How to Qualify
OVERVIEW

In order to work in the USA as a nurse each candidate must first take the NCLEX examination. This examination can be taken in London, England as well as in other countries.

ELIGIBILITY REQUIREMENTS

To take the NCLEX exam, candidates must meet all of the eligibility requirements of the relevant Board of Nursing i.e. have qualified from an RN training program which covered Medical, Surgical, Obstetrics, Pediatrics and Psychiatry both clinical and theory.

Most of the Nursing Boards now require you to hold a CGFNS certificate or have undergone Credential Evaluation Service (CES) before they will make your eligible to sit the NCLEX exam. See www.cgfns.com.

Each State takes a different amount of time to process an application. Most Boards of Nursing take approximately 4-6 months.

Bear these points in mind when applying to sit the NCLEX exam.

Once you have passed NCLEX, it is possible to obtain a license from another state if you desire by going through an endorsing procedure since State Boards recognize other States’ licenses.

WHERE TO TAKE THE TEST

In the UK, the exam is organised and run by PearsonVUE and held on weekdays between 8am and 6pm at 190 High Holborn, London WC1 7BH. For Registration, further details, etc call 00 44 (0)800 783 2210 or see www.pearsonvue.com/nclex.)

PearsonVUE also have testing facilities in the Philippines.

NIS recommends that you begin studying as soon as you decide to relocate to the USA.

Also that you look at the test review site - which is a comprehensive online NCLEX review course sponsored by the National Council of State Boards of Nursing (NCSBN) - http://learningext.com.

HOW TO TAKE THE TEST

Register at PearsonVUE (see above) and you will receive a letter of Authorization to Test (ATT). They will arrange the exam date and when to sit the exam. Take the ATT letter and a valid passport with you.

The computerized NCLEX exam lasts a maximum of 6 hours.
GREEN CARD SPONSORSHIP

The only way for a foreign-trained nurse to be able to work in the USA is by gaining sponsorship as a Resident Alien (Green Card).

NIS works only with hospitals and other healthcare facilities that pay for the immigration procedures and attorney fees.

It will depend on the State where you are licensed as to which of the four immigration-filing centers you will be allocated to. US is divided into 4 immigration process centers. This in turn will dictate the length of time it takes for the Green Card to be approved. This time delay is dependent on the US Immigration Service and so there is no possibility to shortcut or speed up this process.

A Green Card issued to a nurse will allow their spouse and dependent children (under 21 years of age) to live and work in the USA. After five years on a Green Card the nurse (and family, if applicable) can apply to become US Citizens.

VisaScreen Certificate

The Commission on Graduates of Foreign Nursing Schools (CGFNS) is a not for profit immigration neutral organization to screen health professionals who have been educated overseas to meet the licensure and practice requirements in the United States. See www.cgfns.org. They will evaluate your academic credentials. Please follow their instructions carefully.
ABOUT THE COMPUTERIZED ADAPTIVE TEST

The exam is administered by Computerized Adaptive Testing (CAT). With CAT, unlike paper and pencil testing, the computer selects the questions you will be answering as you take the exam in order to give you the best opportunity to demonstrate your competency.

Questions in the NCLEX exam are nearly all multiple choice questions. The questions are presented one at a time on a computer screen. You can view each question as long as you like but you can not go back to previous questions once you have recorded your answers, nor can you leave a question unanswered.

The CAT chooses test items based on your response to the previous question. The computer will “adapt” to your answers, correct or incorrect, by selecting harder or easier items for the next question. For example, at the start of the exam, a question of medium-level difficulty may appear on screen. If you answer correctly, the computer will then ask a more difficult question; if you answer incorrectly the computer will then ask an easier question.

TEST CONTENT

The practice of nursing requires knowledge of the nursing process and the health needs of the patients. These two components are addressed within the framework of the test plan for licensure examination. The percentages of questions relating to the various aspects of the nursing process are as follows:

NCLEX Nursing Process
% of Questions

Assesment

15-25%

Analysis

15-25%

Planning

15-25%

Implementation

15-25%

Evaluation

15-25%


NCLEX Patient Needs
% of Questions

Health promotion/maintenance

24-48%

Psychosocial integrity

10-22%

Physiological integrity

36-60%
Sample questions

Q1 A 46 year old patient has a diagnosis of paranoid schizophrenia. The staffs on the unit are having difficulty getting him to eat because he is afraid that the food is poisoned. Which of the following actions should the nurse plan to take?

A1
1) offer foods that are wrapped or bottled
2) ask him what his favorite foods are
3) institute one to one therapy to discuss his feelings
4) tell him that intravenous feedings maybe necessary

Q2 A pregnant patient expresses concern about her gestational diabetes and asks the nurse “Does this mean I will be diabetic for the rest of my life ?” Which of the following would be the most appropriate response?

A2
1) “In most cases, the gestational diabetic will become insulin-dependant diabetic”
2) “If you follow your diabetic diet , you will have nothing to worry about”
3) “As long as you don’t become pregnant again you will not become a diabetic”
4) “there is a possibility that you may have an onset of diabetes at some point in the future”

Q3 The nurse is caring for a 73 year old patient who is being treated with Buck’s traction preoperatively for a right intertrochanteric hip fracture. Which of the following statements by the patient would indicate that the traction is ineffective:

A3
1) “I can’t move my right leg”
2) “I’m uncomfortable when my position is changed”
3) “my right foot keeps pressing against the foot of the bed”
4) “my right thigh is swollen”

The right answer appears in bold

TEST RESULTS

The test center will transmit your results electronically to your State Board of Nursing who will notify you of the results in approximately 4 weeks.