What are Stand-alone Item Types in Next Generation NCLEX NGN? With Sample Questions and Answers

 

Stand-alone (single) items test either client needs or clinical judgment. 

Client needs items are primarily traditional NCLEX style questions.

Clinical judgment items present information in a clinical scenario specifically targeting one or more NCSBN Clinical Judgment Measurement Model (NCJMM) clinical judgment step. The NCJMM uses an evidence-based method for measuring and deriving valid inferences around the nursing clinical judgment and decision-making ability of prospective entry-level nurses.

Clinical judgment stand-alone items make up approximately 10% of stand-alone items. 

2 Types of Stand-alone Items: 

1. Bow-tie 

2. Trend 

The Bow-tie Stand-alone Item

   A bow-tie is a drag-and-drop response item variation. After reading a clinical scenario, candidates move response options (tokens) to placeholders (targets). On NCLEX the placeholders are arranged in the shape of a bow-tie. Candidates must select: 1 condition the client is most likely experiencing from 4 options. 2 actions to take to address the condition from 5 options. 2 parameters to monitor the client’s progress from 5 options.

The Trends Stand-alone Item

Trend items require the candidate to make clinical judgments based on client data presented at different time points. Trend items may address one or more clinical judgment steps but do not follow the six-item sequence like case studies do. Trend items can feature any item response type except the drag-and-drop bow-tie variation.  

Sample Next Generation NCLEX Bow-tie Stand-alone Item Questions and Answers:

The 16-year-old client is seen in the emergency department for evaluation of fainting episodes.

 From the list of choices drag the 1 condition that the client is most likely experiencing to the box on the right.

Drag and drop items into groups. Within each group, rank items by dragging and dropping them into place.

Items Dehydration Hypoglycemia Severe anemia Shock

Condition most likely experiencing

Drag 2 actions the nurse should take to address that condition to the box on the right.

Drag and drop items into groups. Within each group, rank items by dragging and dropping them into place.

Items Potassium supplementation Glucagon Blood transfusion Oxygen 2L via NC IV fluid*

Actions to Take

Drag 2 parameters the nurse should monitor to assess the client’s progress to the box on the right.

Drag and drop items into groups. Within each group, rank items by dragging and dropping them into place.

Items Urine output Point of care blood glucose Electrolytes* Pulse oximeter Hemoglobin/hematocrits

Parameters to monitor

ANSWERS TO THE NCLEX NGN BOW-TIE STAND ALONE ITEM QUESTIONS

  From the list of choices drag the 1 condition that the client is most likely experiencing to the box on the right.

 Drag 2 actions the nurse should take to address that condition to the box on the right.

 Drag 2 parameters the nurse should monitor to assess the client’s progress to the box on the right. 

Sample Next Generation NCLEX Trends Stand-alone Item Questions and Answers:

The nurse is caring for a 74-year-old woman admitted to a rehabilitation unit.

The nurse reassesses the client the next morning.

For each possible finding, click to specify if the finding indicates that the client’s status has improved, declined, or is unchanged. Each row must have 1 option selected.

ANSWERS TO THE NEXT GEN NCLEX TRENDS STAND ALONE ITEM QUESTION:

I hope this article helps future NCLEX NGN test-takers get familiarized with the NGN exam questions. I will be posting more NGN exam samples in future posts so watch out for them.

Happy learning!

Clinical Nursing Channel Team

References: 

Clinical Judgment Measurement Model | NCLEX