The RN Licensing Process

All states license registered nurses, and in all states, they are referred to by the same title: Registered Nurse or RN. First time RN licensing is referred to as license by examination; candidates take the board exam after they have completed their registered nursing educational requirements. When a registered nurse is already licensed in one U.S. jurisdiction and seeks licensure in another, the process is generally referred to as licensure by endorsement. Sometimes its not necessary to get a new license to take a position in another state. About half of U.S. states belong to the nurse licensure compact, an agreement that makes it easier for registered nurses to practice in multiple states (either through telenursing or by being physically present in the state). An RN holds a license in only one compact state at a time. The RN is allowed to work in other compact states on the basis of a multi-state license issued in their own home state. If the RN changes their primary residence, though, they'll need to transfer their license fairly quickly. The particulars of the licensing process are different from state to state, but there are many commonalities. Registered nurse licensure involves education, examination, good character -- and often quite a bit of paperwork. It's imperative that a candidate become familiar with their own state licensing agency and with the licensing agency of any state where they plan to work. The following overview, though, gives an idea of what to expect.

Initiating the Process: Applying for Examination and Licensure

All 50 states use the same licensing exam: the NCLEX-RN. They all have the same standard for passing, as the exam is computer adapted and graded pass-fail. A nursing graduate or soon-to-be graduate must apply to a particular state licensing agency. They may opt for the state where he or she lives or the state where they intends to work -- at least if the RN licensing candidate is in a non-compact state. If the candidate lives in a compact state and wishes to work in any compact state, they will apply to their own state board. In some states, registered nursing students turn in their applications before they graduate. While they won't actually be licensed until afterward, this can expedite the process. In some states, the nursing school provides official verification when program requirements have been met. In others, official transcripts must be requested -- even for in-state candidates. States have differing policies about working as a nurse in the period following graduation. Some issue temporary permits to candidates who are waiting to take the NCLEX and receive exam results. Some allow them to work for a short period under supervision as graduate nurses. Some states will not allow them to work as registered nurses until the NCLEX is passed and the RN license issued.

Establishing Eligibility: Professional Fitness

All states take into account a registered nursing license applicant's professional and legal history. More than half have a fingerprint-based criminal history check; that number is expected to grow. In some states, the CBC is performed before application, in others, after. The application also asks for self-disclosure about legal and professional issues and, in many cases, medical conditions that may impair practice. Many states require all legal information, including minor juvenile offenses. Candidates should be aware that having something on their record wont necessarily mean they are barred from licensure. However, withholding information could. In some states, a candidate signs a waiver, which allows all information to be released -- including some that normally wouldn't be. Some, but not all, states require a notary signature. In addition to certifying the veracity of the application, candidates may be asked to certify that they have read the rules and understand their responsibilities.

RN License by Endorsement
A nurse whose license is in good standing and who has been actively practicing can get a license in another state without repeating steps they has taken at least not the major ones like education and board examination. The RN will need to provide license verification from at least one state; some states require verification from every jurisdiction the RN has practiced. If the registered nurse has been out of practice for a significant period of time, the RN may be required to take a refresher course prior to RN licensing in the new state.

REQUIREMENTS
Whether the nurse resides outside or within the U.S. when applying, the nurse must be in possession of: 1. A diploma from a nursing school in his/her country; 2. A license to practice nursing in his/her country; 3. A full and unrestricted license to practice professional nursing in the state of intended employment, or a certification that he/she has passed either the U.S. licensing examination (NCLEX-RN) but cannot obtain the license without asocial security number, or the examination given by the Commission on Graduates of Foreign Nursing Schools (CGFNS); and 4. A VisaScreen Certificate In addition, unless the nurse was educated in an English-speaking country, she must achieve a certain score on tests in written and spoken English administered by TOEFL or IELTS in order to qualify for a VisaScreen Certificate. Passing scores for RNs are as follows: TOEFL Paper-Based - 540; TOEFL Computer-Based - 207; Test of Written English (TWE) - 4.0; Test of Spoken English (TSE) - 50 IELTS (Academic Module only) - 6.5; IELTS Spoken Band - 7.0.

