Ghana N&MC Regulatory Eligibility and Exam Process
Not publishedof exam
Professional Practice and Patient Safety
Not publishedof exam
Adult Nursing and Emergency Care
Not publishedof exam
Maternal, Child, Community and Mental Health
Not publishedof exam
Quick Facts
- Exam
- N&MC Ghana Licensing
- Regulator
- N&MC Ghana
- Cadres
- Nurse, Midwife, Assistant
- Items
- Not published
- Time limit
- Not published
- Pass mark
- Not published
- Credential
- PIN or AIN
- Retakes
- Unlimited resits
- Windows
- 4 sittings per year
- Basic fee
- GHc 640
PIN vs AIN
PIN
- Nurse and midwife ID
- Basic/Post-Basic graduates
AIN
- Auxiliary candidate ID
- NAC/NAP graduates
Cadre determines the ID
Legal Basis
- Act 857
- Created N&MC Ghana 2013
- Act 857 Part III
- N&MC's regulatory part
- L.I. 683 (1971)
- Scope of Practice basis
- N&MC object
- Highest training and practice standards
- Sibling councils
- Medical, Pharmacy, Allied Health, Psychology
- SoP review cycle
- Every three to five years
Basic vs Auxiliary Programme
Basic Programme
- RGN, RM, RMN cadres
- Fee GHc 640
Auxiliary Programme
- NAC, NAP cadres
- Fee GHc 401.50
Different fee tier, different ID
Cadres and Programmes
- Basic Programme
- RGN, RM, RMN cadres
- Basic specialty cadres
- Community, Public Health, Paediatric Nursing
- Post-Basic Programme
- One-year specialty courses
- Auxiliary NAC
- Nurse Assistant, Clinical
- Auxiliary NAP
- Nurse Assistant, Preventive
- Foreign Trained route
- Credential review then written exam
Registration Outcomes
- PIN
- Nurse/Midwife registration number
- AIN
- Auxiliary registration number
- Certificate of registration
- Issued with PIN or AIN
- College exam
- School-level exam before Council
- Council exam
- N&MC's licensing exam itself
- Eligibility fee
- Required before sitting exam
Exam Windows and Format
- Feb/Mar window
- Annual sitting one
- Jun/Jul window
- Annual sitting two
- August window
- Annual sitting three
- Nov/Dec window
- Annual sitting four
- Foreign Trained sitting
- June and December only
- Online licensing exam
- Computer-based, accredited centres
Fees and Resits
- Basic exam fee
- GHc 640 whole exam
- Post-Basic exam fee
- GHc 495 whole exam
- Auxiliary exam fee
- GHc 401.50 whole exam
- Foreign Trained fee
- GHc 569 whole exam
- Results-check fee
- GHc 13, every candidate
- Resit fee range
- GHc 213 to 640
SBAR Handover
Situation, Background, Assessment, Recommendation
Situation: what's happeningBackground: relevant historyAssessment: your findingRecommendation: your ask
Escalation and Delegation Picker
- Task fits assistant's training→Delegate to assistant(Delegator stays accountable)
- Task needs clinical judgement→Nurse or midwife only(Do not delegate)
- Suspected abuse or neglect→Protect, then escalate(Report per policy)
- Handing over a patient→Use SBAR format(Situation to recommendation)
- About to give medicine→Check all 5 rights(Then document promptly)
- Before touching any patient→Clean hands first(WHO moment one)
Ethics and Consent
- Code of Ethics
- Council's conduct standard
- Informed consent
- Voluntary agreement after explanation
- Confidentiality
- Share only need-to-know info
- Documentation rule
- Accurate, timely, objective
- Safeguarding duty
- Protect, document, then escalate
- Scope of Practice
- Independent, dependent, interdependent duties
5 Rights of Medication
Patient, drug, dose, route, time
Right patient: 2 IDsRight drug: match orderRight dose: match chartRight time: match schedule
WHO Hand Hygiene Moments
- Moment 1
- Before touching a patient
- Moment 2
- Before an aseptic task
- Moment 3
- After body-fluid exposure risk
