SCOPE OF NURSING LICENSURE EXAMINATION (NLE)

Nursing Board Exam/Nursing Licensure Exam Coverage (Nursing Practice I)

NURSING BOARD EXAM SCOPE/COVERAGE
NURSING PRACTICE I
TEST DESCRIPTION: Theories, concepts, principles and processes basic to the
practice of nursing with emphasis on health promotion and health maintenance. It
includes basic nursing skills in the care of clients across age groups in any setting.
Moreover, it encompasses the varied roles, functions and responsibilities of the
professional nurse in varied health care settings.
TEST SCOPE:
I. Personal and Professional Growth and Development
A. Historical Perspective in Nursing
HISTORICAL FOUNDATION OF NURSING

The Four Great Periods of Nursing

1. INTUITIVE NURSING
*This untaught nursing was instinctive.
*Dated from pre-historic times.
*Practice among primitive tribes and lasted through Christian era.
*Performed out of feeling of compassion to others.
*Out of wish to do good- HELPING

2. APPRENTICE NURSING
*Extends from the founding of religious orders in the 6 th century through the
crusades which began in the 11th century to 1836.
*The Deacons School of Nursing at Kaisserwerth, Germany established by
pastor Fliedner and his wife.
*Period of on the job training- desired of person to be trained

3. EDUCATED NURSING
*Began in 1860.
*Florence Nightingale School of Nursing opened at St. Thomas in London.
First program of formal education for nurses started.

4. CONTEMPORARY NURSING
*Began at the end of World War II (1945)
*Scientific and Technological developments of many social changes occurs.

INTUITIVE NURSING
*Cause of illness was believed to be the invasion of the victims body by an evil spirit.
*Uses black magic or voodoo to harm or driven out by using supernatural power.
*Believed in medicine man (shaman or witch doctor) that had the power to heal by
using white magic.
 They made use of hypnosis, charms, dances, incantations, purgatives, massage,fire,
water, herbs or other vegetations and even animals.
*Performing a trephine
Drilling a hole in the skull with a rock or stone without benefit of anesthesia.
Goal of this therapy is to drive the evil spirit from the victims body.
*Nurses role was instinctive directive toward comforting, practicing midwifery and
being wet nurse to a child.
*Act performed without training and direction.

Babylonia
*Practice of medicine is far advanced.
*Code of Hammurabi.
-Legal and Civil measures is establish
-Regulate the practice of physicians
-Greater safety of patient provided
*No mention of Nurses or nursing this time

Egypt
*Art of embalming enhance their knowledge of human anatomy
*Developed the ability to make keen clinical observations and left a record of 250
recognized diseases.
*Control of health was in the hands of Gods. The first acknowledged physicians was
Imhotep.
*Made great progress in the field of hygiene and sanitation.
*Reference to nurses in Moses 5th book is a midwife and wet nurse.

Palestine
*The Hebrews book of genesis emphazised the teachings of Judaism regarding
hospitality to the stranger and acts of charity.
*Implementation of laws like
-controlling the spread of communicable disease
-cleanliness
-preparation of food
-purification of man (bathing and his food.
*The ritual of circumcision of the male child on the 8th day
*The established of the High Priest Aaron as the physician of people.

China
*Culture was imbued with the belief in spirits and demons.
*Gave the world the knowledge of material medica (pharmacology); method of treating
wounds, infection and muscular afflictions.
*Chan Chun Ching Chinese Hippocrates.
*Emperor Shen Nung said to be the father of Chinese medicine and the inventor of
acupuncture technique.
*No mention of nursing in Chinese writings so it is assumed that care of the sick will fall
to the female members of the household.

India
*First recorded reference to the nurses taking care of patients on the writings of
shushurutu.
*Functions and Qualifications of nurse includes:
- Knowledge in drug preparation and administration.
- Cleverness.
- Devotedness to the patient.
- Purity of both mind and body.
*King Asoke, a Buddhist, published an edict to established hospitals throughout India
where nurses were employed.

Greece
*Made contribution in the area aesthetic arts and clinical medicine, but nursing was the
task of the untrained slave.
*Aesculapius, The Father of Medicine in Greek mythology to whom we associate the
Caduceus, (known insignia of medical profession today)
*Hippocrates, the Father of Medicine insisted that magic and philosophical theories
had no place in medicine.
*The work of women was restricted to the household. Where mistress of the mansion
gave nursing care to the sick slaves.

