NCLEX Drop-Down (Cloze) Questions: Format & Strategy Guide

NCLEX drop‑down (cloze) questions are one of the newest and most important formats introduced in the Next Generation NCLEX (NGN). These questions test clinical judgment by requiring candidates to complete sentences, select correct steps, or choose appropriate interventions from drop‑down menus. To succeed, you must understand how the format works and how to apply NGN thinking strategies. This guide breaks down everything you need to know to master **NCLEX drop‑down** and cloze-style questions.

What Are NCLEX Drop‑Down (Cloze) Questions?

Cloze questions contain statements or sentences with missing parts. Each blank has a drop‑down list with 3–6 answer options. You must select the correct choice for each blank to complete the scenario logically and clinically correctly.

These questions are commonly used in:

• Nursing assessments
• Priority interventions
• Clinical decision pathways
• Medication administration steps
• Patient teaching scenarios

Why NCLEX Uses Cloze Questions

Drop‑down items simulate real nursing tasks, such as choosing the correct action in a sequence. They help measure:

• Clinical reasoning
• Decision accuracy
• Step‑by‑step judgment
• Understanding of nursing processes

Because each blank is scored independently, cloze questions allow **partial credit**, making them fairer and more reflective of real performance.

Common Types of NGN Cloze Questions

• Assessment Cloze Items
  Select the correct assessment finding or risk factor.
• Intervention Sequencing
  Choose what the nurse should do first, next, or last.
• Medication Safety Cloze
  Pick the correct instruction, dosage step, or safety alert.
• Priority Patient Care
  Identify which response fits the highest‑priority nursing action.

Best Strategies for NCLEX Drop‑Down Questions

• 1. Read the Entire Sentence First
  Before opening drop‑downs, understand the context of the blank.
• 2. Use Clinical Judgment Models
  Think through Analyze → Prioritize → Act using CJMM logic.
• 3. Eliminate Clearly Incorrect Options
  Remove answers that are unsafe, unrelated, or contradict the scenario.
• 4. Watch Out for Distractors
  Cloze questions often include:
  • Unnecessary interventions
  • Steps performed later in care
  • Diagnostic rather than nursing actions
• 5. Follow NCLEX Priority Rules
  Use:
  • ABCs
  • Maslow’s hierarchy
  • Safety‑first principles
  • Acute > chronic
  • Unstable > stable
• 6. Avoid Overthinking
  Choose the answer that directly matches the clinical situation.

Example NCLEX Drop‑Down Question (Text Version)

A post‑op patient reports sudden shortness of breath. The nurse should FIRST:

• ✔ (Select from drop‑down) Elevate the head of the bed.
• ✔ Apply oxygen.
• ✔ Notify the provider.

Why this works: ABCs make airway priority.

Final Thoughts

Mastering **NGN cloze questions** requires understanding clinical judgment, thinking step‑wise, and recognizing priority actions. Practice drop‑down items regularly, learn to eliminate distractors, and apply NCLEX frameworks consistently. With the right strategy, you’ll approach these items with confidence and accuracy on exam day.