Alternate Item Formats and How to Prep For Them – ATI Nursing Blog (2024)

Date Published: July 8, 2019

If you’ve started to prepare to take the NCLEX, you know just how overwhelming it can be. There are dozens of acronyms and terms used to describe the test that you’ve probably never heard of before… and that’s before you even begin studying!

One of the new terms that you will come across is alternate item format. While they may sound scary at first, alternate item formats are much easier to manage once you know exactly what you’re dealing with.

So, What Is an Alternate Item?

Alternate items are any items on the NCLEX that are not a standard multiple choice question. There are seven different alternate item formats that may be featured on the test, and there is no specific percentage or ratio of how many alternate items the NCLEX will present to a candidate. Since these items could pop up at any moment during the test, it is important to be prepared to answer them when you see them! Let’s take a look at each of the seven alternate item formats and how you can best prepare to tackle each one.

Multiple Response

Multiple response items are also sometimes referred to as “select all that apply” SATA items, and students say they tend to be one of the trickiest alternate item formats. These items present the candidate with a question and a list of possible responses where multiple answers may be correct, and you have to select all of the correct answers to get the question right. Multiple response items could only have one correct response, or every single one of the responses could be correct, so it’s easy to see why this type of question can overwhelm candidates!

How to tackle it: All of the possible answers to multiple response questions could be correct. Because of this, it’s best to isolate each response option and consider it on its own. Try approaching this item format with a true-false mindset: read the question, then read only the first response option and decide if that response correctly answers the question. If it does, mark it! Then, read the question again and move on to the next response option all by itself, as if it were an entirely separate item. By breaking the process up and using a true-false mindset, multiple response items seem much less intimidating.

Ordered Response

Ordered response items present candidates with a list of steps, tasks, or actions and require them to be put in a specific order. This item type tends to be another tricky one for candidates because, like multiple response items, you have to get all parts of the order correct to get the question right. The nice thing about ordered response questions, though, is that you will always use every piece that the question gives you.

How to tackle it: To put ordered response items in the correct sequence, it is important to think about basic priority rules. Consider the actions in terms of the nursing process and Maslow’s hierarchy of needs and ask yourself which step should take priority over the others using those models. Meeting the client’s basic physiological needs (ABC) and safety needs should come before anything else. You can refresh yourself of these four guidelines, here.

(P.S. These same tricks can help you to answer multiple-choice priority questions, as well!)

Fill in the Blank

Fill in the blank questions may also be called calculation questions, and require candidates to type in a numerical answer.

How to tackle it: The two most important things to pay attention to for fill in the blank questions are rounding and decimal points. Answers to calculation items should always be rounded at the end of the calculation, not during any of the steps in the middle. Decimal places, on the other hand, will vary from question to question. The item will specify if the final answer should be recorded as a whole number or have one or two decimal places. Remember to use a calculator and double check your answer!

Hot Spot

Hot spot items ask a candidate to identify a location on a graphic or table. These types of questions are often designed to test your knowledge of anatomy and physiology and how you would apply that knowledge to nursing practice.

How to tackle it: Hot spot questions are not designed to test how accurate you are with a mouse, so you don’t have to stress too much about marking an exact pixel on the graphic. However, it is very important to pay attention to details. Take note of any key words in the question that may help you to identify what part of the graphic or table to look at, and review all of that section thoroughly before selecting your answer. Another hint? You can also try finding the location on yourself, if feasible. Then, make sure you remember the client graphic is usually facing you.

Variations on Multiple-Choice Alternate Items

These last three alternate item formats are very similar to the standard multiple-choice questions that you will see on the NCLEX but are differentiated by how they present the information in the question and the possible answers.

Chart/Exhibit: Exhibit items require candidates to open a chart or other form of exhibit, review the information it contains, and use that information to select an answer from four multiple-choice options.

How to tackle it: Some exhibits may present you with multiple slides or pages of the information. It is important to review all parts of the exhibit before deciding which section of the chart the answer can be found on.

Added tip: The stem/question will tell you how many ‘exhibits’ there are and you are able to view each one as many times as needed before you choose your answer.

