AAS NURSING PROGRAM - Mohave Community College€¦ · The nursing program is a countywide program with classes being offered for the southern part of the County in Kingman, Lake

AAS NURSING PROGRAM ADMISSION INFORMATION

3/2/2017

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Admission Information Packet Table of Contents

PAGE

Admission Information 3

Prerequisites 4

Admission Procedure (with deadline dates) 4

After Admission to the Program 5

Financial Assistance 5

Clinical Experience 5

RN Program Admissions Criteria 6

LPN Step-Out Curriculum 7

AAS Nursing Curriculum 8

Course Descriptions 9 - 10

Estimated Student Costs 11

RN Program Application Checklist 12

AZ DPS Card 12

Student Application Form 13 – 14

RN Program Notice of No Guarantee of Licensure/Certification 15

Test of Essential Academic Skills (TEAS) Information 16-17

Professional Reference Forms 18-20

Request for Transcripts Form 21

Essential Skills & Functional Abilities 22-25

Online Student PreCheck Directions 26

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Associate Degree Nursing Program Admission Information

Mohave Community College Department of Nursing provides students with the opportunity to acquire the knowledge and skills

requisite to the safe, effective practice of nursing. The associate of applied science degree nurse uses the nursing process in

supervised settings in assisting the client to optimal wellness, comfort or a peaceful death. The associate of applied science

degree nurse fulfills the roles of provider of care, advocate, researcher, counselor, communicator, teacher, manager and member

of the profession while exemplifying the qualities which are essential to the development of the nurse. These qualities are

incorporated throughout the four core nursing courses and include: caring attitude, clinical competence, and critical thinking

skills. The ultimate goal of the Nursing Department is to prepare graduates for safe and effective clinical practice. The mission

of the Mohave Community College Nursing Department is to promote excellence in nursing education and practice by fostering

communication and collaboration among faculty and students.

This course of study incorporates knowledge and principles from the liberal arts with an emphasis on the sciences in theory and

applied skills. Nursing Education at MCC is challenging, rewarding, and prepares graduates to utilize clinical judgment based on

critical thinking processes.

The Mohave Community College Nursing Program is accredited by the Accreditation Commission for Education in Nursing

(ACEN), 3343 Peachtree Road NE, Suite 850, Atlanta, Georgia 30326, 404.975.5000, Fax: 404.975.5020. This program is also

approved by the Arizona State Board of Nursing, 4747 N. 7th Street, Suite 150, Phoenix, Arizona 85014, 602.331.8111.

The nursing program is a countywide program with classes being offered for the southern part of the County in Kingman, Lake

Havasu City, and Bullhead City, and for the northern part of the County in Colorado City. Nursing I, the first core nursing course,

is taught with a faculty member on site in Bullhead City and Colorado City. The Kingman and Lake Havasu City students have the

same benefit of an onsite faculty member, but the lecture portion of the course is in Lake Havasu and the Nursing Skills

Laboratory experience is in Kingman. Clinical site travel is required related to the number of facilities and number of students in

the class. The remainder of the core nursing courses, Nursing II, III, and IV, also has the benefit of a face to face lecture by faculty

member. The students will be required to travel between all three campuses in the southern part of Mohave County in Kingman,

Lake Havasu City, and Bullhead City. Nursing II, III, and IV are “team taught” by varying faculty members. In preparation for

school and industry-wide practices, and to provide equality of student learning materials, students are also required to be

proficient in and use a computer, including the Internet and MCC’s computer-accessible learning management system and

application packets. Clinical experience takes place in Mohave County and Nevada health care facilities as well as Utah facilities

for students in the northern part of the County. Travel between campuses and to clinical facilities will be required at the student’s

expense.

Students interested in becoming nursing assistants do not need to apply for the nursing program, but should register for the

Nursing Assistant class (NAP 115). Students interested in becoming practical nurses or registered nurses must apply for

admission to the respective nursing program.

The Arizona Nurse Practice Act (July 2010) states “If convicted of one or more felonies, the applicant must have received an

absolute discharge from the sentences for all felony convictions five or more years prior to the date of filing an application.”

Therefore, the student should contact the Arizona State Board of Nursing (www.azbn.gov) regarding eligibility to write the

NCLEX for licensure PRIOR to application to the Mohave Community College Nursing Program.

Fingerprinting is a part of the application process to the Arizona State Board of Nursing for nursing assistant, practical nurse, and

registered nurses licensure. Department of Public Safety finger printing and Pre-check Background Check are a portion of the

application process for admittance to the program.

