State final examination
Whakamātautau mutunga o te motu

At the completion of a nursing education programme, students are required to sit and pass the Nursing Council’s state final examination in order to join the profession as either an enrolled nurse or a registered nurse.

Once the examination is successfully passed, a nurse applies to the Nursing Council to join its register, meets the Council’s requirements, and applies for and must hold an annual practising certificate before they can legally practise in New Zealand.

Timeframe

Candidates must sit the state final examination within one year following completion of their programme of study.

  Registered nurse:  Enrolled nurse:  Results released by:
March 2026 Tuesday 17 March 2026 Tuesday 17 March 2026 Wednesday 1 April 2026
July 2026 Tuesday 21 July 2026 Wednesday 22 July 2026 Thursday 6 August 2026
November 2026 Tuesday 17 November 2026 Wednesday 18 November 2026 Thursday 3 December 2026

State final examination structure

The state final examination consists of two parts:

  • Part A: Medicine calculations (10% of questions)
  • Part B: Nursing Knowledge (90% of questions)

Part B: Nursing knowledge contains a range of questions based on the pou of the Nursing Council’s standards of nursing competence for the registered nurse and enrolled nurse scopes of practice.

During 2026, 2027, 2028 the Council will transition to including questions in the examinations which have been specifically developed on the new pou.

Registered nurse examination

The registered nurse examination consists of:

  • 120 multiple choice questions to be completed within 130 minutes.
  • Each question has four answer choices, and one will be the correct answer.

In order to become familiar with the layout of the examination and the style and format of the questions, the Nursing Council has provided examples of typical questions. The answers are not provided so students can discuss and research possible answers with others and with their teachers.

These questions are examples only and will not be used in the actual examination.

Part A: Medicine and fluid calculations

Q1. A patient has been prescribed morphine 8mg 2-3 hourly PRN for pain. Unit stock of morphine is 10mg/1mL. How much morphine should be drawn up for the patient?

  1. 0.08mL
  2. 0.25mL
  3. 0.75mL
  4. 0.80mL

Q2. A child weighs 22.4kg, and the prescription is for 24mg/kg of body weight. The medication comes at the strength of 50mg/mL. How many mL (to one decimal place) of the medication should the child receive?

  1. 7.5mL
  2. 8.5mL
  3. 9.8mL
  4. 10.8mL

Q3. Ondansetron 2mg has been prescribed for a child who weighs 13.6kg. The safe dosage of this medication is 0.15mg/kg. Is 2mg a safe dose?

  1. No, a safe dose would be 0.3mg
  2. No, a safe dose would be 0.6mg
  3. No, a safe dose would be 1.02mg
  4. Yes, 2mg is a safe dose

Q4. A patient is prescribed 250mg of antibiotics in 200mL of intravenous fluid over 30 minutes. The correct rate in mL per hour to set the infusion device is

  1. 100mL per hour
  2. 200mL per hour
  3. 400mL per hour
  4. 500mL per hour

Q5. How many mg is 5000mcg?

  1. 0.5mg
  2. 5mg
  3. 50mg
  4. 500mg

Q6. A patient is prescribed 125mg of a medication. The ampule contains 400mg/4mL. How many mL will you administer?

  1. 0.8mL
  2. 1mL
  3. 1.25mL
  4. 1.5mL

Q7. A patient is prescribed 1g of paracetamol. The available tablets contain 500mg each.

How many tablets will you administer?

  1. 1 tablet
  2. 1.5 tablets
  3. 2 tablets
  4. 2.5 tablets

Q8. A patient's intravenous normal saline infusion of 1000mL is to be completed in 8 hours' time. The drop factor of the giving set is 15 drops per mL. How many drops per minute are required to finish the infusion on time?

