If you enjoy caring for others and interacting with a wide range of people, and if you cope well when confronted with challenges, nursing is a great career choice. Nursing is also a secure profession with excellent starting salaries and very good job prospects. Job opportunities in nursing abound—registered nurses fill more than 2.3 million jobs, making up the largest healthcare occupation in the nation. And the need for nurses is likely to continue to soar—many of today's nurses are beginning to retire, leaving thousands of job openings. The U.S. population as a whole is also aging, and because older people require more nursing care, the demand for skilled nurses willing to work on the front lines of patient care will also increase. Technological advances in medical care, which allow more medical conditions to be treated, and an emphasis on preventive care also create a greater demand for nurses. As you consider your future in nursing, think about these facts:
- More new jobs are likely to be created for registered nurses than for any other occupation.
- Employers in some areas of the country report a nursing shortage, spurring efforts to attract and keep nurses on staff.
- Hospital outpatient facilities—like same-day surgery centers or rehabilitation centers—offer the most rapid growth in nursing jobs.
To become a nurse, you need to pursue one of three educational routes—a bachelor's degree, an associate's degree, or a hospital diploma. You may also consider becoming a licensed practical nurse (LPN), which requires only one year of training in a vocational or technical school and can be a stepping stone to becoming a registered nurse. Most nursing programs require that you take an entrance test, and that's where this book comes in. Nursing School Entrance Exam was designed from real tests, including the admissions test you will face to get into the program of your choice. By tailoring your study plan and using the information in this book, you can achieve your best score and begin the path of your desired career—training to become a nurse.
Career Opportunities in Nursing
Registered nurses (RNs) provide direct patient care and serve as health educators in the effort to promote wellness and prevent disease. In giving care, they monitor and record a patient's symptoms and progress, give medications, assist in rehabilitation, and teach patients and families about proper care practices. They assist physicians in everything from routine exams and treatments to surgery. There are limits to what a nurse does—state regulations determine the scope of tasks a nurse can perform. But the factor that most influences a nurse's daily workload is the type of healthcare facility in which he or she works. Nurses work in a range of settings: in hospitals, doctor's offices, outpatient surgical centers, nursing homes, schools, or work sites. Home health nurses even work in patients' homes. The following is an overview of what you can expect on the job, depending on your work setting.
- Hospital nurses make up the largest group of nurses. They provide bedside care for hospitalized patients, observe and record symptoms, and administer treatments and medications. They often work in a specific department of a hospital, such as pediatrics, emergency care, or cancer care.
- Office nurses work in doctor's offices, clinics, outpatient surgical centers, and emergency medicine clinics. Their job tasks include assisting with exams, giving medications, dressing wounds, and assisting in minor surgeries. They may also do office work and maintain patient records.
- Nursing facility nurses provide care for residents in nursing homes or long-term rehabilitation centers. They monitor residents' progress, develop treatment plans, and oversee nursing aides and licensed practical nurses.
- Home health nurses see patients in the patients' own homes. They give medications, check the patient's condition and environment, and instruct patients and caregivers about care and treatment. They may supervise home health aides.
- Public health nurses work on the community level, in schools, government agencies, retirement communities, or in other settings, and they educate the public about health promotion and disease prevention strategies in areas like nutrition, smoking cessation, or childcare.
- Occupational health nurses provide care to employees at work locations, giving emergency treatments, health counseling, or identifying potential health problems in the work environment.
Most RNs earn between $47,000 and $68,000 annually, with the highest paid receiving more than $80,000 annually. Nurses who earned the highest average salaries worked in employment services, followed by hospitals, home healthcare services, physicians' offices, and nursing care facilities.
Licensed practical nurses (LPNs) care for patients under the supervision of a physician or registered nurse. They provide routine bedside care, such as taking vital signs, preparing injections, applying dressings, or collecting testing samples. They also aid patients with feeding, dressing, and bathing. In nursing facilities, LPNs may evaluate the needs of residents and oversee nursing aides. In private offices or clinics, they may be responsible for some administrative work, such as making appointments or maintaining records. The average yearly salary for LPNs is between $31,000 and $43,000. The highest paying LPN positions were found in employment services, followed by home healthcare services, nursing care facilities, hospitals, and physicians' offices.
Working conditions for nurses depend on the type of healthcare facility. For example, work hours vary according to work setting. In nursing homes or long-term rehabilitation centers where residents need around-the-clock care, nurses may work night or weekend shifts. Public health nurses and nurses who work in offices or on industrial work sites follow schedules during regular business hours.
Risks for nurses in hospitals and clinics include coming in contact with patients who have infectious diseases. Nurses must follow a standard set of precautions to reduce their risk for disease or other kinds of danger, like radiation or chemical exposure. Nurses are also susceptible to back injury from moving patients.
