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Free Practice Questions for Nursing Qualification Level Assessment (Kazakhstan)

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Key Facts: Nursing Qualification Level Assessment (Kazakhstan) Exam

100 Questions

Stage 1 computer-based knowledge test single-best-answer MCQs

NCIE qualification levels page (qazexam.kz)

100 Minutes

Stage 1 knowledge assessment duration without a break

NCIE qualification levels page (qazexam.kz)

60 Points

Stage 1 passing score threshold required to proceed to case testing

NCIE qualification levels page (qazexam.kz)

5 Cases / 90 Min

Stage 1 case testing situational tasks, threshold 60% per task

NCIE qualification levels page (qazexam.kz)

17,700 KZT

Total fee for clinical secondary and post-secondary medical specialists

NCIE specialist price list, Section IV.2, effective 10 January 2026

210 Credits

Continuous professional development (CPD) units required for level assignment

Order No. ҚР ДСМ-283/2020 of the Minister of Health of RK

2 Delivery Languages

Specialist assessment conducted in Kazakh and Russian

Rules for assessing professional preparedness of specialists, paragraph 4 (Appendix 3 to Order No. ҚР ДСМ-249/2020)

Qualification level assignment for nurses in Kazakhstan is administered by NCIE under Order No. ҚР ДСМ-283/2020. Stage 1 involves 100 multiple-choice questions in 100 minutes (60-point threshold) followed by 5 case-testing tasks in 90 minutes (60% threshold), followed by Stage 2 portfolio review. This OpenExamPrep bank provides 100 English-language practice questions as an independent study aid.

Sample Nursing Qualification Level Assessment (Kazakhstan) Practice Questions

Try these sample questions to review concepts for the Nursing Qualification Level Assessment (Kazakhstan) exam. Each question includes a detailed explanation. Start the interactive quiz above for the full 100+ question experience with AI tutoring.