Rome
*Acquired their knowledge of medicine from the Greeks.
*Emperor Vespasian opened schools to teach medicine.
*Developed military medicine First aid, field ambulance service and hospitals for
wounded soldiers.
*Translated Greek medical terminologies into Latin terms which has been used in
medicine ever since.

APPRENTICE NURSING
*Religious orders of Christian Church played a major role in this kind of nursing.

The Crusades (11th Century)

*Series of holy wars were conducted by Christian in an attempt to recapture the Holy
land from the Turks.
*Military religious orders founded during the crusades established hospitals and staffed
them with men who served as nurses. Among these were:
- The knights of St. John of Jerusalem served both as warriors in battle and
nurses in the hospital and was called Knights Hospitallers.
- The Teutonic Knights built hospitals cared for sick and denfended the faith.
 - The Knights of St. Lazarus established primarily for the nursing of lepers,
forerunners of our now known communicable diseases hospital (also called lazarettos).

The Rise of Religious Nursing Orders

* The Regular Orders established monasteries to house travelers, paupers and
patient under one roof. Later as society became better organized hospitals tended to
become separate institutions apart from monsteries.
*The Secular Orders developed for the primary purpose of nursing; were similar to
the regular orders by their temporary vows, uniformity in dress and religious
observation.
*The Nursing Orders definitely organized. The sisters advanced the stage of
probationer to wearing the white robe to receiving the hood; They were all under the
superintendent of nurses or director of nursing; later adopted a uniform dress that
eventually became entirely standardized.

Nursing Saints
* St. Hildegarde a Benedictine abbess in Germany, actually prescribed cures in her 2
books on medicine and natural history.
* St. Francis and Clara took vows of poverty, obedience, service and chastity and
took care of the sick and the afflicted; founders of the Franciscan Order and the Order
of the Poor Clares respectively.
* St. Elizabeth of Hungary the patroness of nurses; built a hospital for the sick and
the needy.
* St. Catherine of Siena the 1st lady with a lamp; became a tertiary of St.
Dominic and engaged in works of mercy among the sick and of the Church.

The Reformation
* St. Vincent de Paul set up the first program of social service in France and
organized the Community of the Sisters of Charity. His 1st superior and co-founder
was Louise de Gras (nee de Marillac).

The Intellectual Revolution (17th Century)

Characterized by the development of natural science, medicine, arts and as well as
interest in human beings and their welfare. Among the leaders for reform were:
* St. John of God founder of the Brother Hospitallers and declared the patron of all
hospitals and sick folk by Pope Leo XIII in 1930.
* George Fox founder of the sect known as the Soicety of Friends (Quakers) who
advocated equality of men and women, thus making it easier for women to become
active in Nursing.
* John Howard introduced prison reforms (fresh air and plenty of water).
* Philippe Pinel introduced his modern open-door treatment of the mentally ill.
* Elizabeth Fry greatly improved prison conditions by developing work fo the
prisoners and the segregations of sexes, later established the Insitute of Nursing
sisters, the first organization of women to be trained as private duty nurse.
* Mother Mary Catherine MccAuley founder of the Order of the Sisters of Mercy,
2nd largest of the Roman Catholic Orders.
* Theodor Fliedner and his wife Friederike Mumster established the Institute of
Kaisserwerth on the Rhine for the practical training of Deaconesses (1836), which is
considered as the 1st Organized training school for nurses. It was here where Florence
Nightingale received some of her training and the inspiration for the establishment of
her school of nursing. Some of its features includes:
1. A rotating 3 year experience in cooking and housekeeping, laundry and linen and
nursing care in the womens and mens wards; and
2. A preliminary and probationary 3 months period of trial and error for both school
and student.

The Dark Period of Nursing (17th 19th Century)

* Many hospitals were closed; the wealth took care of their sick at home; the indigent
sick were taken care of by uneducated, illiterate women who had no background for
nursing.
* Charles Dickens in his book entitled Martin Chuzzleswit published the selfish and cruel
conduct of 2 private duty nurses namely Sairey Gamp and Betsy Prig.

