Cloze Questions on the NCLEX: Drop-Down Strategy

Cloze items embed one or more drop-downs inside a sentence or short paragraph. They feel easy until you realize every option can sound plausible until you read it inside the full sentence.

What Cloze Tests

• Clinical accuracy in context
• Nursing process order (assess vs implement)
• Safety language and scope
• Sometimes calculations (numeric cloze / fill-in)

Step-by-Step Strategy

1. Read the entire sentence with the blank as a pause.
2. Predict the missing idea before opening the menu when you can.
3. Open the drop-down and mentally insert option A, then B, then C.
4. Check three fits: clinical truth, grammar/logic, and stem priority.
5. If there are multiple blanks, solve the one you know first — it often constrains the others.
6. Re-read the completed sentence out loud in your head.

Worked Mini-Example

Sentence: The nurse should first ____ the client’s airway.

| Option | Fit? | |--------|------| | document findings | Weak — delays airway | | assess | Strong — airway first | | notify the provider | Maybe later — not always first if you can assess/intervene |

Multi-Blank Cloze

When two drop-downs interact (e.g., drug + route, or finding + action):

• Ensure the pair is consistent (not a correct drug with the wrong route)
• Watch for contraindications created only when both blanks combine

Traps

| Trap | Fix | |------|-----| | Choosing the option that “sounds nurse-y” | Insert into the sentence | | Ignoring grammar that signals time order | First / then / before | | Solving blanks in isolation | Check the pair together | | Rushing numeric cloze | Write units; re-check decimal |

Practice

• Rewrite textbook rules as cloze sentences and hide the verb
• Do 10 drop-down items focusing only on “insert and re-read”
• Add dosage cloze under timed conditions weekly

Browse NursePath guides for content that makes the blanks obvious.