The Exam

Who is eligible to take the exam?

What is on the examination?

The exam is a written, computerized exam composed of a maximum of 200 multiple-choice questions with a total testing time of four hours.

Content Outline - Spring 2025 Exam

The exam is a written, computerized exam composed of a maximum of 200 multiple-choice, objective questions with a total testing time of four (4) hours.

For a complete Content Outline and Sample Questions, refer to our Handbook for Candidates. The exam will be weighted in approximately the following manner:

  1. 26% Health Appraisal
  2. 27% Health Problems and Nursing Management
  3. 20% Health Promotion/Disease Prevention
  4. 14% Special Health Issues
  5. 13% Professional Issues

Content Outline - Starting with the Summer 2025 Exams

Be sure to see the "Updated Exam Content - Summer 2025" page for more information

  1. Health Appraisal & Nursing Practice - 52 exam items (questions)
  2. Health Promotion/Disease Prevention - 41 exam items
  3. School Health Practice Considerations - 32 exam items
  4. Professional Responsibility - 50 exam items

There are 25 pre-test items on each exam that will represent any combination of the exam domains listed above. These questions are not included in your exam score and are scattered throughout the exam. This practice allows NBCSN to collect statistics on exam items to determine if they can be used for future exams. 

When can I take the exam?

How is the exam administered?

The exam is administered for NBCSN by PSI.

  • PSI is a testing-provider that conducts the exam at testing sites located across the U.S.
  • Note scheduling is done on a first-come, first-serve basis.
  • You will not be able to schedule your examination appointment until you have received an Authorization to Test by email.

Special Testing Accommodations

Special testing accommodations will be made for individuals who may need extra time or have other disability accommodations. Please complete the section on the online application requesting testing accommodations.

What do I need to do to schedule the exam?

  • Confirm eligibility
  • Fill out and submit an application.
    • The application cutoff date is 30 days prior to the start of the testing window.
    • Please consult the directions on the Application and in the Handbook for Candidates
  • Pay application fee  (early bird: $370; regular fee: $390; late application fee: $440)
  • Receive Authorization to Test email from NBCSN
    • Once NBCSN has processed your application and determined that you have met all eligibility requirements, you will be sent an Authorization To Test (ATT) email.
    • Your ATT email will include all of the information you need to schedule your testing date and location within your testing window.
    • You cannot schedule your exam until you receive this ATT communication.
    • If you have not received your ATT within one week of submitting your application, contact NBCSN at 833-276-0986 or info@nbcsn.org.
  • Schedule exam appointment

Withdrawal from Exam

  • If it is 24 hours or more prior to your scheduled appointment or the end of the testing window, you may withdraw your test appointment for a $75 fee. To do so, you must complete two steps:
    • Contact PSI and cancel your original appointment.
    • Withdraw your application by logging into your NBCSN account and completing the withdrawal request. $75 of your exam fee is non-refundable.
  • If you are less than 24 hours prior to the end of your testing window or test date, you are unable to withdraw. You must appear and sit for the exam or all fees will be forfeited.

Late for Testing Appointment / No Show

The entire testing fee is forfeited for candidates who are more than 15 minutes late for a test appointment or who fail to appear for an appointment.

Exam Retake

If you need to retake the NBCSN exam, you may reapply during any subsequent exam session after the end of your testing window. The retake fee is the same as the regular exam.

How is the examination developed?

The questions for the examination are developed through a rigorous process of:

  • Item writing and item review from individuals with expertise in school nursing and school health issues.
  • Item pilot testing to ensure validity and psychometric quality before being used as scored items on the actual examination.

How is the examination scored?

You will receive an unofficial exam result at the conclusion of the exam. Your official results will be sent via email about 2 -7 days after completing the exam.  The score report outlines your competence level for:

  • the entire exam
  • each of the major exam areas

Results related to individual test items will not be shared. Information related to a candidates’ score or test history is confidential and only provided to the candidate. No specific information will be shared with employers or any other individual. Successful candidates will also receive certificates and pins from NBCSN.