NCLEX Highlight Questions: Text Selection Strategy for NGN

Highlight questions are a major part of the Next Generation NCLEX (NGN) format. These items require you to select specific sections of text within a patient scenario, chart, or nursing note. The goal is to identify clinically relevant information that supports safe decision‑making. Mastering **NCLEX highlight questions** is essential because they directly measure your ability to think like a nurse and pick out critical details that affect patient outcomes.

What Are NCLEX Highlight Questions?

Highlight (text selection) items ask you to choose:

• Symptoms
• Assessment findings
• Risk factors
• Lab values
• Medication issues
• Critical teaching points

You simply click or highlight the correct portion of the text. Because several answers may be correct, highlight items often award **partial credit**.

Why Highlight Questions Matter in NGN

These questions simulate real nursing tasks, such as:

• Reading provider notes
• Identifying abnormal findings
• Reviewing patient charts
• Prioritizing relevant information

Because nurses constantly analyze text, the NGN uses highlight questions to assess clinical judgment in a realistic way.

High-Yield Strategies for NCLEX Highlight Questions

• Read the Entire Scenario Before Highlighting
  Do not highlight while reading. First, understand the clinical problem, then go back and select important details.
• Look for Red Flags
  Certain clues always matter:
  • Sudden changes in vital signs
  • Altered mental status
  • Chest pain
  • Shortness of breath
  • Bleeding
  • Abnormal labs
  These should always be highlighted if relevant.
• Use the NCLEX Priority Frameworks
  Apply:
  • ABCs
  • Maslow
  • Safety first
  • Acute vs. chronic
  • Unstable vs. stable
  Highlight information that aligns with these rules.
• Avoid Over-Highlighting
  Many students highlight too much. Only choose text that:
  • Directly supports the nursing action
  • Identifies what the question is asking
  • Helps establish priority
  If the question asks for risk factors, do not highlight symptoms or unrelated history.
• Focus on Numbers and Trends
  Lab values and vitals often contain hidden clues:
  • Trending up glucose → uncontrolled diabetes
  • Low potassium → dysrhythmia risk
  • High temperature → infection
  Highlight only the values outside normal ranges.
• Practice Identifying Key Words
  NCLEX loves certain trigger words:
  • “New onset”
  • “Sudden”
  • “Increasing”
  • “Confusion”
  • “Difficulty breathing”
  • “Post-op day 1”

These almost always signal relevant details.

Example NCLEX Highlight Question (Text Version)

Scenario: A 67-year-old post-op patient reports feeling “a sudden sharp chest pain.” VS: HR 122, RR 28, O2 88%, BP 158/96. History includes hypertension and smoking.

What should the nurse highlight?

• ✔ Sudden sharp chest pain
• ✔ HR 122
• ✔ O2 88%
• ✔ RR 28

These findings suggest pulmonary embolism—an emergency.

Final Thoughts

Highlight questions may seem simple, but they require sharp clinical judgment. The key is knowing what matters most in patient scenarios. By identifying red flags, using priority frameworks, and avoiding over-selection, you can excel in **text selection NGN** items. With consistent practice and strategic thinking, highlight questions become one of the easiest NGN formats to score well on.