Next Generation
NCLEX Guidebook 2023
for Students
PREPARED AND PRESENTED BY:
ATI Nursing Education
Your reference for everything
you need to know about the new
version of the NCLEX
,Table of contents
A NEW NCLEX 4 PRIORITY SETTING 14 NEW ITEM TYPES 25
THE NEW VERSION OF THE NCLEX®........................................................4
Why the new NCLEX was needed........................................................................................ 4
CLINICAL JUDGMENT & ITS IMPACT ON PUBLIC SAFETY.......................5
Clinical judgment is necessary when caring for the complex needs of clients..................... 5
How do you define clinical judgment?................................................................................. 5
How is priority setting related to clinical judgment?............................................................ 5
Priority-setting frameworks (including item examples & rationales)..................................... 6
• Maslow’s hierarchy of needs............................................................................................ 6
• Airway-breathing-circulation............................................................................................ 7
• Safety & risk reduction..................................................................................................... 8
• The nursing process........................................................................................................ 9
• Least restrictive/Least invasive...................................................................................... 10
• Acute vs. chronic/Unstable vs. stable/Urgent vs. nonurgent ........................................ 11
• Survival potential........................................................................................................... 13
STEPS TO PREPARE FOR THE NEW NCLEX............................................15
Step 1: Understand the NCSBN’s Clinical Judgment Measurement Model (CJMM).... 15
Step 2a: Review the six functions of clinical judgment in Layer 3................................. 16
Step 2b: Review the environmental and individual factors in Layer 4........................... 17
2
,Table of contents (continued)
Compare “The relationship of approaches to fostering clinical judgment”...................... 18
Function 1: Recognize cues (assessment)...................................................................... 19
Function 2: Analyze cues (analysis)................................................................................ 20
Function 3: Prioritize hypotheses (analysis)................................................................... 20
Function 4: Generate solutions (planning).................................................................... 21
Function 5: Take actions (implementation).................................................................... 21
Function 6: Evaluate outcomes (evaluation).................................................................. 22
DETAILS ABOUT THE NEW EXAM........................................................... 23
The NGN covers more than just clinical judgment.............................................................23
The length of the Next Gen NCLEX....................................................................................23
• How much time is required to answer new item types?.................................................24
• What hasn’t changed from the previous version of the NCLEX?...................................24
New item types on the NGN...............................................................................................25
• An introduction to the case study..................................................................................26
• The format of case studies.............................................................................................27
An introduction to stand-alone items..................................................................................29
Sample of a bow-tie stand-alone item................................................................................30
The different formats of case study and trend item types...................................................31
• Matrix item type.............................................................................................................32
• Highlight item type........................................................................................................33
• Drag-and-drop item type...............................................................................................34
• Multiple-response item type..........................................................................................35
• Drop-down item type.....................................................................................................36
Differences in scoring the Next Generation NCLEX...........................................................37
• How new item types are scored.....................................................................................37
Note: The information in this guide was current at the
time of publication, but the NCSBN regularly releases
new details on the NGN.
Copyright © 2023 Assessment Technologies Institute® LLC. All rights reserved.
Images from the NCSBN used with permission, 2020.
3
, The new version of the NCLEX:
The Next Generation NCLEX
We’ve gathered everything you need to know so you are prepared
for the Next Generation NCLEX.
The National Council of State Boards NGN). If you haven’t taken your board exam
of Nursing (NCSBN) is the organization yet or will be retaking it, then you will be
that oversees the National Council tested using this new version of the exam.
Licensure Examination, more commonly
referred to as the NCLEX. To help you understand what the test includes,
we’ve gathered all you need to know in this
On April 1, 2023, the NCSBN launched a guide created specifically for students. It
new version of the exam, which it refers provides the most up-to-date and clearly
to as the Next Generation NCLEX (or the explained information currently available.
Why a new NCLEX was needed
Nurses face more complex client needs in a rapidly changing
healthcare environment.
Healthcare is very dynamic today compared to today care for people with more acute, complex,
years past. It moves at a rapid pace. And nurses and chronic illnesses that require completely
new technology.
The NCSBN confirmed this reality by viewing
new nurses at work. This observational practice
analysis verified how often new nurses use
clinical judgment in their daily tasks
in today’s practice settings.
Upon reviewing this research, the NCSBN
realized it was critical to change the NCLEX
so that the exam could accurately assess
candidates’ clinical judgment skills to ensure
public safety.
