Nepal Nursing Council License Exam Syllabus 

Nepal Nursing Council License Exam Syllabus

Background

Nepal Nursing Council is an autonomous body under the Nepal Nursing Council Act 2052 formulated by  the Government of Nepal. It aims at promoting quality nursing and midwifery education in order to bring quality nursing and midwifery service in the country.

The National Licensure Examination for Nurses is an examination for nurses introduced by the Nepal  Nursing Council. The National Licensure Examination for Nurses is an examination to qualify as nursing professionals. It is required for all new pre-service graduates of Proficiency Certificate Level (PCL) and Bachelor of Science in Nursing (BSc N.) Programmes The examination is geared towards testing knowledge and practice in relation to the job functions most commonly required by entry-level professional nurses. The examination determines eligibility to earn a title of registered nurse in order to begin working as a professional nurse.

The Nepal Nursing Council had gone through several processes to establish the National Licensure Examination for Nurses in Nepal. The Nepal Nursing Council sought references on licensing exam from SAARC including developed countries. The Nepal Nursing Council also received technical and human resource from JICA to support in conducting initial licensure examination.

Objectives

The objectives of the national licensure examination are as follows:
1. To maintain quality nursing services to the public.
2. To maintain professional standard of knowledge and practice among new graduates
3. To recommend for strengthening the capability of nursing institutions for quality nursing education

Examination Process / Rule

Duration of Examination 

Licensure Examination will be of two and half hours (2:30 hours) duration. Applicants are not allowed to enter the examination room after 15 minutes from starting examination. Applicants can leave the room only after 1 hour of starting the examination.

Type of Questions 
All of the test items are Multiple Choice Question (MCQ) with four options. Applicants are to select the most appropriate choice.

Subject wise distribution of test items

Frequency of the NLEN
The Nepal Nursing Council conducts the NLEN three times a year. If applicant fails an examination, she/he will be
allowed to apply for the next examination.

Application Fee

The fee for the NLEN online application for Nepalese candidate is NPR 1,600. The fee for a candidate from SAARC countries is NPR 5,100 and for foreigner other than SAARC countries is NPR 10,100.

Scoring System
There is no negative scoring system. It means when applicant gives wrong answer, no minus marking  will be done.

Passing Standard

The grading system on the NLEN is either pass or fail. No numerical score will be provided. In order to  pass the National Licensure Examination, the applicant must score at least 50% marks in aggregate.

Result of NLEN
The result of NLEN will be published on the same exam day in the evening unless and until there is a  technical difficulty. Results will be published on the Nepal Nursing Council notice board and on the NNC’s website. The Nepal Nursing Council will not inform the candidates individually.

Registration (Applicable for Nepalese and SAARC countries)

Once applicant has successfully passed NLEN they can apply for registration to get their registrationlicense from the NNC with the registration fee of NPR 800 paying via eSewa and they should also bringthe admit card along with two photographs same as used for admit card including all the originaldocuments and citizenship.

Syllabus for Nepal Nursing Council License Exam

NLEN Content
Below is the list of topics that will be used by item writers and item reviewers of NLEN

Integrated Science

Integrated Science includes subjects like Anatomy/ Physiology, Microbiology, and Pharmacology related content but is not limited to:

I. Anatomy/ Physiology
Cardiovascular/ Lymphatic System:

• Body fluid/Electrolytes and Acid- Base Balance
• Blood Composition, Plasma and Plasma Proteins
• Physiology of Red Blood Cells, White Blood Cells, Platelets
• Blood Groups and Rh factor
• Anatomy of Cardiovascular System: The Heart and Blood Vessels
• Physiology of Circulation
• Cardiovascular Regulation and Adjustments Lymphatic/ Immune system
• Human cell and its structure

Musculoskeletal System

• The Human Skeleton, its structure and physiology
• The Joints
• The Skeletal Muscles of Human Body, Neuromuscular Junction and Muscle  Physiology

Nervous System

• Functional unit of nervous system, Central Nervous System, Peripheral Nervous System and Autonomic Nervous System
• Somatosensory, Somatomotor System and Reflexes
• Meninges, Cerebrospinal Fluid, Blood- Brain Barrier and Central Blood Flow

Respiratory System

• Structure and Functions of Respiratory System
• Physiology/Mechanism/ Control of Respiration

Gastro-Intestinal System

• Structure and Functions of Digestive System Digestion and Absorption of nutrients Accessory organs of Gastro-Intestinal system

Endocrine System

• Structure and functions of endocrine glands and hormones.

