Aim: This study aimed to describe the practices and perceptions of nurse educators when developing NGN-style test items. Methods: This study used a qualitative descriptive methodology to explore the practices and perceptions of nursing faculty when developing NGN-style test items from nursing faculty in accredited prelicensure programs in the United States who offer an Associate's Degree in Nursing or a Bachelor's Degree in Nursing. Potential participants were identified through a search of accredited schools of nursing websites in the United States and through recruitment of colleagues known to have experience in NGN-style test-item writing. All potential participants were encouraged to distribute the survey to qualified colleagues. Over 500 emails were sent out to potential participants. Thirty-three participants completed the online survey, and six participants completed the interview. Findings: This survey discovered four categories within the data, including internal facilitators, external facilitators, internal barriers, and external barriers to developing NGN-style test items. Internal facilitators included collaboration and practice with peers, while external facilitators included workshops and external resources. Internal barriers included anxiety and an intense time commitment, while external barriers included software compatibility and a lack of resources. Conclusion: The results of this study indicate multiple facilitators and barriers to NGN-style test item development. Further research is needed to evaluate how nursing faculty are adapting NGN-style test-item development into their classrooms. [The dissertation citations contained here are published with the permission of ProQuest LLC. Further reproduction is prohibited without permission. Copies of dissertations may be obtained by Telephone (800) 1-800-521-0600. Web page: http://bibliotheek.ehb.be:2222/en-US/products/dissertations/individuals.shtml.]