How to Apply

The National Certification Examination for School Nurses is offered periodically. The exam is given in a computer-based format at testing centers across the United States.

In order to take the exam, you must apply within the designated time frame. The application cutoff date is 30 days prior to the start of the testing window.

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Eligible candidates must

  1. Submit a copy of their license as a registered nurse (RN) in one of the United States.
  2. Submit an academic transcript or proof of current certification, demonstrating attainment of one of the following:
    1. A bachelor's degree or higher in nursing or the equivalent in other countries (Please note that as of January 1, 2020 a bachelor's degree or higher in nursing or the equivalent in other countries will be the requirement. The Exceptions listed below will no longer be accepted.)  
    2. A bachelor's degree or higher in a health-related field relevant to school nursing, (see list of acceptable health degrees).
    3. Candidates with a bachelor's degree or higher in a non-nursing or non-health-related field must have a total of six (6) additional credits for undergraduate or graduate courses in any combination of the following subjects:
      1. Management of primary health care problems of children and/ or adolescents
      2. Health assessment of children and/or adolescents
      3. Public health/community health/epidemiology
    4. Current certification by NBCSN as an NCSN.
  3. Meet the clinical practice requirements of a minimum of 1,000 hours that have been worked within the three years prior to taking the test. 1000 hours is roughly equivalent to the hours worked by a full-time school nurse who works at least 6 hours/day for a school year of 180 days documented by a note on letterhead from your supervisor or district official. See below for more information about clinical practice requirements.
  4. Complete the online application to take the certification examination for school nurses.
  5. Pay the required fee.

Clinical Practice Requirements for Certification

Clinical Practice in school nursing means employed or contracted to provide a direct or indirect professional contribution to the health and education of students and their families in public or private school settings.

Direct clinical practice in school nursing is defined as involvement in the nursing process in a school setting where the nursing actions and judgments are focused on a particular student, family, school community, or group of students or their families where there is continuing professional responsibility and accountability for the outcomes of these actions.

Indirect clinical practice in school nursing is defined as involvement that:

  1. includes clinical supervision of school nurses, education and clinical supervision of baccalaureate/master's nursing students in school health, administration of school health services, research, consultation or other engagement in the field of school nursing that contributes to the specialty's body of knowledge or enhances the quality of school nursing practice;
  2. entails continuing professional responsibility and accountability for the outcomes of the involvement.


Not eligible as clinical practice in school nursing includes: substitute nursing in a school, except as a full time substitute working consecutive days for the required clinical practice hours; one-to-one nursing as the nurse's sole responsibility within a school; employment in the direct sales, marketing or distribution of school nursing-related products or services in pharmaceutical, technology or other school health-related industries; community health screenings; work in a camp setting; preceptorship/mentor; and jobs unrelated to school nursing.

Eligibility versus readiness to take the exam

The NBCSN board advises that eligibility should not be confused with readiness. Some school nurses may be prepared to take the exam after 1000 hours of acceptable clinical practice (roughly equivalent to the hours worked by a full time school nurse in a 180-day school year), while others may require many more hours of experience and preparation.

Factors that may affect an individual’s readiness include:

  1. level of education
  2. formal coursework in school nursing and education systems
  3. nursing experience prior to school nursing (e.g., child and adolescent primary care and public health versus adult inpatient nursing)
  4. exposure to child health in age ranges outside of school assignment
  5. continuing education
  6. supervision by a school nurse administrator
  7. on the job reference materials
  8. formal or informal mentoring
  9. professional development and professional leadership provided within the school district and state.

Exam Administration & Fees

The exam is administered for NBCSN by Prometric. A testing-provider with locations across the U.S., Prometric provides the testing site and conducts the exam.  

Nonrefundable Application fee - $360.00

See the Handbook for Candidates for payment options.

Scheduling Your Examination Appointment

Once NBCSN has processed your application and determined that you have met all eligibility requirements, we will notify you via email with your Authorization To Test (ATT). 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 844-808-6276 or

Appointment times are available on a first-come, first-serve basis. We recommend you schedule your appointment as soon as you receive your ATT email in order to maximize your chance of testing at your preferred location and on your preferred date. It is your responsibility to contact Prometric at to schedule the exam appointment.

Withdrawal from Exam

  1. If it is 30 days or more prior to your scheduled appointment or end of the testing window, you may withdraw your test appointment for a $75 fee. To do so, you must complete two steps:
    1. Contact Prometric and cancel your original appointment.
    2. Withdraw your application by logging into your NBCSN account and completing the withdrawal request. $75 of your exam fee is non-refundable.
  2. If you are between 29 and 5 days prior to the end of the testing window or test date you may withdraw from the exam for a $125 fee. You must complete two steps:
    1. Contact Prometric and cancel your original appointment. A fee of $50 will be charged.
    2. Withdraw your application by logging into your NBCSN account and completing the withdrawal request. $75 of your exam fee is non-refundable.
  3. If you are 5 days or less prior to 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.