4
NCLEX Guidebook 2023
for Students
PREPARED AND PRESENTED BY:
ATI Nursing Education
Your reference for everything
you need to know about the new
version of the NCLEX
,Table of contents
A NEW NCLEX 4 PRIORITY SETTING 14 NEW ITEM TYPES 25
THE NEW VERSION OF THE NCLEX®........................................................4
Why the new NCLEX was needed........................................................................................ 4
CLINICAL JUDGMENT & ITS IMPACT ON PUBLIC SAFETY.......................5
Clinical judgment is necessary when caring for the complex needs of clients..................... 5
How do you define clinical judgment?................................................................................. 5
How is priority setting related to clinical judgment?............................................................ 5
Priority-setting frameworks (including item examples & rationales)..................................... 6
• Maslow’s hierarchy of needs............................................................................................ 6
• Airway-breathing-circulation............................................................................................ 7
• Safety & risk reduction..................................................................................................... 8
• The nursing process........................................................................................................ 9
• Least restrictive/Least invasive...................................................................................... 10
• Acute vs. chronic/Unstable vs. stable/Urgent vs. nonurgent ........................................ 11
• Survival potential........................................................................................................... 13
STEPS TO PREPARE FOR THE NEW NCLEX............................................15
Step 1: Understand the NCSBN’s Clinical Judgment Measurement Model (CJMM).... 15
Step 2a: Review the six functions of clinical judgment in Layer 3................................. 16
Step 2b: Review the environmental and individual factors in Layer 4........................... 17
2
,Table of contents (continued)
Compare “The relationship of approaches to fostering clinical judgment”...................... 18
Function 1: Recognize cues (assessment)...................................................................... 19
Function 2: Analyze cues (analysis)................................................................................ 20
Function 3: Prioritize hypotheses (analysis)................................................................... 20
Function 4: Generate solutions (planning).................................................................... 21
Function 5: Take actions (implementation).................................................................... 21
Function 6: Evaluate outcomes (evaluation).................................................................. 22
DETAILS ABOUT THE NEW EXAM........................................................... 23
The NGN covers more than just clinical judgment.............................................................23
The length of the Next Gen NCLEX....................................................................................23
• How much time is required to answer new item types?.................................................24
• What hasn’t changed from the previous version of the NCLEX?...................................24
New item types on the NGN...............................................................................................25
• An introduction to the case study..................................................................................26
• The format of case studies.............................................................................................27
An introduction to stand-alone items..................................................................................29
Sample of a bow-tie stand-alone item................................................................................30
The different formats of case study and trend item types...................................................31
• Matrix item type.............................................................................................................32
• Highlight item type........................................................................................................33
• Drag-and-drop item type...............................................................................................34
• Multiple-response item type..........................................................................................35
• Drop-down item type.....................................................................................................36
Differences in scoring the Next Generation NCLEX...........................................................37
• How new item types are scored.....................................................................................37
Note: The information in this guide was current at the
time of publication, but the NCSBN regularly releases
new details on the NGN.
Copyright © 2023 Assessment Technologies Institute® LLC. All rights reserved.
Images from the NCSBN used with permission, 2020.
3
, The new version of the NCLEX:
The Next Generation NCLEX
We’ve gathered everything you need to know so you are prepared
for the Next Generation NCLEX.
The National Council of State Boards NGN). If you haven’t taken your board exam
of Nursing (NCSBN) is the organization yet or will be retaking it, then you will be
that oversees the National Council tested using this new version of the exam.
Licensure Examination, more commonly
referred to as the NCLEX. To help you understand what the test includes,
we’ve gathered all you need to know in this
On April 1, 2023, the NCSBN launched a guide created specifically for students. It
new version of the exam, which it refers provides the most up-to-date and clearly
to as the Next Generation NCLEX (or the explained information currently available.
Why a new NCLEX was needed
Nurses face more complex client needs in a rapidly changing
healthcare environment.
Healthcare is very dynamic today compared to today care for people with more acute, complex,
years past. It moves at a rapid pace. And nurses and chronic illnesses that require completely
new technology.
The NCSBN confirmed this reality by viewing
new nurses at work. This observational practice
analysis verified how often new nurses use
clinical judgment in their daily tasks
in today’s practice settings.
Upon reviewing this research, the NCSBN
realized it was critical to change the NCLEX
so that the exam could accurately assess
candidates’ clinical judgment skills to ensure
public safety.
4
