videos and exploring the new test-taking strategies textbook.

How many questions will we have in each content area? How many maternity, pediatrics, mental health, and adult health questions will we have?

The test questions you receive are not based on content areas but on what NCSBN calls Client Needs. These are your 4 client needs areas that the NCSBN identifies and these are:

  • Safe and Effective Care Environment
  • Health Promotion and Maintenance
  • Psychosocial Integrity
  • Physiological Integrity

We encourage you to access the NCSBN site to review these the test plans. We want to point out that the Safe and Effective Care Environment and Physiological Integrity Client Needs categories have subcategories and these areas present are the largest % of questions on the test.

Are Key Words bolded in the questions on the exam?

There are words that will be in bold. According to the NCSBN, these are:

  • Best
  • Most
  • Essential
  • First
  • Priority
  • Immediately
  • Highest
  • Initial
  • Next
  • Refute
  • Increased
  • Decreased
  • Support

Does NCLEX use trade names for medications?

NCSBN understands most clinicians acknowledge both generic and brand/trade names when referring to drug medications. However, at this time, the NCLEX will reflect, on most occasions, the use of generic medication names only. The use of the generic name is more consistent, while a brand/trade medication name may vary.

How many select all that apply questions will be on the NGN?

There is no established percentage of items with alternate formats that will be administered to candidates. The exam is computer adaptive and items are selected based on the candidate’s ability. Note that there are alternate item types in all areas of the test plan, across all difficulty levels.

I heard partial credit is given for SATA questions? Is that true?

There is partial credit scoring for some items on the test and SATA are given partial credit.  

There will be three methods for scoring items for partial credit and there are the plus/minus, zero/one, and rationale scoring.

For SATA, the plus/minus Scoring Rule applies. This means that you earn points (+1) for selecting correct information and lose points (-1) for selecting incorrect information The maximum points applied would be the number of correct options and the minimum points would be 0. There are no negative scores.

Which lab values do I need to memorize for the NGN?

There is no need to memorize lab values. All questions with lab values will be presented in a table with the test and reference range and the test result. Along with your knowledge, you will have the information you need to interpret the result.

Will normal vital signs be available for questions?

No, normal vital signs will not be available Only lab results and the reference range will be provided on the exam.

Will we be allowed to go back to the original scenario if necessary with these unfolding types of questions?

You will only be allowed to move forward, not backward with questions, once a question has been answered.  However, note that NCLEX will always have the case on the left screen so there is no need to go back to review the case.

What do I need to bring with me to take the NCLEX?

You will need 2 forms of identification.

The NCLEX candidate bulletin is a valuable resource for all of this information 2022 NCLEX® Candidate Bulletin.

Will we be provided scratch paper for NGN to sort through the notes on case studies?

You will be provided with a dry erase board and markers to use during the exam. You can request more boards if needed but remember that the case information will always be on the left screen.

In regard to the SATA questions, will we be likely to see upwards of 8 answer choices on the NGN NCLEX? I’m in a 1 year accelerated program and so far we’ve been given four answer choices for questions.

All SATA questions will have a minimum of 5 answer choices and a maximum of 10. Of the number of answer choices provided, there could be 1 correct answer, all could be correct, or any number of them could be correct answers.

What are the rules for bringing personal items into the exam room?

All electronic devices must be placed inside a Pearson VUE provided plastic bag and placed in an assigned locker. After the exam, you must return your unopened, Pearson VUE bag to the administration desk to be opened and examined. Any tampering of the bag before checkout will result in an incident case report.

Items are not allowed in the testing room include:

  • Bags/purses/wallets/watches
  • Coats/hats, scarves/gloves
  • Food or drink, gum, candy
  • Lip balm

Note though, that certain medical devices are allowed; a listing can be found on the NCSBN website.

Will we get results of the test same day?

No, you will not receive the results the same day. We encourage you to refer to the candidate bulletin for the 2-day unofficial result report option and how to obtain this report.