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Refresher Course - RN

Refresh your knowledge

Are you registered nurse looking to review and update your nursing knowledge and skills? This self-study refresher course was developed to assist the inactive nurse for this purpose, thus allowing you to move with confidence into a nurse orientation program and return to practice.

The independent study refresher course is offered as a nursing continuing professional development distance education program and may be completed in one's home community at a pace and time which best meets individual needs. The refresher course is not a college credit-granting program. This course is taken to pursue professional re-certification of a nursing license.

"The course offered through SDSU was excellent, thorough and easy to self-navigate."

-Former RN refresher course participant, Kansas

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number of theory hours (completed online)

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maximum time for course completion

12 months
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minimum Number of clinical hours

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program fee


Course Structure

    Course Objectives

    The objectives of the course are to provide an opportunity for the participant to:

    • Recognize current philosophy, objectives and social and cultural implications of nursing.
    • Review selected nursing skills and identify their evidence base for practice.
    • Recognize the role of the registered nurse in assessing clients’ needs, planning and implementing individualized care.
    • Review and identify therapies, procedures, current diagnostic and treatment measures, and patient care needs for selected medical and surgical conditions.
    • Demonstrate dosage calculation to selected client situations.
    Course Start Date

    The program is ongoing. Participants may enroll at any time.

    Required Technology

    All course materials and theory module exams are delivered online through Desire2Learn (D2L) and Assessment Technologies Institute (ATI) supported modules. The participant will complete course review and exams at a time and location of their choosing. Participants are required to have camera access on their computer when taking a module exam in the D2L. This webcam may be included in the participant’s computer or an added accessory. A webcam is not provided by SDSU and will be an additional cost to the participant. When logging in to take an exam in the course delivery system D2L, the participant will initially download the safe and free software application Respondus Monitor and LockDown Browser. This application will provide participant verification and testing security measures and video the participant while an exam is taken. Once an exam is accessed, the participant’s browser will be locked to prevent other software applications or web pages to run or be accessed.

    A desktop or laptop computer is required when taking exams. iPads, iPhones, Tablets, etc. are not permissible. The system requirements are:

    • Windows 10, 8, 7 Mac
    • OS 10, 12 or higher

    It may not be possible to access exams when using a computer operating system that is not listed above.

    Theory Component

    Theory Component

    The theory component is based on a textbook to help direct and reinforce learning. The theory portion has been organized into ten major instructional modules with an examination after each module. ATI products are integrated in the theory modules and include Skills, Pharmacology Made Easy and Dosage Calculation – Dimensional Analysis, with a final medication calculation test. After successful completion, the RN refresher participant is awarded 145 theory hours. Completion of theory involves successful completion of all module tests, ATI skills, ATI pharmacology, ATI dimensional analysis modules and the final medication calculation test. 


    Modules one through nine contain multiple choice examinations. Each examination contains 25 questions in varying formats such as true/false, multiple choice or multiple select. Two opportunities are allowed to successfully complete each module post-test with a score of 76% or greater. If a score of less than 76% is attained on post-test A, the participant will re-enter test A submission to review incorrect answers, refer to textbook content as noted in rationale and review the module material again before completing post-test B. If a score of 76% or greater is not obtained on either post-test A or B, the participant will be dismissed from the program.

    ATI Skills

    The 21 required ATI skills provide learning opportunities related to the requirements of a registered nurse in various clinical settings and are assigned in modules five through ten. The ATI skills provide in-depth information and visual cues for each learning experience and should be completed as assigned. ATI skills modules are designed with a pre-test, completion of learning modules, then followed by a post-test. The modules are self-paced and interactive, contain audio and video clips as well as step-by-step procedures. Case studies in the form of practice challenges are included in each module. The modules will support participant’s skill-building, apply the theoretical and evidence-based information, and instill confidence in understanding of skills. Participants should allow time to complete the pre-test, review the tutorial including the overview, step-by-step viewing, accepted practice components and post-test.

    A post-test score of 76% or greater must be achieved on each of the 21 mandatory ATI Skills. If a 76% is not attained on the first attempt, participants will re-take the post-test until the passing score of 76% or greater is achieved. Participants will document their test activities on the SDSU provided form and submit to the CNE office upon completion. This data will be verified by the CNE office before approval will be granted to proceed to the clinical experience.

    Participants will also complete five virtual ATI Skill scenarios: HIPAA, Nutrition, Blood Administration Pain Assessment and Vital Signs. The participant will document time spent and date completed on the SDSU provided form and submit to the CNE office upon completion. This data will be verified by the CNE office before approval will be granted to proceed to the clinical experience.