Urinary System

• Functional unit of urinary system Physiology of urine formation

Reproductive System

• Male Reproductive System, Female Reproductive System
• Contraceptives and Action and side effects of contraceptives

Special Sensory System

• Eye, Ear, Nose, Throat The Skin and Fascia

2. Microbiology/Parasitology 

• Factors affecting the growth and survival of micro organisms
• Types of parasites affecting to human body and its mechanism to develop diseases

Pharmacology

• Types and Function of Drugs
• Pharmacokinetics: Absorption, distribution, metabolism, excretion of drug, and factors influencing the pharmacokinetics
• Pharmacodynamics: drug action, adverse reaction to drugs
• Essential, emergency and Life Saving Drugs used in Nepal
• Drugs acting on different body systemsII. Fundamentals of Nursing

Related content includes but is not limited to:

• Ethics in Nursing: International Councils of Nurses (ICN) Code, Nepal Nursing Council Act and Regulation.
• Patient’s Rights
• Informed Consent
• Assessment (history taking vital signs and physical
• Nursing diagnosis
• Evaluation of nursing care: objective data
• Nursing Process
• Caring
• Admission and discharge procedure
• Role and responsibility of nurse in laboratory test/examination: invasive and  non- invasive procedures: e.g. blood test, lumbar puncture, thoracentesis, ultrasonography
• Personal hygiene
• Safety and Infection Control: Safety Devices, Accident/ Injury Prevention, Infectious Materials, Universal Precaution
• Rest and Sleep pressure relief measure, Comfort/ pain relief measure
• Meeting nutritional needs Meeting elimination needs: catheterization, intake
• Rehabilitative care
• Care for dead body
• Nursing responsibility for drug administration
• Routes of administration of the drug
• Dosage Calculation and Administration of drugs
• Indications, contraindications and interactions, adverse effect , side-effect
• Responsibility of nurses in administration of medicine: e.g. Six rules in administration of the drug
• Administration and management of IV fluids, Blood and Blood products
• First Aid
• Basic Cardiopulmonary Resuscitation (CPR)
• Bites : insects, snake, animals and their first aid management
• Burn: Degrees / types of management
• Wounds: Dressing and Bandage
• Hemorrhage
• Choking
• Fracture
• Drowning
• Frostbite
• Poisoning

Community Health Nursing

Related content includes but is not limited to:

• Community Health and Community Health Nursing
• Communication skills
• Community resources
• Health Education
• Home visiting
• Primary Health Care (PHC): Elements and role of nurses in PHC
• Demography/ Health Indicators: (e.g. IMR. MMR, TFR)
• Epidemiology
  Role of epidemiology
  Community Diagnosis
  Role and responsibilities of Nurses in epidemiological approach
• Environmental Health: Sanitation, Water, Housing, Pollution
• Nutrition
• Nutritients and their functions
• Nutritional Deficiency disorders: Types and characteristics
• Management of the clients with nutritional deficiency
• Immunization
• Types, Purposes and Functions of immunization
• Administration of immunization Routs
• National Immunization Program in Nepal
• Maternal and Child Health
• MCH clinics: Antenatal Care (ANC), Postnatal Care (PNC)
• Growth Monitoring of Under Five Children
• Under Five’s Clinic
• Gender Issues
• Sex and gender  Gender issues: e.g. gender equity, gender equality, gender discrimination, Domestic Violence
• Family Planning
• Population problems in Nepal
• Types, methods, advantages and disadvantages of different family planning methods
• Emergency Contraception and methods
• FP Counseling
• HIV/AIDs, STI
• Prevention of HIV/AIDS, STI
• Treatment and management for the clients with HIV/AIDS, STI
• Family Health Nursing

III. Adult Nursing

Related content includes but is not limited to:

• Characteristics of adulthood, developmental tasks of young adult, middle aged adults, elderly adults
• Aging process
• Disorders of each body system: Blood, Body Fluids/Electrolytes, Nervous System, Circulatory System,
• Respiratory System, Musculoskeletal System, Gastro-Intestinal and Nutritional System, Urinary System, Endocrine System, Sensory System
• Common disorders, investigations and medical/surgical treatment of different body system disorders
• Medical/Surgical nursing management for the client with disorders in each system
• Mental Health Problems
• Assessment of mentally ill clients, characteristic of mental health
• Major and minor disorders, treatment and nursing management
• Operation Theatre Nursing
• Operation Theatre (OT) Nursing, Characteristics of OT nurse OT technique (e.g. aseptic technique, sterilization, scrubbing, gowning, gloving) Role and Responsibilities of scrub nurse, circulatory nurse, and recovery nurse Common surgical materials, equipments, and supplies in OT and their preparation Sterilization and Pre and Post-operative Nursing care
• Rehabilitation Disability: Types and characteristics Role and responsibility of nurses in rehabilitation Nursing management of disable client
• Nursing care of the client in the terminal stage Stages of dying Grief and Loss  Holistic Care
• Stress and Crisis Management
• Body’s response to stress
• Role of nurses in stress and crisis management

