BowTie
NCLEX® Practice Questions
16 options across 3 columns · 5 correct · All 6 CJMM steps
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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The most complex format on the NCLEX®. A single item that exercises all 6 Clinical Judgment steps at once.
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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). NCSBN describes BowTie items as addressing all six Clinical Judgment Measurement Model steps in one 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?
BowTie items are part of the 2026 Next Generation NCLEX® item pool. The computer adaptive algorithm decides which item types you see and how many, so your mix varies.
Can I practice BowTie questions for free?
Try the sample question on this page for free. BowTie practice requires Full Access and is unlimited, with instant rationales for every selection.
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