Revised 5/2015

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PRE-REQUISITES

Before a student will be considered eligible to enter the nursing program, certain pre-requisites must be met.

All pre-requisites must be completed before admission into the nursing program.

1. Graduation from an accredited high school (or hold a GED certificate), be 18 years of age or older, demonstrate evidence

of potential success in the community college, and/or is a transfer student in good standing from another college or

university.

2. Students must successfully complete the following (with a GPA of 2.0 or higher) one 100-level chemistry course and one

100-level biology course. Acceptable college courses are:

A. Choose one option from the following (0-4) credits:

1. Successful completion of Biology Competency Exam Credits: (0)

2. Bio 100 – Biology Concepts with Lab Credits: (4)

3. Bio 181 – General Biology I (Majors) with Lab Credits: (4)

B. Choose one option from the following (4) credits:

1. CHM 130 – Fundamental Chemistry with Lab Credits: (4)

2. CHM 151 – General Chemistry I with Lab Credits: (4)

3. Students must successfully complete (with a GPA of 2.85 or higher) all prerequisites for NUR 121 – Nursing I Credits: (8)

including the following courses (one of the 200 level BIO courses may be used to meet the requirements in 2.A above):

BIO 201 – Human Anatomy & Physiology I with Lab Credits: (4)

BIO 202 – Human Anatomy & Physiology II with Lab Credits: (4)

BIO 205 – Microbiology with Lab Credits: (4)

ENG 101 - English Composition I Credits: 3)

MAT 142 – College Mathematics Credits: (3) or MAT 151 – College Algebra Credits: (4)

PSY 101 – Introduction to Psychology Credits: (3)

4. College courses over ten (10) years old will not be accepted as credit for biology, chemistry, or general education science

requirements.

5. GPA of 2.85 or above compiled of all Nursing prerequisites.

6. Acceptable score on the Test of Essential Academic Skills (TEAS) minimum accepted score 60-strive for 70 or higher.

7. Copy of Department of Public Safety Fingerprint Clearance Card (front and back).

8. Copy of Student PreCheck online Background Check.

9. Consideration is given to applicants with Arizona residency, healthcare experience and (3) positive references.

*TRANSFER STUDENTS MUST complete a minimum of 1/3 of their required program credits at MCC to graduate. This could mean you may

have to take some of the required program courses over to meet the minimum of 1/3 of the required program credits at MCC.

ADMISSION PROCEDURE

Students are admitted to the Nursing program without discrimination regarding age, creed, ethnic origin, marital status, or sex. Application

for the program is in addition to the application for general admission to the college and must be completed in the semester before

enrollment is planned. Student spaces are limited; therefore, students are encouraged to submit applications early. Applications do not

guarantee admission to the program. INCOMPLETE applications as of the date of the Admissions Committee meeting will not be

considered.

1. A completed application packet with the following items should be received in the nursing office at:

1801 Detroit Ave., Kingman, AZ 86401, postmarked no later than February 15 for the fall admission and no later than October 1

for the spring admission.

a. Completed nursing application.

b. Three (3) professional references from persons who have known the applicant in a supervisory or educational setting and

who are familiar with applicant’s academic and/or work ethics.

c. Official college transcripts, if any, should be submitted directly to the Nursing Department.

d. Student copy of transcripts (other than MCC) should be attached to the application.

e. Test of Essential Academic Skills (TEAS) test results (minimum accepted score of 60-strive for 70 or higher). (Results will

be sent directly to the Nursing Department after scoring.)

f. Copy (front and back) of Department of Public Safety Fingerprint Clearance Card must accompany application.

g. Copy of Student PreCheck Background Check Report must accompany application.

h. Verification of health care experience.

i. Verification of residency (copy of driver’s license)

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2. Applications must be completed and in the nursing office by February 15 for fall admission, and October 1 for spring admission. It

is the student’s responsibility to verify that all documents have been received and his/her file is complete. Incomplete

applications will not be considered.

