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National League for Nursing

The National League for Nursing (NLN) offers professional development, networking opportunities, testing services, nursing research grants and public


As nursing schools and programs switched to working and learning from home in March 2020, the National League for Nursing partnered with Questionmark to move assessments online, allowing nursing programs to continue to deliver crucial exams. This meant students who wanted to take assessments for admission, progression, or completion of programs could continue their studies, despite the challenges of COVID-19


The National League for Nursing (NLN) provides crucial assessment content to over 300 nursing colleges and training programs across the U.S. Each year, over 100,000 nurses or nursing students take an NLN assessment.

COVID-19 made it more important than ever to train future nurses. But at the same time, it was harder for nurses to access training and qualify, due to social distancing measures.

Providers of nursing education were unable to proctor entrance exams since facilities and assessment centers had to shut down. It was imperative that delays in potential students being admitted for training and a corresponding shortage of nurses be averted.

The NLN formed a partnership with Questionmark and brought its pre-admission exam (PAX) online, meaning that colleges and training providers could continue to admit student nurses, ensuring that their studies could begin and progress.


The new partnership between NLN and Questionmark means that colleges can offer the PAX assessment online when students cannot go to physical test centers.

Candidates can book an appointment with a proctor through Examity, which will supervise the test through the webcam built into the test-taker’s computer, or Proctorio, which will record and review the session for test security.

This means the college can be confident that results will reflect actual ability.

The NLN also makes other important assessments online through Questionmark. This includes the Nursing Acceleration Challenge Exam (NACE), which helps nurses determine whether they have sufficient knowledge to begin advanced training.

The new partnership makes assessments more efficient to deliver than when they were run in physical buildings, and it is easier for colleges and training providers to purchase these exams. Questionmark offers direct technical support to test-takers, so the partnership saves training providers time and makes it easier for them to manage assessments.

The results

  • Crucial exams continued – the NLN offers 100,000 assessments each year through working with Questionmark.
  • Easier for colleges to purchase assessments – colleges and training providers can simply order the test content they want and process the payment online because of Questionmark’s e-commerce function.
  • Maintained revenue stream for test publisher – creating a secure online assessment means that the NLN could continue to sell their content despite the pressures of social distancing and restrictions imposed.
  • Continued training – Nurses have been able to access training, keep on top of their continued professional development, and sharpen their skills during a generation-defining public health crisis.
  • Extra support for test-takers – people taking the assessments can access Questionmark support directly, saving colleges time.

The Director of Assessment Services, Dr. Leanne Furby, from the NLN said, “Questionmark has helped us create a secure online exam environment that guards against cheating. Candidates have continued to sit important assessments despite the pressures of social distancing.

“The Questionmark platform also brings advantages that will continue to help assessment delivery when social distancing measures ease up. It serves as a one-stop-shop solution allowing us to manage everything from e-commerce to proctoring through one platform. Our partnership with Questionmark makes it easier for our customers and their students to purchase materials, analyse and access their results.”

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