    ATI Pharmacology Made Easy

    There are 11 modules assigned in modules five through nine. Each pharmacology module includes a welcome / introductory, lessons, activities and case study. There is one module, Introduction to Pharmacology, that must be completed in its entirety followed by as post-test. The post-test contains 25 NCLEX-style questions to assess knowledge acquisition. Participants will receive immediate feedback with rationales provided for both correct and incorrect answer choices to reinforce learning. Participants must receive a score of 76% or greater on the test. If a 76% is not attained on the first attempt, participants will re-take the post-test until the passing score of 76% or greater is achieved.

    Module content will be reviewed for the other ten pharmacology modules, with no post-test required. The participant will identify one medication from the module content that they are familiar with and document it on the provided form. Participants will document their test activity, familiar medication and date on the SDSU provided form and submit to the CNE office upon completion. This data will be verified by the CNE office before approval will be granted to proceed to the clinical experience.

    Note: Review of two modules is optional – Hematologic and Immune System.

    ATI Dosage Calculation and Safe Medication Administration

    This ATI product is an interactive, media-rich, online tutorial that is designed to help participants learn the basics of safe medication administration. The dosage calculation series improves comprehension and critical-thinking skills in relation to safely calculating medication dosages. The seven modules include activity questions interspersed throughout the material to provide practice problems, in which the participant receives immediate feedback with rationales provided for both correct and incorrect answer choices along with equations to reinforce learning.

    Participants must receive a 76% or greater score on each of the seven required module tests. If a 76% is not attained on the first attempt, participants will re-take the post-test until the passing score of 76% or greater is achieved. The participant will document their test activities on the SDSU provided form and submit to the CNE office upon completion. This data will be verified by the CNE office before approval will be granted to proceed to the clinical experience.

    Final Medication Calculation

    The participant will take a Medication Calculation Test in D2L at the end of theory in module ten, and before proceeding to clinical. The test includes ten questions that require the participant to calculate and document their answer. A practice medication calculation test is available for the participants to help prepare for the final test and may be utilized as many times as needed.

    Three opportunities are allowed to successfully complete the medication calculation test with a score of 100%. The participant will take test A. If a score of less than 100% is attained on test A, the participant will reenter the submission, review questions answered incorrectly noting their rationale, and review ATI modules as needed. After review, the participant will take test B. If a score of less than 100% is attained on test B, the participant will reenter the submission, review questions answered incorrectly noting their rationale and review ATI modules as needed. When participant is ready for the final attempt, test C, the participant will email instructor the date and time they request to take test C. The instructor will open test C for participant completion. If a score of less than 100% is attained on medication calculation tests A, B and C, the participant will be dismissed from the program.

    Theory Overview

    Module 1            

    Professional Concepts

    • Unit A – The Profession of Nursing
    • Unit B – The Nurse’s Role In Healthcare Quality and Patient Safety
    • Unit C – Values, Ethics and Legal Issues
    • Unit D – Nursing Research and Evidence-Based Care
    • Unit E – Nursing Process: Foundations for Clinical Judgement
    Module 2          

    Nursing Process

    • Unit A – Nursing Assessment
    • Unit B – Nursing Diagnosis
    • Unit C – Outcome Identification and Planning
    • Unit D – Implementation and Evaluation
    • Unit E – Healthcare Team Communication: Documenting and Reporting
    • Unit F – Focus Studies in Leadership and Management, Delegation, Informatics
    Module 3         

    Healthcare Delivery Concepts

    • Unit A – Health, Wellness and Integrative Healthcare
    • Unit B – Healthcare In the Community and Home
    • Unit C – Culture and Diversity
    • Unit D – Communication in the Nurse-Patient Relationship
    • Unit E – Patient Education and Health Promotion
    • Unit F – Caring for the Older Adult
    Module 4        

    Psychosocial Concepts

    • Unit A – Self-Concept
    • Unit B – Families and Their Relationships
    • Unit C – Cognitive Processes
    • Unit D – Sexuality
    • Unit E – Stress, Coping and Adaptation
    • Unit F – Loss and Grieving
    • Unit G – Spiritual Health
    Module 5        

    Clinical Care Competencies - Part One

    • Unit A – Safety
    • Unit B – Health Assessment
    • Unit C – Vital Signs
    • Unit D – Asepsis and Infection Control
    Module 6        

    Concepts Involving Protection and Movement - Part One

    • Unit A – Hygiene and Self-Care
    • Unti B – Skin Integrity and Wound Health
    • Unit C – Infection Prevention and Management
    MODULE 7