- Moment 4
- After touching a patient
- Moment 5
- After touching surroundings
- Standard precautions
- Applies to every patient
Communication and Medication
- SBAR-S
- Situation
- SBAR-B
- Background
- SBAR-A
- Assessment
- SBAR-R
- Recommendation
- Delegation rule
- Delegator stays accountable
- 5 Rights
- Patient, drug, dose, route, time
ABC Priority
Airway, then Breathing, then Circulation
Airway firstBreathing secondCirculation third
Hypovolemic vs Septic Shock
Hypovolemic
- Fluid or blood loss
- Give volume replacement
Septic
- Infection, vasodilation
- Fluids plus antibiotics
Same low BP, different cause
Shock Type Picker
- Trauma with bleeding, fast pulse→Hypovolemic shock(Replace volume first)
- Infection, warm skin, low BP→Septic shock(Fluids plus antibiotics)
- Allergen exposure, airway swelling→Anaphylactic shock(Give IM adrenaline)
- Spinal injury, slow pulse→Neurogenic shock(Fluids plus vasopressor)
- qSOFA 2 or more signs→High sepsis risk(Escalate care urgently)
- Shock suspected, unclear cause→Reassess ABC first(Call senior help)
ABC and Consciousness
- Airway
- Assessed first always
- Breathing
- Assessed second always
- Circulation
- Assessed third always
- GCS range
- 3 to 15 total
- GCS parts
- Eye, Verbal, Motor scores
- GCS severity
- Mild 13-15, severe 3-8
GCS Eye Verbal Motor
Eye 1-4, Verbal 1-5, Motor 1-6
Eye: 4 maxVerbal: 5 maxMotor: 6 maxTotal: 3 to 15
Anaphylactic vs Neurogenic Shock
Anaphylactic
- Severe allergic reaction
- IM adrenaline first
Neurogenic
- Spinal cord injury
- Slow heart rate
Fast pulse vs slow pulse
Pressure Injury Stage Picker
- Intact skin, redness only→Stage 1(Non-blanchable, prevent now)
- Shallow ulcer or blister→Stage 2(Partial thickness loss)
- Fat visible, no bone→Stage 3(Full thickness loss)
- Muscle, tendon, bone exposed→Stage 4(Deepest tissue loss)
- Wound base hidden, slough→Unstageable(True depth unknown)
- Intact skin, deep discoloration→Deep tissue injury(Damage below surface)
Shock Types
- Hypovolemic shock
- Fluid loss, give volume
- Septic shock
- Infection, fluids plus antibiotics
- Anaphylactic shock
- Allergic, IM adrenaline first
- Neurogenic shock
- Spinal injury, slow pulse
- qSOFA cutoff
- 2 or more signs
- qSOFA signs
- RR, low BP, GCS
WHO Surgical Safety Checklist
Sign In, Time Out, Sign Out
Sign In: before anaesthesiaTime Out: before incisionSign Out: before leaving
Unstageable vs Deep Tissue Injury
Unstageable
- Slough or eschar covers wound
- True depth unknown
Deep tissue injury
- Intact or broken skin
- Deep purple discoloration
Hidden depth vs hidden damage
Skin and Safety Checks
- Stage 1
- Non-blanchable redness only
- Stage 2
- Shallow ulcer or blister
- Stage 3
- Fat visible, no bone
- Stage 4
- Muscle, tendon, bone exposed
- Unstageable
- Depth hidden by slough
- Deep tissue injury
- Intact skin, deep discoloration
- Falls risk factors
- Age, mobility, sedating drugs
- Transfusion check
- ID, group, watch reactions
Hypoglycemia vs Hyperglycemia
Hypoglycemia
- Fast onset, sweating, shaky
- Needs prompt glucose
Hyperglycemia
- Slow onset, thirst, urination
- Fruity breath if severe
Fast drop vs slow rise
Glucose and Theatre Safety
- Hypoglycemia signs
- Sweating, shaky, confused, fast pulse
- Hyperglycemia signs
- Thirst, urination, fruity breath
- Sign In
- Before anaesthesia checks
- Time Out
- Before incision checks
- Sign Out
- Before leaving theatre
AMTSL Steps
Oxytocin within 1 minute, then cord traction
10 IU oxytocin IMWithin 1 minute of birthControlled cord traction next
Ghana vs WHO PPH Threshold
Ghana threshold
- 500 mL or more blood
- Any deteriorating condition
WHO 2025 trigger
