The NCLEX exam is the licensing exam for nurses in the United States and Canada. This question type realizes the NCLEX Matrix Multiple Response question and is pre-configured with the required +/- scoring rules. 

Like the standard ‘choice matrix’ questions, the question displays a grid, where learners can select as many cells as applicable.

Learners earn points for every correct response, and lose points for each incorrect response, with a floor score of zero points per column. There are no penalty points for missing a correct answer.

The question is therefore out of the total number of correct cells that need to be selected, and cannot go below zero.

The question in action

Here are examples of the scored feedback a learner would receive by selecting different combinations of correct, incorrect, and skipped answers.

The learner’s responses are shown in the grid as pink, with the scoring alongside it.

The above response earns full marks for selecting all eight correct cells, shown highlighted in green, with a green check mark.

The above response would earn seven marks since the learner has missed one correct answer, shown as a yellow highlight and dark check mark.

The response above would score five out of eight:

• Pneumonia: three points for three correct answers (one missed)
• Urinary Tract Infection: two points for two correct answers (zero missed)
• Influenza: zero points. one correct answer, one missed, and minus one for an incorrect answer. The incorrect answer is shown highlighted in red, with a red cross.

The response above would also score five out of eight:

• Pneumonia: three points for three correct answers (one missed)
• Urinary Tract Infection: two points for two correct answers (zero missed)
• Influenza: zero points. two correct answer, and minus three for incorrect answers with a floor of zero. The incorrect answer is shown highlighted in red, with a red cross.

Create a Question

‘Choice matrix - NCLEX Scoring’ is found in the ‘Other’ category. 

On the edit page, enter a question in the Compose Question area. ‘Stems’ are rows in the table, the elements selected per column, and ‘Options’ are the column headers. Click +Add for each new stem or option, and the trash can icon beside a stem or option to remove it.

In order to configure scoring for the question:

• Under ‘Set correct answer(s)’, enter a value in the Point(s) box. This is the number of points given per correct cell. The default value is 1.
• Underneath, you will see the matrix created by the stems and options. To indicate correct responses simply click on the cells.
• Under ‘More options’, set the penalty point(s). This is the number of points subtracted for selecting an incorrect cell. The default value is 1.

Other Scoring options:

• Unscored/Practice usage type - Enabling this option will remove all scoring from the question.
• Check answer button - If this is enabled, a "Check answer button" will appear to the student alongside the question; clicking this button will indicate to the student if their answer is correct or incorrect, but it will not tell them the correct response. This can be useful for informal assessment.
• Check answer attempts - The value entered here will indicate how many times the student can use the "Check answer button". A value of 0 indicates an infinite number of times.
• Minimum score if attempted - Set attempt marks for the question, which will be awarded to the student even if their responses might score below this. 

This Question type is supported on Long Term Support versions 2024.2.LTS and onward.