THE PERIOD OF EDUCATED NURSING

England
* June 15, 1860 marked the day when 15 probationers entered St. Thomas Hospital
in London to establish the Nightingale system of Nursing, founded by Florence
Nightingale (May 12, 1820). Among the highlights in her life are the following:
- At age of 31, obtained parental consent to enter the Deaconess School at
Kaisserwerth.
- Had 3 months training at Kaisserwerth; later superintendent of the Establishment
for Gentlewomen During Illness (1853) during which time she initiated the policy of
admitting and visiting the patients of all faiths.
- In 1854 a Volunteered for Crimean war service together with 38 women at Scutari
in the Crimea upon the request of Sir Sidney Herbert, Minister of War in England. At first
their work is not accepted because it consisted of cleaning the area, thus reducing the
infections, clothing for the men, writing letters to their families; their work served as
inspiration for the Red Cross later on.
- In 1860 started the Nightingale System of Nursing at the St. Thomas Hospital in
London believed that schools should be self-supporting; that schools of nursing should
have decent living quarters for their student; that they should have paid nurse
instructors; that the school should correlate theory to practice and these students should
be taught the why not just how in nursing.
 - 2 books written Note on Nursing and Notes on Hospital, contain many timely
portions applicable in the 1970s as they were in 1859.

United States
* At the time that Florence Nightingale was opening her school in London; the U.S was
on the brink of the civil war. However though the country was in a condition of chaos,
nursing had many supporters and the needs to train nurses were recognized.
- Linda Richards is the first graduate nurse in the U.S completed her training at the
New England Hospital for Women and Children in Boston, Massachusetts, patterned
after the DeaconessesSchool of Kaisserwerth.
- In 1873 3 schools of nursing opened, patterned after the Nightingale plan the
Bellevue Training School for Nurse in the New York City , the Connecticut training.
School in New Haven and the Massachusetts General Hospital in Boston.
- In 1881 founding of American Red Cross by Clara Barton.
- In 1889 John Hopkins hospital opened a school of Nursing with Isabel Hampton
Robb as its 1st principal and the person most influential in directing the development of
nursing in the U.S.
- In 1893 the groundwork for the estimate of the 2 new nursing organization was
lad:
1. The Associated Alumnae, later known as the American Nurses Association was
begun at the Chicago Worlds fair and
2. The American Society of Superintendent of Training Schools for Nurses, later
known as the National League for Nursing Education, also began.
- During the Spanish American War (1898 1899) nurse were concerned with the
care of the wounded as well as care of those inflected with malaria and yellow fever.
Nurse Clara Louise Maas gave her life for the advancement of medical science in the
search for control yellow fever.

The 20th Century

1. Nursing Leaders
Florence Nightingale (1820-1910)
 -
Clara Barton (1812-1921)
-
Lilian Wald (1867-1941)
-
Lavinia L. Dock (1858-1956)
-
Margaret Sanger (1879-1966)
-
Lydia Hall

B. Nursing as a Profession

C. Theoretical Foundation of Nursing Applied in Health Care Situations

THEORETICAL FOUNDATION OF NURSING
I. Philosophy
Specifies the definition of the metaparadigm concepts (person, environment, health,
and nursing) in each of
the conceptual models of nursing.
Sets forth meaning through analysis, reasoning, and logical argument. It provides a
broad understanding and
direction.
D. Continuing Professional Education
E. Professional Organizations in Nursing.

F. The Nurse in Health Care

1. Eleven Key Areas of Responsibility

ELEVEN KEY AREAS OF RESPONSIBILITY

a. NURSING PROCESS
b. SAFE AND QUALITY NURSING CARE
c. MANAGEMENT OF RESOURCES AND ENVIRONMENT
d. HEALTH EDUCATION
e. LEGAL RESPONSIBILITIES
f. PERSONAL AND PROFESSIONAL DEVELOPMENT
g. QUALITY IMPROVEMENT
h. RESEARCH
i. RECORD MANAGEMENT
j. COMMUNICATION
k. COLLABORATION AND TEAMWORK

