How to answer cloze and drop-down questions
Written and reviewed by Dana Whitfield, RN, MSN · 5 min read · Updated September 2026
Short answer
A cloze item is a sentence about the client with words missing and a drop-down list at each gap. It reads like a fill-in-the-blank and behaves like a clinical argument: the sentence is usually 'the client is at risk of ___ as evidenced by ___', and the two choices have to agree with each other, not just be individually true.
Read the whole sentence first
Both blanks filled, then read it back as one statement. The commonest error is choosing a defensible option at each gap separately and producing a sentence that does not hold together — a real risk paired with evidence that does not support it.
The item is testing whether you can connect a finding to its meaning, which is exactly the analyse-cues step of the clinical judgement model. Two individually plausible words that do not belong in the same sentence is the trap the distractors are built around.
The lists are not parallel
Each drop-down has its own options and they are not in matching order, so there is no positional pattern to lean on. Some lists contain an option that is correct for a different client in the same case study, which is why the scenario must be re-read rather than remembered.
Where a drop-down offers a number — a rate, a dose, a value — check the units before the digits. Distractors here are usually the right number in the wrong unit.
Practising the format
Cloze items reward being able to say what is wrong with a client in one sentence, which is a habit worth building outside the exam anyway. After any practice question, try summarising the client as 'at risk of X as evidenced by Y'. That is the cloze skill, drilled without needing cloze items.
Answer every blank. Like the other Next Generation types they carry partial credit, and an empty drop-down scores nothing.
Whatever you take from this, the next step is the same: answer questions and read the rationales. Our med-surg practice questions are the closest set to what this guide covers, there are ten more on the practice questions hub, and the pricing page spells out what the free tier includes.
One question from the med-surg set
A client with chronic obstructive pulmonary disease has an oxygen saturation of 88% on 2 L/min via nasal cannula and is alert with no distress. What should the nurse do first?
Rationale
In COPD a saturation of 88–92% is the therapeutic target, not an emergency, and this client is alert with no distress. The first action is the independent nursing intervention that is least invasive and most likely to help: sit them up and reassess. Turning the oxygen up to 6 L/min risks blunting the hypoxic drive, and calling rapid response or drawing an ABG escalates ahead of an assessment you have not finished.
Answer: B
Common questions
What is a cloze question on the NCLEX?
A sentence about the client with one or more words missing, each replaced by a drop-down list. You choose the option at each gap that makes the whole sentence clinically true.
Do the drop-down lists contain the same options?
No. Each gap has its own list, and some contain options that are correct for a different client in the same case study. Re-read the scenario rather than relying on memory.
Is a cloze question scored all or nothing?
No, they carry partial credit per blank. Answer every gap — an unanswered drop-down scores nothing at all.