Graphic Answers: Graphic items are exactly the same as a standard multiple-choice question, but with graphics instead of text given for the four answer options.

How to tackle it: Just like exhibit questions, the important strategy to answer graphics items is to pay attention to detail. The differences between the answer options may be slight, so make sure you look at each option carefully before picking one.

Audio Questions: Audio items present candidates with an audio clip to listen to and then asks a question based on the content of that clip.

How to tackle it: Are you getting tired of hearing how important paying attention to detail is yet? Just like the others, audio questions require your full attention. Try listening to the clip two or three times to make sure you absorb all of the information before you take a stab at answering the question.

Where Should You Go From Here?

Reviewing all of the information about the NCLEX and its various components is an important part of your preparation, and beginning at the source is a great place to start! The NCSBN website has many resources to help familiarize you with the test, including What the Exam Looks Like and a detailed test plan for each version of the exam.

Related read: 12 NCSBN Resources You’ll Be Glad You Read before Taking the NCLEX

But of course, the most important thing that you can do to prepare yourself to tackle the alternate items on the NCLEX is to practice, practice, practice! The more you are exposed to the different types of alternate item formats, the more confident you will feel answering them during the real deal.

Wanting added practice? Get started with this helpful video from ATI’s own nurse educators – Prep Live! ATI’s Mini NCLEX Review.

Alternate Item Formats and How to Prep For Them – ATI Nursing Blog (1)

Alternate Item Formats and How to Prep For Them – ATI Nursing Blog (2024)

FAQs

What is alternate format in ATI? ›

So, What Is an Alternate Item? Alternate items are any items on the NCLEX that are not a standard multiple choice question. There are seven different alternate item formats that may be featured on the test, and there is no specific percentage or ratio of how many alternate items the NCLEX will present to a candidate.

What is the alternate format style questions used on the NCLEX exam? ›

In this post, we've covered the first four types of alternate-format NCLEX questions: audio, chart/exhibit, graphic, and hot spot. These questions may seem tricky at first because they are different. The only way to become more familiar with these types of questions is to practice answering them.

What are alternate item type questions? ›

AITs are questions that fall outside the traditional multiple-choice questions we are accustomed to working. These question types will include: MULTIPLE CORRECT OPTIONS which will allow for multiple choices to be correct.

Is ATI similar to NCLEX? ›

All of the material that ATI offers with their assessment tools models the NCLEX. Most school considers the ATI Predictor Exam a clear indicator of NCLEX success. Those who take the ATI Predictor Exam usually do better on the first administration of the NCLEX than those who do not.

What is alternate format text? ›

Alternate (or alternative) Format Text is typically a request for a required textbook or article used in a class in a format other than standard print such as digital or electronic (e.g., PDF), braille or audio.

Which of the following are types of alternate test items that can be anticipated on NCLEX exams select all that apply? ›

The official list of alternate-format questions includes the following types of questions:
  • Audio. Listen to an audio clip to answer the question.
  • Chart/Exhibit. ...
  • Graphic. ...
  • Hot Spot. ...
  • Multiple Response. ...
  • Ordered Response. ...
  • Fill-in-the-Blank.
Jun 4, 2019

What is the trick to answering NCLEX questions? ›

You must always figure out what the question is asking, and you must always eliminate answer choices. Choosing the right answer often involves choosing the best of several answers that have correct information. This may entail your correct analysis and interpretation of what the question is really asking.

Can you pass 145 questions on NCLEX? ›

Answering all 145 questions on the NCLEX-RN alone does not mean you failed the exam. However, with each correct answer you provide, the test should give you a question that becomes increasingly more difficult than the previous one.

How to get 75 questions on NCLEX? ›

How to Pass the NCLEX with 75 Questions in One Attempt
  1. Stop Stressing.
  2. Don't Cram.
  3. Review an NCLEX Strategy Guide.
  4. Use Your Nursing School Notes.
  5. Review Questions and Take Practice Tests.
  6. NCLEX Prep Resources and Tools.
  7. Study, But Don't Over Study.
  8. Focus on Your Problem Areas.
Sep 30, 2022

What is alternate choice items? ›

Alternate choice items are similar to true/false items; however, rather than asking whether a single statement is correct or not, alternate choice offers two statements and asks the respondent to select the better option.