Child Health Nursing

Related content includes but is not limited to:

• Terminology of Child Health Nursing
• Growth and development of child in each stage: infancy,
• school-age and adolescence
• Nursing role on promotion of growth and development of children
• Nursing care to child and family
• Influences brought by diseases and hospitalization
• Nursing care for children with accident/ injury
• Nursing care for children with common communicable diseases
• Nepal Nursing care for children with congenital/ chromosomal disorders
• Nursing care for children with illness conditions: nervous system, musculoskeletal system, respiratory system, circulatory system, blood, gastro-intestinal, urinary system, endocrine system, sensory
• Health Promotion for system children: Nutrition, exercise, play, anticipatory guidance
• Mortality and Morbidity in Under Five Children and their prevention
• Nursing role on prevention and management of children with HIV/AIDs
• Integrated Management of Childhood Illness (IMCI) program
• Pediatric Procedure
• Oxygen administration (e.g. head box, oxygen tent), Nebulization, Positioning/ Restraining, Calculation of drugs and its administration,
• Different types feeding, IV fluid administration and management,
• Phototherapy
• Care for incubator
• Colostomy and tracheostomy care
• Cardio Pulmonary Resuscitation (CPR)
• Specimen collection
• Assisting in common invasive procedures (e.g. lumbar puncture)

Midwifery and Gynecology

Related contents include the following but not limited to:

• Deformation of sex and sexuality, Reproduction in human being
• Components of reproductive health
• Reproductive rights
• Maternal and Newborn Health in Nepal
• Strategies and policies of reproductive health in Nepal
• National Policy on Skill Birth Attendant (SBA)
• Safe Motherhood Program
• Nursing care in every stage of female life cycle
• Puberty/ Adolescent Health: Physical and psychological changes, nursing care for during  puberty /adolescent
• Reproductive age/years: nursing care for the client of reproductive ages/years
• Climacteric care: physical and psychological changes during the peri-menopause, counseling medical management (e.g. Hormone Replacement Therapy; HRT)
• Fetal growth and development: normality and abnormalities on fetal, placenta, membrane and cord
• Care during Pregnancy
• Health promotion of pregnant women
• Components of antenatal care
• Birth Preparedness and Complication readiness
• Care of pregnant women with minor/major disorders of pregnancy (e.g. constipation, varicose  veins, back pain, edema, threatened abortion, placenta preavia)
• Care during labor and birth
• Physiology and mechanism of labor
• Management of mother in labor : normal delivery, induction and augmentation of labor
• Monitoring fetal condition: prevention and management of fetal distress
• Postnatal Care
• Physical and psychological changes during puerperial period
• Nursing care for women with minor/major problems of puerperium (e.g. hemorrhage,infection)
• Breast Feeding: Importance, mechanism of secretion of breast milk, nursing care for mother with problems on breast feeding (e.g. mastitis)
• Breast feeding in HIV/ Hepatitis B positive mothers (e.g. PMTCT) Newborn Baby Care
• Neonatal assessment Immediate care of newborn
• Nursing care for newborn baby with dysfunction and problems (e.g. Respiratory distress syndrome, meconium aspiration syndrome
• Obstetric Emergencies
• Nursing management for the clients with high risk/ critical condition in antenatal period (e.g.PIH)
• Nursing management for the clients with high risk/ critical condition in perinatal period (e.g mal presentation and prolapse of the cord. )
• Nursing management for the clients with high risk/ critical condition in postnatal period (e.g. PPH, ruptured uterus )
• Nursing Care for Gynecological problems Sub fertility/ Infertility: Types, cause and treatment and nursing management of infertility in both male and female,
• Sexually Transmitted Infection (STI): National Protocol to manage STIs, Cervical Cancer,  Breast Cancer Prolapsed of pelvic organs

Leadership and Management

Related content includes but is not limited to:

• Concept of Leadership and Management
• Role, Styles, Characteristics and Functions of Leadership
• Role and Responsibilities of Health Care Team Members Principles, Types and Functions of Management Conflict Management Purpose, principles, categories of Supervision Qualities of Supervisor
• Health Service Delivery System: Hospital and Community
• Methods of Organizational management
• Organogram Management of resources
• Patient assignment methods: Rotation Plan, assignment  Job Description of different categories of health personnel  Job Description of different level of nursing personnel
• Professional Development
• Definition and Criteria of Profession
• Professional Organizations: Nepal Nursing Council (NNC), Nursing Association of Nepal (NAN), International Council of Nurses (ICN), International Confederation of Midwives (ICM)
• Health Policy and Planning
• National Health Planning: SLTHP and Five Year Plans Country Profile

Note: For further information visit Nepal Nursing Council’s website: http://www.nnc.org.np