NCLEX question types

Each page explains the format, how it is scored and shows one item from our practice exams. The NCLEX tutorial on NCLEX.com is NCSBN’s own walkthrough of every format.

• Bow-tie

  How NCLEX bow-tie items work: pick the condition, two actions and two parameters to monitor. How partial credit works, with a worked practice example.

• Matrix (grid)

  How NCLEX matrix (grid) items work: one decision per row, or several. Which partial-credit rule applies, with a worked practice example and rationale.

• Select all that apply (multiple response)

  How NCLEX select-all-that-apply items are scored: plus/minus partial credit, what "one or more" means, and a worked practice example with rationale.

• Drop-down cloze

  How NCLEX drop-down cloze items work: fill each blank in a sentence or chart from a list. How each drop-down is scored, with a worked practice example.

• Highlight

  How NCLEX highlight items work: select the words or phrases in a note or table that answer the question. How partial credit works, with a practice example.

• Trend

  How NCLEX trend items work: compare findings across several times and decide what the change means. How they are scored, with a worked practice example.

Items with more than one correct answer can earn partial credit. NCSBN uses three rules, and which one applies depends on what the instructions ask you to do.

• Plus/minus (+/-)

  Used when you may select an unspecified number of options.

  You earn a point for each correct option you select and lose a point for each incorrect one. The most you can earn is the number of correct options; the lowest score is zero.

• Zero/one (0/1)

  Used when you are told to choose a specific number of responses.

  You earn a point for each correct response and nothing for an incorrect one. On an item worth several points, the item score is the sum of the correct responses.

• Rationale scoring

  Used when you evaluate closely linked information, such as a cause and its effect.

  The answers come in pairs. Both parts of a pair must be correct to earn its point.

For calculation items, NCSBN says to round only at the end, and to enter a decimal point when the item asks for decimal places. There is no set percentage of each format on an exam.

Sources: NCLEX.com, Frequently Asked Questions; NCSBN, 2026 NCLEX-RN Test Plan (PDF). Checked against NCSBN as of October 29, 2026.