Next Generation
Item Types

The Next Generation NCLEX is launching April 1, 2023 and the updated exam will introduce new and updated item types designed to better measure candidates’ clinical judgment. Candidates may find these items in the new unfolding case studies or the clinical judgment stand-alone items.

Preview Next Generation NCLEX Sample Item Types

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.

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).


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.


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 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.


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.

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.

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