North Carolina Nursing License Requirements: Become a Nurse in NC

Internationally Educated Nurses
International candidates will need to have their education evaluated by one of two approved organizations: the Commission on Graduates of Foreign Nursing Schools or Josef Silny & Associates (http://www.ncbon.com/content.aspx?id=214). International candidates will also need to take an English proficiency exam unless their education was in one of the following nations or territories: Australia, Canada, Guam, Ireland, the Mariana Islands, New Zealand, Samoa, the UK, or the Virgin Islands. Puerto Rican nurses do need to demonstrate English proficiency as do those educated in the Canadian providence of Quebec. There are two accepted exams: the IELTS and the TOEFL. International nurses must meet the education and English proficiency requirements before they can be authorized by North Carolina to take the NCLEX. They will need to complete a criminal background check and provide a social security number before they can be licensed; however, this does not necessarily have to be done before NCLEX approval.

State Board of Nursing

CGFNS services required or accepted for REGISTERED NURSES CES or VS

CGFNS services required for accepted for LICENSED PRACTICAL OR VOCATIONAL NURSES CES or VS

North Carolina

Secondary school evaluation required for CES report No

Requirements for licensure by examination for applicants who were educated outside of the United States and other member board jurisdictions include:
1. Documentation of Education 2. English Proficiency Examination 3. *Valid Social Security Number 4. *Satisfactory criminal background check *required prior to license being issued. NCLEX examination may be taken prior to completion of these requirements.

Step One: Documentation of Education (Choose one agency)

Do not send transcripts to the NCBON. All official transcripts must be sent to the education evaluation agency:

Commission on Graduates of Foreign Nursing Schools 3600 Market St., Suite 400 Philadelphia, PA 19104-2651 Telephone: 215.222.8454 Note: Credentials Evaluation Service (CES Professional Report), or CGFNS Certificate or VisaScreen is accepted or Josef Silny & Associates 7101 SW 102 Avenue Miami, FL 33173 Telephone: 305.273.1616

Step Two: English Proficiency Examination (choose either TOEFL or IELTS)

TOEFL - Test of English as a Foreign Language (www.toeflgoanywhere.org) Passing score: TOEFL- written overall score of 560, CBT overall score of 220, iBT overall score of 83. NCBON code: 3236 IELTS - International English Language Testing Service (www.ielts.org) Passing score: IELTS-overall score of 6.5 with a minimum of 6.0 on all modules. The English Proficiency examination expires two years after the date the examination was taken. A CGFNS certificate or VisaScreen is also accepted to meet the English proficiency examination. For applicants to be EXEMPT from the English proficiency requirement, the applicant must have attended their entry-level professional nursing education program in the United States, Canada (except Quebec), the United Kingdom, Ireland, Australia, New Zealand or the U.S. Territories of Samoa, Guam, Mariana Islands, and the Virgin Islands. All other countries must take the English proficiency examination. If your country is not listed as exempt, even if your nursing courses were taught in English and/or using English textbooks, you will still need to complete an English proficiency examination. There are no exceptions for this requirement. For example, if you graduated from a nursing education program in the Philippines, and the program was taught in English and English textbooks were used, you would still need to complete an English proficiency examination since the Philippines is not an exempt country. Step Three: As soon as the NCBON approves the education evaluation and the English examination, then the candidate can complete the online Application for Licensure on the NCBON website www.ncbon.com/nclex As soon as your NCBON online application has been completed, an instruction packet will be mailed to you regarding the criminal background check process. Please complete the forms and mail them to the NCBON. Step Four: Register to take the examination. The National Council of State Boards of Nursing has contracted with Pearson Vue to give the the National Council Licensure Examination for Registered Nurses examination (NCLEX). Candidates must register to take the NCLEX examination with Pearson Vue www.vue.com/nclex The NCLEX examination can be taken at any Pearson Vue testing location. You do not have to be in NC to take the NCLEX examination. Your Authorization To Test (ATT) number will be sent to you via email by Pearson Vue.