What are the four 4 types of questions? ›

There are four types of questions in English: general or yes/no questions, questions using wh-words, choice questions, and disjunctive or tag/tail questions.

What are alternate items? ›

An Item Alternative is an Item similar to the original one and can be used instead of the original Item in manufacturing. If the raw material defined in the BOM is not available during the production process then their respective available alternative Item can be used to complete the production process.

Is the ATI nursing test hard? ›

Many test takers have found the Reading and English section to be moderately difficult. However, many TEAS takers vouch that the Science and Math section are more complex and challenging. The timed nature of the exam can be difficult for some.

What is the pass rate for ATI NCLEX prep? ›

ATI — Best Product Offerings

Its Virtual-ATI + BoardVitals program boasts a 99% pass rate for NCLEX-RN takers and 100% for NCLEX-PN. This 12-week course features personalized coaching by an experienced nurse educator who provides study plans and a post-review “green light” when you're NCLEX-ready.

What are the three types of text formatting? ›

Bold, italics, and underline are common text-formatting features. The “Bold” feature thickens the text's individual characters, like this. The italics feature tilts the characters of text slightly to the right, like this. The underline feature inserts a line under the text, like this.

What are the examples of alternate formats and communication supports? ›

Some examples include plain language, sign language interpreter, reading the information out loud to a person with vision loss, adding captioning to videos or using written notes to communicate with someone who is hard of hearing.

What are the two types of format? ›

In Microsoft Word, there are basically two types of formatting - character formatting and paragraph formatting. Character formatting applies formatting to individual characters while Paragraph formatting applies formatting to individual paragraphs.

What is considered a hard NCLEX question? ›

Analysis, synthesis and evaluation questions would be considered higher-level NCLEX questions. Synthesis questions are based on creating or proposing solutions, such as a plan of care.

What is the passing score for the NCLEX 2023? ›

The 2023 passing standard for the NCLEX-RN is 0.00 logits and -0.18 logits for the NCLEX-PN.

Does the last question on NCLEX matter? ›

If the last question is below the level of difficulty needed to pass, the candidate fails. If the last question is above the level of difficulty needed to pass, the candidate passes.

How to do the Pearson trick on the NCLEX? ›

HOW TO DO THE PEARSON VUE NCLEX TRICK?
  1. Take the NCLEX and submit it through the Pearson Vue servers. ...
  2. Visit the Pearson VUE test-takers login page and log in to your Pearson Vue account. ...
  3. Click on the “register” tab and attempt to re-register for the NCLEX exam. ...
  4. Verify information before submitting.

How can I increase my chances of passing the NCLEX? ›

How to Pass NCLEX-RN: 8 Tested Tips
  1. Give Yourself Sufficient Time to Prepare. ...
  2. Familiarize Yourself with the Test Structure. ...
  3. Learn the Types of Questions. ...
  4. Take Practice Tests. ...
  5. Develop Test-Taking Strategies. ...
  6. Create a Robust Study Plan. ...
  7. Hone Your Stress Management Skills. ...
  8. Prepare for Exam Day.
May 3, 2022

What answers to avoid on NCLEX? ›

Never choose an answer that contains the following words: always, never, all, and only. These words do not allow for the possibility of an exception, and therefore the answers that contain these words can be automatically eliminated. Never choose an answer that describes the nurse's actions as "vigorous."

Is NCLEX shutting off at 75 good? ›

You answered the least number of questions possible, which is 75. As mentioned in #2, the NCLEX progresses variably, depending on whether you answer a question correctly or incorrectly. If your questions continually got more complex and the test shut off at 75, this is another good sign you passed the NCLEX.

Is 90% chance of passing NCLEX good? ›

Specifically, nurse educators viewed students with predicted probabilities of passing the NCLEX-RN/NCLEX-PN greater than 90% as “on track” and therefore “low risk.” Nurse educators further categorized students with predicted probabilities of passing NCLEX-RN/NCLEX-PN between 80% and 89.9% as having “moderate need of ...