  1. 11 drops per minute
  2. 15 drops per minute
  3. 31 drops per minute
  4. 35 drops per minute

Part B: Nursing knowledge

Q9. The role of the Nursing Council of New Zealand is to

  1. protect the unregulated and regulated health workforce.
  2. regulate doctors to protect public safety.
  3. regulate nursing to protect public safety.
  4. protect the nursing workforce.

Q10.  A mother asks you why her child needs to be weighed before a scheduled surgery.

What is your best response?

  1. "Surgery is not carried out on children above the ideal body weight."
  2. "We need to compare your child’s weight before and after the procedure."
  3. "Medication doses for children are often based on weight to ensure safety."
  4. "It is routine for all paediatric admissions."

Q11.  Prior to surgery a patient is to have nothing to eat or drink. This is necessary to

  1. assist in the proper absorption of the anaesthetic.
  2. prevent nausea and vomiting immediately after surgery.
  3. avoid the danger of inhaling the stomach contents (aspiration).
  4. avoid incontinence during surgery.

Q12.  A person with asthma arrives at the emergency department and is visibly distressed, coughing and with audible wheeze. Why are they prescribed salbutamol (beta-adrenergic agonist)?

  1. To dilate the airways.
  2. To reduce secondary infections.
  3. To decrease postnasal drip.
  4. To reduce airway inflammation.

Q13.  A patient has had a myocardial infarction involving a large section of the heart muscle. You assess them at risk for

  1. hypovolaemic shock.
  2. cardiogenic shock.
  3. metabolic shock.
  4. neurogenic shock.

Q14.  What may a person experience in a hypomanic phase of a bipolar mood disorder?

  1. Hallucinations, fatigue, anhedonia.
  2. Social withdrawal, decreased self-esteem, obsessive thoughts.
  3. Elevated mood, reduced need for sleep, irritability.
  4. Increased activity, increased need for sleep, pressured speech.

Q15.  Furosemide (a diuretic) has been prescribed for a patient with congestive heart failure. The prescriber has not signed the medication chart. You should

  1. double check the medication with a senior registered nurse.
  2. contact the prescriber to sign the prescription.
  3. give the furosemide, sign for it and inform the nurse manager.
  4. ask your nurse manager to sign the prescription, then give it.

Q16.  A resident/patient in an aged care facility/rest home/nursing home frequently apologises for being so much trouble to the staff. Your best response would be to

  1. talk to them about something else to distract them.
  2. listen to them and acknowledge their concerns.
  3. contact their family to visit and keep them company.
  4. tell them to stop apologising.

Q17.  A patient tells you they do not want to have the prescribed enoxaparin sodium injection. Your first response would be to

  1. inform them they must have the injection as it has been prescribed.
  2. reassure them that it is prescribed for everyone who has a surgical procedure.
  3. accept that they do not want the injection.
  4. ask what concerns them about having the injection.

Q18.  A patient has been admitted with symptoms of alcohol withdrawal. What is your main responsibility to them during their medical detoxification?

  1. Administer fluids via a naso-gastric tube to maintain hydration.
  2. Don't disturb the patient so they can sleep.
  3. Prepare to physically restrain them if necessary.
  4. Keep the person safe and monitor for any deterioration.

Q19.  After surgery a patient has a morphine infusion running at the maximum prescribed rate of 15mg per hour. When you conduct a pain assessment, they say the pain is unbearable and they are obviously distressed. You should

  1. increase the infusion rate to 20mg per hour.
  2. reassess the pain and contact the doctor to review the patient’s medication.
  3. help the patient to relax and reassure them that the pain will go.
  4. give the patient two paracetamol tablets and reassess them in half an hour.

Q20.  An older adult patient is admitted with confusion, fever, urinary urgency, dysuria, and foul-smelling urine. The most likely differential diagnosis is

  1. a urinary tract infection (UTI).
  2. delirium from dehydration.
  3. adverse effects from medications.
  4. an electrolyte imbalance.

