NCLEX Video Questions: New Multimedia Format Strategy 2025-2026

As the Next Generation NCLEX (NGN) continues to evolve, multimedia question formats—especially NCLEX video questions are becoming more common in the 2025–2026 exam cycle. These new question types assess your ability to analyze clinical cues from moving images, patient interactions, sounds, and real‑time situations. This guide explains how video questions work and how to build a winning strategy for this challenging NGN format.

What Are NCLEX Video Questions?

Video-based NGN items present a short clinical video such as:

• A patient demonstrating symptoms:
  Watch for signs of distress such as shortness of breath, coughing, or confusion; interpret clinical cues shown in the video.
• A nurse performing a procedure:
  Observe the nurse's technique, hand hygiene, use of personal protective equipment (PPE), and step-by-step actions.
• A caregiver interview:
  Listen for key information provided by the caregiver about the patient's history, symptoms, or recent changes.
• A real-time patient assessment:
  Analyze examiner-patient interactions—note vital signs, responses to stimuli, and communication skills.
• A respiratory or cardiac pattern:
  Identify abnormal breathing (e.g., wheezing, retractions) or cardiac rhythms and relate them to possible interventions.

After watching, you must answer follow-up questions that measure your clinical judgment. These may include:

• Identifying cues
• Prioritizing assessments
• Choosing interventions
• Selecting safety actions
• Flagging abnormal findings

Why NCLEX Uses Multimedia NGN Formats

The exam aims to simulate real nursing environments more accurately. Videos:

• Improve realism
• Show nonverbal cues
• Highlight subtle symptoms
• Assess decision-making under pressure

Because nurses rely heavily on visual and auditory assessment, the multimedia NGN format helps evaluate real-world readiness.

How to Approach NCLEX Video Questions

• 1. Watch the Entire Video Without Clicking Anything Early
  Avoid distractions. Your first viewing should focus on:
  • Patient behavior
  • Breathing pattern
  • Skin color
  • Emotional cues
  • Procedure accuracy
• 2. Identify Critical Visual Cues
  Look for red flags like:
  • Cyanosis
  • Retractions
  • Altered LOC
  • Tachypnea
  • Sweating
  • Grimacing
  • Safety issues during procedures
  These are highly testable clues.
• 3. Listen Carefully for Key Sounds
  Some video questions include:
  • Lung sounds
  • Heart murmurs
  • Cough patterns
  • Stridor
  • Wheezing
  • Pain levels described verbally
  Always pair what you hear with what you see.
• 4. Apply Clinical Judgment (CJMM Model)
  Break the video into the NGN reasoning steps:
  • Recognize cues
  • Analyze cues
  • Prioritize problems
  • Generate solutions
  • Take action
  • Evaluate outcomes
• 5. Expect Multiple Question Formats
  After the video, common follow-ups include:
  • Multiple Response (SATA)
  • Drop-down cloze
  • Highlight text
  • Matrix response
  • Drag-and-drop steps
• 6. Focus on Safety First
  Videos often include hidden errors or safety violations. Watch for:
  • Missing PPE
  • Incorrect patient positioning
  • Nonsterile technique
  • Incorrect oxygen device
  • Fall risks

NCLEX loves testing your ability to spot safety issues.

Example NCLEX Video Scenario (Text Version)

You watch a video of a patient breathing rapidly with nasal flaring and using accessory muscles.

Follow-up question: What is the priority action?

✔ Apply oxygen and assess respiratory status.

Another: The nurse inserts a Foley catheter without sterile gloves.

✔ Identify a break in sterile technique.

Tips for Success with Multimedia NGN

• Practice interpreting clinical videos (YouTube simulation labs help)
• Improve your recognition of respiratory and cardiac patterns
• Use active watching—not passive observing
• Expect subtle clues, not dramatic ones
• Always combine visual, auditory, and clinical reasoning

Final Thoughts

The **video format** in the 2025–2026 NCLEX is designed to measure real clinical competence. By practicing visual assessment, recognizing subtle cues, and applying clinical judgment frameworks, you’ll be fully prepared to tackle multimedia NGN questions with confidence