The National Council Licensure Examination (NCLEX) is a pivotal assessment for aspiring nurses in the United States and Canada. It ensures that candidates possess the necessary knowledge and skills to practice nursing safely and effectively. As of 2024, the NCLEX has undergone significant updates to better align with the evolving healthcare landscape. This article will explore the latest changes in the test pattern of the NCLEX-RN, delve into current question types, and provide a detailed overview of what to expect from the Next Generation NCLEX (NGN), including harder question content, new question formats, and the number of scored questions.

Latest Changes in the Test Pattern of NCLEX-RN

The NCLEX-RN test pattern has been restructured to reflect contemporary nursing practices and to address the complexities of modern healthcare. These changes aim to enhance the exam’s effectiveness in evaluating a candidate’s readiness for real-world clinical scenarios. Here are the key updates:

1. Emphasis on Clinical Judgment: The new test pattern places a greater focus on assessing clinical judgment. This change is driven by the recognition that the ability to make sound clinical decisions is crucial for patient safety and care quality. Candidates will face more scenarios requiring critical thinking and decision-making.
2. Incorporation of New Technology: The NCLEX has integrated advanced technology to simulate real-life clinical settings more accurately. This includes interactive item types and enhanced multimedia content to provide a more immersive and realistic testing experience.
3. Revised Content Distribution: The distribution of content areas has been adjusted to reflect current healthcare priorities. Topics such as infection control, pharmacology, and patient safety are given more prominence, while less critical areas have been scaled back.
4. Increased Difficulty Level: The overall difficulty of the exam has been raised to ensure that only well-prepared candidates pass. This change aims to uphold the high standards of the nursing profession and ensure that newly licensed nurses are competent.
5. Shorter Testing Time: Despite the increase in difficulty, the total testing time has been slightly reduced. This adjustment is intended to make the exam more efficient while still thoroughly assessing candidates’ abilities.

NCLEX Current Question Types

The NCLEX exam includes a variety of question types designed to test different aspects of nursing knowledge and skills. Understanding these question types is crucial for effective preparation. Here are the primary types currently used:

1. Multiple-Choice Questions (MCQs): These are the most common question type, where candidates select the best answer from four options. MCQs assess a wide range of knowledge and are straightforward to grade.
2. Multiple Response Questions: Similar to MCQs, but with more than one correct answer. Candidates must select all correct answers to receive credit. These questions evaluate the ability to recognize multiple aspects of a clinical scenario.
3. Fill-in-the-Blank: These questions require candidates to enter a numerical answer, such as a dosage calculation. They assess precision and accuracy in applying mathematical skills to clinical tasks.
4. Hotspot Questions: Candidates identify specific areas on an image or graphic, such as locating an anatomical structure. Hotspot questions test visual recognition and the application of theoretical knowledge to practical situations.
5. Drag-and-Drop/Ordered Response: These questions require candidates to arrange a series of steps or items in the correct order. They evaluate the ability to understand and apply processes, such as clinical procedures or care plans.
6. Chart/Exhibit Questions: Candidates must interpret data presented in charts, tables, or exhibits to answer questions. These questions assess data analysis and the ability to extract relevant information from complex sources.

What to Expect from Next Gen NCLEX

The Next Generation NCLEX (NGN) represents a significant shift in how nursing competencies are assessed. The NGN is designed to better evaluate a candidate’s clinical judgment and decision-making abilities. Here’s what to expect:

1. Harder Question Content

One of the most notable changes in the NGN is the introduction of more challenging question content. This shift is intended to ensure that newly licensed nurses are prepared for the complexities of modern healthcare environments. Here are the key aspects:

• Increased Complexity: Questions are designed to reflect real-world clinical scenarios, which often involve multiple variables and require nuanced decision-making.
• Higher Cognitive Demand: Candidates will face questions that require higher-order thinking, such as analysis, synthesis, and evaluation, rather than mere recall of facts.
• Scenario-Based Questions: Many questions are embedded in detailed clinical scenarios that mimic actual patient care situations. This approach assesses the ability to apply knowledge in context and make informed decisions under pressure.

2. New Question Formats

The NGN introduces several new question formats that go beyond traditional MCQs. These formats are designed to provide a more comprehensive assessment of a candidate’s clinical judgment and critical thinking skills. Here are some of the new formats:

• Cloze (Drop-Down): These questions include sentences with missing words or phrases that candidates must select from drop-down menus. They test the ability to understand and apply clinical information in context.
• Extended Multiple Response: Similar to multiple response questions but with more answer choices and more than one correct combination. These questions assess the ability to prioritize and recognize multiple correct actions in a clinical situation.
• Matrix/Grid: Candidates must select answers from a grid or table format, often involving multiple parameters. These questions evaluate the ability to analyze complex data and make informed decisions.
• Extended Drag-and-Drop: More complex than standard drag-and-drop questions, these may involve categorizing items, sequencing steps, or matching related concepts. They test organizational skills and the ability to follow procedures.
• Bowtie and Trend: Bowtie questions involve identifying causes and effects in a scenario, while trend questions require analyzing changes over time, such as vital signs or lab results. These formats assess pattern recognition and longitudinal thinking.