Q21.  You are visiting a patient at their home. A neighbour stops you and asks for information about the patient's condition. Your best response is to

  1. tell them how the patient is, then inform the patient you have talked to their neighbour.
  2. tell them how the patient is, as long as the disclosure is not contrary to the patient's wishes.
  3. ask the patient to contact their neighbour so they can give them an update.
  4. explain that you can't disclose any information for privacy reasons.

Q22.  Which of these is a legal right of a person admitted under the Mental Health (Compulsory Assessment and Treatment) Act 1992?

  1. Right to refuse treatment and care.
  2. Right to receive information about their status.
  3. Right to self discharge against medical advice.
  4. Right to choose their mental healthcare provider.

Q23.  One of your responsibilities when caring for a patient in the post-operative phase is to observe for signs of haemorrhage. The type of shock resulting from haemorrhage is

  1. hypovolaemic.
  2. vasogenic.
  3. neurogenic.
  4. cardiogenic.

Enrolled nurse examination

The enrolled nurse examination consists of:

  • 90 multiple choice questions to be completed within 100 minutes.

Each question has four answer choices, and one will be the correct answer.

Part A: Medicine calculations

Q1. Oral digoxin 125mcg daily is prescribed for a patient. The tablet strength available is 62.5mcg. How many tablets must be given?

  1. 2 tablets.
  2. 3 tablets.
  3. 3.5 tablets.
  4. 4 tablets.

Q2. A patient is prescribed 125mg of medication. The ampule contains 400mg/4mL. How many mL will you administer?

  1. 0.8mL
  2. 1mL
  3. 1.25mL
  4. 1.5mL

Q3. A patient is prescribed 250mg of antibiotics in 200mL of intravenous fluid over 30 minutes. The correct rate in mL per hour to set the infusion device is

  1. 100mL per hour
  2. 200mL per hour
  3. 400mL per hour
  4. 500mL per hour

Q4. How many mg is 5000mcg?

  1. 0.5mg
  2. 5mg
  3. 50mg
  4. 500mg

Part B: Nursing knowledge

Q5. The role of the Nursing Council of New Zealand is

  1. to protect the unregulated and regulated health workforce.
  2. to regulate doctors to protect public safety.
  3. to regulate nursing to protect public safety.
  4. to protect the nursing workforce.

Q6. Which of these is a legal right of a person admitted under the Mental Health (Compulsory Assessment and Treatment) Act 1992?

  1. Right to refuse treatment and care.
  2. Right to receive information about their status.
  3. Right to self discharge against medical advice.
  4. Right to choose their mental healthcare provider.

Q7. A patient tells you they are afraid of their surgical procedure. You should

  1. call the hospital chaplain to come and talk with the patient.
  2. listen to the patient's concerns and use reflective communication skills.
  3. change the subject to something more positive.
  4. call the family and report the patent's concerns to them.

Q8. When working with colleagues, nurses should

  1. have the right to hold different opinions and work as individuals.
  2. treat colleagues with respect and work in a collaborative and co-operative manner.
  3. avoid colleagues they find challenging to work alongside.
  4. alert patients if a colleague is less than capable.

Q9. A person with asthma arrives at the emergency department and is visibly distressed, coughing and with audible wheeze. Why are they prescribed salbutamol

(beta-adrenergic agonist)?

  1. To dilate the airways.
  2. To reduce secondary infections.
  3. To decrease postnasal drip.
  4. To reduce airway inflammation.

Q10. A patient has had a myocardial infarction involving a large section of the heart muscle. You assess them at risk for

  1. hypovolaemic shock.
  2. cardiogenic shock.
  3. metabolic shock.
  4. neurogenic shock.

Q11. What may a person experience in a hypomanic phase of a bipolar mood disorder?

  1. Hallucinations, fatigue, anhedonia.
  2. Social withdrawal, decreased self-esteem, obsessive thoughts.
  3. Elevated mood, reduced need for sleep, irritability.
  4. Increased activity, increased need for sleep, pressured speech.