3. Applicants will be notified of their status in 45 to 60 days after application deadline.

4. Admission to the program will be determined on the basis of:

a. Ability to pass the online Student PreCheck.

b. Ability to obtain Department of Public safety Fingerprint Clearance Card.

c. GPA (Minimum of 2.85 overall GPA on prerequisite courses.)

d. Test of Essential Academic Skills (TEAS) scores (form enclosed). The applicant’s adjusted individual total scores

on the TEAS must be minimum score of 60 to be considered for admission. The TEAS can be taken 3 times in an

academic year (August to August), and the highest score will be considered. TEAS Exams must be taken one

month apart.

e. Number of courses completed pre-requisites and co-requisites at the time application was submitted for

admission. (Co-requisite courses: ENG 102, PSY 245)

f. Health Care experience. (2-years)

g. Professional references (3 must be completed).

h. Arizona Residency.

Applicants who are not accepted to the nursing program must notify the nursing office if they wish to be considered for the next

admitting semester.

AFTER ADMISSION TO THE PROGRAM

1. Students will be required to have a complete physical examination and must be able to meet the requirements identified on the

form as well as the Essential Skills and Functional Abilities of a Nurse (See end of packet). Immunizations and drug testing are also

necessary prior to the start of classes.

2. Proof of private health/accident insurance is required prior to the start of classes.

3. Students must attain CPR certification (American Heart Association-Healthcare Provider). This certification must be maintained

during the entire program. (Adult, child, or community CPR is not acceptable.)

4. Students must notify the nursing office of any changes in address, contact information, or plans to attend classes. Failure to do

so could hinder your process in the RN Program.

5. Travel between campus sites for lecture and clinical experience is required throughout the Nursing Program for all students in all

semesters.

6. The nursing courses are interrelated and are taken in sequence. A grade of “C” or better in all required courses must be

maintained for continuation in the program.

7. After successful completion of the requirements for either the LPN step out certificate or the AAS nursing degree, the student will

be eligible to apply to write the licensure examination offered by the National Council Licensure Examination for Registered Nurses

(NCLEX-RN) or for LPN (NCLEX-PN). Licensure requirements are the exclusive responsibility of the Arizona State Board of Nursing

and students must satisfy those requirements independently of requirements for graduation from the college.

FINANCIAL ASSISTANCE

Financial assistance is available in the form of scholarships, loans, and work-study assistance. The necessary forms can be secured at the

Financial Aid Office. Students are encouraged to contact the Financial Aid Director in the year preceding admission to the nursing program.

CLINICAL EXPERIENCE

A majority of MCC nursing students will be required to travel to Las Vegas, Nevada for a portion of their clinical experiences. Usually the

students are in Las Vegas for two days and one night per week for approximately four to six weeks. Transportation to and from clinical and

all food/meals are the responsibility of the student. The College reserves the rooms, for the group in advance.

Revised 9/2015

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RN Program Admissions Criteria is based on the following:

GPA

TEAS

Number of classes completed (pre-requisite and co-requisites are

included) at the time application was submitted for admission.

Healthcare Experience

Reference Forms Received

AZ Resident

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LPN STEP-OUT CURRICULUM

PRE-REQUISITES: CHM 130 Fundamental Chemistry or CHM 151 General Chemistry I, BIO 100 Biology Concepts or

BIO 181 General Biology I, BIO 201 Anatomy & Physiology I, BIO 202 Anatomy & Physiology II, BIO

205 Microbiology, ENG 101 English Composition I, PSY 101 Introduction to Psychology, MAT 142

College Mathematics or MAT 151 College Algebra.

CO-REQUISITES: ENG 102 English Compositions II, PSY 245 Lifespan Development

Pre-requisites for LPN Certificate Semester I NUR 121 Pre-requisites for Semester II

BIO 100 (Can Demonstrate Competency;

Prerequisite to Program.)

0-4 NUR 121 Nursing I 8

CHM 130 Or-----------Prerequisite to Program.

CHM 151 4 Total Credits: 8

GPA 2.85 Semester II NUR 122 Co-requisites TEAS - 70 goal – 60 minimum score accepted

BIO 201-General Education Requirement for PN

Step-out certificate

4 NUR 122 Nursing II 8

BIO 202- General Education Requirement for PN

Step-out Certificate

4 NUR 227 - Pharmacology 3

BIO 205- General Education Requirement for PN


4 Total Credits: 11

ENG 101- General Education Requirement for PN


3 NUR 123 – Transition to PN Or NUR 221 – Nursing III is acceptable

3

8

PSY 101- General Education Requirement for PN


3 TOTAL NURSING CREDITS: 22

MAT 142 Or---General education requirement for AAS

Nursing Degree.