3. Number of Scored Questions

The NGN also brings changes to the structure and scoring of the exam, including the number of scored questions. Here’s what candidates can expect:

• Variable Length: The exam continues to use a computerized adaptive testing (CAT) format, where the number of questions varies based on the candidate’s performance. The total number of questions can range from 85 to 150, with the exact number depending on how quickly the candidate demonstrates competency.
• Scored and Unscored Questions: The NGN includes both scored and unscored questions (also known as pretest items). Unscored questions are used to gather data for future exams and do not count towards the candidate’s final score. Candidates will not know which questions are unscored.
• Minimum and Maximum Questions: Candidates must answer a minimum of 85 questions, with up to 150 questions possible if the algorithm requires more data to make a reliable pass/fail decision. This structure ensures a thorough assessment of each candidate’s abilities.

Is NCLEX Changing in 2024

Yes, the NCLEX is changing in 2024 with the introduction of the Next Generation NCLEX (NGN). These changes are designed to improve the assessment of a candidate’s clinical judgment and decision-making abilities, which are crucial for safe and effective nursing practice.

The NGN introduces several new question formats, including cloze (drop-down), extended multiple response, matrix/grid, and extended drag-and-drop questions. These formats go beyond traditional multiple-choice questions to provide a more comprehensive evaluation of a candidate’s knowledge and skills.

The NGN also emphasizes scenario-based questions that reflect real-life clinical situations. These questions require candidates to apply their knowledge in context, making informed decisions based on complex patient care scenarios. This shift aims to better assess a candidate’s ability to think critically and make sound clinical judgments.

Is the New NCLEX Easier

The new NCLEX, known as the Next Generation NCLEX (NGN), is not easier than its predecessors. In fact, it is designed to be more challenging. The NGN incorporates complex question formats and places a stronger emphasis on clinical judgment, critical thinking, and decision-making skills. These updates aim to ensure that newly licensed nurses are well-prepared for the complexities of modern healthcare environments.

How Many Items Are in NCLEX 2024

The NCLEX-RN exam in 2024 will feature a range of 85 to 150 questions. This range includes both scored and unscored items. The minimum number of questions is set at 85, while the maximum can go up to 150, depending on the candidate’s performance.

The exam employs a computerized adaptive testing (CAT) format, which means the number of questions a candidate receives will vary. The CAT system adjusts the difficulty of questions based on the candidate’s ability level as demonstrated by their responses to previous questions. This adaptive approach ensures that the exam can accurately gauge a candidate’s competence with a variable number of questions.

Included in the total count are unscored questions, also known as pretest items, which are used by the test administrators to gather data for future exams. Candidates will not be able to distinguish these from scored questions as they appear randomly throughout the exam.

What Is the Minimum Number of Questions for the NCLEX-RN 2024

The minimum number of questions for the NCLEX-RN exam in 2024 is 85. This lower limit ensures that the computerized adaptive testing (CAT) system has enough data to make a reliable determination of a candidate’s competence. The minimum question requirement is designed to balance the need for a thorough assessment with the efficiency of the testing process.

Candidates must answer at least 85 questions, which include a combination of scored and unscored items. Unscored questions, also known as pretest items, are randomly interspersed throughout the exam and do not count towards the candidate’s final score. These pretest items are used to collect data for future versions of the exam.

When Was the NCLEX Last Updated

The NCLEX was last significantly updated in 2023 with the introduction of changes that are being fully implemented in 2024 under the Next Generation NCLEX (NGN) initiative. These updates represent a major shift in the exam’s structure and content, aiming to better assess the clinical judgment and decision-making abilities of nursing candidates.

The NGN updates include the introduction of new question formats, such as cloze (drop-down), extended multiple response, matrix/grid, and extended drag-and-drop questions. These new formats are designed to reflect real-life clinical scenarios and require candidates to apply their knowledge in context.

Final Comments

The 2024 updates to the NCLEX-RN exam represent a significant evolution in how nursing competencies are assessed. By incorporating more challenging question content, introducing innovative question formats, and adjusting the number of scored questions, the NCLEX aims to better evaluate candidates’ readiness for the demands of modern nursing practice. These changes reflect a commitment to maintaining high standards in the nursing profession and ensuring that new nurses are well-prepared to provide safe, effective, and compassionate care.

As candidates prepare for the Next Generation NCLEX, they should focus on developing their clinical judgment and decision-making skills, as well as familiarizing themselves with the new question formats. Comprehensive nclex preparation in 2024 and a deep understanding of the updated test pattern will be crucial for success in this more rigorous and dynamic examination.