2. Fields of Nursing
3. Roles and Functions

II. Safe and Quality Care

A. The Nursing Process
B. Basic Nursing Skills
1. Vital Signs
2. Physical Examination and Health Assessment
3. Administration of Medications
4. Asepsis and Infection Control
5. First Aid Measures
6. Wound Care
7. Perioperative Care
8. Post-operative Care
9. Post-mortem Care
C. Measures to meet physiological needs
1. Oxygenation
2. Nutrition
3. Activity, Rest and Sleep
4. Fluid and Electrolyte Balance
5. Urinary Elimination
6. Bowel Elimination
7. Safety, Comfort and Hygiene
8. Mobility and Immobility

III. Health Education

A. Teaching and Learning Principles in the Care of Client
B. Health Education in All Levels of Care
C. Discharge Planning

IV. Ethico-Moral Responsibility

A. Bioethical Principles
1. Beneficence
2. Non-maleficence
3. Justice
4. Autonomy
5. Stewardship
6. Truth Telling
7. Confidentiality
8. Privacy
9. Informed Consent
B. Patients Bill of Rights
 C. Code of Ethics in Nursing

V. Legal Responsibility
A. Legal Aspects in the Practice of Nursing
B. The Philippine Nursing Law of 2002 (R.A 9173)
C. Related Laws Affecting the Practice of Nursing

VI. Management of Environment and Resources

A. Theories and Principles of Management
B. Nursing Administration and Management
C. Theories, Principles and Styles of Leadership
D. Concepts and Principles of Organization
E. Patient Care Classification
F. Nursing Care Systems
G. Delegation and Accountability

VII. Records Management

A. Anecdotal Report
B. Incident Report
C. Memorandum
D. Hospital Manual
E. Documentation
F. Endorsement and End of Shift Report
G. Referral

VIII. Quality Improvement

A. Standards of Nursing Practice
B. Nursing Audit
C. Accreditation/Certification in Nursing Practice
D. Quality Assurance

IX. Research
A. Problem Identification
B. Ethics and Science of Research
C. The Scientific Approach
D. Research Process
E. Research Designs and Methodology
1. Qualitative
2. Quantitative
F. Utilization and Dissemination of Research Findings

X. Communication
A. Dynamics of Communication
B. Nurse-Client Relationship
C. Professional-Professional Relationship
D. Therapeutic Use of Self
E. Use of Information Technology

XI. Collaboration and Teamwork

A. Networking
B. Inter-agency Partnership
C. Teamwork Strategies
D. Nursing and Partnership with Other Profession and Agencies

Nursing Board Exam/Nursing Licensure Exam Coverage (Nursing Practice II)

NURSING BOARD EXAM SCOPE/COVERAGE
NURSING PRACTICE II
TEST DESCRIPTION: Theories, concepts, principle and processes in the care of
individuals, families, groups and communities to promote health and prevent illness, and
alleviate pain and discomfort, utilizing the nursing process as framework. This includes
care of high risk and at-risk mothers, children and families during the various stages of
life cycle.
TEST SCOPE:
Part I: CHN
I. Safe and Quality Care, Health Education and Communication, Collaboration and
Team work
A. Principles and Standards of CHN
B. Levels of Care
C. Types of Clientele
D. Health Care Delivery System
E. PHC as a Strategy
F. Family-based Nursing Services (Family Health Nursing Process)
G. Population Group-based Nursing Services
H. Community-based Nursing Services/ Community Health Nursing Process
I. Community Organizing
J. Public Health Programs

II. Research and Quality Improvement

A. Research in the Community
B. National Health Situation
C. Vital Statistics
D. Epidemiology
E. Demography

III. Management of Resources and Environment and Records Management

A. Field Health Services and Information System
B. Target-setting
C. Environmental Sanitation
IV. Ethico-Moral-Legal Responsibility
A. Socio-cultural Values, Beliefs and Practices of Individuals, Families, Groups
and Communities
B. Code of Ethics for Government Workers
C. WHO, DOH, LGU Policies on Health
D. Local Government Code
E. Issues

V. Personal and Professional Development

A. Self-assessment of CHN Competencies, Importance, Methods, Tools
B. Strategies and Methods of Updating Ones Self, Enhancing Competence in
Community Health Nursing and Related Areas.