You will not receive an ATT until you have had your education and English proficiency examination score approved by the NCBON. If there is no email address given, a letter will be mailed to you. General instructions will be included about the testing process. You must have the ATT number in order to register for NCLEX examination with Pearson Vue. On the day of your NCLEX examination, be sure and take your ATT number with you in order to be admitted to the testing center. Next: You can check the status of your NC application for NCLEX by visiting the website www.ncbon.com. It will identify that the application has been received, date declared eligible, and date ATT issued. The initial Application for Licensure by Examination, and the criminal background check will be held active for one year from the date the candidate is determined to be eligible to test. The Authorization to test (ATT) is valid for 180 days from the date of eligibility. If you do not take NCLEX, and the ATT expires, you will have to re-establish eligibility. Examination results will be mailed to you within one month after taking the examination.DO NOT CALLthe North Carolina Board of Nursing, NCLEX Candidate Services, or the Pearson Vue Centers for NCLEX examination results. We do not provide exam results by phone; however, you may verify licensure by our verification system at website www.ncbon.com. Telephone inquiries and letters requesting information will not accelerate the process. All individuals seeking licensure by examination must have a valid social security number to be issued a license to practice nursing. While you are making application for a Social Security number, you may take the NCLEX examination. No license will be issued until proof of the Social Security number is submitted to North Carolina Board of Nursing. The North Carolina Board of Nursing does require a Criminal Background check before a license can be issued, but it is not required for you to be eligible to apply for and take the NCLEX examination. Requirements for application and licensure by examination for applicants who were educated outside the United States. Detailed and printable information about the following is available on the NCBON website: Documentation of Education, English Proficiency Examination, NCBON Application for Licensure, Pearson Vue Registration for NCLEX , ATT Number from Pearson Vue, NCLEX examination, Social Security Number, and Satisfactory Criminal Background Check

Application for Licensure by Examination

1. Once the above eligibility requirements are complete and approved by the North Carolina Board of Nursing, then the applicant becomes eligible for licensure by examination. Complete the Application for Licensure and submit it to the North Carolina Board of Nursing 2. The National Council of State Boards of Nursing has contracted with Pearson Vue to give the NCLEX examination. Candidates must register to take the NCLEX examination with Pearson Vue Pearson Vue will send an AUTHORIZATION TO TEST (ATT), by email if you have provided an email address on your registration, or else it will be sent by mail. Your ATT will provide instructions on scheduling your examination. You must have your ATT document before you call to make an appointment to take NCLEX examination, and you must take your ATT to be admitted to the test center on the day of your examination.

Application status check for Exam

Applicants can check the status of their NC application for NCLEX here. It will identify that the application has been received, date declared eligible, and date ATT issued.

The initial Application for Licensure by Examination, and the criminal background check will be held active for one year from the date the candidate is determined to be eligible to test. The ATT is valid for 180 days from the date of eligibility. If you do not take NCLEX, and the ATT expires, you will have to re-establish eligibility. NCBON is unable to release NCLEX examination results by telephone. NCBON participates in NCSBN Quick Results Services, where unofficial NCLEX results are available 2 business days following the exam. Candidate will pay a required fee. We do not provide exam results by phone; however, you may verify licensure by our verification system.

Social Security Number Required

Individuals or foreign graduates, who are seeking licensure by examination, must have a valid social security number to be issued a license to practice nursing. While making application for a Social Security number, you may take the NCLEX examination. No license will be issued until proof of the Social Security number is submitted to North Carolina Board of Nursing.

Mailing Address
North Carolina Board of Nursing PO Box 2506 Raleigh, NC 27602

http://www.ncbon.com/dcp/i/licensurelisting-licensure-by-examination-internationally-educatedapplicants

CGFNS
The Commission on Graduates of Foreign Nursing Schools (CGFNS) Certification Program is designed specifically for first-level, general nurses educated and licensed outside the United States who wish to assess their chances of passing the U.S. registered nurse licensing exam, the NCLEX-RN examination, and attaining licensure to practice as registered nurses within the United States. The program is comprised of three parts: a credentials review of the nurse's education, registration, and licensure; the CGFNS Qualifying Exam, a one-day qualifying exam testing nursing knowledge; and, an English language proficiency exam. Upon successful completion of all three elements of the program, the applicant is awarded a CGFNS Certificate. Eligibility The CGFNS Certification Program is designed ONLY for first-level, general nurses educated and/or licensed outside the United States who wish to assess their chances of passing the NCLEX-RN examination and attaining licensure to practice as registered nurses within the United States. In order to be eligible for the program, a nurse must be properly educated and hold both initial and current registration/licensure as a first-level, general nurse as defined historically by the International Council of Nurses (ICN). A first-level nurse is called a registered or professional nurse in most countries. A second-level nurse, often called an enrolled, vocational, practical nurse or nurse assistant, is not eligible to be licensed as a registered nurse in the U.S., and therefore, is not eligible for the Certification Program.

