International nurses who are educated outside the United States can use this resource to serve their special needs:

1. To check their experiences, skills, and knowledge for equivalency to those of nursing candidates from U.S. programs, in terms of their ability to deliver effective and safe health care as determined by U.S. standards of practice.
2. To identify cultural differences in perception of client needs and nursing responses and actions (see Chapter 3. Safe, Effective Care Environment).
3. To learn about the structure and format of the examination (see Chapter 1. Orientation and Pre-Tests).
4. To learn how to prepare for the examination (see Chapter 1. Orientation and Pre-Tests).
5. To practice taking tests made up of multiple-choice and fill-in-the-blank questions (see questions and tests-taking tips in Chapter 1. Orientation and Pre-Tests, Chapter 3. Safe, Effective Care Environment, Chapter 4. Health Promotion and Maintenance, Chapter 5. Health Promotion and Maintenance, Chapter 6. Physiological Integrity, Chapter 7. Physiological Integrity, Chapter 8. Physiological Integrity, Chapter 9. Physiological Integrity: Basic Care and Comfort—Nutrition, Chapter 10. Psychosocial Integrity, Chapter 11. Reduction of Risk Potential, and Chapter 12. Final Tests 1 and 2).
6. To assess the level of language difficulty in reading the examination.
7. To become skilled in test-taking techniques (see following section).

If you are an international nurse and wish to compare your preparation with that of U.S.-educated nurses, you will find that the practice questions with detailed answers and tests-taking tips for each question that are included at the end of each major content chapter can serve as an effective self-assessment guide. If you find that you need further in-depth study after taking the practice tests and reviewing the essential content presented in outline format and in tables and figures throughout the resource, you may wish to seek assistance from online or mobile review courses for self-paced review on DVD, CD-ROM, or mobile device. In addition, Chapter 8. Physiological Integrity may help you review drugs used in the United States that may be called by other names outside the United States.

Cultural differences may be one cause of incorrect answers stemming from your different perception of clients' needs or nursing action. In addition, Chapter 3. Safe, Effective Care Environment contains the code of ethics and standards of nursing practice and legal aspects that pertain to nursing in the United States. We suggest that the international nurse become familiar with these sections to determine what is emphasized in this country.

The Orientation section (see Chapter 1. Orientation and Pre-Tests) is designed to help the international nurse know what to expect during the examination, what the examination structure and format will be like, what content will be covered, and how it will be scored.It will also help the examination candidate learn how to study for the test, how to take a multiple-choice test, and how to reduce test-taking anxiety.

If you are concerned about your ability to read and comprehend English as it might be used in the examination, first check yourself by looking at the examination questions in this resource. The terms used here are those used in the health care field and are considered to be those a nurse needs to know and use. If the vocabulary is different from yours or is difficult, look at the list of common terms in Appendix C .You may also want to consult local colleges for courses in English as a second language (ESL courses).

If you are not familiar with or proficient in taking examinations with multiple-choice questions when more than one answer looks good, the approximately 3530 test questions in this resource and the accompanying disk will provide you with sufficient practice for taking such a test. The following section on test taking tips was specifically included to help you choose the best answer(s) by narrowing your choices to increase your chances of selecting the best answer(s).