MAT 151

3-4

Co-requisites for LPN Certificate

ENG 102- General Education Requirement for PN


3

PSY 245- General Education Requirement for PN


3

TOTAL GENERAL EDUCATION CREDITS: 35 - 36 TOTAL CERTIFICATE CREDITS: 57 - 58

Each core nursing course must be completed and successfully passed before progression into next core nursing course.

Revised 9/2015

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AAS NURSING CURRICULUM

PRE-REQUISITES: CHM 130 Fundamental Chemistry or CHM 151 General Chemistry I, BIO 100 Biology Concepts or BIO

181 General Biology I, BIO 201 Anatomy & Physiology I, BIO 202 Anatomy & Physiology II, BIO 205

Microbiology, ENG 101 English Composition I, PSY 101 Introduction to Psychology, MAT 142 College

Mathematics or MAT 151 College Algebra.

CO-REQUISITES: ENG 102 English Compositions II, PSY 245 Lifespan Development

Pre-requisites: Admission AAS Program Semester I NUR 121

BIO 100 (Can Demonstrate Competency;

Prerequisite to Program.)

0-4 NUR 121 Nursing I 8

CHM 130 Or-----------Prerequisite to Program.

CHM 151

4 Total Credits: 8

TEAS 70 goal – 60 minimum score accepted Semester II NUR 122 Co-requisites GPA 2.85

NUR 122 Nursing II 8

Total Credits: 0-8 NUR 227 Pharmacology 3

Pre-requisites: Semester I NUR 121 Total Credits: 11 BIO 201-General education requirement for AAS

Nursing Degree.

4 Semester III NUR 221 Co-requisites BIO 202-General education requirement for AAS

Nursing Degree.

4

BIO 205-General education requirement for AAS

Nursing Degree.

4 NUR 221 Nursing III 8

ENG 101-General education requirement for AAS

Nursing Degree.

3 Nursing 228 – Pharmacology Nursing Specialties 1

MAT 142 Or---General education requirement for AAS Nursing

Degree.

MAT 151

3-4

Total Credits: 9 PSY 101-General education requirement for AAS

Nursing Degree.

3 Semester IV NUR 222 Co-requisites

NUR 222 Nursing IV 8

Total Credits: 21 - 22 Nursing 229 – Adv. Pharmacology 1

Total Credits: 9

Required: Co-Requisite General Education for AD Program taken prior to NUR 221

Total Nursing Credits: 37

ENG 102-General education requirement for AAS

Nursing Degree.

3 Each core nursing course must be completed and successfully passed before progression into next core nursing course. PSY 245-General education requirement for AAS

Nursing Degree.

3

Must be completed by end of Nursing II semester.

Total Credits: 6 Total Program Credits: 72-73 Note: Pre-requisite general education courses must be completed prior to acceptance into the nursing program.

All Co-requisite general educational core courses must be satisfactorily completed prior to starting NUR 221,

Semester 3 of the Nursing Program. Nursing Co-requisites must be taken as stated on page 4.

Revised 9/2015

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COURSE DESCRIPTIONS

NUR 121 – Nursing I (8 Credit Hours) The focus is on fundamental concepts of contemporary professional nursing, student’s development as caring competent nurse within the

legal/ethical and scientific frameworks of the profession, critical thinking, and communication skills. Using the transitions “model,” students

learn to provide nursing care for individuals undergoing situational transitions in well-defined practice settings. Situational transitions include

that of the individual to the nursing student role and the client’s admission to and movement within the healthcare system. Concepts of

nutrition, pathophysiology and pharmacology are integrated.

5 lecture; 9 lab

Pre-requisites: BIO 201 Anatomy & Physiology I, BIO 202 Anatomy & Physiology II, BIO 205 Microbiology, ENG 101 English Composition I, PSY

101 Introduction to Psychology, MAT 142 College Mathematics or MAT 151 College Algebra, Admission to the AAS Degree Nursing Program.

General Co-requisites: ENG 102 English Composition II, PSY 245 Lifespan Development

NUR 122 – Nursing II (8 Credit Hours) The focus is on nursing care to promote healthy transitions for individuals and families with chronic health conditions in well-defined practice

settings. Emphasis is on basic management concepts and continued development of critical thinking, clinical judgment, and skills. Principles

of pharmacology, culture, pathophysiology, and nutrition are integrated throughout the course.

4 lecture; 12 lab

Pre-requisites: Successful completion (with a “C” or better) of NUR 121.

