The Next Generation NCLEX (NGN) format includes a set number of unfolding case studies to assess clinical judgment skills. On the current NCLEX-RN and NCLEX-PN exams, there are three case studies, and each case study features six questions directly connected to the scenario. This means the NCLEX includes 18 scored case-study questions as part of the exam.
These NCLEX case studies focus on real clinical situations where candidates must review patient data, analyze assessment findings, interpret lab results, and choose appropriate nursing actions. The questions are designed to measure the candidate’s ability to make safe, effective, and timely nursing decisions in a practical patient-care environment.
In addition to the required case studies, the NCLEX may also include stand-alone NGN clinical judgment items, which are not attached to a full case scenario but still test the same decision-making skills. Depending on performance and exam length, some candidates may encounter more NGN-style questions beyond the core case-study set.
Because the NCLEX now ranges from 85 to 150 total questions, the three case studies make up a significant percentage of the exam especially when a test ends near the minimum number of questions. This makes it essential to practice unfolding case studies during NCLEX preparation and become comfortable with new item types such as drag-and-drop, matrix multiple-response, cloze (drop-down) items, and highlighting relevant text in charts.
To summarize: There are exactly three unfolding case studies on the NCLEX, totaling 18 scored case-study questions, and they play a crucial role in evaluating clinical judgment and ensuring nursing readiness for patient care.