May 5, 2023

How to Answer Next Gen NCLEX Highlight Questions

How to Answer Next Gen NCLEX Highlight Questions

Preparing to take the NCLEX? It’s important to understand all the question types you’ll be tasked with. That’s why we’ve partnered with* to break down the new Next Gen NCLEX question types. 

In this article, Professor Beth RN explains everything you need to know to answer the highlight question types in the Next Gen NCLEX. Join’s free test-taking webinar available at for even more Next Gen NCLEX tips! 

>>Related: How to Answer NCLEX Drop-Down Questions

What Are Highlight Questions on the Next Gen NCLEX?

Highlight questions are presented in two different ways:

  • Highlight Text Format - You’ll be given a case study or nursing notes with information in it. 

  • Highlight Table or List - You’ll be given a table or a bulleted list of information like lab results, for example.

This question comes from NPQ. Check out* for NCLEX prep

How to Answer Highlight Questions

You'll be instructed to click and highlight the relevant answers to a specific question. These questions can have a maximum of up to 10 options to select from, and you may be asked to analyze cues or prioritize a hypothesis. 

For example, you might be asked to click to indicate the client may be experiencing a complication. In this case, you're looking for some kind of symptom. If you're asked to take action, then you're going to be reviewing client information that requires immediate intervention.

To answer these questions, you need to get comfortable with the clinical judgment model and the verbiage, which will help you understand what they're looking for. 

>> Test Taking Tip: Don't get caught up in distractors! We're looking for only what is relevant. 

NCLEX Highlight Question Example

Let's do a highlight question together to understand this better. 


This question comes from NPQ. Check out* for NCLEX prep

1. Before we start looking at answers, let's look at what the question is telling us.

I'm a nurse in the ICU, and I have a 78-year-old male patient with weight loss, decreased mobility, and loss of appetite. We did a skin assessment and found a stage one pressure area. We started TPN, placed him on a pressure reduction mattress, and used barrier cream on the stage one area. We're repositioning him hourly, and PT is working with him for strength and mobility. He's alert and oriented times four, and his muscle strength is normal. 

2. Now, we're going to click to highlight findings in the table below that demonstrate the interventions have been effective.

This question comes from NPQ. Check out* for NCLEX prep

Our interventions have been effective, which means we're looking for positive outcomes. 

  • Neurologically, he's alert and oriented times four, but that doesn't mean our intervention has been effective as he already was when he came in. 

  • He does have normal muscle strength in the upper and lower extremities, which is an effective outcome from an intervention.

  • His skin has no evidence of deterioration or additional injuries, which means we're doing the right thing, and we're keeping that stage one from moving into a stage two. That's an effective intervention. 

  • One plus non-pitting edema found in the lower extremities sounds like fluid overload, so that's not good. 

  • Gastrointestinal flat stomach, non-distended, bowel sounds, and no pain are a little tricky, but I don't think this man came in with pain. He came in with weight loss and a loss of appetite, and we started him on TPN. So, weight gain would be more a sign of an effective outcome from an intervention. 

  • Increase in muscle strength and balance due to low mobility stage one and working with PT is an effective outcome.

3. There could be up to 10 options to select from, but these are the three that I was able to choose to correlate with an effective intervention. 

How Are Highlight Questions on the NCLEX Scored?

The scoring rule for these questions is using the plus-minus scoring rule, which means you gain a point for every correct answer, but an incorrect answer will subtract from that total. Remember to remediate what you miss, even if it's just bullet points. 

More NCLEX Resources

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