Co-requisite: NUR 227

General Co-requisites: ENG 102 English Composition II, PSY 245 Lifespan Development

NUR 227 – Pharmacology (3 Credit Hours) The focus is common drug classifications, actions, uses, and side effects of pharmacological agents. Accurate calculation of dosages,

administration techniques, legal/safety considerations and nursing implications of common medications will be emphasized.

3 lecture

Pre-requisites: Successful completion (with a “C” or better) of NUR 121, current LPN or Paramedic licensure with intention of enrollment in

nursing courses beyond NUR 121 or permission of the instructor.

Co-requisites: NUR 122 General Co-requisites needed prior to NUR 221: ENG 102 English Composition II, PSY 245 Lifespan Development

NUR 123 – Transition to Practical Nurse (3 Credit Hours) The focus on scope of practice issues specific to the practical nurse, including care of individuals and families experiencing developmental

and acute health-illness transitions. Concepts of clinical judgment, pathophysiology, pharmacology, and nutrition are integrated. Also,

includes practical nurse level concepts of management and supervision.

2 lecture; 3 lab

Pre-requisite: Successful completion (with a “C” or better) of NUR 121, NUR 122, NUR 227

NUR 221 – Nursing III (8 Credit Hours) The focus on nursing care to promote healthy transitions for individuals and families experiencing developmental milestones. Course

includes the transition of birth, childhood, adolescence, and young adulthood, childbearing and middle adulthood. The student’s transition

to nurse includes group theory and nursing therapeutics when assisting the client through acute health care issues. Topics of nutrition and

pharmacology are integrated. Concepts of critical thinking, organizational skills and psychosocial nursing are included.

4 lecture; 12 lab

Pre-requisites: Successful completion (with a “C” or better) of NUR 122, NUR 227

Co-requisites: NUR 228

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NUR 228 – Pharmacology for Nursing Specialties: Mental Health, Pediatrics, Obstetrical

(1 Credit Hours)

Focus is review of common drug classifications, actions, uses, and side effects of pharmacological agents in the specialties area of Mental

Health, Pediatrics, and Obstetric. Accurate calculation of dosages, administration techniques, legal/safety considerations and nursing

implications of common medications will be emphasized.

1 lecture

Pre-requisites: Successful completion (with a “C” or better) of NUR 121, NUR 122, NUR 227, admission to LPN to RN or Paramedic to RN

Tracks.


NUR 222 – Nursing IV (8 Credit Hours) Focus is on the impact of acute health/illness transitions on individuals, families, and groups. Emphasis is on synthesis and application of

nursing therapeutics in the transition of students to their role in the profession of nursing with an introduction to organizational transitions.

Concepts of nutrition, pharmacology, pathophysiology and nursing therapeutics are integrated.

4 lecture; 12 lab



NUR 229 – Advanced Pharmacology for Nursing (1 Credit Hours) Focus is review of common drug classifications, indications, actions, and side effects of pharmacological agents commonly utilized in the

acute care setting. Accurate calculation of dosages using three factor dimensional analysis, significant laboratory tests, and monitoring

parameters will be emphasized.

1 lecture



Reviewed 5/2015

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ESTIMATED STUDENT COSTS

Prior to admissions and Nursing I, there will be additional Health Requirement costs for yearly Physical, titers, TB test, immunizations,

DPS Card, Background Check, etc.

Allied Health Programs at MCC are exempt from the Western Undergraduate Exchange (WUE) Tuition Rates. Out of state tuition is $283.50 per credit hour. The

Nursing Department recognizes that the MCC Governing Board reserves the right to change or withdraw, without notice, curriculum, policies, tuition or any other

matters contained in this information packet.

Clinical travel is likely all semesters of the program. Students should plan on an additional $2,000 or more for semesters 3 and 4 to cover car fuel and food

expenses.

Registration costs are based on 2015-16 tuition fees plus technology and activity fees as applicable.

Book, uniform, watch, shoes and clinical equipment costs are estimates and do not include involved sales tax.

Graduation Gala, nursing pins, and testing fees for NCLEX are responsibility of the student.

“You may obtain more information regarding tuition and fees when registered for course.”