Can you get 75 questions on the NCLEX and still fail? ›

To pass the NCLEX RN or PN, test takers must correctly answer at least 85 questions (the minimum amount). Unfortunately, that means you can also fail the exam within those 85 questions or items.

Which state has the hardest Nclex exam? ›

None. There is no “easy” state to take the NCLEX. The NCLEX is a national exam administered by the National Council of State Boards of Nursing (NCSBN). Because it's national, the NCLEX will be the same regardless of what state you choose to take it in.

What does it mean if your NCLEX shuts off at 85? ›

In other words, if the computer shuts off at 85 questions, the only thing that means was that the computer had a high enough confidence to determine that you either passed or failed at that point. You may have done really well or horribly. You won't know until you receive your results.

Does ATI help with NCLEX? ›

Students who complete an ATI Live Review have a substantially higher NCLEX pass rate than the national average.

What is the strongest disadvantage of the alternative response type of test? ›

Disadvantages: It is difficult to discriminate between students that know the material and students who do not. Individual true-false items are less discriminating than individual multiple choice items. There is a tendency to write trivial true-false items, which lead students to verbatim memorization.

What is an incorrect alternative on a multiple choice item? ›

The alternatives consist of one correct or best alternative, which is the answer, and incorrect or inferior alternatives, known as distractors.

What is the difference between alternative and alternate options? ›

Although both can refer to a different or backup option, typically alternate refers to an action of rotating or taking turns while alternative usually refers to another option or choice. For example: Each year, their family vacation alternates between the beach and Disney World.

What is the 4 question strategy? ›

The Four Question Strategy is a series of tests designed to identify experimental variables and help students generate an experimental procedure (Cothron, Giese, and Rezba 2000).

What do you call a question with no answer? ›

A rhetorical question is a question that is not meant to have or does not require an answer.

What is alternate and alternative example? ›

' If the word 'alternate' is used as a noun, it means substitute of something/someone. For example, 'We had an alternate teacher teaching us Mathematics on Mondays', but the term 'alternative' indicates the presence of more than one choice/possibility. For example, 'Is there an alternative way out of here?

Why do we use alternate? ›

It is suggestive of an 'interchange': especially taking turns back and forth. For example, you might alternate between being optimistic and realistic, meaning you are going back and forth between those two perspectives. 'Alternate' is the verb; it's the action of going between these two states.

How do you use alternate? ›

Example Sentences

Adjective Alternate shades of wood formed a pattern around the window. We took an alternate route because of the traffic. Due to an emergency, the plane landed at an alternate airport. Verb The poem alternates fear and hope.

What level is 70% on ATI? ›

My understanding was that anything below a 70% is below a level 1... And that in order to score a level 3, you practically have to have a 90-95%.

What is the hardest nursing test? ›

Preparing to take the NCLEX is enough to make just about anyone nervous. It's a difficult exam, and a major stepping stone in your career as a registered nurse. Remember that most people pass the NCLEX on the first try. However, preparation and confidence are key to passing.

What is the hardest exam for nurses? ›

The National Council Licensure Examination, or NCLEX, is a critical exam that every nursing student must take to become a licensed nurse. Passing the NCLEX is essential to begin your nursing career, but it is also one of the most challenging exams you will ever take.

What is a good score on ATI test? ›

Typically, this score should be above 70%. Any TEAS score over 80% would be considered advanced or exemplary. You can read our guide on the TEAS exam difficulty for more information. If you want a top score, use our ATI TEAS practice test to prepare.

Can you pass the NCLEX just using ATI? ›

Can I pass NCLEX with just ATI? Yes, many nursing students have successfully passed the NCLEX with just the ATI. Share via: More.

How do I know if I passed my ATI test? ›

To access results, sign in to www.atitesting.com with your Username and Password. From the home page, click the My Results tab to access your full transcript.

How many nurses pass NCLEX on first try? ›

The number of unsuccessful test-takers is low compared to the more than 86% who pass the exam on their first try. Candidates who fail the NCLEX-RN can retest forty-five days after their most recent attempt. Being alert for signs you failed the NCLEX-RN will help you prepare before receiving official results.

