Well, we certainly like positive feedback from our many users, and we are always happy to share that feedback. In this case, our happy nursing graduate makes a particular point of mentioning that she was helped in her success by the select-all-that-apply questions found in our NCLEX-RN test bank and practice board exam. Of course, Multiple Response questions, as these are called, are just one of the item types found on the actual NCLEX exam, and in addition to multiple choice, constructed response, etc.

Our experience, and the opinion of the educators we work with is that students need practice with these alternate item types, even when they may know the material very well. It is something about the way the brain reviews and processes information presented in new ways that can really throw students a curve if they don’t have prior practice or experience. Our NCLEX resources, both our simulated board exams as well as the full question bank, contain dozens of carefully constructed multiple response test items just like the real NCLEX-RN.

A multiple response question is basically a multiple choice question with an important distinction, more than one answer choice can be correct, and it is often necessary to select all correct responses to get full credit (or any credit) for the question. Multiple response questions are normally more difficult to answer compared to multiple choice questions because the participant needs to simultaneously consider more information. Because more than one answer choice is typically required for a fully correct response, these questions feature more permutations than a single-best-answer multiple choice question, and they make guessing more difficult. Here is an example:

What are the elements of a therapeutic milieu environment? Select all that apply.

Answer Choices:

A. Clarifying patient expectations for care
B. Creating a written contract with the patient
C. Creating flexible rules for positive outcomes
D. Avoiding limitations or boundaries within the process
E. Positively reinforcing appropriate behavior

Our 265-item NCLEX-RN simulated board exam contains several dozens of these questions to provide our aspiring students the best possible practice and preparation for this important exam. Click here for a copy of our NCLEX-RN simulated board exam test plan. In this case, practice does make perfect as attested to by our happy nursing graduate.

Of course, developing valid, high-quality test questions is not easy, and typically, the more complex the test question, the harder they are to develop. For the multiple response question, think of scenarios that have elements which almost always go together, like when you change your car’s oil, you always change the filter, too! Likewise, sometimes it helps to develop scenarios that theoretically could be answered without looking at the answer choices. That is also often an important element of a quality test question, the existence of an objective answer not dependent on a set of responses. For more information on developing high-quality test questions including those found in nursing, please reach out here and let’s have a conversation.

According to the National Council of State Boards of Nursing (NCSBN) over 5.4 million nursing professionals have taken the NCLEX since April of 1994. That’s a lot of aspiring nursing professionals, and not surprising given that there are close to five million active nurses in the United States. Since those days, when Green Day, Nirvana and Pearl Jam were at the tops of the charts(!), the nursing profession has undergone many changes. Not least of these is the movement to raise the educational and practiced standards of the profession in response to the ever changing demands of our health care system. Magnet status is now ubiquitous among hospitals and hospital systems a status that requires, among other things, that RN nursing staff working at these facilities have at least a BSN degree. The Doctor of Nursing Practice Degree (DNP), not really seen before 1999, is now the capstone of the nursing profession. According to the American Association of Colleges of Nursing, there are over 330 DNP programs in the U.S. with another 100+ in the planning stages.

Stakeholders in the nursing profession recognize the valuable and vital role that the nursing professional plays in our healthcare system and healthcare delivery. That system has been characterized by rapid change, driven in part by the rapid expansion of knowledge required by nursing and other health professionals to function in interdisciplinary teams. The system is increasingly complex, increasingly data driven, with major emphasis placed on cost-effective and safe delivery of care. Evidence-based practices are de rigueur. These changes have placed new demands for nurses to function at higher levels than ever before as they navigate the increasing complexity of our health care system.

These changes in the landscape where nurses work bring us to “the Next Generation NCLEX” or NGN. A 2013-14 NCSBN Strategic Practice Analysis brought to light the increasingly complex role newly licensed nurses faced during the course of patient care, particularly in the area of clinical judgment and clinical decision-making. The study revealed that many or most newly- licensed nurses were not as prepared as they needed to be to meet the requirements of the modern healthcare system. These findings had serious implications for patient safety, the hallmark of all nursing practice.

If nursing programs need to better prepare nurses for success going forward, it was vitally important that these attributes be measurable by means of the NCLEX, the licensure pathway for all RN and PA nurses. The NGN, therefore, is a research project designed to determine if higher level skills can be assessed by means of a standardized exam. Central to the new NCLEX will be use of new item types, now under research, that are expected to better measure clinical judgment. We will be keeping an eye on this landscape and are working to help prepare the next generation of nursing professionals. Assuming the outcomes of the NGN research demonstrate efficacy in these methods of higher level assessment, the Next Generation NCLEX will be coming to a testing center near you!