Which Nursing Program Is Right for You?
You may need to consider many factors in deciding the nursing program that is right for you. If your financial situation is tight, you might choose to earn a two-year associate's degree, land a job as a nurse, and then use tuition benefits that come with your employment to take additional courses and work toward a bachelor's degree. Whether you are entering the workforce from high school or making a mid-career change may be another consideration.
Of the programs described in the following list, the bachelor's degree of science in nursing (BSN) offers the most job opportunities. Nurses with bachelor-level education can more easily advance in their jobs, and some positions—like administrative work or those requiring a clinical specialty—may require a bachelor's degree or even an advanced degree.
Nursing programs combine hands-on, supervised clinical experience at a healthcare facility with traditional coursework. In addition to general education requirements, students fulfill courses in anatomy, physiology, microbiology, chemistry, nutrition, psychology, and nursing. After completing a nursing program, students must pass a licensing exam to become a nurse. Here is an overview of the degree programs that prepare students for entry-level nurse positions:
- Diploma Programs are run by hospitals and usually take three years to complete. These programs are few and their numbers are declining. To broaden their job opportunities, nurses from diploma programs may later opt to earn a bachelor's degree by completing coursework in an RN-to-BSN program. Staff nurse positions often offer tuition reimbursement programs to help allay the cost of additional education.
- Associate's Degree in Nursing (ADN) programs are offered by community colleges and last from two to three years. There are about 700 associate-level nursing programs throughout the country. ADN-schooled nurses may also later choose to earn a bachelor's degree to increase their job choices.
- A Bachelor's of Science Degree in Nursing (BSN) takes four years to complete at a college or university. More than 670 programs offer this degree. For people who have earned a bachelor's degree in another field and are interested in becoming a nurse, accelerated BSN programs are available; they grant credit for the liberal arts requirements you have already completed. They take from one year to 18 months to complete.
To become a licensed practical nurse (LPN), you must complete a state-approved one-year training program at a technical or vocational school, community college, or high school. You must also pass a licensing exam. If you want to become an LPN first, but wish to continue your education to become an RN, you can enroll in an LPN-to-RN program. These programs give you credit for your LPN coursework, so you can build upon your training to become an RN.
On the other end of the educational spectrum is a master of science in nursing (MSN). These two-year programs give nurses the opportunity to specialize in clinical training or research. People seeking this degree typically have a BSN or an RN license.
Selecting a Program That Meets Your Needs
Some considerations for finding a nursing program are obvious. For example, most applicants limit their search by geographic area. Some people need to find a school within driving distance; others are willing to relocate to attend school. An Internet search or a published listing of nursing schools will help locate schools in the area of your choice.
Tuition is another factor in choosing a nursing school—cost can vary depending on whether the institution is private or public, or whether you qualify as an in-state student. Financial aid availability also differs by institution. When you research schools, collect as much information as possible considering these and the factors listed here.
- Is it approved by the state? Each state determines the standards for nursing schools and approves them. Your school must be state-approved. However, state approval does not mean that the institution is accredited—for more about accreditation, see the following paragraph.
- Is it accredited? Accreditation means that a national accrediting organization, like the National League for Nursing Accrediting Commission (NLNAC) or the Commission on Collegiate Nursing Education (CCNE), has determined that the nursing school has met certain educational criteria. Earning your degree from an accredited school can give you an edge in the job market—when employers review your educational background, they know you were trained according to an established set of standards. Attending an accredited school also allows you to continue your education at a graduate-level accredited school. To find out if your preferred school is accredited, contact a school representative or go to the NLNAC's website at www.nlnac.org/home.htm.
- Pass rate. What percentage of the school's students passed the nursing licensing exam after graduating? Ask a school representative for information about pass rates from the last five years.
- What is its focus? Consider what kind of nursing program interests you (for example, are you interested in a particular clinical specialty?) before you begin your school search. After you choose what kind of program interests you, look for the institution that meets your needs.
- School size and class size. Do you want the close-knit community of a small school or the wider mix of students you will find at a large school? Make sure to research the student-to-teacher ratios at prospective schools. Smaller class sizes often mean more attention from faculty.
- Clinical experience. What kind of clinical placements does the school offer? How much time does it allot for clinical experience? You can find this information by talking to current students.