1A ward nurse receives a written medication order in which the prescribed dose is ten times the usual dose for that drug. The prescriber has left the department and is not answering the telephone. What does professional deontology and the nurse's own legal responsibility require?
A.Administer the dose exactly as written, because responsibility for the prescription rests entirely with the prescriber
B.Withhold administration, escalate immediately to the senior nurse and the duty physician, document the query and the response, and administer only once the order has been clarified or corrected in writing
C.Administer the usual dose the nurse believes was intended and correct the figure on the prescription sheet afterwards
D.Omit the drug silently, make no entry in the record, and wait for the prescriber to notice at the next round
Explanation: A nurse who administers a medicine shares responsibility for that administration and cannot discharge it by pointing to the prescription. Where an order is unclear, implausible or apparently erroneous, the duty is to stop, escalate through the chain (senior nurse, duty physician), and document both the query and the answer. Neither silent compliance nor silent omission is acceptable: compliance risks a tenfold overdose, while unrecorded omission leaves the patient untreated and the record false.
2A nurse realises that they have just given a patient a medicine intended for the patient in the next bed. The patient currently shows no adverse effect. What does professional deontology require the nurse to do?
A.Say nothing, observe the patient quietly, and record the incident only if symptoms appear
B.Report the error immediately to the senior nurse and duty physician, stay with the patient and monitor for effects of the drug given and for the omission of the intended one, make a factual entry in the record and the incident report, and inform the patient
C.Enter the drug on the other patient's chart so that the stock count and the documentation agree
D.Tell the patient that the medicine was an additional vitamin so as not to alarm them, and notify no one
Explanation: Deontology and patient-safety practice require prompt, factual and complete disclosure of a medication error, whether or not harm has occurred. Two patients are now affected: one received a drug not prescribed for them, and the other has not received their prescribed drug, so both need clinical review. The record must describe what actually happened; falsifying documentation to reconcile stock is a separate and more serious breach. Incident reporting exists to find the system weakness that allowed the error, which only works if errors are reported even when no harm results.
3According to Article 137 of Code No. 360-VI ЗРК of the Republic of Kazakhstan, in which situation is emergency medical assistance permitted to be provided to an adult patient WITHOUT their informed consent?
A.Whenever an attending physician deems a non-urgent diagnostic blood test clinically desirable
B.When the patient is unconscious or in shock and cannot express their will, and delayed treatment poses an immediate threat to life
C.Whenever a family member expresses disagreement with the patient's personal choice of therapeutic regimen
D.When an adult patient with full decision-making capacity explicitly refuses emergency intervention in writing
Explanation: Under Article 137 of the Code, medical care without informed consent is permitted when a patient is in a condition that prevents them from expressing their will (such as coma, shock, or severe acute impairment) and there is an immediate threat to life. The decision is made by a consultation of doctors, or if a consultation cannot be assembled in time, directly by the emergency medical professional, followed by notification of officials and relatives.
4Under the Sanitary Rules 'Sanitary-epidemiological requirements for healthcare facilities' approved by Order of the Minister of Health of the Republic of Kazakhstan No. ҚР ДСМ-96/2020, into which waste class do used needles and blood-soaked dressings from a general surgical ward belong, and into which class do the same items belong when they arise in a tuberculosis or infectious-disease department?
A.Class А (non-hazardous, comparable to municipal solid waste) in both situations
B.Class Б (epidemiologically hazardous) in the general surgical ward, and Class В (extremely epidemiologically hazardous) when they arise in a tuberculosis or infectious-disease department
C.Class В in the general surgical ward, and Class Б in the tuberculosis department
D.Class Г (toxicologically hazardous) in both situations, because sharps are classed with chemical waste
Explanation: Healthcare waste in Kazakhstan is divided into five classes: А — non-hazardous, similar to municipal solid waste, collected in white bags; Б — epidemiologically hazardous (sharps and materials contaminated with blood and body fluids), collected in yellow puncture-resistant containers and bags; В — extremely epidemiologically hazardous, which covers waste associated with pathogens of the first and second groups and waste from tuberculosis and infectious-disease departments, collected in red containers; Г — toxicologically hazardous (expired medicines, disinfectants, cytostatics, mercury-containing devices); Д — radioactive. The same physical item therefore changes class according to the department it comes from, which is why the source unit must be recorded when waste is segregated.
5Which of the following interventions represents the single most effective standard precaution measure for preventing the transmission of healthcare-associated infections (HAI) in inpatient medical facilities in Kazakhstan?
A.Routine prophylactic administration of broad-spectrum antibiotics to all hospitalized patients
B.Performing compliant hand hygiene with alcohol-based rub or soap according to the WHO '5 Moments' framework
C.Wearing sterile gloves continuously during all non-contact nursing documentation and rounds
D.Relying on scheduled ultraviolet air irradiation of the ward instead of hand hygiene between patients
Explanation: Adhering to hand hygiene protocols using alcohol-based hand rub or soap and water according to the WHO '5 Moments for Hand Hygiene' is universally recognized in Kazakhstan infection control standards as the single most critical and evidence-based practice to interrupt pathogen transmission and prevent HAIs. Prophylactic antibiotics and unindicated continuous glove use promote resistance and skin breakdown.
6A patient whose biopsy has just confirmed a malignancy asks the ward nurse directly what the histology report says. The attending physician has not yet spoken to the patient. Under the deontological norms of nursing practice and the disclosure rules of the Code 'On Public Health and Healthcare System', how should the nurse respond?
