They’ve gone and done it! The National Council of State Boards of Nursing (NCSBN) has shaken things up by revamping the questions in the NCLEX. And they’re calling it…

Next Generation NCLEX (NGN). Dun dun duuuuuun!

As you likely know, the National Council Licensure Examination (NCLEX) is the standardized test that nursing students must pass in order to become licensed as a registered nurse (RN) or a licensed practical nurse (LPN). The test is designed to assess the knowledge, skills, and abilities that are essential for entry-level nurses to provide safe and effective care to patients.

But now, with the introduction of Next Generation NCLEX questions, both nurse students and educators are forced to rethink their studying / instructional strategies because these questions differ from the traditional, multiple-choice format in several ways…

We’ll be taking a look at those differences in this Next Generation NCLEX study guide in just a bit but first, who are we and what do we know about nurse education?

Hi! We’re Brainscape

We’re the brains, minds, and hearts behind the world’s smartest study app. Led by NCLEX prep expert Justine Buick——we’ve compiled a comprehensive collection of study guides (like this one) and digital flashcards for the NCLEX-RN and NCLEX-PN licensing exams.

Brainscape NCLEX flashcards for nursing students
The flashcard above (question side on the left, answer side on the right) was taken from Brainscape’s certified RN flashcard collection, specifically the deck on nutrition.

These have been carefully curated and vetted to offer nurse students a hyper-efficient way to drill the enormous amounts of content they need to learn and remember to answer the more complex questions posed by the NCLEX.

The 3,490+ smart, digital flashcards in this collection cover the most important concepts in the latest NGN test plan, as well as Saunders, Kaplan, Hurst, Lippincott, HESI, Khan Academy, and other top NCLEX review books and courses. In other words, no matter which one you’re using, we’ve got you covered!

And if you're still in nursing school, check out our flashcards for all the topics you'll be learning: Pediatrics flashcards, Adult Health flashcards, Pharmacology flashcards, Management of Care flashcards, Maternity flashcards, Mental Health flashcards, and Safety & Infection flashcards.

What sets Brainscape apart from any other study app is that its adaptive learning algorithm leverages spaced repetition (and several other key learning tactics) to help you memorize fundamental nursing concepts WAY more efficiently than the traditional study methods you’ve probably been taught.

So, now that you know who we are and why we know a thing or two about acing the NCLEX, let’s officially kick off this Next Generation NCLEX study guide! Also be sure to check out the following video interview with NCLEX prep guru Damion Jenkins (RN, MSN) of The Nurse Speak

How do Next Generation NCLEX questions differ?

Nursings studying for the NCLEX

Next Gen NCLEX is being heralded as the “new and improved” version of this milestone examination, which countless students and educators have invested a ton of time into trying to understand; either so that they can pass it themselves or help other students do so.

And considering that the NCLEX is the gateway through which every nursing student must travel in order to establish a career in healthcare, it’s little wonder that the coming changes are making people a little nervous.

So, how do Next Generation NCLEX questions differ from their predecessors?

Next Gen NCLEX questions focus on case studies or real scenarios

There is a shift towards examining real healthcare scenarios and case studies, which compel test-takers to analyze the information and make a clinical judgment (as you would if you were a practicing nurse). This means that students will need to really understand the underlying principles and concepts behind the question, rather than simply memorizing facts.

The exam will present three unfolding case studies with six questions each, all focusing on the same patient, for a total of 18 healthcare scenarios. Other questions will be included, too, including up to 10 questions that are a bit more complex than your traditional Select All That Apply (SATA).

Next Gen NCLEX questions are more complex

Because of the afore-mentioned simulation of case studies, NGN questions tend to be more complex; requiring a higher level of critical thinking.

The reason this doesn’t suck, contrary to how you may be feeling after reading this, is because it’s FAR better to make your mistakes outside the clinical healthcare environment—on an exam, say—than when someone’s life could be at stake! The NCLEX is simply trying to make sure you are prepared to provide quality healthcare.

Next Gen NCLEX features new types of / extended questions

The NGN has adjusted its questioning in FIVE ways:

  • Extended multiple response questions, which essentially expands on the number of possible answers for all the multiple-response questions (like the ‘Select All That Apply’ section).
  • Extended drag-and-drop questions: Test-takers are required to drag the correct response(s) into one of the blank answer spaces provided but now they’ll have to determine whether to use some or ALL of the options provided.
  • “Cloze” type or Drop-Down questions: Test-takers are required to complete a statement by selecting the correct answers from a drop-down menu of answers, for example:
Next Gen NCLEX practice questions
An example of a "Cloze" type question. Note that there may be multiple drop-down answers in a single question. 
  • Enhanced “Hot Spot” questions require you to HIGHLIGHT or select relevant words or phrases from a sample medical record that corresponds to the question itself.
  • Matrix / Grid questions: features rows and columns with options that you must select, example:
Next Gen NCLEX practice questions

Next Gen NCLEX questions cross-pollinate subject areas

Secondly, Next Generation NCLEX questions are designed to assess the test-taker's ability to integrate and apply knowledge across different areas of nursing. For example, a question might require you to consider how a patient's medications, laboratory values, and physical examination findings are related.