A general nurse must have obtained theoretical instruction and clinical practice in a variety of nursing areas. A nurse who specialized in one area without being educated and registered/licensed as a general nurse is not eligible for the CGFNS Certification Program. Elements of the Program The Certification Program is a three-part program, comprised of a credentials review, a oneday qualifying exam of nursing knowledge, and an English language proficiency exam. Upon successful completion of all three elements of the program, the applicant is awarded a CGFNS Certificate. Credentials Review CGFNS evaluates an applicant's education and registration credentials to certify that the applicant is a first-level, general nurse, and meets all of the registration requirements to be licensed as a professional in the nursing field. Applicants must have: 1. completed a senior secondary school education separate from their nursing education; 2. graduated from a government-approved nursing program of at least two years in length; and 3. received theoretical instruction and clinical practice in nursing care of the adult (including medical and surgical nursing), maternal/infant nursing care, nursing care of children, and psychiatric/mental health nursing. Applicants must have a full and unrestricted license/registration to practice as a first-level, general nurse in the country where they completed their general nursing education, and hold a current license/registration as a first-level, general nurse. Note: All transcripts and validations must come directly from the source agencies. CGFNS Qualifying Exam The CGFNS Qualifying Exam of nursing knowledge is offered during five-day test windows fourtimes a year at more than 600 locations around the world. The exam is divided into two parts with a total of 260 questions. Applicants are given two hours and 30 minutes for Part 1, which includes 150 questions. After breaking for lunch, applicants are given one hour and 50 minutes to complete Part 2, consisting of 110 questions. The Qualifying Exam measures an applicant's nursing knowledge and is based on what nurses must know and do when they practice nursing in the United States. The foundations of the Qualifying Exam are based on patient needs. The traditional clinical areas of nursing practice -- adult nursing care, nursing care of children, maternal/infant nursing, psychiatric/mental health nursing, and community health nursing -- are covered. The exam ensures that an applicant has the same level of understanding of nursing with various client groups, in a number ofsettings, as recent graduates of U.S. schools of nursing. Both the CGFNS Qualifying Exam and the NCLEX-RN examination are based on the same framework of patientneeds because it provides a universal structure for defining nursing actions and competencies across all settings for all patients. English Language Proficiency Exam

Applicants must demonstrate English language proficiency as part of the CGFNS Certification Program by submitting passing scores from an approved testing organization. Currently, applicants may take the Test of English as a Foreign Language (TOEFL),either paper-based or Internet-based, administered by the Educational Testing Service (ETS); the Test of English for International Communication (TOEIC), administered by the Chauncey Group; or, the International English Language Testing System (IELTS), administered by Cambridge ESOL Examinations, the British Council and IDP Education Australia. Applicants must successfully complete one of the English exams (TOEFL, TOEIC or IELTS) and the Qualifying Exam within a two-year period in order for test scores to be considered valid. The English exam may be taken prior to or following the CGFNS Qualifying Exam. The minimum passing scores on each of the English proficiency exams are as follows: TOEFL 540 paper-based, 207computerized, and 83 Internet-based TEOEIC 725 IELTS 6.5 overall Applicants must apply directly with the appropriate testing organization in order to take one of the English language proficiency exams. Exam scores must be forwarded from the appropriate testing organization directly to CGFNS. CGFNS cannot accept test scores sent by the applicant. Program Benefits Employers and organizationswith an interest in selecting candidates who have a high probability of success on the NCLEX-RN examination will find the program highly beneficial. Nurse applicants, U.S. Boards of Registered Nurses, the U.S. Department of Labor, the U.S. Immigration and Naturalization Service, universities, and employers all make use of the CGFNS Certification Program. Attaining a CGFNS Certificate helps applicants in three ways: 1. The certificate will help applicants meet state requirements for the registered nurse licensure exam. Most states require a CGFNS Certificate from nurse educated abroad before they can take the NCLEX-RN examination. 2. CGFNS Certificate holders consistently have a higher rate of success on the NCLEXRN examination than internationally-educated nurses who do not hold a CGFNS Certificate. Passing the CGFNS Qualifying Exam can help applicants to feel reasonably assured of success on the NCLEX-RN examination. 3. The CGFNS Certificate helps applicants to qualify for an occupational visa. CGFNS was named in section 343 of the Illegal Immigration Reform and Immigrant Responsibility Act (IIRIRA) of 1996 as an organization qualified to administer a screening program for healthcare professionals who are seeking an occupational visa. The International Commission on Healthcare Professions (ICHP), a division of CGFNS, developed VisaScreen : Visa Credentials Assessment to m eet the requirements of section 343. For foreign-educated nurses who do not hold a U.S. license by examination, passing a predictor exam, such as the CGFNS Qualifying Exam, is a requirement of section 343.