A.Read the histology conclusion aloud so that the patient is not kept in ignorance of their own data
B.Acknowledge the patient's concern, confirm that the results have arrived, explain that the diagnosis is communicated by the attending physician, and arrange that conversation without delay
C.State that no results have been received yet, so that the patient is spared distress until the doctor is free
D.Decline to discuss anything with the patient and pass the information to relatives instead
Explanation: Communicating a diagnosis is the attending physician's competence, but nursing deontology forbids deceiving the patient or ignoring the question. The nurse stays truthful within their own scope: they confirm that results exist, explain who will discuss them and when, stay with the patient, and escalate to the physician so the conversation happens promptly. Under the Code, information about health status is given first to the patient themselves; relatives receive it only with the patient's agreement or where the patient cannot express their will.
7A patient admitted to a general therapeutic ward reports intense itching that is worst at night, and the nurse finds thin greyish burrows with paired papulovesicles in the interdigital web spaces and on the flexor wrists. Scabies (қотыр / чесотка) is confirmed. Which set of nursing measures is required?
A.No isolation is needed; apply an antipruritic cream to the visibly affected fingers only
B.Place the patient in a separate room, apply the prescribed scabicide to the whole body surface below the neck after a warm shower and leave it on for the prescribed time, change and heat-process all bed linen and underwear, and arrange examination and simultaneous treatment of household and ward contacts
C.Continue treatment in the shared ward and disinfect only the mattress, since scabies is transmitted exclusively through bedding
D.Start a systemic antibiotic and discharge the patient without contact examination
Explanation: Sarcoptes scabiei is transmitted by prolonged direct skin-to-skin contact and, less often, through shared linen. Control therefore has three inseparable parts: separating the patient until treatment is completed, applying the scabicide to the entire body below the neck (not only to visible lesions, because mites are present in clinically normal skin), and treating all close contacts at the same time while heat-processing linen and clothing. Treating only the visible lesions or only the patient reliably produces reinfestation.
8A patient attending a dermatovenereological dispensary has a single painless, firm, indurated ulcer on the genitalia with painless regional lymph node enlargement, and treponemal serology is positive for primary syphilis. What are the nurse's correct responsibilities in this case?
A.Keep the finding entirely within the dispensary, undertake no notification, and rely on the patient to inform partners
B.Place the patient in a negative-pressure airborne isolation room and wear a particulate respirator for all contact
C.Observe standard precautions with gloves when handling lesion exudate and specimens, submit the statutory emergency notification for a sexually transmitted infection, and assist the physician with confidential partner identification, examination and treatment
D.Advise the patient that treatment can be deferred because the chancre heals on its own within a few weeks
Explanation: Syphilis is a notifiable sexually transmitted infection in Kazakhstan: an emergency notification goes to the territorial sanitary-epidemiological control unit, and partner (contact) work is a core part of the dispensary's response. Clinically the organism is transmitted by direct contact with lesion exudate and by blood, so standard precautions with gloves are sufficient; airborne isolation has no role. Spontaneous healing of the primary chancre does not mean cure, because untreated infection progresses to secondary and tertiary stages.
9During an evening shift in a psychiatric department a patient tells the nurse that they intend to end their life and describes a specific method and time. Which nursing action takes priority?
A.Move the patient to a quiet single room alone so that reduced stimulation can settle the crisis
B.Agree to keep the disclosure confidential from the treating team, to preserve the patient's trust
C.Institute continuous observation, remove objects that could be used for self-harm from the patient's access, notify the attending psychiatrist immediately, and record the content of the disclosure and the risk assessment
D.Tell the patient that such statements are attention-seeking and resume routine duties
Explanation: A disclosed suicidal plan with a stated method and timing indicates high, immediate risk. Nursing priority is physical safety plus escalation: uninterrupted observation, removal of means (belts, cords, sharps, glass, hoarded medication), immediate notification of the psychiatrist, and accurate documentation of exactly what the patient said. Risk of harm to self is one of the recognised limits on confidentiality, so the disclosure must be shared with the treating team.
10A patient receiving haloperidol for an acute psychotic episode develops a temperature of 39.5 °C, generalised 'lead-pipe' muscle rigidity, fluctuating consciousness, tachycardia, labile blood pressure and profuse sweating over about 24 hours. What should the nurse suspect, and what is the correct immediate response?
A.An expected sedative effect of the antipsychotic; continue the prescribed dose and reassure the patient
B.Neuroleptic malignant syndrome; withhold the next antipsychotic dose pending urgent medical review, summon the doctor immediately, monitor temperature, pulse, blood pressure, consciousness and urine output, and begin physical cooling and rehydration as prescribed
C.Isolated acute dystonia; apply a warm compress to the neck and reassess on the next round
D.A febrile respiratory infection; give an antipyretic, continue the antipsychotic unchanged, and review in the morning
Explanation: The combination of hyperthermia, severe generalised rigidity, altered consciousness and autonomic instability in a patient on an antipsychotic is neuroleptic malignant syndrome, a life-threatening reaction with a real mortality risk. Nursing action is to stop further exposure to the drug pending medical decision, escalate immediately, and support the patient with intensive monitoring, active cooling and fluid replacement; rhabdomyolysis with acute kidney injury is the main complication, so urine output and colour matter.

