Matrix and Grid Questions on the NCLEX
How to answer NGN matrix/grid items cell by cell — indicated vs contraindicated, expected vs unexpected, without pattern guessing.
Matrix (grid) items look like spreadsheets: rows of findings or actions, columns of categories such as indicated / contraindicated or expected / unexpected. Students lose points when they treat the grid like one puzzle instead of many tiny questions.
How a Matrix Works
Each cell is its own decision. Selecting “indicated” for one row does not tell you anything about the next row.
Cell-by-Cell Method
- Read the scenario once for context (diagnosis, orders, acuity).
- Read column headers carefully — indicated vs contraindicated is not the same as effective vs ineffective.
- Take row 1 only. Cover other rows.
- Decide the correct column(s) for that row.
- Move to the next row and reset your mind — no carry-over.
- Final pass: scan for absolute words and scope-of-practice errors.
Worked Thinking (Indicated / Contraindicated)
Client: Acute pancreatitis, NPO, severe abdominal pain.
| Action | Column | Why | |--------|--------|-----| | Maintain NPO | Indicated | Standard for acute pain / enzyme rest | | Offer high-fat snack | Contraindicated | Stimulates enzymes / worsens pain | | Assess pain and give ordered analgesics | Indicated | Comfort + assessment | | Encourage alcohol “in moderation tonight” | Contraindicated | Harmful and inappropriate |
Column Types You Will See
- Indicated / contraindicated
- Expected / unexpected
- Anticipated / not anticipated
- Appropriate / not appropriate for role (RN / LPN / UAP)
When columns involve delegation, combine this method with prioritization and delegation.
Traps
| Trap | Fix | |------|-----| | Matching the same column down the page | Reset each row | | Using general nursing knowledge only | Apply this client’s orders | | Selecting both columns for one row when only one applies | Read instructions | | Ignoring contraindications hidden in “helpful” actions | Ask: could this harm? |
CJMM link
Matrices often test Analyze Cues + Generate Solutions. Keep the CJMM script nearby while you practice.
Practice Prescription
- One matrix daily for 10 days
- Say out loud: “Row 2 is a new question”
- Review wrong cells as false for this client, not “I hate grids”
Explore structured NCLEX content in our guides catalog.