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Refresher Course - LPN

Refresh your knowledge

Are you an inactive licensed practical nurse looking to review and update your nursing knowledge and skills? This self-study refresher course was developed to help the inactive licensed practical nurse review and update their nursing knowledge and skills, thus allowing them to move with confidence into a nurse orientation program and return to practice.

This course is offered over the Internet 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.

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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


"I absolutely loved the program. Thank you for ALL your help!"

- Former LPN Refresher Course participant, Arizona

Course Structure

    Course Objectives

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

    • Gain an understanding of current philosophy, social and economic trends, and objectives in nursing today.
    • Review previously acquired nursing skills.
    • Understand the functions of the LPN/LVN in assessing patient needs and in planning individualized care.
    • Review and increase knowledge of selected medical and surgical conditions, therapies and procedures, current diagnostic and treatment measures and patient care needs.
    Course Start Date

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

    Course Delivery and Required Technology

    Course Components

    This course is split into two components: 120 hours of theory and a minimum of 80 hours of supervised clinical (or hours as required by your state board of nursing). The theory portion of the course can be completed entirely online, and the clinical component can be completed in your home community.


    All course materials and theory module exams are delivered online through Desire2Learn (D2L) and Assessment Technologies Institute (ATI) supported modules, followed with a medication calculation test. All required exams in D2L and ATI must be successfully completed before proceeding to the clinical component of the course.

    The participant will complete course review and exams at a time and location of their choosing. A computer with built in or add-on webcam is required for taking exams. A desktop or laptop computer is required when taking exams. iPads, iPhones, Tablets, etc. are not permissible. Video proctoring and browser lockdown applications are enabled through D2L for this time to provide participant verification and testing security measures. A webcam is not provided by SDSU and will be an additional cost to the participant.

    Participants need to make sure their browser is properly configured to use the D2L system. The following checks ensure that the browser is properly configured:

    • JavaScript Cookies enabled,
    • Adobe Flash plug-in,
    • Screen resolution recommendation -- 1024 by 768 pixels and
    • Rich content editing.

    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 int he theory modules and include skills, pharmacology made easy and dosage calculation - dimensional analysis, with a final medication calculation test (see appendix a). After successful completion, the LPN Refresher participant is awarded 120 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.


    There are ten (10) multiple choice examinations, one for each theory module. Each examination contains twenty-five (25) questions in varying formats such as true/false, multiple choice, 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 review the module material again and complete 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 twenty-six (26) required and four (4) optional ATI Skills modules are integrated throughout the course material to provide learning opportunities related to the requirements of a licensed practical nurse in various clinical settings. The ATI Skills are used in conjunction with the textbook to provide in-depth information and visual cues for each learning experience. 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. The participant should expect to spend an hour to complete the pre-test, review of the tutorial including the overview, step-by-step viewing, accepted practice components and post-test.

    Participants must receive a post-test score of 76% or greater on each of the twenty-six (26) 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 SDState 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

    The thirteen (13) modules are integrated throughout the theory modules to provide learning opportunities and application of skills. Video case studies that simulate providers interacting with clients focus on the clinical application of drug information. 10-item drills at the conclusion of each module reinforce content and enhance learning. Recommended time for completion of modules range from one (1) hour (Introduction) to four (4) hours (cardiovascular system). Each module includes a post-test that contains twenty-five (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 post-test score of 76% or greater on each of the thirteen (13) 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 SDState 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 Dosage Calculation 2.0 – Dimensional Analysis

    This module 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 nine (9) modules provide approximately six (6) hours of interactive instruction in which participants practice clinical reasoning and problem-solving skills while working through in-depth tutorials and real-life case scenarios. Questions are interspersed throughout each module to provide practice problems. A twenty (20) question post-test will be completed after each module with participants receiving immediate feedback with rationales provided for both correct and incorrect answer choices to reinforce learning.

    Participants will complete the nine (9) ATI modules and receive a 76% or greater score on each of the 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 then proceed to the ATI final by completing the nine (9) case studies and take the four (4) post-tests. Participants must receive a score of 76% or greater on each of the four final tests. If a 76% is not attained on the first attempt, participants will re-take the four (4) final tests until the passing score of 76% or greater is achieved. Participants will document their test activities on the SDState 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

    Participants will take a medication calculation test at the end of theory and before proceeding to clinical. The test will include ten (10) questions that require the participant to calculate and document their answer. Up to three (3) opportunities are allowed to successfully complete the medication calculation test with a score of 100%. Participants that do not obtain a 100% on the medication calculation exam A, B or C will be dismissed from the program.

