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Next Generation NCLEX

NCLEX Case Study Questions: Unfolding Next Gen Practice

An NCLEX case study follows one client through six questions. The chart grows as the story unfolds, and each question tests one step of clinical judgment. Practice them here in the NCLEX-style test interface, with a rationale for every answer. They are free, with no sign-up.

Choose a case study

Nursing case study examples by condition

Each case study is named for the client's condition. Start one to work through it screen by screen in the NCLEX-style test interface, or open its page to read about the case first. Your progress and score are saved in this browser.

Case studyFree

Heart Failure case study

Medical-surgical unitNot started
Start case study
Case studyFree

Anaphylaxis case study

Medical-surgical unitNot started
Start case study
Case studyFree

Pneumothorax case study

Emergency departmentNot started
Start case study

Every full-length practice exam also includes three unfolding case studies. NCLEX-RN practice exams

The format

How an NCLEX case study works

A case study is a set of six questions about one client, built around a chart that changes as the story moves on.

  1. 01

    One client

    A case study stays with one client from the first screen to the last.

  2. 02

    A chart with tabs

    Nurses' Notes, Vital Signs, Laboratory Results and Orders sit beside every question.

  3. 03

    Six questions, in order

    Each question tests one step of clinical judgment, from recognizing cues to evaluating outcomes.

  4. 04

    The story unfolds

    New chart entries appear as time passes, and the later questions depend on them.

Clinical judgment

The six clinical judgment steps, in order

The six questions follow the NCSBN Clinical Judgment Measurement Model, one step per question.

Step 1Recognize cuesPick out the relevant and important information in the chart.
Step 2Analyze cuesConnect those cues to the client's clinical presentation.
Step 3Prioritize hypothesesRank the possible problems by urgency, likelihood and risk.
Step 4Generate solutionsIdentify the expected outcomes and the interventions that fit.
Step 5Take actionCarry out the actions that address the highest priority.
Step 6Evaluate outcomesCompare what you observe with the outcomes you expected.

On the exam

How many case studies are on the NCLEX?

Three. On a minimum-length exam, 18 of the 85 questions belong to case studies. The other questions stand alone, and some of those are bow-tie and trend questions.

Case studies
3
Questions in each case study
6
Case-study questions
18
Scored standalone questions
52
Unscored pretest questions
15

Counts for a minimum-length exam of 85 questions. Source: NCSBN 2026 NCLEX-RN Test Plan.

FAQ

NCLEX case studies: FAQ

Does the NCLEX have case studies?
Yes. Every NCLEX-RN includes three clinical judgment case studies. Each one is a set of six questions about one client, one for each step of the NCSBN Clinical Judgment Measurement Model.
How many case studies are on the NCLEX?
Three. A minimum-length exam of 85 questions has 18 case-study questions (3 case studies of 6), 52 scored standalone questions and 15 unscored pretest questions.
Where can I find free NCLEX case study questions?
The case studies on this page are free to practice, with no sign-up. NCSBN also offers a free tutorial on NCLEX.com that shows each question type.
Practice all 16 NCLEX question types