What stayed exactly the same
- ✓Client-needs category weights (all eight categories unchanged)
- ✓Total question count: 75–150 questions
- ✓Time limit: 5 hours
- ✓NGN structure: 3 case studies, 18 scored NGN items, standalone clinical judgment questions
- ✓15 unscored pretest items distributed throughout
- ✓Passing standard methodology (logistic model, 95% confidence)
- ✓Question formats (no new item types)
- ✓Computerized adaptive testing algorithm
What changed
| Category | Detail |
|---|---|
| Category renamed | "Safety and Infection Control" is now "Safety and Infection Prevention and Control." Same content, refined name. |
| Health equity added | New emphasis on unbiased care across culture, ethnicity, sexual orientation, and gender identity. Culturally competent assessment and LGBTQ+ affirming care are now explicitly tested. |
| Social media privacy | Patient confidentiality in digital contexts (HIPAA applied to social media, what nurses can and cannot post, digital privacy for patients). |
| Workplace safety | De-escalation techniques, reporting protocols, environmental safety for healthcare providers, workplace violence prevention. |
| ICP monitoring | Intracranial pressure monitoring: normal values, waveform interpretation, nursing interventions for elevated ICP. |
| IUPC interpretation | Intrauterine pressure catheters: indications, placement, interpreting readings in labor management. |
| Complementary therapies | Common complementary and alternative modalities (aromatherapy, acupuncture, herbal supplements), drug interactions, patient education. |
| Point-of-care testing | Glucometers, bedside ABGs, troponin at bedside — interpreting results and taking nursing action. |
| Language: substance misuse | "Substance abuse" updated to "substance misuse" throughout — reflects current clinical and patient-centered language. |
| Pacing guidance removed | The unofficial "1–2 minutes per question" heuristic has been removed from official NCSBN materials. Your pacing strategy does not need to change. |
8 topics to add to your study plan
- 1Health equity framework — social determinants, implicit bias recognition, culturally competent care
- 2LGBTQ+ affirming care — appropriate terminology, privacy considerations, inclusive assessment
- 3Social media and patient privacy — HIPAA in digital contexts, what nurses can and cannot post
- 4Workplace violence and safety — de-escalation, reporting, environmental controls
- 5ICP monitoring — normal values, waveforms, nursing interventions for elevated ICP
- 6IUPC interpretation — indications, placement, readings in labor management
- 7Complementary therapies — common modalities, drug interactions, patient education
- 8Point-of-care testing — glucometers, bedside ABGs, troponin, acting on results