Updated for Next Generation NCLEX (NGN)

NCLEX-RN Overview

How the exam works, what the new NGN format means for you, how it's scored, and what to expect on test day.

How CAT works

NCLEX uses Computer Adaptive Testing (CAT). The exam adapts to your performance in real time — after each answer, the algorithm selects your next question based on your estimated ability level.

The exam ends when the algorithm is 95% confident your true ability is above (pass) or below (fail) the passing standard — or when you hit the question limit (minimum 85, maximum 145 for RN).

Minimum Questions85

Maximum Questions145

Time Limit5 hours

Passing StandardPerformance-based

ResultsUnofficial within 48 hrs

Retake Wait45 days

Next Generation NCLEX

The 6 new NGN item types

Introduced in 2023, NGN items test clinical judgment — not just memorized facts. They require you to analyze patient scenarios and make real nursing decisions across multiple steps.

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Extended Drag & Drop

Arrange responses into a specific order or match items across columns. Tests understanding of clinical sequences.

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Matrix Grid

Select multiple responses across rows and columns. Often used to test which interventions apply to which conditions.

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Trend

Presented with changing patient data over time. Select how the patient's condition is trending and what to do.

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Highlight

Read a medical record or clinical note and highlight the specific text that answers the question.

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Drop-Down Cloze

Complete sentences about patient care by selecting from drop-down menus embedded in the text.

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Bow-Tie

The most complex NGN type. Identify conditions, actions to take, and parameters to monitor — all in one item.

Practice NGN Questions

NCLEX content areas

The four client needs categories and their weight on the exam.

Safe & Effective Care Environment

~38%

Management of Care (17–23%)
Safety & Infection Control (9–15%)

Health Promotion & Maintenance

~6–12%

Across lifespan, risk reduction, prevention

Psychosocial Integrity

~6–12%

Mental health, coping, therapeutic communication

Physiological Integrity

~38–62%

Basic Care (6–12%)
Pharmacology (12–18%)
Reduction of Risk (9–15%)
Physiological Adaptation (11–17%)