Background: The Next Generation NCLEX (NGN) includes new item types. Little is known about nursing students' confidence and accuracy in answering these questions.
Method: A descriptive comparative study examined prelicensure nursing students' confidence and accuracy in answering NGN-style items versus multiple-choice questions (MCQs) of the same content via a 12-item quiz.
Results: Less than one third of students ( = 194; 32.1%) reported feeling confident in answering NGN questions. Students' confidence levels had no relationship on scores with NGN items. When comparing NGN-style items to MCQs, students' ( = 221) scores on NGN-style items were lower with bowtie or a select-all-that-apply questions but higher with highlight table or matrix multiple-choice questions.
Conclusion: Students' lack of confidence with certain item types suggests faculty should incorporate these item types into classroom activities or course assignments. NGN test-taking strategies also should be incorporated and frequently reinforced throughout the curriculum. .
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