Test Guidelines for

the National Licensure Examination for Nurses (NLEN) 2012 (Revised 2019)

Prepared by:

National Licensure Examination Committee,

Nepal Nursing Council (NNC)

Approved by:

Board of Nepal Nursing Council (NNC) on February 27, 2012 First revised: August, 2012 Second revised September 2014

Third revised: January 2019

Published by:

Nepal Nursing Council Address: Kathmandu, Nepal

Tel : 977-1-4372521

Fax : 977-1 4377214

E-mail: [email protected]


I 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.

II 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

Test guidelines for the National Licensure Examination for Nurses (NLEN)

Pre requisite for NLEN


Nepalese citizen graduated from Nepal

To meet the professional education requirement for licensure as a qualified professional nurse, the candidate must present satisfactory evidence of having received pre-service nursing education programmes approved by the NNC and must submit the documents as mentioned in Table 1. These programmes include a four-year Bachelor of Science in Nursing or 3 years of Proficiency Certificate Level (Diploma level) programmes.

Nepalese citizen graduated from other countries

Applicants, who have completed pre-service nursing education from other countries, must have their equivalence certificate from the concerned government authority. Individual applicant needs to be graduated from the institute recognized from the respective nursing council or authorized government body and must submit the documents as mentioned in Table 1.

Foreigners graduated from Nepal

Foreign applicants graduated from Nepal must have completed pre-service nursing programme from the institution approved by the NNC and must submit the document as mentioned in Table 2.

Foreigners graduated from other countries

A person, who comes to Nepal to work, must appear the National Licensure Examination for Nurses in order to register in the NNC. A person, who came on tourist visa are not allowed to apply.


Reporting prior convictions or disciplinary action against licensing

Applicants are required under 'Regulation of the National Licensure Examination for Nurses' to report all misdemeanor and felony convictions. Failure to report prior disciplinary action is considered falsification of application and is a ground for denial of licensure or revocation of license.

Applicants with disability

Applicants, who are constitutionally provisioned for special consideration, will be provided opportunity to appear in the examination based on their limitation.

Application process  

The following documents are required for application.

Table 1: List of documents required for PCL Nursing/B.Sc. Nursing







Complete online personal information



Upload scanned original copies of the following documents (size not more than 2MB and


must be in jpg format)




SLC/SEE Mark sheet and Character Certificate








Academic Transcript or Mark sheets and Character Certificate of PCL Nursing








Academic Transcript or 10+2 Mark sheets or I. Sc. Mark sheets, and Character




Certificate for B.Sc. Nursing Programme



Upload recent white background Passport size photo (size not more than 2MB and must be in


jpg format)




Examination fee NRs. 1,600/- should pay through eSewa



Upload original scanned copies of  documents related to recognition/accreditation of institute


from the respective nursing council or individual registration in the respective nursing council or


in the authorized government body (only in case of non-existence of nursing council) of the


respective country (Only applicable for the Nepalese graduated from other countries).



Upload original scanned copy of Equivalency letter from CTEVT/TU


* All original academic certificates, citizenship and related documents need to bring for


verification during receiving registration certificate from NNC.


Table 2: List of documents required for foreign nurses (candidates from SAARC countries)







Complete online personal information


2. Original scanned copies of the following documents (if applicable)




SLC/SEE Mark sheet and Character Certificate




Passport / citizen identity card




Academic Transcript or Mark sheets and Character Certificate of PCL




Nursing Programme




Academic Transcript or 10+2 Mark sheets or I. Sc. Mark sheets, and




Character Certificate for B.Sc. Nursing Programme



Upload original Certification of registration from the nursing council of respective





Upload recent white background Passport size photo (size not more


than 2MB and must be in jpg format)






Examination fee should pay through eSewa (Candidates from


SAARC countries NRs. 5,100/-


Table 3: List of documents required for foreign nurses (candidates from outside SAARC countries)





Application from original



Photocopy of certificates of nursing education degree



Photocopy of certification of registration from the nursing council of respective country



Recommendation letter from the organization in Nepal where the applicant is going to work





Original valid visa or Passport for those who do not need to have visa to enter Nepal,


original as well as photocopy

6. Examination fee  NRs. 10,000/- (Rastriya Banijya Bank, Maharajgunj,


Chakrapath, Kathmandu Voucher original) current A/C No. 115000222101



Passport size photo


The process is:

  1. The applicant must upload all the documents to online NLEN registration process within the time period mentioned in the notice.
  1. The examination center, time and other important information will be notified on the online admit card. The admit card can be downloaded from online application.



  • If an applicant changes her/his name and/or address after submitting an application
  • for licensure, the applicant must notify the NNC immediately in order to document receive current information. An applicant is required to submit legal documentation of any change to the NNC immediately after the change occurs.
  • An Applicant’s name must match EXACTLY as it appears on photo identification that will be at the test center. The same name must also be used to the NLEN online at the time s/he registers in order to prevent delays with issuing examination authorization.

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.

Distribution of Test Items

Table 4: Subject wise distribution of test items



Distribution of test items (%)

Possible numbers of items




Integrated Science






Fundamental of Nursing






Community Health Nursing






Adult Nursing



Child Health Nursing






Midwifery and Gynecology






Leadership and Management














Frequency of the NLEN

The Nepal Nursing Council conducts the NLEN three times a year. If applicant fails an examination, s/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 registration license from the NNC with the registration fee of NPR 800 paying via eSewa and they should also bring the admit card along with two photographs same as used for admit card including all the original documents and citizenship.

Syllabus for NLEN

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:

1.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


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 systems

Fundamentals of Nursing

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


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


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


Nutritients and their functions

Nutritional Deficiency disorders: Types and characteristics Management of the clients with nutritional deficiency


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

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

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)


Positioning/ Restraining

Calculation of drugs and its administration

Different types feeding

IV fluid administration and management


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
  • 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
  • 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: or

contact Nepal Nursing Council's Office Tel: 4372521.