- 300 mL plus abnormal vitals
- Earlier action point
WHO adds an earlier trigger
Danger Sign Escalation Picker
- Bleeding 500 mL or more→Treat as PPH(Start emergency protocol)
- BP 140/90 after 20wks→Pre-eclampsia workup(Check urine protein)
- FHR under 120, irregular→Possible fetal distress(Needs urgent review)
- Newborn breathing under 30→Danger sign, newborn(Give oxygen, refer)
- Labour crosses action line→Decide intervention now(Augment or deliver)
- Heavy bleeding after birth→Postpartum danger sign(Needs urgent care)
Antenatal and Postpartum Signs
- Antenatal bleeding
- Danger sign, urgent review
- Severe headache/blurred vision
- Possible pre-eclampsia sign
- Absent fetal movement
- Antenatal danger sign
- Postpartum heavy bleeding
- Danger sign after birth
- Postpartum convulsions
- Danger sign after birth
- Foul-smelling discharge
- Postpartum infection sign
Alert Line vs Action Line
Alert line
- Start of active labour
- Expected progress pace
Action line
- 4 hours right of alert
- Decide intervention now
Crossing action line means act
PPH and AMTSL
- Ghana PPH threshold
- 500 mL or more
- WHO 2025 PPH trigger
- 300 mL plus abnormal vitals
- AMTSL oxytocin
- 10 IU IM, one minute
- AMTSL next step
- Controlled cord traction
Antenatal vs Postpartum Danger Signs
Antenatal
- Swelling, headache, bleeding
- Absent fetal movement
Postpartum
- Heavy bleeding, convulsions
- Foul discharge, wound pain
Timing before vs after birth
APGAR and Partograph
- APGAR components
- Colour, HR, reflex, tone, respiration
- APGAR timing
- 1 and 5 minutes
- APGAR range
- 0 to 10 total
- APGAR reassuring
- 7 to 10 score
- Partograph alert line
- Start of active labour
- Partograph action line
- 4 hours right of alert
Newborn Care and Immunisation
- Eye prophylaxis
- Within 1-2 hours of birth
- Vitamin K under 2kg
- 0.5 mg IM dose
- Vitamin K 2kg or more
- 1.0 mg IM dose
- TT2 protection
- 1 to 3 years
- TT5 protection
- Lifelong protection
- Exclusive breastfeeding
- 6 months, breastmilk only
Fetal Distress and Mental Health
- Abnormal FHR
- Below 120 or irregular
- Abnormal newborn breathing
- Under 30 or 60+
- Pre-eclampsia threshold
- 140/90 after 20 weeks
- Severe pre-eclampsia
- Diastolic 110+ or proteinuria 3+
- Mental Health Act 846
- Voluntary and involuntary admission
- Review Tribunal
- Reviews involuntary admissions
Common Traps
500 mL vs 300 mL Trigger
Ghana PPH is 500 mL ≠ WHO 2025 trigger is 300 mL
PIN vs AIN Confusion
PIN is nurse or midwife ≠ AIN is auxiliary only
Alert Line vs Action Line
Alert line starts tracking ≠ Action line means intervene
Blanchable vs Non-Blanchable Redness
Blanching fades on pressure ≠ Stage 1 does not fade
Unlimited Resits, Not Unlimited Fee
Resits have no attempt limit ≠ Fees rise per failed paper
College Exam vs Council Exam
College exam is school-level ≠ Council exam is the licensing test
Vitamin K Dose by Weight
Under 2kg gets 0.5 mg ≠ 2kg+ gets 1.0 mg
Basic Fee vs Auxiliary Fee
Basic whole exam costs GHc640 ≠ Auxiliary whole exam costs GHc401.50
Last Minute
- 1.No published item count exists
- 2.PIN = nurse/midwife; AIN = auxiliary
- 3.Resits unlimited; fees rise per paper
- 4.Four exam windows each year
- 5.ABC assessed before anything else
- 6.GCS scale ranges 3 to 15
- 7.PPH = 500 mL Ghana threshold
- 8.AMTSL: oxytocin then cord traction
- 9.Vitamin K dose depends on weight
- 10.Action line is 4h past alert
- 11.Pre-eclampsia needs BP plus protein
- 12.Check all 5 rights before giving
- 13.Foreign trained exam sits June December
- 14.Clean hands before every patient contact
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