Field NotesJun 2026

NCLEX® SATA Partial Credit: How It's Scored and How to Answer

Yes, NCLEX® SATA questions earn partial credit. Since April 2023 they use +/- scoring, floored at zero per item. Here's the math and a method for answering them.

June 21, 20268 min readBy Harrison Hesslink

Short version: SATA questions on the NCLEX® earn partial credit now. Since April 1, 2023, NCSBN scores them with the +/- method. You gain a point for every correct option you pick, lose one for every wrong option, and the item bottoms out at zero (NCSBN, 2023). Treat every option as its own true-or-false question.

SATA is the question type that wrecks the most study sessions. Five or six options, any number of them can be right, and it feels like a coin flip you were always going to lose.

It's less of a coin flip than it used to be. The old rule, where you had to get every option right or score zero, went away on April 1, 2023, when the Next Generation NCLEX® launched (NCSBN, 2023). Plenty of study guides and old notes still teach the old rule. Partial credit changes how you should answer.

Also, first-time US-educated test-takers passed the NCLEX-RN® at 86.7% in 2025 (NCSBN, 2026). SATA is learnable. Below: what these questions are, how the scoring works, and a method you can run on every one.

A nursing student reviewing NCLEX® practice questions on a laptop with a stethoscope nearby

What does "Select All That Apply" mean on the NCLEX®?

A Select All That Apply question is a multiple response item on the NCLEX®: it gives you a list of options, usually five or six, and asks you to choose every option that is correct (Kaplan, 2023). There is no fixed number of right answers. Could be two, could be five. You decide each option on its own.

Students fear this format most, and it makes sense. Standard multiple choice lets you pick the best answer and move on. SATA makes you call every option yes or no. One question, five or six small decisions.

Mechanics to lock in before test day:

The correct count is hidden. The screen never tells you how many to pick. Walk in expecting "probably three" and you'll talk yourself into a wrong one.
You cannot leave it blank. You have to make at least one selection to move forward.
Options are independent. Each one is either in or out on its own merits. Two similar options can still be one right and one wrong.
SATA shows up in two places. Standalone items, and inside the unfolding case studies, especially in the "Recognize Cues" step of the clinical judgment model (ATI, 2023).

Does the NCLEX® give partial credit for SATA questions?

Yes. As of April 1, 2023, NCLEX® Multiple Response Select All That Apply items are scored with the +/- method, which awards partial credit. Before that date, these items were all-or-nothing: you scored the point only if every selection was perfect (NCSBN, 2023).

The Next Generation NCLEX® uses three scoring rules across its item types: 0/1 scoring, +/- scoring, and rationale scoring (Nurse Plus, 2023). SATA uses +/- scoring. How it works:

You earn +1 point for each correct option you select.
You lose 1 point for each incorrect option you select.
The points are summed for a total item score.
If that total is negative, it is floored at zero. You can never score below zero on a single item.

A wrong pick costs you, but only inside that one question. It can't push your score negative or carry into the next item. Take a SATA item with five options where three are correct. The maximum score is 3.

What you select	Correct picked	Wrong picked	New +/- score	Old all-or-nothing
All 3 correct, 0 wrong	3	0	3 of 3	Full credit
2 correct, 0 wrong	2	0	2 of 3	0
3 correct, 1 wrong	3	1	2 of 3	0
1 correct, 2 wrong	1	2	0 (floored)	0

Illustrative example based on the +/- scoring rule. Not an official NCSBN sample item.

Row two is the one to notice. You knew two of the three answers cold and skipped the one you weren't sure about. Old rules: a flat zero. +/- scoring: two-thirds credit.

How to answer SATA questions: a 6-step method

Stop treating a SATA item as one big question. It's a stack of small ones. Here's a method you can run on every item, standalone or inside a case study.

1. Read the stem, then cover the options

Before you look at the choices, answer the question in your head. What's the patient situation, and what would safe care look like? If you form your own answer first, the option list can't steer you somewhere you wouldn't have gone.

2. Turn each option into its own true-or-false question

This is the core move. Go down the list and ask of each option: "Is this true for this patient, yes or no?" Decide in isolation. Don't compare options against each other. SATA isn't "pick the best ones." It's "judge each one." Five options, five clean decisions.

