NGN Cloze Questions: Your Complete Guide

Master drop-down and sentence completion questions on the Next Generation NCLEX. Learn strategies, see real-world examples, and build clinical judgment skills essential for exam day.

What Are NGN Cloze Questions?

NGN Cloze questions are a new item type on the Next Generation NCLEX. They present clinical scenarios requiring you to fill in blanks by selecting answers from drop-down menus. The blanks may appear in sentences, tables, or clinical pathways—testing your ability to apply nursing knowledge in realistic contexts.

These questions assess core clinical judgment skills from the NCSBN Clinical Judgment Measurement Model (NCJMM):

Recognize Cues — Identify relevant clinical information
Analyze Cues — Interpret significance and clinical relevance
Prioritize Hypotheses — Focus on urgent patient needs
Generate Solutions — Choose best interventions
Evaluate Outcomes — Assess effectiveness and adjust

Key Features of Cloze Questions

Understanding what makes Cloze questions unique helps you approach them strategically:

Integrated Clinical Scenarios — Realistic patient cases with histories, vital signs, labs, and nursing notes
Multiple Related Items — A single scenario may have several connected Cloze questions
Clinical Judgment Focus — Emphasis on decision-making, not just fact recall
Dynamic Information — Scenarios may evolve, requiring you to adapt decisions
Drop-Down Menus — Flexible answer format with multiple options per blank

Types of NGN Cloze Questions

Sentence Completion

Complete a sentence with one or more blanks by selecting from drop-down options.

Example: A patient with heart failure presents with shortness of breath. The nurse should prioritize administration of [blank] to reduce fluid overload.

Options: furosemide, morphine, oxygen, digoxin

Correct: furosemide

Table Completion

Fill in missing cells in a clinical table by selecting from drop-down menus.

Example: Complete the table matching patient conditions to priority interventions.

Options: Hypoglycemia → [blank]

Correct: Provide orange juice

Clinical Pathway

Complete a clinical algorithm or care pathway by filling in missing steps.

Example: A patient presents with chest pain. Step 1: Assess vital signs. Step 2: Administer [blank] as prescribed. Step 3: Notify provider if pain persists.

Options: oxygen, nitroglycerin, morphine, aspirin

Correct: nitroglycerin

Strategies for Success

Read the Scenario Thoroughly

Identify the key clinical issue, patient history, and relevant data like vital signs or lab results. Understanding the context is crucial.

Identify the Question's Purpose

Are you being asked to prioritize an intervention, interpret labs, or select a nursing action? Clarify before answering.

Evaluate Each Option Individually

Treat each drop-down option as a separate true/false statement. Ask: Does this align with best practices? Is it appropriate for this patient?

Prioritize Patient Safety

Always choose the option that ensures patient safety. Avoid answers that could harm the patient or delay treatment.

Use the NCJMM Framework

Apply the NCSBN Clinical Judgment Measurement Model: Recognize cues → Analyze cues → Prioritize hypotheses → Generate solutions → Evaluate outcomes.

Manage Your Time

Cloze questions may take longer than traditional MCQs. Pace yourself—if stuck, make your best guess and move on.

Real-World Examples

Medication Administration

Scenario: A patient with hypertension is prescribed lisinopril. The patient reports a persistent dry cough and dizziness. BP 140/90 mmHg, potassium 5.5 mEq/L.

Question: The nurse should prioritize [blank].

Options: administering lisinopril, monitoring potassium levels, notifying the provider, assessing for dehydration

Correct Answer: notifying the provider

Rationale: The elevated potassium (hyperkalemia) and symptoms suggest an adverse reaction to lisinopril (ACE inhibitor). Notify the provider to reassess the medication regimen.

Patient Assessment

Scenario: A postoperative patient reports incisional pain rated 8/10. VS: HR 110 bpm, BP 150/90 mmHg, RR 22/min, SpO2 95% on room air.

Question: The nurse should first [blank].

Options: administer pain medication, assess the incision site, monitor vital signs, notify the provider

Correct Answer: administer pain medication

Rationale: The pain level and vital signs indicate acute pain requiring immediate intervention. Administering analgesia is the priority to prevent complications.

Lab Interpretation

Scenario: A patient with diabetes has the following labs: fasting glucose 250 mg/dL, HbA1c 9.5%, potassium 3.0 mEq/L, sodium 130 mEq/L.

Question: The nurse should prioritize [blank].

Options: administering insulin, monitoring potassium levels, notifying the provider, assessing fluid status

Correct Answer: monitoring potassium levels

Rationale: The potassium is critically low (hypokalemia), which can cause cardiac arrhythmias. While other interventions are important, potassium monitoring is the safety priority.

Assess Your Readiness for NGN Cloze Questions

Take our diagnostic quiz to evaluate your understanding and identify areas for improvement.

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Common Mistakes to Avoid

Overlooking Scenario Details

Missing key details leads to wrong answers. Read carefully and note patient history, vital signs, and lab values.

Assuming Only One Correct Answer

Some Cloze items have multiple correct components. Evaluate each option on its own merits.

Ignoring Patient Safety

Never choose an answer that could harm the patient. If an option includes administering a medication the patient is allergic to, eliminate it immediately.

Rushing Through

Take time to read both the scenario and all options. A missed detail can cost you the question.

Neglecting Evidence-Based Practice

Choose options aligned with current nursing standards. Avoid outdated or unsupported interventions.

How Cloze Questions Fit into the NGN

Cloze questions are one of several new NGN item types assessing clinical judgment. Others include:

Matrix Questions — Select all correct answers from a grid or table
Highlight Questions — Mark relevant portions of clinical text
Trend Questions — Interpret data changes over time

Together, these create a comprehensive assessment of your readiness for clinical practice.

Preparing for NGN Cloze Questions

Build your skills with these preparation strategies:

Review Core Concepts — Focus on pharmacology, patient assessment, and clinical interventions
Practice with Realistic Scenarios — Use NCLEX question banks with Cloze items
Simulate Test Conditions — Practice under timed conditions
Review Rationales — Understand why answers are correct or incorrect
Join Study Groups — Discuss strategies with peers
Target Weak Areas — Focus extra time on challenging topics