    Theory Overview

    Module I

    Foundations and Settings

    • Unit A – The Origins of Nursing
    • Unit B – Beginning Your Nursing Career 
    • Unit C - The Healthcare Delivery System
    • Unit D – Legal and Ethical Aspects of Nursing
    • Unit E – Nursing in a Variety of Settings

    Module II

    Personal, Environmental Health and Safety

    • Unit A – Basic Human Needs
    • Unit B – Health and Wellness
    • Unit C – Community Health
    • Unit D – Transcultural Healthcare
    • Unit E – The Healthcare Facility Environment
    • Unit F – Emergency Preparedness
    • Unit G – Introduction to Microbiology
    • Unit H – Medical Asepsis
    • Unit I – Infection Control Unit J – Emergency Care and First Aid

    Module III

    Development Throughout the Life Cycle

    • Unit A – The Family
    • Unit B – Infancy and Childhood
    • Unit C – Adolescence
    • Unit D – Early and Middle Adulthood
    • Unit E – Older Adulthood and Aging
    • Unit F - The End of Life: Death, Dying, Grief, Loss
    • Unit G – Gerontology: The Aging Adult
    • Unit H – Cognitive Impairment in the Aging Adult

    Module IV

    The Nursing Process and Focus Studies

    • Unit A – Introduction to the Nursing Process
    • Unit B – Nursing Assessment
    • Unit C – Nursing Diagnosis and Planning
    • Unit D – Implementing and Evaluating Care
    • Unit E – Documenting and Reporting
    • Unit F – Delegation (Focus Study)
    • Unit G – Informatics (Focus Study) 
    • Unit H – Management and Leadership (Focus Study)

    Module V

    Structure, Function and Disorders (Part 1)

    • Unit A – Organization of the Human Body
    • Unit B – Integumentary System and Skin Disorders
    • Unit C – Fluid & Electrolyte Balance and Disorders
    • Unit D – Musculoskeletal System and Disorders
    • Unit E – Nervous System and Disorders ATI – Pharmacology – selected modules

    Module VI

    Structure, Function and Disorders (Part 2)

    • Unit A – Endocrine System and Disorders
    • Unit B – Sensory System and Disorders
    • Unit C – Cardiovascular System and Disorders
    • Unit D – Hematologic/Lymphatic Systems and Disorders
    • Unit E – Immune System and Disorders ATI – Pharmacology – selected modules

    Module VII

    Structure, Function and Disorders (Part 3)

    • Unit A – Respiratory System and Disorders
    • Unit B – Digestive System and Disorders
    • Unit C – Nutrition System and Disorders
    • Unit D – Urinary System and Disorders
    • Unit E – Male Reproductive System and Disorders
    • Unit F – Female Reproductive System and Disorders ATI – Pharmacology – selected modules

    Module VII

    Skills/Client Care (Part 1)

    • Unit A – Therapeutic Communication Skills
    • Unit B – Admission, Transfer, Discharge
    • Unit C – Vital Signs
    • Unit D – Data Collection in Client Care
    • Unit E – Moving and Positioning Clients
    • Unit F – Beds and Bed Making
    • Unit G – Personal Hygiene
    • Unit H – Elimination  Unit I – ATI Skills

    Module IX

    Skills/Client Care (Part 2)

    • Unit A – Specimen Collection
    • Unit B – Bandages and Binders
    • Unit C – Heat and Cold Applications
    • Unit D – Pain Management
    • Unit E – Preoperative and Postoperative Care
    • Unit F – Surgical Asepsis
    • Unit G – Special Skin and Wound Care
    • Unit H – End-of-Life Care ATI Skills

    Module X

    Pharmacology and Administration of Medications

    Unit A - Review of Mathematics Unit B – Introduction to Pharmacology Unit C – Classification of Medications Unit D – Administration of Noninjectable Medications Unit E – ATI Pharmacology – selected modules Unit F – ATI Dosage/Calculations and FINAL

    Integrated material throughout Modules

    ATI Skills

    • HIPPA
    • Physical Assessment (Adult)
    • Vital Signs
    • Blood Administration
    • Central Venous Access Devices
    • Intravenous Therapy
    • Medication Administration 1-4
    • Enemas
    • Ostomy care
    • Personal Hygiene
    • Urinary Catheter Care
    • Specimen Collection
    • Air-way Management
    • Closed-Chest Drainage
    • Oxygen Therapy
    • Diabetes Management
    • Enteral Tube Feedings
    • NG Intubation
    • Nutrition, Feeding and Eating
    • Infection Control
    • Surgical Asepsis
    • Ambulation, Transferring and ROM 
    • Pain Management