3. Ignore how many you have selected

There's no magic number. Two selected is fine. Five is fine. The moment you think "I have four, there's probably one more," you start hunting for an answer that may not exist. Trust the call you made on each option.

4. Watch the absolutes

Words like "always," "never," "all," or "none" are often a red flag, because nursing rarely deals in absolutes. Softer words like "usually," "may," or "can" are more often defensible. It's not a guarantee, but it's a decent tiebreaker when you're stuck on one option.

5. Default to safety, airway, and the least invasive action

When an option leaves you unsure, run it through the safety lens. Does it protect airway, breathing, and circulation? Does it meet physiological and safety needs first, like Maslow says? Is it the least invasive choice? An option that breaks basic safety is almost always false, even when it sounds reasonable.

6. For case-study SATA, use the clinical judgment steps

Inside an unfolding case study, SATA items usually live in the early "Recognize Cues" and "Analyze Cues" stages of the NCSBN Clinical Judgment Measurement Model: Recognize Cues, Analyze Cues, Prioritize Hypotheses, Generate Solutions, Take Action, and Evaluate Outcomes (ATI, 2023). Ask which pieces of patient data are relevant and abnormal. Those cues are usually your correct selections.

Why partial credit should change how you answer

Select what you believe is correct and leave the rest alone. Each wrong pick subtracts a point under +/- scoring, so "select everything just in case" is the worst approach you could take (NCSBN, 2023).

Look at the scoring table again. Every correct pick adds a point and every wrong pick takes one away. Two habits hurt you:

Over-selecting. A shaky option you don't believe in can cancel out a right one.
Freezing. Not committing to options you know leaves partial credit on the table.

Select the options you can defend with a reason. Skip the ones you can't. You don't need certainty across the whole list to score anymore. You just need to be right about the ones you pick.

A nurse reviewing patient information on a mobile device between tasks

How to practice SATA before test day

The students who stop fearing SATA are the ones who've answered enough of them that it gets boring. You want the six steps on autopilot so test-day nerves can't knock you off them.

Ways to build that:

Drill SATA on purpose. Filter your practice to multiple-response items and do sets, instead of waiting for them to show up at random.
Review by option, not by question. When you miss one, go through every option and write a sentence on why it was true or false. The miss is usually one or two options, not the whole question.
Practice the case-study version. Standalone and case-study SATA feel different under time pressure. Rehearse both.

Study With Lily turns your class notes and lecture slides into adaptive NCLEX® practice, so the SATA you drill matches what your program actually tests. The difficulty adjusts as you improve, and every answer option gets its own rationale so you can see why each one was true or false.

Start practicing SATA free

Frequently Asked Questions

Does the NCLEX® give partial credit for Select All That Apply questions?

Yes. Since April 1, 2023, NCLEX® Multiple Response SATA items use +/- scoring, which awards partial credit (NCSBN, 2023). You earn a point for each correct option, lose one for each incorrect option, and the item score bottoms out at zero. The old all-or-nothing rule is gone.

How does +/- scoring work on SATA?

You gain +1 for every correct option you select and lose 1 for every wrong option. The points are summed for the item, and if the total is negative it is set to zero (Nurse Plus, 2023). A wrong pick only costs you inside that question.

How many options does a SATA question have, and how many are correct?

Most SATA items present five or six options (Kaplan, 2023). The number of correct answers is not fixed and is never shown to you. It could be one or all of them, so judge each option on its own instead of aiming for a count.

Should I guess on SATA questions?

Select every option you can defend with a clinical reason and leave the rest. Each wrong pick subtracts a point, so options you don't believe in can cancel out credit you earned on the ones you do.

Can I leave a SATA question blank?

No. You must make at least one selection to advance to the next question. If you're unsure, pick the options you're most confident in. Under partial credit, a single right selection still scores.

Is SATA the hardest part of the NCLEX®?

Plenty of students find SATA the most intimidating format, but first-time US-educated test-takers passed the NCLEX-RN® at 86.7% in 2025 (NCSBN, 2026). A consistent method and repeated practice take most of the sting out.

Sources

About the Author

Harrison is the founder of Study With Lily. He built the platform after watching his wife and her nursing school classmates wrestle with expensive, outdated prep tools. He writes about NCLEX® strategy, test-plan changes, and evidence-based study methods, using NCSBN primary sources and what he saw supporting a nursing student through the exam.

Last updated: June 21, 2026 · 9 min read