Millions aspire to work in the nursing industry, which is the largest healthcare profession, to improve the quality of healthcare for patients and citizens.

With over 5.2 million registered nurses, the NCLEX-RN exam is the final hurdle for ambitious nurses pursuing their licenses. Passing this extensive test demonstrates your ability to provide safe and effective patient care. 

Since April 2023, students preparing for the exam have faced a new challenge: the Next Generation NCLEX (NGNCLEX). Given that a change in the licensure exam forces a change in preparation and training, students tend to grow concerned, nervous, and anxious.

In this article, we will take you through the rationale behind the NGNCLEX implementation, explore its changes, and equip you with strategies to excel in your nursing licensure journey. Read on!

Table of Contents:

Why was the NGN Format Introduced?

The NG NCLEX implementation was more than just a name change. Considering the healthcare industry’s evolving needs, it required a change to review and ensure that aspiring nurses also evolved to meet these needs.

The old NCLEX format, with its memorization-based structure, was incredibly focused on nurses’ technical capabilities and left critical thinking and decision-making under-tested. The nursing licensure board adopted the next-generation NCLEX implementation to close this gap.

The NGN format was implemented to ensure that future nurses are prepared to handle the complexities of modern healthcare. This involved assessing their ability to deliver optimal patient care, their aptitude for embracing technological changes, and their handling of evolving patient needs and behaviors.

Also Read: Level Up Your Healthcare Training: Measuring the Power of eLearning

Exploring the Changes in the NCLEX Implementation

Understanding the reason behind any action goes a long way in understanding the next course of action, especially for change.

With the reason behind the NG NCLEX implementation in mind, let’s review what aspects of the licensure exam have changed:

1.  The Focus

With next-generation NCLEX implementation, critical thinking takes center stage. The NGNCLEX now emphasizes the ability to analyze situations, apply knowledge, and make sound clinical judgments. 

This is a clear shift from simply recalling facts to applying knowledge. The net result of this change is that the exam now assesses how one can interpret patient data, identify potential problems, prioritize interventions, and evaluate the effectiveness of care. 

2.  Test Format

In the traditional NCLEX, the primary question format was multiple choice questions (MCQs), testing your awareness of theoretical medical procedures and facts. With the next-generation NCLEX implementation, the nursing board has reduced the percentage of MCQs in the test format and introduced new question formats such as:

  1. Extended Multiple Choice: This format has multiple answers instead of MCQs with only one answer. This allows the candidate to assess and discern the numerous factors that must be considered in real-life scenarios.
  2. Drag-and-Drop Questions: This format challenges you to associate concepts or actions with the appropriate category. The question is presented so that you must drag and drop facts, medicines, or procedures into their correct classifications or diagnoses.
  3. Highlighting Text Questions: The new NCLEX implementation tests a candidate’s attention to detail. When provided with a passage, the candidate is required to identify and highlight key information within the passage that supports the answer to the question.
  4. Virtual Simulations: This new format tests the candidate’s decision-making. With information provided through a simulated electronic health record (EHR), the patient’s medical history, vital signs, laboratory results, medications, and nursing notes will be made available. Also, you can see and hear the patient using a virtual interface to assess their condition by analyzing their appearance, listening to lung or heart sounds, and reacting to vocal cues. You’ll need to order virtual diagnostic tests, prioritize interventions (e.g., drugs, nursing activities), document your care in the virtual EHR, and make clinical choices regarding the patient’s condition and treatment using this information.

3.  The Scoring Pattern

The NGNCLEX scoring system has been refined. It acknowledges the complexity of nursing decisions and rejects the all-or-nothing approach.

The scoring system allows you to obtain partial credit for some questions, especially in extended multiple-choice formats with many partially correct responses. This change will enable you to clearly understand the concepts, even if you don’t choose all the correct answers.

With that said, here are the two key ways that the NGNCLEX scoring pattern has been refined:

  1. Acknowledgment of Complexity: By embracing partial credit, the system recognizes the nuanced nature of nursing scenarios, where decisions often involve navigating through shades of gray. This departure from strict binary scoring underscores the importance of understanding underlying concepts, thereby fostering a more comprehensive evaluation process.
  2. Emphasis on Conceptual Grasp: Beyond mere correctness, the scoring system prioritizes the depth of candidates’ understanding. It highlights the significance of mastering fundamental principles, transcending mere memorization or surface-level comprehension.

NGN Strategies and Tips to Ace Your Nursing Licensure

With the new NCLEX implementation changing the way nursing skills are assessed, adapting your NGN strategies to develop these skills is an intelligent way to ace this licensure examination and keep yourself relevant to evolving healthcare needs.

Here are three key strategies and tips to help with your NCLEX test preparation:

1.  Shift Your Learning Perspective

With memorization no longer having significant sway in the NGN format, aspiring nurses must shift their learning perspective to strengthen their foundations and understanding of core concepts. Understanding the “why” effectively prepares you to apply your knowledge across situations.

2.  Leverage Official Resources

Along with the latest NCLEX implementation, the NCSBN has updated its official exam resources, including practice questions, test-taking strategies, and candidate information bulletins, to align with the latest NGN format.

3.  Take Advance Virtual Simulation Learning Solutions

One of the key changes of the new NCLEX implementation is its approach to evaluating decision-making. The virtual simulation questions play a vital role in this assessment. Using learning solution experts to deliver engaging virtual simulations will help you gain more experience and ace the examination.

Quick Tips to Manage Anxiety

Is the new NCLEX implementation still giving you anxiety? Here are some quick tips to help you calm your nerves,

  1. Acknowledge Your Anxiety: Bottling up nervous energy damages mental health; by acknowledging your emotions, you allow yourself to begin solving them.
  2. Focus on the Preparation: Giving it your all through preparation is a crucial element to achieving catharsis and gaining confidence. It also helps build a positive mindset towards the result.
  3. Refrain from Over-Exerting Yourself: Routine breathing breaks and relaxation keep the mind fresh and ready to learn more. Make sure to prioritize self-care amidst your preparation journey.

Also Read: Customized Assessments to Help Evaluate Competencies and Progress in Healthcare Education


Acquiring the NGNCLEX can become seamless by focusing on building a solid foundation, cultivating a positive learning attitude, and implementing effective preparation strategies. Most importantly, practicing virtual simulations plays a pivotal role in preparation, boosts critical thinking, and helps strengthen foundations.

At Hurix Digital, our learning solution experts can help you craft personalized, knowledge-rich virtual simulations that seamlessly prepare you for the exam. Contact us now and start your journey to NGNCLEX mastery!