Credentials Evaluation Service Professional Report

Service Credentials Evaluation Service Professional Report Application Expedited Service Reprocess Application Description For those educated outside the United States pursuing licensure to practice in the United States. Faster review process - after application submission To continue paid in full application for another 12 months (only one reprocess application is accepted after an initial application expires). Additional report prepared after the first one has been issued. Either same as initial recipient or different one. Report to more recipients other than the initial one included in the application English proficiency report included as a state board of nursing requirement Additional license/registration evaluated in addition to the two nonU.S. registrations/licenses Unofficial copy of the report mailed to applicant Fee $350.00

$250.00 $160.00

Click for Details Click for Details Click for Details

Re-evaluation Additional report recipients (each) English language proficiency report Additional license/registration evaluation (each) Duplicate report for applicant (each)

$210.00 $100.00 $85.00 $75.00

Click for Details

$75.00

VISA SCREEN
U.S. immigration law now requires that healthcare professionals, other than physicians, complete a screening program in order to qualify for certain occupational visas. VisaScreen: Visa Credentials Assessment, a program offered by CGFNS's International Commission on Healthcare Professions (ICHP), enables healthcare professionals to meet this requirement by verifying and evaluating their credentials to ensure compliance with the U.S. government's minimum eligibility standards. Applicants who successfully complete the VisaScreen receive a VisaScreen Certificate, which can be presented to a consular office, or in the case of adjustment of status, the attorney general, as part of a visa application. Meeting Federal Requirements Section 343 of the Illegal Immigration Reform and Immigrant Responsibility Act (IIRIRA) of 1996 requires that certain non-U.S. healthcare professionals successfully complete a screening program prior to receiving an occupational visa. Screening includes an assessment of an applicant's education to ensure that it is comparable to that of a U.S. graduate in that same profession, verification that licenses are valid and unencumbered, English language proficiency, and, in the case of nurses, verification that the nurse has either earned a CGFNS Certificate or passed the National Council Licensure Examination for

Registered Nurses (NCLEX-RN examination). The Commission on Graduates of Foreign Nursing Schools (CGFNS) was named in the IIRIRIA as an organization qualified to offer this federal screening program. In response to this legislation, CGFNS created a new division, the International Commission on Healthcare Professions (ICHP), which administers VisaScreen. Program Elements TheVisaScreen program is comprised of an educational analysis, licensure validation, English language proficiency assessment, and, in the case of nurses, an examination of nursing knowledge. Once the applicant has successfully completed all elements of the VisaScreen program, the applicant is awarded a VisaScreen Certificate, which can be presented to a consular office, or in the case of adjustment of status, the attorney general as part of a visa application. Educational Review The educational review ensures that the applicant's education meets all applicable statutory and regulatory requirements for the profession the applicant intends to practice, and verifies that the alien nurses education is comparable to that of a U.S. graduate seeking licensure. In order to meet the educational requirements for the VisaScreen program, applicants must have: 1) Successfully completed a senior secondary school education that is separate from their professional education; 2) Graduated from a government-approved, professional healthcare program of at least two years in length; and 3) Successfully completed a minimum number of clock and/or credit hours in specific theoretical and clinical areas during their professional program*. * Physical therapists must include a self-reported, typed summary of their supervised clinical experience. Licensure Review The licensure review evaluates initial, current, and past licenses. Validations provided directly to ICHP by the issuing/validating institution, affirm that the applicant has completed all practice requirements and that the registration/licensure has no encumbrances. Predictive Examination for Nurses Applicants who wish to obtain an occupational visa to practice as nurses in the United States must present a CGFNS Certificate or a passing score on the NCLEX-RN Examination to provide proof of their nursing knowledge. In order to obtain a CGFNS Certificate, applicants must successfully complete CGFNS's Certification Program, a three-part program, comprised of a credentials review, a one-day

Qualifying Exam of nursing knowledge and an English language proficiency exam. Upon successful completion of all three elements of the program, applicants are awarded a CGFNS Certificate. Most states require the CGFNS Certificate from nurses educated abroad before they can take the NCLEX-RN examination. Program Benefits Applicants who successfully complete the VisaScreen program will receive a VisaScreen Certificate. The VisaScreen Certificate, which satisfies all federal screening requirements as set forth in section 343 of the IIRIRA, can then be presented to a consular office or, in the case of adjustment of status, the attorney general as part of a visa application. ICHP, through its parent company, CGFNS, was named in section 343 as a qualified provider of such a screening program.

