NGN case studies and item formats, explained

SINCE APRIL 2023

1. What NGN changed

• NCSBN launched NGN on April 1, 2023Built to measure clinical judgment and decision making
• Clinical judgment is tested 2 waysCase studies and stand-alone items

Sources: NCSBN NGN launch release; 2026 NCLEX-RN Test Plan

CASE STUDIES

2. One client, six questions

• Each case study has 6 items about the same client
• New client information unfolds as you go
• Each item matches one clinical judgment step
• The minimum-length exam has 3 case studies (18 items)

Source: NCSBN 2026 NCLEX-RN Test Plan

THE 6 STEPS

3. NCSBN's clinical judgment steps

1. Recognize cuesFind the information that matters
2. Analyze cuesConnect it to the client's situation
3. Prioritize hypothesesRank concerns by urgency and risk
4. Generate solutionsSet outcomes and plan interventions
5. Take actionDo what addresses the top priority
6. Evaluate outcomesCompare what happened with what you expected

Source: NCSBN 2026 NCLEX-RN Test Plan

STAND-ALONE ITEMS

4. Clinical judgment outside a case

• About 10% stand-alone clinical judgment itemsSelected depending on how long your exam runs
• Any item can include charts, tables or graphicsRead the exhibit before the options

Source: NCSBN 2026 NCLEX-RN Test Plan

SCORING

5. Partial credit and pacing

• Items with more than one key can earn partial creditPlus/minus, zero/one or rationale scoring
• Rapid guessing can drastically lower your scoreKeep a steady pace and read every item

Sources: NCSBN 2026 NCLEX-RN Test Plan; 2026 NCLEX Candidate Bulletin

PRACTICE THE FORMATS

6. See them before test day

• Start with NCSBN's candidate tutorialNCSBN points candidates to it on NCLEX.com
• Then practice every formatOur free set has matrix, drop-down, highlight, ordered, drag-and-drop, bowtie and trend items