BowTie
NCLEX® Practice Questions
16 options across 3 columns · 5 correct · All 6 CJMM steps
The most complex format on the NCLEX®. A single item that exercises all 6 Clinical Judgment steps at once. Identify the condition, choose interventions, and select monitoring parameters across three simultaneous columns.
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Clinical judgment steps
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A 72-year-old patient is admitted with confusion, elevated temperature (39.2°C), and a productive cough with rust-colored sputum. Chest X-ray reveals right lower lobe consolidation. SpO2 is 89% on room air.
Actions to Take
Select 2 (0/2)
Actions to Take
Select 2 (0/2)
Potential Condition
Select 1 (0/1)
Parameters to Monitor
Select 2 (0/2)
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Common questions
What is a BowTie question on the NCLEX®?
A BowTie question has three columns: Actions to Take (6 options, select 2), Potential Condition (4 options, select 1), and Parameters to Monitor (6 options, select 2). It tests all 6 steps of the Clinical Judgment Measurement Model in a single item.
How do you answer a BowTie question?
Start by reading the clinical scenario, then identify the most likely condition from the center column. Once you know the condition, select the 2 best nursing interventions from the left column and the 2 monitoring parameters that confirm your treatment is working from the right column. All three columns are interdependent.
Are BowTie questions on every NCLEX® exam?
Yes. The 2026 NCLEX® includes BowTie items as part of the Next Generation question formats. The computer adaptive algorithm determines how many you see based on your performance level.
Can I practice BowTie questions for free?
Try the sample questions on this page. Sign up free for 5 questions a day. Upgrade to Full Access for $9.99/month to unlock unlimited BowTie practice. Lily walks you through the 3-column format with instant rationales for every selection.
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