(Updated April 2025)
The NCLEX (National Council Licensure Examination) and the Next Generation NCLEX (NGN) are both essential licensure exams for nurses in the United States and Canada. While they share the same goal — determining whether a candidate is ready to practice safely as a nurse — the NGN represents a major evolution in how nurses are tested.
In this guide, we’ll break down the differences between the classic NCLEX and the Next Gen NCLEX, walk through new question types, scoring changes, and how to best prepare in 2025.
📘 Quick Summary: The NGN officially launched on April 1, 2023 and has now fully replaced the old NCLEX format for both RN and PN candidates.
🧠 What Is the NCLEX?
The NCLEX has been the standard for nursing licensure for decades. It's a computerized adaptive test (CAT) designed to measure your clinical knowledge and decision-making skills across core nursing categories.
There are two versions:
- NCLEX-RN – for registered nurses
- NCLEX-PN – for licensed practical/vocational nurses
Administered by the National Council of State Boards of Nursing (NCSBN), the NCLEX determines whether you're ready to begin safe nursing practice.
🧪 NCLEX Exam Format (Before 2023)
- Type of Questions: Multiple choice, fill-in-the-blank, hot spot, and SATA (Select-All-That-Apply)
- Questions: Between 75–265 (adaptive)
- Test Length: Up to 6 hours
- Scoring: Pass/fail based on ability estimate
-
Content Areas:
- Pharmacology
- Medical-Surgical
- Pediatrics
- Psychiatric/Mental Health
- Safety & Infection Control
- Health Promotion
⚡ Enter the NGN: What Changed?
The Next Generation NCLEX (NGN) launched in April 2023 to better reflect the real-world decision-making nurses use daily. It was built around clinical judgment measurement — how nurses think, act, and prioritize in high-stakes patient care scenarios.
The NGN doesn’t just test what you know — it tests how you apply what you know.
🔄 Key Differences Between NCLEX and NGN
| Feature | Traditional NCLEX | Next Gen NCLEX (NGN) |
|---|---|---|
| Launched | Before 2023 | April 2023 |
| Focus | Knowledge-based | Clinical judgment-based |
| Question Types | MCQ, SATA, Fill-in-Blank | + Matrix Grid, Bowtie, Case Studies |
| Scoring | Pass/fail estimate | Partial credit, rationale scoring |
| Tools | Basic calculator, notes | Enhanced exhibits, case tabs, real-time data |
🧩 New NGN Question Types (2025)
NGN added several innovative formats that reflect the complexity of patient care decisions. Here's what to expect:
📋 1. Case Studies (Clinical Judgment Measurement)
Each case study includes multiple tabs of information (labs, history, vital signs) and a series of 6 questions. You're expected to synthesize the data and make step-by-step decisions about care.
📘 Try It: Next Gen NCLEX Case Studies – 25 Practice Questions
🧠 2. Matrix/Grid Questions
Select correct options from rows and columns. Used for things like:
- Matching symptoms to interventions
- Prioritizing tasks based on risk
🧪 3. Bowtie Questions
You're shown a visual bowtie diagram to match:
- Top: Most likely condition
- Middle: Assessment data
- Bottom: Interventions
🔥 4. Extended Multiple Response
Similar to SATA but with more than one correct answer — and partial credit for each right one.
🧠 How NGN Measures Clinical Judgment
The NCSBN Clinical Judgment Model is the framework behind NGN. It tests your ability to:
- Recognize cues
- Analyze data
- Form hypotheses
- Prioritize actions
- Respond appropriately
- Evaluate outcomes
The NGN scoring system gives partial credit, so you’re rewarded for what you do know — not penalized as harshly for partial answers.
🎯 Want to practice these skills? Learn about NGN question formats here
📆 NGN Timeline and Adoption
- 2019–2022: Research and pilot testing
- April 1, 2023: NGN officially replaced all NCLEX exams
- 2024–2025: Nursing schools continue adapting curricula and test prep materials
GoodNurse was among the first platforms to incorporate NGN-style question practice, with real case studies, clinical scenarios, and detailed explanations.
🎓 How to Prepare for the NGN in 2025
✅ 1. Use NGN-Aligned Resources
Make sure your NCLEX prep materials include case studies, drag-and-drop, and matrix items.
📘 Try our AI-powered NCLEX tutor and case questions
✅ 2. Focus on Clinical Reasoning
Understand not just the “what” but the “why.” NGN rewards rationale-based thinking.
✅ 3. Take Practice Exams with NGN Formats
Expose yourself to full-length exams with new question types to reduce test-day anxiety.
✅ 4. Reinforce Vocabulary and Concepts
Knowing core nursing terms makes navigating NGN questions easier.
📘 Check out: 50 Must-Know Nursing Terms for the NCLEX (2025)
🔁 Cross-Link Your Study Plan
If you're reading this, you're serious about passing. Use this roadmap to keep learning:
- 📘 NCLEX Study Tips That Actually Work in 2025
- 🧠 Different Types of Questions on the NCLEX Exam
- 🧪 Next Gen NCLEX Case Studies: 25 Questions with Answers
✅ Final Takeaway: NCLEX vs NGN
| Aspect | NCLEX (Pre-2023) | NGN (Current) |
|---|---|---|
| Format | Adaptive, knowledge-heavy | Clinical decision-making |
| Question Types | MCQ, SATA | + Case Studies, Matrix, Bowtie |
| Scoring | Right/wrong binary | Partial credit, multidimensional |
| Goal | Competency check | Real-world nursing readiness |
The NGN is here to stay — and it’s reshaping how we prepare future nurses.
📘 Ready to Crush the NGN?
Join over 17,000 students using GoodNurse to prepare for the Next Gen NCLEX with AI-powered explanations, flashcards, and case-based question banks.