How close is ATI to NCLEX? ›

How is the ATI Comprehensive Predictor Exam Scored? The ATI exam attempts to predict the probability of passing the NCLEX based on the score you achieve on the ATI exam. For example, it may state the following score prediction: 80.7% – 100% (Comprehensive Predictor) = 99% (Probability of Passing the NCLEX)

What is a good percentile for ATI? ›

The top score is your National percentile Rank and must be 45% or more to qualify for the nursing program.

What is the format of ATI TEAS 6? ›

ATI TEAS FORMAT: The ATI TEAS test is comprised of 170 questions set up in a multiple-choice format with four-option answers. Questions are designed to test the basic academic skills you will need to perform in class in the areas of: Reading, Math, Science, and English and Language Usage.

Are there different versions of ATI proctored exams? ›

ATI Comprehensive Predictor Exam (20 Versions) & ATI Proctored Exam: Community Health, Fundamentals, Leadership, Management, Maternal Newborn, Maternity, Med-Surg, Mental Health, Nursing Care of Children, Pediatric, Pharmacology (Multiple Versions, 2021)

How does adaptive test work in ATI? ›

Computer adaptive testing works by measuring your competency with each question asked. If you answer a question correctly, the computer re-estimates your ability and presents a new question that is a little more difficult — a question that you should have a 50% chance of answering correctly.

How many versions does ATI Proctored have? ›

Open Proctor Guide & Resources to access the Proctor Oath, help documents, and forms. Note that there are two versions of the ATI Report of Testing Irregularity form; the link at the bottom of the window enables you to complete and submit the form electronically. (This is the preferred method.)

Is ATI TEAS 7 harder than 6? ›

Will Version 7 be harder than version 6? No – the ATI TEAS, Version 7 is not designed to be any more difficult than the previous version of the TEAS exam. These tests are equated, which means they are comparable to each other and have roughly the same degree of difficulty.

Can ATI detect cheating? ›

ATI uses multiple methods of detection to uncover test cheating and theft. Web-crawling processes. Every day, ATI examines the Internet for unauthorized postings of ATI assessment materials. When found, ATI swiftly takes steps to have that content removed.

How do I ace the ATI TEAS exam? ›

Here are some tips to help you prepare and pass your TEAS:
  1. Make a plan. Before you start preparing for your exam, make a plan. ...
  2. Don't cram study. ...
  3. Invest in a TEAS practice exam. ...
  4. Practice time management. ...
  5. Go with your gut! ...
  6. Answer every question. ...
  7. Take care of yourself.

Is ATI enough to pass NCLEX? ›

Can I pass NCLEX with just ATI? Yes, many nursing students have successfully passed the NCLEX with just the ATI. Share via: More.

Is ATI testing hard? ›

Many test takers have found the Reading and English section to be moderately difficult. However, many TEAS takers vouch that the Science and Math section are more complex and challenging. The timed nature of the exam can be difficult for some.

What is the difference between ATI 6 and ATI 7? ›

The biggest differences between the TEAS 6 and TEAS 7 exams include more chemistry, reduction of A & P questions, additional English and language usage questions, and the introduction of new question types. Click this link to view the new question types being introduced on the ATI TEAS, Version 7 Exam.

What is the passing rate for ATI? ›

The passing score for the ATI is around 65%. This is quite a high mark to achieve as the national average on the test is around 60%.

What is a good score on ATI BoardVitals? ›

The exam will automatically select more or less difficult questions based on your performance. At the end of the exam, you will see your results. Our research shows that BoardVitals users are prepared to sit for their board exams when scoring in the 65-75% range.

How many times can you retake ATI? ›

You are allowed to take the ATI TEAS up to 3 times in a calendar year. 10. Do I have to pay a fee each time to take the ATI TEAS? Yes, the cost is $93 for each testing.

Does ATI record your screen? ›

During assessments, students will be monitored via webcam, microphone, and screen. The system will capture things like eye movement, clicks, sound captured by the microphone, and it will flag anything that may not be allowed. This is done by a machine, so a human is not actively watching you.

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