NCLEX Question Types
Most of the questions of the NCLEX exam are worded multiple choice questions. In recent years, however, the NCSBN has added new format questions which do not involve simple multiple choice selection. Examples of the new formats include identifying and selecting a particular area of a drawn body part; selecting multiple correct answers via check boxes; free response mathematical questions usually involving medication calculations; and ordering the steps of a medical or nursing procedure.
Since the practice of nursing requires the application of knowledge, skills and abilities, the majority of items on the examination are written at the application or higher levels of cognitive ability using Bloom’s taxonomy and revised taxonomy (Bloom, 1956; Anderson and Krathwohl, 2001). These “higher level” items are said to require more complex thought processing and problem solving. For example, a pediatric client undergoing a medical procedure may additionally have a mental illness and therefore all factors must be considered in order to prepare the client for the procedure and to correctly answer the item.
Questions on the NCLEX exam are of three different types or levels: Level 1, Level 2, and Level 3. Level 1 questions are the most basic questions and make up less than 10 percent of the total questions.
Level 1 questions test the individual’s knowledge and understanding. These questions require the individual to recall specific facts and information.
Level 2 questions require an additional level of thinking in order to answer the question. In these types of questions, the individual will be required to know specific information and then use it to interpret or analyze the question. Level 2 questions are analysis and application type questions.
Level 3 questions are the most complex type of question on the NCLEX. These questions require the individual to judge, evaluate, and combine information. The individual will have to apply the rules, facts, and processes they know and then make decisions about what is best for the patient’s care based on the situation. What makes level 3 questions difficult is the likely existence of more than one correct answer forcing the individual to decide which answer is the best choice.
Level 2 and Level 3 questions make up about 95 percent of the questions on the NCLEX exam. However, it is possible for the exam to have no Level 1 question.