About the Nursing Qualification Level Assessment (Kazakhstan) Exam

The Nursing Qualification Level Assessment (Оценка уровней квалификации по специальности «Сестринское дело») is the national professional examination in Kazakhstan for assigning and confirming qualification levels to nurses and specialists with secondary and post-secondary medical education. Introduced under the Code 'On Public Health and Healthcare System' No. 360-VI ЗРК and Order No. ҚР ДСМ-283/2020 to replace the former qualification categories, the assessment is administered by the National Center for Independent Examination (НЦНЭ / ҰТЕО). Stage 1 consists of 100 computer-based multiple-choice questions in 100 minutes (threshold 60 points), followed immediately by case testing of 5 clinical situational tasks in 90 minutes (threshold 60% per task). Stage 2 is an expert commission assessment of CPD credits and a 3-year clinical practice report. A distinct certification pathway ('Сертификация Врачей и СМР') applies to nurses with breaks over three years or foreign training. The official assessment is delivered in Kazakh and Russian. This is an independent OpenExamPrep study resource: 100 English-language multiple-choice practice questions distributed across the section weights of the published NCIE 'Сестринское дело' specification. It is an English-language MCQ study adaptation, not an official translation, not an NCIE item release, and it does not reproduce the case-testing environment or substitute for the Stage 2 portfolio and competency review.

Exam sponsor: Ministry of Healthcare of the Republic of Kazakhstan; assessment administered by the National Center for Independent Examination (НЦНЭ / ҰТЕО); qualification level certificates registered via elicense.kz. The requirements and fees below concern the certification or admission exam, separate from our free practice resources.

Assessment

The qualification level assessment for healthcare specialists is governed by Order of the Minister of Health of the Republic of Kazakhstan No. ҚР ДСМ-283/2020 and is administered by the National Center for Independent Examination (НЦНЭ / ҰТЕО). For assignment of a level, candidates pass two consecutive stages. Stage 1 has two parts: first, a computer-based knowledge test of 100 multiple-choice questions in 100 minutes without a break, scored 1 point per correct answer, with a threshold of 60 points (60%); second, for candidates who pass the knowledge threshold, case testing on the same day comprising 5 clinical situational tasks in 90 minutes, with items weighted by complexity and a threshold of 60% correct per task. An in-test appeal can be lodged during computer testing. Specialists who fail may re-sit no earlier than 3 working days. Stage 2 is a remote competency evaluation by a 5-member NCIE expert commission reviewing continuous professional development (210 credits), a 3-year performance report of labour functions, and professional recommendations, with a threshold of 60% of criteria. Confirmation of an existing level requires Stage 2 only. Qualification levels replaced the former five-year second, first, and highest qualification categories under the 2020 Health Code.

Time Limit

100 minutes (Stage 1 knowledge test) + 90 minutes (Stage 1 case testing)

Passing Score

60 points out of 100 (60%) on Stage 1 knowledge test; 60% per task on case testing; 60% of criteria on Stage 2

Exam / Certification Fees

Under Section IV.2 of the NCIE price list effective 10 January 2026, specialists with secondary and post-secondary medical education in clinical specialities pay 5,600 KZT for Stage 1 knowledge testing, 8,800 KZT for Stage 1 case testing, and 3,300 KZT for Stage 2 competency assessment, totaling 17,700 KZT. Under Section V.2, specialists whose qualification category expired after 1 January 2021 and who claim the equivalent level pay 13,600 KZT.

Exam sponsor website

Fees, eligibility, and exam policies can change. Confirm them with the exam sponsor before applying or paying.

Official sources

Our practice resources: topics covered

We aim to reflect publicly available exam outlines and topic information in our study resources. Coverage, format, and difficulty may differ from the actual exam, and we cannot guarantee that every detail is accurate or current. Confirm exam requirements, fees, and policies with the official exam sponsor.

10%

Provision of emergency and urgent care to patients

BLS and CPR parameters, automated external defibrillation, anaphylaxis, choking in adults and infants, hypovolaemic shock, diabetic emergencies, and burn first aid.

10%

Sanitary-hygienic regime and epidemiological safety

Hand hygiene, healthcare waste classes А to Д under Order No. ҚР ДСМ-96/2020, instrument reprocessing and pre-sterilization cleaning control, transmission-based precautions, PPE doffing, and needle-stick exposure.

18%

Nursing in therapy

Dynamic follow-up of chronic non-communicable diseases, national adult cancer screening under Order No. ҚР ДСМ-174/2020 as amended in 2025, and patient education in health schools.