Q12. A patient has been admitted with symptoms of alcohol withdrawal. What is your main responsibility to them during their medical detoxification?

  1. Administer fluids via a naso-gastric tube to maintain hydration.
  2. Don't disturb the patient so they can sleep.
  3. Prepare to physically restrain them if necessary.
  4. Keep the person safe and monitor for any deterioration.

Q13. A patient tells you they do not want to have the prescribed enoxaparin sodium injection. Your first response would be to

  1. inform them they must have the injection as it has been prescribed.
  2. reassure them that it is prescribed for everyone who has a surgical procedure.
  3. accept that they do not want the injection.
  4. ask what concerns them about having the injection.

Q14. Prior to surgery a patient is to have nothing to eat or drink. This is necessary to

  1. assist in the proper absorption of the anaesthetic.
  2. prevent nausea and vomiting immediately after surgery.
  3. avoid the danger of inhaling the stomach contents (aspiration).
  4. avoid incontinence during surgery.

Q15. After surgery a patient has a morphine infusion running at the maximum prescribed rate of 15mg per hour. When you conduct a pain assessment, they say the pain is unbearable and they are obviously distressed. You should

  1. increase the infusion rate to 20mg per hour.
  2. reassess the pain and contact the doctor to review the patient’s medication.
  3. help the patient to relax and reassure them that the pain will go.
  4. give the patient two paracetamol tablets and reassess them in half an hour.

Q16. Furosemide (a diuretic) has been prescribed for a patient with congestive heart failure. The prescriber has not signed the medication chart. You should

  1. double check the medication with a senior registered nurse.
  2. contact the prescriber to sign the prescription.
  3. give the furosemide, sign for it and inform the nurse manager.
  4. ask your nurse manager to sign the prescription, then give it.

The nursing programme providers offer a practice session for candidates to familiarise them with what the state final examination will look like. The Nursing Council provides the log-ons so everyone can be familiar with the process.

The Council recommends that the practice session is offered on-site in the same computer suites where the state final examination will take place.

Registered nurse/enrolled nurse first-time sitting $240 ($165 examination fee and $75 registration fee)
Nurses already registered (EN transitioning/EN completing RN) $165
If resitting an examination $165

Application for the state final examination

The nursing programme providers supply the Nursing Council with a list of candidates for the state final examinations.

When applications open, the Nursing Council will email candidates the login details for the application.

Examination results

Results are issued on a pass or fail basis. To achieve a pass in the examination requires candidates to achieve an overall mark of 70% across the whole exam. This provides the Council reasonable confidence that the candidate can safely enter the nursing profession.

A robust moderation process is undertaken to ensure a consistent standard is maintained.

Successful candidates who have met all requirements will be emailed directly with their results, confirmation of registration, and a link to apply for an annual practising certificate online.

Successful candidates who have not yet met other requirements (see referees and/or criminal record history below) will be emailed their results but must wait for confirmation of registration until all other requirements are met.

Unsuccessful candidates will be notified by email. This communication will also include information about re-sit attempts where applicable.

Unsuccessful candidates may apply to the Nursing Council for an analysis of their examination results. This is not available for successful candidates.

If a candidate is unsuccessful with their first attempt of the examination, they may sit a second attempt. If unsuccessful with their second attempt, one further opportunity is offered.

The Council’s policy only allows for three attempts. The second and third attempts must be within two years of sitting their first attempt.

In exceptional circumstances, a candidate may apply for extra time to complete the examination. 25 minutes is the maximum additional time that can be approved by the Nursing Council.

The programme provider must acknowledge in the spreadsheet the Council supplies to them, any student/ ākonga who needs additional time.

Extra time can be granted for the following reasons: medical conditions, learning disabilities, temporary incapacity e.g. broken arm, and other extenuating circumstances (at the Nursing Council’s discretion).