In other words you shouldn’t learn each topic in isolation. Instead, you should be able to quickly switch between different concepts, understand how they relate to each other, and be comfortable assessing real clinical scenarios that involve multiple interleaving factors.

Pro Tip: To really hone the skills of being able to jump between different concepts, use Brainscape’s Smart Study feature (the blue ‘Study’ button right at the top of your mobile dashboard). This will randomly test you on concepts that are drawn not just from a single nursing class—like Adult Health, for example—but from multiple subjects; say, Adult Health, Maternity, and Pharmacology (or even more if you desire).

(This taps into a powerful learning strategy called interleaving practice, which deepens your understanding of each individual concept.)

So, to start studying a random, yet optimized mix of nursing content across multiple classes, click on the configure icon to the left of the ‘Smart Study’ button in mobile and adjust your settings accordingly.

Brainscape Smart Study feature
Brainscape's Smart Study feature allows you to configure what percentage of each subject you study at the same time, unlocking a learning strategy called 'interleaving practice'.

Next Gen NCLEX questions align more closely with actual nursing practice

Next Generation NCLEX questions are more closely aligned with the nursing practice and the outcomes that are important for patient safety and quality of care. The NCSBN developed Next Gen NCLEX questions using an evidence-based approach, which means that the questions are based on the most current and relevant research and practice standards.

Next Gen NCLEX changes that make your life easier

At this point, you might be asking yourself why the heck the NCSBN would do this to you and every other student out there, who is just trying to pass this exam so they can join the workforce.

The answer is simple.

Next Generation NCLEX questions prepare you to be a better nurse.

The NCSBN has changed the NCLEX questions to better reflect the current practice of nursing, and to ensure that the test is measuring the knowledge and skills that are essential for entry-level nurses. In other words, the NCSBN is better preparing students for the demands of the nursing profession!

Also, Next Gen NCLEX comes with three changes that you’ll certainly find to be great news

Overall, the content is the same

If you’ve been working your butt off to prepare for the NCLEX and have just realized that your test date is set for after the April 1st shift to Next Generation NCLEX, you can relax. The content is the same as before so you don’t have to worry about any of your studying going to waste.

You now get partial credit

Next Gen NCLEX has changed their scoring model to now award test-takers partial credit on questions with multiple-response items.That’s a huge improvement on the old model, which either awards full credit or NO credit, even if you only missed a single item in a multiple-response question. (And, yes, this includes the dreaded Select All That Apply questions!)

You don’t have to memorize normal lab values anymore

No more drilling yourself on a formidable slew of normal lab values. These are now provided on the exam; however, you still need to know what labs refer to and what it means when results are abnormal. Still though, that’s a significant chunk of work off your plate!

Are Brainscape’s NCLEX-RN or PN flashcards affected by the change?

Brainscape certified NCLEX flashcards
Together with NCLEX prep expert, Justine Buick——the Brainscape team has distilled down the medical content tested by NCLEX into a collection of 3,000+ smart, digital flashcards, which you can use anytime, anywhere to drill yourself on the most important concepts you need to know.

Some of you reading this will be well-acquainted with Brainscape’s collections of expert-curated NCLEX-RN and NCLEX-PN flashcards, which are designed to drill you on the key concepts you need to know to tackle the more complex questions posed by the exam.

The good news is that the arrival of Next Gen NCLEX doesn’t affect these flashcards because the content they drill you on—the content you need to be well-versed in as a nurse—is essentially the same.

The test will continue to measure the same critical content areas with most Next Generation NCLEX questions remaining standard, knowledge-based questions.

As such, from Pharmacology, Safety & Infection Control, and Maternity to Adult Health, Mental Health, and Pediatrics, all the facts you need to understand and have ingrained in your brain are still covered by Brainscape’s NCLEX flashcards, which are expert-curated and vetted according to the latest NCLEX test plan.

What has changed is HOW you are required to apply your knowledge to solving the various complex healthcare scenarios the NCLEX throws at you.

A final word on Next Generation NCLEX

Advice on studying for Next Generation NCLEX

Overall, the arrival of Next Generation NCLEX is a good thing. A great thing! Running the gauntlet of this exam will ensure that the first day you step into a real healthcare environment, you won’t feel crippled by Imposter Syndrome. You’ll have the tools and sharpened critical thinking and problem-solving skills to make safe decisions no matter what scenario is thrown at you. Also, lest we forget, partial credit! That’s a huge benefit!

So remember that: Next Generation NCLEX questions are designed to more closely align with current nursing practice and outcomes so that you are better prepared to transition seamlessly into the real healthcare environment. To better prepare, you should focus on developing your critical thinking skills and familiarize yourself with current research and practice standards.

If you do that and establish a daily study habit with Brainscape’s nursing flashcards, you will rise to the challenge of the Next Generation NCLEX!

For more information about Next Generation NCLEX (straight from the horse’s mouth) check out the official NCSBN website.

To start studying for the NCLEX more efficiently than ever, add Brainscape’s certified NCLEX-RN flashcards to your study plan. We also have certified flashcards for the NCLEX–PN.