By Kelly Phillips, NurseZone feature writer
A review of Puerto Rico’s registered nurse licensure exam being conducted by
the National Council of State Boards of Nursing appears unlikely to show it is
interchangeable with the NCLEX-RN, the NCSBN announced recently.
The NCSBN’s look at the Puerto Rico Board of Nursing Registered Nurse
Licensure Examinations was prompted by a discussion among the state boards that
make up NCSBN membership, the Puerto Rico nursing board among them.
"It led us to want to know more about this exam that people erroneously
referred to as the ‘Spanish NCLEX,’ " said Casey Marks, Ph.D., director of
testing services for NCSBN.
None of the state boards has been using the Puerto Rico exam as the basis for
a licensure decision, but some individual state boards, including the Puerto
Rico one, wanted direction as to whether it would be equivalent to the NCLEX.
The comparison report isn’t expected to be finalized until the NCSBN’s
delegate assembly in August. Currently, information is incomplete, Marks said.
"What we do have points strongly toward the exam’s not being substantially
equivalent," he said.
In past years, a handful of states had accepted the English version of the
Canadian exam in lieu of the NCLEX-RN for licensure in the United States, but in
recent years the NCSBN deemed that the Canadian test wasn’t equivalent, Marks
The Puerto Rico comparison, under way since 2002, involves checking
similarity of the content, difficulty, security and validity of the exam.
Citing one facet of the comparison, Marks noted there appear to be
substantial differences in terms of scope of practice and information the exam
is based on. If the Puerto Rico exam is based on nursing practice there, it may
not be applicable in the United States.
The aim of the review is to provide a nonbinding recommendation to members on
whether they should accept the Puerto Rico exam in lieu of the NCLEX. This way,
the individual states don’t have to do their own comparison legwork.
Most other countries don’t use licensure exams because their governments
design the nursing school curriculums, Marks said. In those cases, no national
exam is needed because final course tests are deemed sufficient for practice by
the ministries of health in those nations.
With different educational programs operating in the United States, a
standardized test is necessary for assessment of minimal competence, Marks
Those involved in administering Puerto Rico’s exam are cooperating in the
comparison, Marks said.
"We’ve never deemed another exam to be substantially equivalent to the NCLEX,
and the information is not pointing to that at this time," Marks said.
Whatever the outcome, it likely will affect relatively few nurses, as
generally fewer than 200 people from Puerto Rico register to take the NCLEX
every year, he added.
The comparison is "not designed to facilitate or limit the movement of
nurses," Marks said.
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