VisaScreen: Visa Credentials Assessment

Service VisaScreen Application Reprocess Application Renewal Application Expedited Review Service Certificate Verification Letter Replacement Certificate Description Initial VisaScreen application. Includes VisaScreen Certificate Reprocess an existing, expired VisaScreen application Renewal application for an expired VisaScreen Certificate Expedited review within five business days of receiving all required documents. VisaScreen Certificate mailed with next day express mail delivery. Designated recipient receives an official letter that applicant was issued a VisaScreen certificate. Allow 10 business days for delivery Replace an original VisaScreen Certificate. Limit one (1) per applicant Fee $540.00 $175.00 $275.00 $500.00 Click for Details Click for Details Click for Details Click for Details Click for Details

$100.00

$150.00

Time limits for applications and payment

Applicants applying for the following services are given 12 months to meet the requirements of an order.

CGFNS Certification Program, the Credentials Evaluation Service VisaScreen: Visa Credentials Assessment Orders will expire within 12 months if:

Applicant is not rostered to take the CGFNS Qualifying Exam for the Certification Program A Credentials Evaluation Service report has not been issued An ICHP VisaScreen certificate has not been issued Fee payment(s) has not been received in full If a paid in full application expires an applicant has up to 12 months to apply for a reprocess (another 12 months on that application) and fully pay the reprocess fee. Only one reprocess application is accepted after an initial application expires. Applicant does not qualify for reprocess it the order iss not paid in full, or if fees paid were applied to previous services, and the initial application order expires. A new application must be submitted and and paid in full to have 12 months to process the application and complete all the requirements. The subsequent 12 months begins when we receive the new application.

NCLEX
The National Council License Exam (NCLEX) is a test that each nurse must pass in order to obtain a license to practice nursing in the state where they will work. In the U.S., licensing is under the authority of each individual state, not the federal government. Nurses cannot apply directly to the NCLEX, but must apply through one of the states. Unlike the CGFNS exam, the NCLEX-RN exams can only be taken within the U.S., including Guam or Saipan. Although the CGFNS exam certificate will allow for the filing of the I-140 with a U.S. employer sponsor, some U.S. employers will require that the nurse pass the NCLEX prior to departing and arriving in the U.S. to start employment. At one point in the past, the CGFNS web site asserted that the foreign educated nurses who obtained a passing score on the CGFNS exam werepredicted to have an 85% probability of passing the NCLEX. However, U.S. employers are learning that these claims are questionable. In fact, the published statistics from the NCLEX indicated that foreign educated nurses pass NCLEX at a rate of about 40%. The NCLEX requires knowledge of the nursing role within the U.S. as well as the role of personnel such as LPNs. This will be a challenge to a foreign-educated nurse who has not worked in a U.S. hospital or is not familiar with the U.S. healthcare system. The NCLEX is a Computer Adaptive Test. The NCLEX is a unique test of experience which uses advanced computer programming,allowing the test to increase levels of difficulty for the individual test-taker, depending upon correct and incorrect responses to various questions. States Requirements for Foreign Educated Nurses Each state has unique laws and regulations for Registered Nurses (RNs). Differences are apparent between states in requirements for foreign educated nurses. Most states require that a foreign educated nurse have passed the CGFNS exam in order to apply to take the NCLEX exam. The following states

maintain this requirement: Alabama, Alaska, Arizona, Colorado, Connecticut, District of Columbia, Florida, Georgia, Hawaii, Idaho, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maine, Maryland, Massachusetts, Michigan, Minnesota, Missouri, Montana, Nebraska, New Hampshire, New Jersey, North Carolina, North Dakota, Oklahoma, Pennsylvania, Rhode Island, South Carolina, South Dakota, Texas, Vermont, Virginia, Washington, West Virginia, and Wyoming. Nurses who have passed the NCLEX-RN in states that do not require CGFNS may acquire the nursing license of another state through endorsements. Each state's Board of Nursing has its web site that lists the requirements on endorsement.