One-sentence definition (featured snippet)
Matrix multiple-response items score each row separately, so you can earn partial credit by selecting all safe choices in a row—even if you miss others.
Building full NGN skills? Read: Cue Recognition, Analysis & Prioritization, and NGN Partial Credit.
Why matrix multiple response is high-value
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Row-level scoring = built-in partial credit
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Predictable patterns and traps you can learn fast
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Perfect for structured, stepwise clinical thinking
How to read a matrix (90-second flow)
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Re-read the stem and name the current priority (oxygenation, perfusion, neuro).
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Work row → row (never hop across columns).
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Mark unsafe / out-of-scope = No first.
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Keep only items that match the current problem and timing.
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Do a quick duplicate/contradiction scan before you submit.
The 3 trap rows (learn once, reuse forever)
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Look-alikes: Two rows seem right; one hides a contraindication.
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Frequency bias: “Often / usually” does not mean now. Match the current priority.
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Half-true: Correct idea but missing a required monitoring or safety step.
Role & scope (fast reference)
Use scope to eliminate wrong rows quickly.
| Team member | Typical responsibilities |
|---|---|
| RN | Initial assessment, teaching, evaluation, complex clinical judgment, IV pushes per policy |
| LPN | Care for stable clients, routine meds, wound care, data collection, reinforce teaching |
| UAP | ADLs, hygiene, stable vitals, transport, intake/output (no interpretation) |
If a row assigns assessment, teaching, or complex IV meds to UAP/LPN in the wrong context, mark No.
Worked mini-grid 1 (anticoagulation safety)
Stem: Client on IV heparin for DVT. Which actions are indicated?
| Action | Pick | Why |
|---|---|---|
| Check aPTT per protocol | ✅ | Required monitoring |
| Keep protamine available | ✅ | Reversal agent |
| Give IM injections | ❌ | ↑ bleeding risk |
| Massage injection site | ❌ | ↑ bleeding risk |
| Monitor gums/urine/stool for bleeding | ✅ | Safety check |
Score smart: Each row can earn points. Unsafe picks can zero that row—even if another choice is correct.
Worked mini-grid 2 (isolation & delegation)
Stem: Client with suspected C. difficile. Which actions are appropriate?
| Action | Pick | Why |
|---|---|---|
| Initiate contact precautions (gown + gloves) | ✅ | Correct isolation |
| Alcohol-based hand rub only | ❌ | Use soap & water (spores) |
| Assign UAP to disinfect room with bleach per policy | ✅ | Within UAP scope (per facility protocol) |
| RN performs initial teaching on hand hygiene | ✅ | RN responsibility |
| Place client in negative-pressure room | ❌ | Not needed (contact, not airborne) |
Key lesson: Use policy + organism to drive correct rows. Tie rows to scope and safety.
Matrix multiple response: quick reasoning prompts
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Does this row protect airway, perfusion, or neuro now?
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Is it within scope for the role listed?
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Is monitoring required for this action/medication?
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Is the timing right for the problem shown in the stem?
60-second checklist (print this)
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Stem priority confirmed (O₂ / perfusion / neuro)
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Unsafe/out-of-scope rows marked 'No' first
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Duplicates and contradictions removed
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Rows match the current problem and timing
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Final row scan → submit
Common mistakes (and fixes)
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Column hopping → contradictions
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Fix: Go row by row only.
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Teaching before stabilization
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Fix: Stabilize first; teach later.
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Background care during an acute threat
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Fix: Apply ABCs → Safety → Stability → Time-sensitive.
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Image (hero)
File: hero-matrix-multiple-response.jpg
Alt: “Row-by-row checklist over a matrix grid for matrix multiple response partial credit”
More Resources
FAQs
Q: How many boxes per row should I tick in a matrix multiple response?
A: As many as are safe and indicated—there’s no fixed number.
Q: Do wrong boxes erase right ones?
A: Unsafe choices can zero that row. Remove them first.
Q: What if two boxes say the same thing?
A: Keep the best fit for the stem; drop the duplicate.
Q: How do I move faster on big grids?
A: Mark unsafe/out-of-scope rows first. Then add the remaining safe rows that match the current priority.
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