18%

Nursing in pediatrics

IMCI danger signs and classifications, the national vaccination schedule under Government Decree No. 612, infant feeding and growth monitoring, weight-based dosing, and rehydration plans.

18%

Nursing in surgery and resuscitation

Preoperative and postoperative care, surgical asepsis and dressings, drains and stoma care, burn surface estimation, compartment syndrome, transfusion observation, and high-alert intravenous medicines.

10%

Nursing in obstetrics and gynecology

Preeclampsia criteria and magnesium sulfate monitoring, stages of labour, active management of the third stage, immediate newborn care, postpartum haemorrhage, and postpartum mental health.

2%

Nursing in dermatovenereology

Scabies management and contact treatment, and notification and partner examination for sexually transmitted infections.

2%

Nursing in psychiatry

Suicide risk and continuous observation, and recognition of neuroleptic malignant syndrome.

2%

Nursing in neurology

Acute stroke recognition and time last seen well, and safe management of a generalised tonic-clonic seizure.

2%

Nursing in ophthalmology

Eye drop instillation technique, and acute angle-closure glaucoma with the contraindication to mydriatics.

2%

Nursing in otorhinolaryngology

Anterior epistaxis first aid, and ear drop instillation with the age-dependent auricle manoeuvre.

2%

Nursing in the infectious diseases hospital and phthisiology

Tuberculosis infection control under Order No. ҚР ДСМ-214/2020 and the tuberculosis sanitary rules, and diagnostic sputum collection.

4%

Ethics and deontology in nursing

Responsibility for a questionable medication order, disclosure of medication errors, patient rights and emergency care without consent, and the nursing-medical competence boundary.

Preparing for the Nursing Qualification Level Assessment (Kazakhstan) Exam

What You Need to Know

  • Passing score: 60 points out of 100 (60%) on Stage 1 knowledge test; 60% per task on case testing; 60% of criteria on Stage 2
  • Assessment: The qualification level assessment for healthcare specialists is governed by Order of the Minister of Health of the Republic of Kazakhstan No. ҚР ДСМ-283/2020 and is administered by the National Center for Independent Examination (НЦНЭ / ҰТЕО). For assignment of a level, candidates pass two consecutive stages. Stage 1 has two parts: first, a computer-based knowledge test of 100 multiple-choice questions in 100 minutes without a break, scored 1 point per correct answer, with a threshold of 60 points (60%); second, for candidates who pass the knowledge threshold, case testing on the same day comprising 5 clinical situational tasks in 90 minutes, with items weighted by complexity and a threshold of 60% correct per task. An in-test appeal can be lodged during computer testing. Specialists who fail may re-sit no earlier than 3 working days. Stage 2 is a remote competency evaluation by a 5-member NCIE expert commission reviewing continuous professional development (210 credits), a 3-year performance report of labour functions, and professional recommendations, with a threshold of 60% of criteria. Confirmation of an existing level requires Stage 2 only. Qualification levels replaced the former five-year second, first, and highest qualification categories under the 2020 Health Code.
  • Time limit: 100 minutes (Stage 1 knowledge test) + 90 minutes (Stage 1 case testing)
  • Exam / certification fees: Under Section IV.2 of the NCIE price list effective 10 January 2026, specialists with secondary and post-secondary medical education in clinical specialities pay 5,600 KZT for Stage 1 knowledge testing, 8,800 KZT for Stage 1 case testing, and 3,300 KZT for Stage 2 competency assessment, totaling 17,700 KZT. Under Section V.2, specialists whose qualification category expired after 1 January 2021 and who claim the equivalent level pay 13,600 KZT. Official sources

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Nursing Qualification Level Assessment (Kazakhstan): Suggested Study Strategy

