NCLEX Explained

NGN Cloze (Drop-Down) Questions

Learn how NCLEX Cloze drop-down items work, how each blank earns 0 or 1 point, and how to answer with clinical judgment and a worked example.

What a Cloze Item Asks You to Do

A Cloze item asks you to complete missing information by selecting an option from a drop-down menu. The blank may be part of a sentence, passage, or table. The mechanical action is simple; the clinical task is deciding which option best fits the prompt and the patient data.

A single item may contain more than one drop-down. Read the complete thought around each blank and use the item directions to determine whether you are interpreting a finding, naming a problem, choosing an action, or evaluating an outcome.

The Two Drop-Down Formats NCSBN Names

Format	What appears on screen	Your job
Drop-Down Cloze	One or more drop-down response options embedded in a sentence or passage	Complete each blank with the option supported by the stem and clinical context
Drop-Down Table	Drop-down elements placed in table cells rather than prose	Complete each drop-down cell while following its row, column, and item directions

How Cloze Questions Use Clinical Judgment

Depending on its content, a Cloze item may assess different clinical-judgment steps; the response interface alone does not identify the step being assessed. The six steps of the NCSBN Clinical Judgment Measurement Model (NCJMM) are:

Recognize Cues — Recognize important information in the clinical scenario
Analyze Cues — Connect cues to the client’s clinical presentation
Prioritize Hypotheses — Rank explanations by urgency, likelihood, risk, and time constraints
Generate Solutions — Define desired outcomes and identify interventions that can achieve them
Take Action — Implement the priority solutions
Evaluate Outcomes — Compare observed outcomes with expected outcomes

Start by naming what the blank is asking you to decide. That prevents an answer about treatment from distracting you when the task is really to interpret a cue or evaluate a result.

How to Answer a Cloze Question in 6 Steps

Use the same mechanics for a sentence, passage, or table. On a multi-blank item, solve carefully and then review the result — read a completed sentence or passage as one coherent clinical statement, and check each completed table cell against its row and column headers.

Step 1

Read the full sentence first

Read the full sentence, passage, or table row before opening any menu so every choice is made in context, not from the options alone.

Step 2

Identify the clinical-judgment task

Ask whether the blank is testing cue recognition, analysis, prioritization, a solution, an action, or an outcome. The interface alone does not tell you the task.

Step 3

Review the available patient data

Use the chart, vital signs, labs, notes, medication record, and timing. Give more weight to data that directly changes the decision requested by the blank.

Step 4

Predict before reading options

Name the kind of answer you expect before opening the drop-down. A prediction makes familiar but mismatched distractors easier to reject.

Step 5

Eliminate unsafe or mismatched options

Remove choices that contradict the data, delay needed care, answer a different question, or do not fit the sentence. Use the facts supplied instead of assuming a dose or protocol.

Step 6

Re-read the completed text

After choosing each option, read the complete sentence or table row again. It should be clinically supported, logically consistent, and grammatically coherent.

Worked Drop-Down Example

This classroom-style example shows how two menus combine into one sentence. The answer comes from the data provided, not from guessing what kind of word sounds natural.

Scenario

A client with diabetes is awake, diaphoretic, shaky, weak, and hungry. Point-of-care blood glucose is 52 mg/dL, and the client can swallow.

Cloze item

The nurse should first [drop-down 1] because the client is showing signs of [drop-down 2].

Drop-down 1

administer a fast-acting carbohydrate
hold all oral intake
prepare for transport to radiology
document and reassess in 4 hours

Drop-down 2

hypoglycemia
hyperkalemia
fluid overload
respiratory alkalosis

Best completion

The nurse should first administer a fast-acting carbohydrate because the client is showing signs of hypoglycemia.

The symptoms and glucose value support hypoglycemia. Because the client is awake and can swallow, a fast-acting carbohydrate directly addresses the finding; the other choices delay or fail to address it.

Scoring: Each Drop-Down Is Worth 0 or 1

NCSBN lists Drop-Down Cloze under its 0/1 scoring model. Each drop-down is worth 1 point: selecting the correct option earns 1, while selecting an incorrect option earns 0. The total item score is the sum of the scores for all drop-downs. NCSBN describes Drop-Down Table as similar to Drop-Down Cloze, with the elements placed in a table instead of a sentence or passage.

The practical consequence is simple: treat every blank as its own decision. A mistake in one menu does not make careful reasoning on the remaining menus pointless.

Common Mistakes to Avoid

Choosing by familiarity

A familiar option is not automatically the keyed option. Tie every selection to the data and the exact blank.

Treating every abnormal finding as the priority

Several findings may be abnormal. Compare their relevance, timing, severity, and relationship to what the item asks.

Solving blanks in isolation

In a multi-blank item, verify that the completed sentence or passage makes sense as a whole, even though each drop-down is scored independently.

Guessing an unstated protocol or dose

Use the order, calculation data, and scenario provided. Do not fill missing facts with a memorized default.

Practice NGN Clinical Judgment Today

Cloze-specific drills are planned. Paid full-access plans include case-based NGN practice.

View Plans

Frequently Asked Questions

Are Cloze and drop-down questions the same thing?

Cloze names the completion item, while drop-down describes its response interface. NCSBN uses Drop-Down Cloze for options embedded in a sentence or passage and Drop-Down Table for similar elements in a table.

How are NCLEX Drop-Down Cloze items scored?

NCSBN lists Drop-Down Cloze under 0/1 scoring. Each drop-down is worth 1 point: the keyed option earns 1 and a distractor earns 0. The item total is the sum of all drop-down scores. Read the NCLEX scoring and partial credit guide.

How many Cloze questions will I see on the NCLEX?

NCSBN does not publish a fixed candidate-level count for Cloze items. Prepare to recognize the directions and solve the format shown rather than expecting a guaranteed number.

Should I read the options or the patient information first?

Read the sentence and relevant patient data first. Predict what kind of answer the blank requires, then open the drop-down and compare every option with that clinical context.

What is the best way to study for Cloze questions?

Practice clinical judgment rather than interface tricks. Work through case-based questions, identify the evidence behind each decision, and review why both correct and incorrect options fit or fail the prompt.

Sources

Official NCLEX references

Item-format, scoring, and test-plan statements were checked against current NCSBN materials. Reviewed August 9, 2026.