Exam Audit Information after Exam Administration & Fees.

Failed Exam Audit Refund Policy

School nurses holding a baccalaureate degree or higher in nursing or health-related field relevant to school nursing are automatically educationally qualified to sit for the NBCSN exam. School nurses holding a bachelor's degree or higher in a non-nursing or non-health-related field must provide evidence of having completed 6 credits in any combination of the following subjects:

  1. Management of primary health care problems of children and/ or adolescents
  1. Health assessment of children and/or adolescents
  1. Public health/community health/epidemiology

The 6 credits must be complete prior to applying if not included in prior curriculum and documented in the provided transcripts.


School nurses who do not provide documentation of the above credits, or do not meet current eligibility requirements, will fail the audit and be charged a $75.00 failed audit fee.

Test Dates

The exam is held periodically throughout the year. It is offered at various locations throughout the country.

The exam will be available during three testing windows in 2018:

  • Winter/Spring Testing Window: March 1–March 14
    Registration opens November 19, 2017, and closes February 1, 2018, at 11:59 PM Mountain
    Score Report to be sent within 8 weeks of March 14 (i.e., by May 9, 2018) 
  • Summer Testing Window: July 12–August 1 
    Registration opens March 15, 2018, and closes June 12, 2018, at 11:59 PM Mountain
    Score Report to be sent within 8 weeks of August 1 (i.e., by September 26, 2018)
  • Fall Testing Window: November 1–November 14
    Registration opens August 2, 2018, and closes October 1, 2018, at 11:59 PM Mountain
    Score Report to be sent within 8 weeks of November 14 (i.e., by January 8, 2019)

The application cutoff date is 30 days prior to the start of the testing window.


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. 27% Health Appraisal
  2. 28% Health Problems and Nursing Management
  3. 20% Health Promotion/Disease Prevention
  4. 13% Special Health Issues
  5. 12% Professional Issues



Exam preparation is a unique process for each candidate. School nurses have formed study groups, attended school nurse curriculum workshops, and reviewed school nursing and related texts in preparation for the examination. The examination is national in scope and reflects the broad variety of student and community populations, specialty practice situations, and legal and current health issues that school nurses confront in everyday practice. Exam questions are chosen from a larger pool of questions which provides for enabling variation of exam content and undergo a rigorous process to ensure their validity, reliability and applicability to current school nursing practice.

Although there is no single study guide, the List of Resources included in the Handbook for Candidates may be helpful in preparing. Many of those resources are available on the NASN website  and through the NASN bookstore. In addition, you will find Sample Questions in the handbook.



An individual may appeal a failed examination due to technical issues, or a denial of recertification.

Appeals related to technical issues incurred during the examination process should be immediately addressed to Prometric for investigation of testing center and computer issues. All other appeals or challenges are to be submitted in writing, addressed to the NBCSN President within 30 days of the denial or receipt of the examination results, citing all of the reasons for the appeal or challenge.

The NBCSN President shall issue a decision on the matter in writing within 30 days of the receipt of the appeal or challenge. The individual will then have an additional 30 days to submit a written appeal to the NBCSN Board of Directors. The Board of Directors shall issue a written decision within 30 days from the receipt of the appeal. The decision of the NBCSN Board of Directors shall be final.

Disclaimer of Endorsement

NBCSN does not endorse or support any certification preparation program of study, course or study guide advertised to prepare school nurses to take the certification (NCSN) examination. Such programs, courses and guides are not affiliated with the National Board for Certification of School Nurses, Inc. (NBCSN), even if their materials and advertisements suggest otherwise. Representatives of these programs and courses have no involvement in the development, preparation, review or administration of the NCSN examination. They are neither sanctioned nor approved by the National Board for the Certification of School Nurses.

NBCSN does not sanction or recommend any commercial study guide, course or program of study

In addition, reference in this site to any specific commercial product, process, or service, or the use of any trade, firm or corporation name is for the information and convenience of the public, and does not constitute endorsement, recommendation, or favoring by NBCSN. While NBCSN strives to make the information on this website as timely and accurate as possible, NBCSN makes no claims, promises, or guarantees about the accuracy, completeness, or adequacy of the contents of this site, and expressly disclaims liability for errors and omissions in the contents of this site.

 NBCSN strives to ensure that issues of bias and sensitivity are addressed in its exams and recertification procedures related to characteristics that have no bearing on the competencies being measured such as ethnic background, race, color, religion, gender, national origin, political affiliation, marital status, sexual orientation, age, disability, economic status and any other concerns unrelated to ability.

 Candidates with foreign educational degrees must submit validated transcripts with both general academic and professional licensure evaluation reports from an accredited foreign educational credential evaluation service indicating the degree is equivalent to an accredited program in the United States, such as those with memberships in the National Association of Credential Evaluation Services (NACES).