1Familiarize yourself with the 60-point threshold for Stage 1 knowledge testing and the 60% threshold per situational case in case testing; falling below 60 points on knowledge testing bars admission to case testing.
2Review the key provisions of Health Code No. 360-VI ЗРК, particularly informed consent in written form for invasive procedures (Article 134), patient refusal rules (Article 136), emergency care without consent (Article 137), and medical confidentiality exceptions (Article 273).
3Memorize the Kazakhstan vaccination schedule from Government Decree No. 612: BCG and the first hepatitis B dose both in the 1-to-4-day row, the pertussis-diphtheria-tetanus, Hib and polio components at 2, 3 and 4 months, pneumococcal at 2 and 4 months, and measles-rubella-mumps at 12-15 months and again at 6 years. Do not transplant timings from neighbouring countries.
4Master the IMCI (Integrated Management of Childhood Illness / БАЖБ) general danger signs: inability to drink or breastfeed, vomiting everything, convulsions, and lethargy or unconsciousness.
5Know the exact BLS CPR parameters: 30 compressions to 2 ventilations, rate 100-120 compressions per minute, depth of 5-6 cm in adults, with full chest recoil.
6Understand the national tuberculosis screening protocol (Order No. ҚР ДСМ-214/2020): any patient with a cough exceeding 2 weeks must undergo sputum molecular-genetic testing (GeneXpert) and microscopy.
7Check the current national screening age bands rather than older summaries: since 11 August 2025 breast screening runs at even ages from 40 to 76, cervical screening every 4 years from 30 to 74, and colorectal screening at even ages from 50 to 76.
8Note that the published 'Сестринское дело' specification devotes a small but real share of the paper to dermatovenereology, psychiatry, neurology, ophthalmology and otorhinolaryngology, plus 4% to ethics and deontology; these sections are easy marks that candidates often skip.

Frequently Asked Questions

What is the Nursing Qualification Level Assessment in Kazakhstan?

It is the official assessment of professional preparedness administered by the National Center for Independent Examination (Ұлттық тәуелсіз емтихан орталығы / НЦНЭ) under Ministry of Health Order No. ҚР ДСМ-283/2020. It evaluates nurses and specialists with secondary and post-secondary medical education for the assignment or confirmation of qualification levels, which replaced the former qualification categories under the 2020 Healthcare Code.

How is the qualification level examination structured?

Assignment of a qualification level involves two stages: Stage 1 consists of a computer-based knowledge test of 100 single-best-answer MCQs in 100 minutes (passing threshold: 60 points), followed automatically on the same day by case testing of 5 clinical situational tasks in 90 minutes (passing threshold: 60% per task). Stage 2 is a remote expert review of the specialist's continuous professional development (210 credits) and a 3-year activity report by a 5-member commission (threshold: 60% of criteria). Confirmation of an existing level requires Stage 2 only.

How does this qualification level assessment differ from nurse certification?

Qualification level assessment (присвоение уровня квалификации under Order No. ҚР ДСМ-283/2020) is career progression tied to salary grades and replaces categories. In contrast, specialist certification ('Сертификация Врачей и СМР' under Order No. ҚР ДСМ-249/2020) is the legal admission to practice required for nurses with a career break of over three years, those who completed a certification retraining course, or foreign-educated specialists. The certification assessment consists of 100 MCQs in 100 minutes (60-point threshold) followed by computer video-simulation of 5 cases in 50 minutes (70% threshold).

What are the official examination fees for nurses in 2026?

Under Section IV.2 of the NCIE specialist price list effective 10 January 2026, specialists with secondary and post-secondary medical education pay 5,600 KZT for Stage 1 knowledge testing, 8,800 KZT for Stage 1 case testing, and 3,300 KZT for Stage 2 competency assessment, totaling 17,700 KZT. Under Section V.2, nurses whose former qualification category expired after 1 January 2021 and who apply for the equivalent qualification level pay 13,600 KZT.

In what languages is the official examination administered?

Paragraph 4 of the Rules for assessing the professional preparedness of healthcare specialists (Appendix 3 to Order No. ҚР ДСМ-249/2020, as restated in 2024) states that the assessment is conducted at the branches and regional representative offices of the assessment organisation in Kazakh and Russian. The wider choice of Kazakh, Russian or English applies to students and graduates of educational programmes, not to the specialist pathways. Registration and application are submitted through the NCIE information system at exam.ncie.kz.

What does this OpenExamPrep practice question bank provide?

This independent OpenExamPrep bank provides 100 English-language multiple-choice practice questions distributed across the section weights of the published NCIE 'Сестринское дело' specification, from emergency care and epidemiological safety through therapy, paediatrics, surgery, obstetrics, the specialised nursing sections and ethics and deontology. The official assessment is delivered in Kazakh and Russian, so this bank is an English-language MCQ study adaptation rather than an official translation. It is an independent educational resource, not an NCIE publication, it does not reproduce NCIE examination material, and it does not simulate the case-testing software interface or the Stage 2 competency review.