NCLEX-RN Preparation Guide: What You Need to Know About Next Generation NCLEX (NGN)
Apr 3
/
Vinod Sasidharan
NCLEX-RN Preparation: Your Beginner's Guide to the Next Generation NCLEX (NGN)
So you have decided to take the NCLEX-RN - congratulations on taking this important step in your nursing career. Whether you are an internationally educated nurse preparing to practise in the United States, Canada, Australia or another country that recognises the NCLEX credential, understanding what the exam involves - and how it has recently changed - is the first and most important step in your preparation journey.
What is NCLEX-RN?
The NCLEX-RN, or National Council Licensure Examination for Registered Nurses, is the standardised licensing examination that every candidate must pass in order to practise as a registered nurse in the United States and Canada. Administered by the National Council of State Boards of Nursing (NCSBN), the exam is designed to assess whether a candidate has the knowledge, skills, and clinical judgement necessary to provide safe and effective nursing care.
What is the Next Generation NCLEX (NGN)?
The NGN assesses clinical judgement using a framework called the NCSBN Clinical Judgement Measurement Model (NCJMM), which focuses on six key cognitive skills: recognising cues, analysing cues, prioritising hypotheses, generating solutions, taking action, and evaluating outcomes. Every question on the NGN is designed to test one or more of these skills in a realistic clinical context.
What Are Next Generation Question Types?
1. Extended Multiple Response - select all options that apply from a larger list, requiring careful analysis rather than guesswork.
2. Extended Drag and Drop - arrange or match clinical information in a meaningful order, testing your ability to prioritise and sequence nursing actions.
3. Cloze (Drop-Down) - complete a clinical sentence or nursing note by selecting the most appropriate word or phrase from a drop-down menu.
4. Enhanced Hot Spot (Highlighting) - read a clinical document such as a nurse's note or medical history and highlight the information that is most relevant to the clinical scenario.
5. Matrix/Grid - assess multiple conditions or actions simultaneously by completing a grid, evaluating your ability to think across several clinical variables at once.
6. Trend - review a series of clinical data points over time and use that trend to inform your nursing judgement.
How Should a Beginner Approach NGN Preparation?
First, familiarise yourself with the NCSBN Clinical Judgement Measurement Model. Understanding the six cognitive skills it measures will help you approach every question with the right mindset - asking yourself not just "what is the answer?" but "why is this the right clinical decision?"
Third, do not neglect content mastery. While clinical judgement is central to the NGN, you cannot think critically about a situation you do not understand. Build a strong foundation in medical-surgical nursing, pharmacology, maternal-newborn, mental health, and paediatric nursing - these remain the core content areas of the exam.
Finally, seek guidance from those who understand both the exam and your unique journey as an internationally educated nurse. The NCLEX can feel overwhelming, particularly when you are adapting to a new healthcare context and learning a new exam format at the same time.
How Nurse Trainer Can Help
At Nurse Trainer, our NCLEX-RN programme is designed specifically for internationally educated nurses starting their preparation journey. Our content is aligned with the latest NGN blueprint, incorporating all six new question types alongside clear explanations, clinical case studies, and a personalised learning approach that helps you build both knowledge and confidence. With affordable fees and an easy-to-navigate platform, we make high-quality NCLEX preparation accessible - wherever you are in the world.
What is the Next Generation NCLEX (NGN)?
In April 2023, the NCSBN introduced a significant update to the NCLEX-RN — known as the Next Generation NCLEX, or NGN. This was not simply a cosmetic change. The NGN was developed in response to growing evidence that clinical judgement is one of the most critical - and most commonly deficient - skills among newly graduated nurses. The updated exam is specifically designed to measure a candidate's ability to think like a nurse, not just recall facts.
The NGN assesses clinical judgement using a framework called the NCSBN Clinical Judgement Measurement Model (NCJMM), which focuses on six key cognitive skills: recognising cues, analysing cues, prioritising hypotheses, generating solutions, taking action, and evaluating outcomes. Every question on the NGN is designed to test one or more of these skills in a realistic clinical context.
What Are Next Generation Question Types?
This is where the NGN differs most noticeably from the traditional NCLEX. Alongside familiar multiple-choice questions, candidates will now encounter six new question formats specifically designed to assess clinical judgement:
1. Extended Multiple Response - select all options that apply from a larger list, requiring careful analysis rather than guesswork.
2. Extended Drag and Drop - arrange or match clinical information in a meaningful order, testing your ability to prioritise and sequence nursing actions.
3. Cloze (Drop-Down) - complete a clinical sentence or nursing note by selecting the most appropriate word or phrase from a drop-down menu.
4. Enhanced Hot Spot (Highlighting) - read a clinical document such as a nurse's note or medical history and highlight the information that is most relevant to the clinical scenario.
5. Matrix/Grid - assess multiple conditions or actions simultaneously by completing a grid, evaluating your ability to think across several clinical variables at once.
6. Trend - review a series of clinical data points over time and use that trend to inform your nursing judgement.
Many of these question types are presented within case studies - called unfolding case studies - where a patient scenario evolves across a series of questions, asking you to apply your clinical thinking at each stage of care.
How Should a Beginner Approach NGN Preparation?
If you are new to NCLEX prep, the most important thing to understand is this: the NGN rewards thinking, not memorising. Here is how to start on the right foot.
First, familiarise yourself with the NCSBN Clinical Judgement Measurement Model. Understanding the six cognitive skills it measures will help you approach every question with the right mindset - asking yourself not just "what is the answer?" but "why is this the right clinical decision?"
Second, practise with NGN-style questions from the very beginning of your preparation. Do not wait until you have finished content review to start practising. Integrating question practice into your daily study routine helps you apply knowledge in context, which is exactly what the NGN demands.
Third, do not neglect content mastery. While clinical judgement is central to the NGN, you cannot think critically about a situation you do not understand. Build a strong foundation in medical-surgical nursing, pharmacology, maternal-newborn, mental health, and paediatric nursing - these remain the core content areas of the exam.
Finally, seek guidance from those who understand both the exam and your unique journey as an internationally educated nurse. The NCLEX can feel overwhelming, particularly when you are adapting to a new healthcare context and learning a new exam format at the same time.
How Nurse Trainer Can Help
At Nurse Trainer, our NCLEX-RN programme is designed specifically for internationally educated nurses starting their preparation journey. Our content is aligned with the latest NGN blueprint, incorporating all six new question types alongside clear explanations, clinical case studies, and a personalised learning approach that helps you build both knowledge and confidence. With affordable fees and an easy-to-navigate platform, we make high-quality NCLEX preparation accessible - wherever you are in the world.
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