    Concepts Involving Protection and Movement - Part Two 

    • Unit A – Mobility
    • Unit B – Pain Management
    • Unit C – Sensory Perception
    Module 8  

    Concepts Involving Homeostasis and Regulation - Part One

    • Unit A – Nutrition
    • Unit B – Urinary Elimination
    • Unit C – Bowel Elimination
    • Unit D - Sleep
    Module 9

    Concepts Involving Homeostasis and Regulation - Part Two

    • Unit A – Respiratory Function
    • · Unit B - Cardiac Function’
    • · Unit C – Fluids, Electrolytes and Acid-Base
    Module 10

    Clinical Care Competencies - Part Two

    • Unit A - Medication Administration
    • Unit B - Intravenous Therapy

    Integrated Material Throughout Modules

    ATI Skills

    • Air-way Management
    • Blood Administration
    • Central Venous Access Devices
    • Closed-Chest Drainage
    • Concepts of Medication Administration
    • Diabetes Management
    • Enteral Tube Feedings
    • HIPAA
    • Infection Control
    • Injectable Medication Administration
    • Intravenous Therapy and Peripheral Access
    • IV Medication Administration
    • Nasogastric Intubation
    • Nutrition
    • Oral and Topical Medications
    • Oxygen Therapy
    • Pain Management
    • Physical Assessment – Adult
    • Surgical Asepsis
    • Urinary Elimination
    • Vital Signs

     ATI Pharmacology Made Easy

    • Introduction to Pharmacology
    • The Neurologic System Part 1 & 2
    • The Gastrointestinal System
    • The Reproductive and Genitourinary Systems
    • The Respiratory System
    • The Cardiovascular System
    • The Endocrine System
    • Infection
    • The Musculoskeletal System
    • Pain and Inflammation
    • Optional: The Hematologic System and The Immune System

    ATI Dosage Calculation - Dimensional Analysis

    • Safe Dosage
    • Medication Administration
    • Oral Medications
    • Injectable Medications
    • Powdered Medications
    • Parenteral (IV) Medications
    • Dosage by Weight
    • Optional: Pediatric Medications and Critical Care Medications
    Clinical Component

    Clinical Component

    Arranging for the clinical experience is the responsibility of each prospective participant. A verbal commitment from a clinical site is required prior to requesting enrollment in the course. Clinical sites must be within the United States, or on a US Military base in a health care setting operated by medical staff licensed within the US. Examples of accepted clinical settings include but are not limited to hospitals, nursing homes, surgery centers, urgent care centers, rehabilitation centers, home health or hospice agencies. The prospective participant must check with the appropriate board of nursing to learn if specific heath care settings for clinical are required.

    Prospective participants will make the initial contact to request and secure that the facility can provide a clinical experience. After a verbal commitment is achieved, enrollment in the course can begin. SDSU staff will contact the clinical site to establish the required affiliation agreement.

    Hours Required

    A minimum of 80 clinical hours is required for course completion. If the respective state board of nursing requires more than 80 hours, this requirement will be adhered to during the clinical experience.


    Where required, a limited license must be obtained from the state board of nursing during the clinical component of the refresher course. The limited license allows nursing practice under the direct personal supervision of a licensed registered nurse identified as the clinical preceptor. The limited license is only valid for a specific time period and may not be used for gainful employment.

    Clinical Plan and Pre-Clinical Requirements

    When preparing for clinical, the participant will submit a completed Clinical Plan to SDSU. This one-page form is reviewed and may be approved after the following pre-clinical requirements are uploaded and approved in the participant’s CastleBranch account. When all pre-clinical requirements are met, the Clinical Plan is approved and a date range for clinical hours will be set. The start date for clinical will be a minimum of 10 business days after approval, or longer if work to complete a required affiliation agreement with the site is still underway.

    Pre-Clinical Requirements

    1. Copy of Government issued photo identification card (submitted with enrollment)
    2. FBI Background Check with Fingerprinting (completed with enrollment application)
    3. Online Background Check (completed with enrollment application)
    4. Multi-Waiver Release Form
    5. Measles (Rubeola) Immunity
    6. Mumps Immunity
    7. Rubella (German Measles) Immunity
    8. Varicella Immunity
    9. Hepatitis B Immunity or Waiver
    10. TB skin test
    11. Tetanus, Diphtheria, Pertussis Immunity
    12. Influenza Vaccination – required during flu season October - March
    13. COVID-19 Vaccination (where required)
    14. CPR Certification for the Professional Rescuer / Health Care Provider
    15. Proof of Personal Health Insurance Coverage
    16. Professional Liability Insurance
    17. Drug Screening (10 panel – current within 3 months of beginning clinical)
    18. Temporary Permit or Limited License (where required)

    Participants that elect to complete only the theory portion of the course will not open a CastleBranch account to obtain the above pre-admission background checks or pre-clinical requirements. A copy of a government issued identification card may be submitted with the enrollment application.