Financing Your Nursing Education
Planning how you are going to pay for your nursing education is essential to your preparation process. The cost of nursing education can be considerable—a four-year program at a state university can be $14,000 a year, and private schools can be twice as much. Fortunately, many resources offer financial assistance to nursing students. Financial aid may be awarded based on financial need or on merit, and comes in three basic forms—scholarships, loans, or student employment. Be sure to fill out a financial aid form when you apply to nursing school—this form helps schools determine your financial need. Plan on visiting the financial aid office at the school of your choice or searching the Internet for funding possibilities from a variety of sources, such as the following:
- Government: The U.S. Department of Education offers a range of loans and scholarships. The U.S. military also offers financial aid for service people. State governments often provide aid for students attending school in their home state.
- Your prospective school: Check with the school of your choice about its scholarships. In addition to aid based on your financial need, you may qualify for a merit-based grant, scholarship, or fellowship.
- Your employer: Find out if your employer offers scholarships or tuition reimbursement benefits for education.
- Nursing associations: State nursing associations and national professional organizations are other possible sources for financial aid.
Test Overview
To begin preparing for the test, you need an overview of the type of exam you are facing, and some tips about how to use this book to achieve your best test score. There is no single test required by all nursing programs. Schools have different requirements for admission, depending on the institution, your choice of study, and whether you are applying for a one-year LPN degree, a two-year RN degree, a four-year BSN degree, a hospital diploma program, or a graduate program. Many accredited nursing schools ask candidates to pass one of these two tests: the Registered Nursing School Aptitude Exam (RNSAE) or the Nurses Entrance Test (NET).Community college LPN programs may require applicants to take the Aptitude for Practical Nursing Exam (APNE). However, even if the school of your choice uses another exam, you will most likely need to demonstrate the essential skills covered in this book. You must show that you can communicate effectively, read and understand college-level materials, and that you have basic math skills. You may also be asked to demonstrate that you have fundamental knowledge about biology, chemistry, natural science, anatomy, and physiology.
Contact the school of your choice immediately to learn about its admissions requirements and test dates and sites in your area. The dates when the test is offered in your area may determine when you take the exam. However, if you have a choice of test dates, and if you have not already applied to take the exam, do not apply until you have conducted the self-evaluation outlined in this chapter. The results of that self-evaluation can help you decide when to take the exam.
The following provides contact information and an overview of the common nursing aptitude tests— the NET, RNSAE, and APNE. If you know you will need to take one of these tests, contact the testing agencies in each section for more information about registration, testing locations, and dates.
Registered Nursing School Aptitude Exam (RNSAE)
Nursing programs that offer degrees ranging from the bachelor's level to a master's degree may require that applicants take the RNSAE. Developed by the Psychological Services Bureau, Inc., this exam consists of five parts and takes about two and a half hours to complete. The first section is divided into three subsections.
- Part 1: Academic Aptitude
Analytical Reasoning, 30 questions
- Part 2: Spelling, 50 questions
- Part 3: Reading Comprehension, 40 questions
- Part 4: Natural Sciences (Chemistry, Biology, Health), 90 questions
- Part 5: Vocational Adjustment, 90 questions
Aptitude for Practical Nursing Exam (APNE)
The Psychological Services Bureau test for practical nursing varies somewhat from the exam for registered nursing. Many community colleges with practical nursing programs use the APNE.
- Part 1: Academic Aptitude
Analytical Reasoning, 30 questions
- Part 2: Spelling, 50 questions
- Part 3: Natural Sciences (Chemistry, Biology, Health), 90 questions
- Part 4: Judgment and Comprehension in Practical Nursing Situations, 50 questions
- Part 5: Vocational Adjustment, 90 questions
To register for the RNSAE or the APNE, or to learn about testing sites, contact the school of your choice, or:
Psychological Services Bureau, Inc.
Health Careers Aptitude Tests
Charlottesville, VA 22901
Nurse Entrance Test (NET)
Many RN and LPN nursing programs use the NET as a pre-admissions test. This approximately two-and-a-half- hour test measures your ability in two general academic areas—your critical reading ability and your knowledge of basic math. The test includes two academic sections:
- Mathematics, 60 questions
- Reading Comprehension, 33 questions
Some schools require a different version of this test that includes a written expression section. Find out from the training program of your choice whether this is required. If it is, you will have an additional hour to complete this section.
In addition to reading comprehension and math questions, the basic NET includes questions that evaluate your learning style, stress, and social skills. These nonacademic sections include the following: Test- Taking Skills (30 questions); Stress Level (45 questions); Social Interaction Profile (30 questions); and Learning Style (50 questions). These sections are not used to determine whether you will be accepted into a nursing school. The purpose of these sections is to help learning institutions after a student has been accepted to their program—it aids the school in considering how a student will best learn—and to increase the likelihood that a student will complete the program successfully.
If you know you need to take the NET, contact the school you are applying to or the testing agency for more information about the test:
Educational Resources, Inc.
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