    ATI Pharmacology Made Easy

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

    · ATI Dosage Calculation - Dimensional Analysis

    • Safe Dosage
    • Medication Administration
    • Oral Medications
    • Injectable Medications
    • Powdered Medications
    • Parenteral (IV) Medications 
    • Dosage by Weight
    • Pediatric Medications
    • Critical Care Medications
    • Case Studies (9)
    Clinical Component

    Clinical Component

    Arranging for the clinical experience is the responsibility of each prospective participant. 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 specific health care settings for clinical are required.

    COVID-19 Waiver

    Due to the current COVID-19 Outbreak, SDSU is temporarily waiving the requirement to obtain a verbal commitment for the clinical experience prior to enrollment. Because of current restrictions in healthcare facilities, SDSU will allow participants to enroll and begin the theory component of the course before a clinical site is secured.

    Arranging Clinical

    Clinical hours must be arranged with an approved health care provider before or at the completion of the theory component. Arranging the clinical experience is still the responsibility of the participant. Participants will make the initial contact to request and secure that the facility can provide a clinical experience. After a verbal commitment is achieved, SDSU Continuing Nursing Education (CNE) 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. However, each state Board of Nursing determines the number of clinical hours necessary for license reactivation. If the state requirement is more than 80 hours, the participant will be notified of this with enrollment and this requirement will be adhered to during the clinical experience.


    WA limited license must be obtained from the State Board of Nursing during the clinical component of the refresher course and allows nursing practice only under the direct personal supervision of a licensed registered nurse identified as your clinical preceptor, and may not be used for gainful employment. 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 will be 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 ten (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. CPR Certification for the Professional Rescuer / Health Care Provider
    14. Proof of Personal Health Insurance Coverage
    15. Professional Liability Insurance
    16. Drug Screening (10 panel – current within 3 months of beginning clinical)
    17. 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 or pre-clinical requirement (ie 2-17 above). A copy of a government issued identification card may be submitted with the enrollment application.

    Clinical Evaluation Procedure

    The clinical experience is evaluated by:

    1. The setting and attainment of personal learning objectives,
    2. The evaluation of the clinical preceptor during the clinical experience, using the evaluation tool included in the course materials,
    3. Clinical hours log and
    4. The participants typed summary of 400 words or more, of what was learned during the course.

    The clinical experience requires a satisfactory performance evaluation by the clinical preceptor. If the participant’s performance is unsatisfactory on any given clinical day, it is at the discretion of the clinical preceptor whether to count that clinical day toward the total hours required for the clinical component.

    If the participant’s overall clinical performance is unsatisfactory, the preceptor, in collaboration with the College of Nursing faculty, will determine if further experience beyond the required clinical hours is needed or if dismissal from the program is in order. Additional information pertaining to the clinical experience is available in the Clinical Syllabus and the CNE Program Handbook.

    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 to have 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 (1) year to complete the LPN Independent Study Course. If the course is not completed within the one-year deadline, participants may purchase a one-time extension for $500. The extension adds three months for course completion. A request to extend must be received within thirty (30) days of the course end date.  After this period of time, re-enrollment with payment of the program fee and background check is required.

      Course Enrollment and Cost

      Requirements to Enroll

      Admission Criteria

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

      • Formerly licensed LPNs who wish to reactivate their nursing licensure.
      • Currently licensed LPNs who desire to refresh their knowledge or skills in the profession, due to time away from practice.
      • Unlicensed LPNs who have successfully completed an LPN education program however have not yet successfully completed the NCLEX-LPN exam. Admission for this participant is accompanied by the requirement that s/he must successfully complete the NCLEX-LPN 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 offence, 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$1500
      CastleBranch pre-enrollment$139.75
      CastleBranch post-enrollment$77.75
      TextbookPurchase locally or online
      • 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.
      • Program fee includes: access to all course material within D2L and ATI, supervision and coordination of the course, correction of exams, record keeping and Board of Nursing reporting, program advising to course participant, postage and handling for initial and regular course communication and certificate of completion.
      • 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 "Textbook of Basic Nursing” 11th edition by Caroline Bunker Rosdahl and Mary T Kowalski, ISBN-13: 978-1469894201. The textbook may be purchased locally or online.
      • 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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