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34 unit 1 | Professional Considerations CikguOnline
malpractice. This can result in the nurse losing his contract with the state boards. Initially, each state
or her license and perhaps even facing a wrongful determined its own passing score; however, the
death suit due to an error in judgment. states did adopt a common passing score. The
Nurses practice under state or provincial examination is called the NCLEX-RN and is used
(Canada) nurse practice acts.These state that nurses in all states and territories of the United States.
are held accountable for the safety of their clients This test is prepared and administered through a
Once a nurse accepts an assignment for the client, testing company, Pearson Professional Testing of
that nurse becomes liable under his or her license. Minnesota (Ellis & Hartley, 2004).
Many states are working to create legislation
restricting mandatory overtime for nurses. NCLEX-RN
The NCLEX-RN is administered through com-
Licensure puterized adaptive testing (CAT). Candidates must
register to take the examination at an approved
Licensure is defined by the National Council of testing center in their area. Because of a large test
State Boards of Nursing as the “process by which an bank, CAT permits a variety of questions to be
agency of state government grants permission to an administered to a group of candidates. Candidates
individual to engage in a given profession upon taking the examination at the same time may not
finding that the applicant has attained the essential necessarily receive the same questions. Once a can-
degree of competency necessary to perform a didate answers a question, the computer analyzes
unique scope of practice”(NCSBN, 2007). Licenses the response and then chooses an appropriate ques-
are given by a government agency to allow an indi- tion to ask next. If the question was answered cor-
vidual to engage in a professional practice and use a rectly, the following question may be more difficult;
specific title. State boards of nursing issue nursing if the question was answered incorrectly, the next
licenses, thus limiting practice to a specific jurisdic- question may be easier.
tion (Blais, Hayes, Kozier, & Erb, 2006). The minimum number of questions is 75, and
Licensure can be mandatory or permissive. the maximum is 265. Although the maximum
Permissive licensure is a voluntary arrangement amount of time for taking the examination is
whereby an individual chooses to become licensed 5 hours, candidates who do well or those who are
to demonstrate competence.However,the license is not performing well may finish as soon as 1 hour.
not required to practice. Mandatory licensure The test ends once the analysis of the examination
requires a nurse to be licensed in order to practice. clearly determines that the candidate has success-
In the United States and Canada, licensure is fully passed, has undoubtedly failed, has answered
mandatory. the maximum number of questions, or has reached
the time limit (NCSBN, 2007). The computer
Qualifications for Licensure scores the test at the time it is taken; however, can-
The basic qualification for licensure requires grad- didates are not notified of their status at the time of
uation from an approved nursing program. In the completion. The information first goes to the test-
United States, states may add additional require- ing service, which in turn notifies the appropriate
ments, such as disclosures regarding health or state board. The state board notifies the candidate
medications that could affect practice. Most states of the examination results.
require disclosure of criminal conviction. Nursing practice requires the application of
knowledge, skills, and abilities (NCSBN, 2007).
Licensure by Examination The items are written to Bloom’s taxonomy and are
A major accomplishment in the history of nursing organized around client needs to reflect the candi-
licensure was the creation of the Bureau of State dates’ ability to make nursing decisions regarding
Boards of Nurse Examiners. The formation of this client care through application and analysis of
agency led to the development of an identical exam- information. The examination is organized into
ination in all states.The original examination,called four major client need categories.Two of these cat-
the State Board Test Pool Examination, was created egories, safe and effective care and physiological
by the testing department of the National League needs, include subdivisions (NCSBN, 2007).
for Nursing.This was done through a collaborating Integrated processes incorporate “nursing process,