    Course Completion

    Successful Course Completion

    The participant must successfully pass both the theory and clinical components to complete the refresher course. Upon successful completion, a certificate will be mailed to the participant. A copy of the certificate will be sent to the participant’s board of nursing to document successful completion of the course.

    If a participant is unable to successfully complete either the theory or the clinical portion, this will result in failure of the refresher course. Appeals for the opportunity to retake course exams or the clinical experience are not guaranteed and will be handled on a case-by-case basis. No participant will be allowed more than two opportunities to successfully complete clinical. Any dismissal from the course for academic reasons is appealable pursuant to University Policy 2:4.

    Completion Time Frame

    The refresher course is self-paced. Once enrolled, the participant has one year to complete the course. If the course is not completed within the one-year deadline, the participant may purchase a one-time extension for $500.00. The extension adds three months for course completion. A request to extend must be received within 30 days of the course end date. After this period, re-enrollment with payment of the full program fee and background checks is required.  

      Course Enrollment and Cost

      Admission Criteria

      Admission Criteria

      The refresher course considers enrollment from prospective participants in the following circumstances:

      • Formerly licensed RNs who wish to reactivate their nursing licensure.
      • Currently licensed RNs who desire to refresh their knowledge or skills in the profession, due to time away from practice.
      • Unlicensed RNs that have successfully completed an RN education program however have not yet successfully completed the NCLEX-RN exam. Admission for this participant is accompanied by the requirement that s/he must successfully complete the NCLEX-RN exam prior to receiving approval to begin the clinical component of the course.

      Conditional Admission

      Admission to the clinical portion of the refresher course is conditioned on the results of the background checks completed through CastleBranch and acceptance into clinical placement determined by a health care agency.

      If a prospective participant has been convicted, pled guilty or no contest to, or received a suspended imposition of sentence for a felony or other criminal offense, or is under disciplinary action with their current or former Board of Nursing, the participant is advised it may not be possible to be accepted into the refresher course at SDSU. Participants may be denied reinstatement from their state Board of Nursing, from taking the required licensure exam, and/or may be prevented from gaining employment in the field of nursing.

      Participants that elect to complete only the theory portion of the refresher course are not required to open a CastleBranch account to complete the background checks.

      Technical Standards

      CNE program participants must be able to independently, with or without reasonable accommodation, meet identified technical standards for enrollment in and successful progression through the refresher course program. These requirements pertain to participant conduct regardless of the setting (ie didactic, clinical, email communication, etc). Please review the identified technical standards.

      Enrollment Process
      See the enrollment page for details.
      Cost of Course
      Program fee$1750
      CastleBranch pre-enrollment$139.75
      CastleBranch post-enrollment$77.75
      TextbookPurchase locally or online.
      Clinical PreparationVaries per participant
      • Full payment of the program fee is due when the participant is accepted for enrollment. Payment plans are not available. Payment may be made via check, money order or credit card. The accepted credit cards are MasterCard, VISA, American Express and Discover.
      • All refresher course participants must establish an account with CastleBranch, the chosen vendor for document management. CastleBranch is endorsed by the AACN – American Association of Colleges of Nursing, and is the source to submit program pre-admission and the aforementioned clinical requirements. The pre-enrollment package price for CastleBranch covers the two background checks. The post-enrollment package is required for clinical preparation. These are additional costs to the participant and will be paid directly to CastleBranch. The participant will experience variable expenses as they prepare for clinical. Participants that elect to complete only the theory portion of the course are not required to open a CastleBranch account to submit the background checks or pre-clinical requirements.
      • Participants will purchase the textbook Fundamentals of Nursing – Concepts and Competencies for Practice, 9th edition by Craven, Hirnle and Henshaw.  ISBN-13:  978-1975120429. The textbook may be purchased locally. This is an additional cost to the participant.
      • If the participant receives the course materials and decides against continuing, s/he is allowed 30 days from the date of enrollment to notify the CNE office of their intent to withdraw and receive a refund of 70%. After 30 days, no refund will be granted. No refund will be extended to the participant if s/he is dismissed from the refresher course.
      • Participants in this course will not be issued a 1098T from SDSU for qualified educational expenses.

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