VI. Part II: MCN

VII. Safe and Quality Care, Health Education, and Communication, Collaboration and
Teamwork
A. Principles and Theories of Growth and Development
B. Nursing Care in the Different stages of Growth and Development including
1. Nutrition
2. Safety
3. Language Development
4. Discipline
5. Play
6. Immunization
7. Anticipatory guidance
8. Values formation
C. Human Sexuality and Reproduction including Family Planning
D. Nursing Care of Women during Normal Labor, Delivery and Postpartum
E. Nursing Care of the Newborn
1. APGAR Scoring
2. Newborn Scoring
3. Maintenance of Body Processes (oxygenation, temperature)
F. Nursing Care of Women with Complications of Pregnancy, Labor, Delivery and
Postpartum Period (High-risk conditions)
G. Nursing Care of High-risk Newborn
1. Prematurity
2. Congenital defects
3. Infections
H. Nursing Care of Women with Disturbances in Reproduction and Gynecology

VIII. Research and Quality Improvement

A. Fertility Statistics
B. Infant Morbidity and Mortality
C. Maternal Mortality
D. Standards of Maternal and Child Nursing Practice

IX. Ethico-Moral-Legal Responsibility

A. Socio-Cultural Values, Belief, and Practices of Individuals, Families related to MCN.
B. WHO, DOH, LGU Policies on Health of Women and Children
C. Family Code
D. Child and Youth Welfare Code
E. Issues related to MCN

X. Personal and Professional Development

A. Self-assessment of MCN Competencies, Importance, Methods, Tools
B. Strategies and Methods of Updating Ones self, Enhancing Competence in MCN and
Related Areas.

Nursing Board Exam/Nursing Licensure Exam Coverage (Nursing Practice III, IV

and V)
NURSING BOARD EXAM SCOPE/COVERAGE
NURSING PRACTICE III, IV, V
TEST DESCRIPTION: Theories, concepts, principles and processes in the care of
clients with altred health patterns, utilizing the nursing process and integrating the key
areas of nursing competencies.
TEST SCOPE:
I. Safe & Quality Care, Health Education, Management of Environment & Resources,
and Quality Improvement.

A. TEST III
1. Client in Pain
CLIENT IN PAIN

Pain- the fifth vital sign

- an unpleasant sensory and emotional experience associated with actual or

potential

Basic Categories of Pain:

1. Acute Pain- sudden pain which is usually relieved in seconds or after a few
weeks.
2. Chronic Pain (Non-Malignant)- constant, intermittent pain which usually
persists even after healing of the injured tissue
3. Cancer-Related Pain- May be acute or chronic; may or may not be
relieved by medications.

Pain Transmission:
1. Nociceptors are called pain receptors. These are the free nerve endings in the skin
that respond to intense, potentially damaging stimuli.
2. Peripheral Nervous System
3. Central Nervous System
4. Descending Control System

2. Peri-operative Care
3. Alterations in Human Functioning
a Disturbance in Oxygenation
b Disturbance in Metabolic and Endocrine Functioning
c Disturbance in Elimination

B. TEST IV
1. Alterations in Human Functioning
a. Disturbances in Fluids and Electrolytes
b. Inflammatory and Infectious Disturbances
c. Disturbances in Immunologic functioning
d. Disturbances in Cellular functioning
2. Client Biologic Crisis
3. Emergency and Disaster Nursing

C. TEST V
1. Disturbances in Perception and Coordination
a. Neurologic Disorders
b. Sensory Disorders
c. Musculo-skeletal Disorders
d. Degenerative Disorders
2. Maladaptive Patterns of Behavior
a. Anxiety Response and Anxiety Related Disorders
b. Psycho-physiologic Responses, Somatoform, and Sleep Disorders
c. Abuse and Violence
d. Emotional Responses and Mood Disorders
e. Schizophrenia and Other Psychotic and Mood Disorders
f. Social Responses and Personality Disorders
g. Substance related Disorders
h. Eating Disorders
i. Sexual Disorders
j. Emotional Disorders of Infants, Children and Adolescents.

II. Personal and Professional Development

A. Nurse-Client Relationship
B. Continuing Education
III. Communication, Collaboration and Teamwork
A. Team approach
B. Referral
C. Network/linkage
D. Therapeutic communication

IV. Ethico-Moral-Legal Responsibility

A. confidentiality
B. Clients Rights
1. Informed Consent
2. Refusal to take medications, Treatment and Admission Procedures
C. Nursing Accountability
D. Documentation/charting
E. Culture Sensitivity