In exceptional circumstances, a candidate may request a reader/writer. The request may be granted subject to the following criteria:

  • Evidence of the candidate’s requirement for a read/writer in internal examinations/tests (and the support provided by the provider throughout the programme).
  • The request must be made by and supported in writing by the head of school when returning the application template, unless this is not possible due to the nature of why a candidate requires a reader/writer.
  • Medical evidence must be provided for any temporary incapacity.

Please note:

The Council does not normally approve a reader/writer for the examination. The rationale for this is that all nurses in all practice settings are required to be able to read, write, think, and act under pressure in a manner like that which may be experienced by a candidate sitting the examination.

Examination misconduct is not tolerated by the Council. Misconduct includes, but is not limited, to:

  • Copying from another candidate's work.
  • Unauthorised communication with another person during the examination.
  • Possession or sharing of, or access to, unauthorised material during the examination.
  • Logging on to the examination using another person's User Id / Password.
  • Sharing User Id/Password with an unauthorised person.
  • Attempting to copy or communicate the examination questions to another candidate sitting the same or a later examination.

Examination misconduct reported to the Council will be investigated. Once the investigation is complete, the candidate may be invited to meet with the Registrant Quality Committee to determine their suitability for registration.

The head of school must notify the Council via email of any candidate to be withdrawn as soon as possible prior to the state final examination.

A candidate who does not sit the state final examination at the first opportunity because of illness, bereavement or other unavoidable situations should normally sit at the next available opportunity.

Fees paid by the candidate who is subsequently withdrawn will be refunded to them or credited for when they sit the exam.

The Council does not award aegrotat passes. Therefore, if a candidate believes that their performance may be impacted by their circumstances, they have the option to withdraw from the exam prior to it commencing. The request to withdraw can come from the candidate, the provider or the chief invigilator.

 

All candidates are required to submit the names, addresses, contact numbers and email addresses (all contact details are mandatory) for two people of good standing in the community where they live or have lived in New Zealand who have known them during the period of their nursing education.

These people cannot be relatives, flatmates, fellow students or educators from a nursing school and must be willing to support the candidate’s application for registration.

If the candidate has a conviction(s) they must ensure that the two people of good standing are aware of these conviction(s).

Criminal record history

All state final examination candidates are required to supply the Nursing Council with their Ministry of Justice record, obtained within three months prior to the examination.

The candidate must go to the Ministry of Justice website to request their own report, whether you have a criminal conviction or not. Ask for an electronic copy of your record and not the full record. Then forward the electronic copy directly to the Council by emailing [email protected] with your name and candidate number in the subject line.

Failing to supply this information will delay a candidate’s registration.

  • The Nursing Council requests a Ministry of Justice criminal record history to identify court convictions.
  • A candidate is also required to disclose any convictions or charges that occur from the date of completing the application until their registration.
  • Under the Criminal Records (Clean Slate) Act 2004, criminal convictions may have been removed from your record and you do not need to declare these convictions. Information about this is available at justice.govt.nz
  • If a candidate has a conviction, they are required to provide a written explanation, outline any mitigating circumstances and any steps they have taken to address the conduct that led to the conviction. They will be required to satisfy the Nursing Council that the conviction does not reflect adversely on their fitness to practise as a nurse.
  • The Head of Nursing from the candidate's school is required to provide a letter supporting their application and acknowledging that they have declared their conviction.
  • The Registrar may decide to register the candidate after considering both the letter of support and the candidate’s written explanation or may refer their application for registration to a Registrant Quality Committee. They will be given the opportunity to provide a written and/or oral response to that committee before any decision about their registration is made.

What we do with personal information

The personal information collected in this application is required and held by the Nursing Council for the purpose of an application for registration under section 15 and 16 of the Health Practitioners Competence Assurance Act 2003.

An applicant is entitled to ask the Nursing Council for access to, and correction of, personal information.

Unless the applicant advises the Nursing Council otherwise, their results will be disclosed to the relevant school of nursing.