1st-Year Student 1st Semester 2nd Semester Totals

1) Registration Fees:

Registration $ 648.00 $ 891.00 $ 1,539.00

• Technical Fee $ 48.00 $ 66.00 $ 114.00

• Activity Fee $ 8.00 $ 11.00 $ 19.00

Program Fee $ 1,300.00 $ 1,300.00 $ 2,600.00 Gen Ed Co-requisites Tuition and Fee $ 264.00 $ 264.00 $ 528.00

Semester Fee Totals $ 2268.00 $ 2,532.00 $ 4,800.00

2) Miscellaneous: Books:

• Nursing $ 1,250.00 $ 293.00 $ 1,543.00

• Co-requisites $ 149.00 $ 119.00 $ 268.00

Uniform, Watch, Shoes $ 475.00 $ 475.00

Miscellaneous Totals $ 1,874.00 $ 412.00 $ 2,286.00

1st Year Totals $ 4142.00 $ 2,944.00 $ 7,086.00

2nd-Year Student 3rd Semester 4th Semester Totals

1) Registration Fees:

Registration $ 727.00 $ 729.00 $ 1,458.00

• Technical Fee $ 54.00 $ 54.00 $ 108.00

• Activity Fee $ 9.00 $ 9.00 $ 18.00

Program Fee $ 1,300.00 $ 1,300.00 $ 2,600.00

Co-requisites Fee

Semester Fee Totals $ 2,092.00 $ 2,092.00 $ 4,184.00

2) Miscellaneous:

Books:

• Nursing $ 384.00 $ 247.00 $ 631.00

• Co-requisites

Miscellaneous Totals $ 384.00 $ 247.00 $ 631.00

2nd Year Totals $ 2,476.00 $ 2,339.00 $ 4,815.00

Revised 5/2015

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RN Program APPLICATION CHECKLIST

□ Application for General Admission to Mohave Community College

□ Completed RN Program Application

□ General Education Courses must be received and evaluated in the MCC Registrar’s office. Official college transcripts, if any, should be submitted directly to the RN Department.

□ Three (3) Professional references from persons who have known the applicant in a supervisory or educational setting and who are familiar with applicant’s academic and/or work ethics.

□ Student copy of transcripts (other than MCC) should be attached to the application.

□ Copy of your Test of Essential Academic Skills (TEAS) Entrance Exam Scores.

□ Copy of your Student PreCheck Background Check Report.

□ Copy of FRONT AND BACK of your Arizona Department of Public Safety (DPS) Fingerprint Clearance Card.

□ Verification of Health Care Experience.

□ Verification of Residency.

AZ DPS Card

The online fingerprint clearance card application and fingerprint scheduling is available at: http://fieldprintarizona.com/ Please Note: It can take 10 weeks or longer for the Arizona Department of Public Safety to process your application.

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ASSOCIATE DEGREE NURSING PROGRAM

Student Application Form

AREA OF INTEREST

Please Select from the Following Location(s) you wish to be considered for:

Kingman Campus Lake Havasu City Campus Bullhead City Campus North Mohave Campus (Only admits in Fall)

Please Specify the Semester and Year You wish to begin: FALL (or) SPRING

APPLICANT INFORMATION

Date:

Social Security #: / / Birthdate: / / MCC ID#:

Full Name: Other Name(s) Used:

Mailing Address:

City:

State:

Zip:

Home Phone: ( ) Cell Phone: ( )

Email Address:

ACADEMIC HISTORY

List all colleges, universities and institutions attended, including high school.

High School: Location: Degree: Dates:

College: Location: Degree: Dates:

College: Location: Degree: Dates:

Other: Location: Degree: Dates:

Nursing Program PREREQUISITES: Please state if Completed or In Progress (Official Use Only)

100 level Biology or Biology Competency Location: Completed: Grade: In Progress: Verified:

Chemistry 130 Location: Completed: Grade: In Progress: Verified:

BIO 201: Anatomy & Physiology I Location: Completed: Grade: In Progress: Verified:

BIO 202: Anatomy & Physiology II Location: Completed: Grade: In Progress: Verified:

BIO 205: Microbiology Location: Completed: Grade: In Progress: Verified:

ENG 101: English Composition I Location: Completed: Grade: In Progress: Verified:

PSY 101: Introduction to Psychology Location: Completed: Grade: In Progress: Verified:

MAT 142: College Mathematics Location: Completed: Grade: In Progress: Verified:

WORK HISTORY

Last (5) years, beginning with most recent:

Occupation/Job Title Employer City/State Start Date End Date 1

2

3

4

5

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LICENSURE

If you have a current licensure such as Arizona LPN/LVN, CNA Paramedic or Certificate of an Allied Health profession or current license in another state, PLEASE submit a copy with this application.

Are you a current resident of the State of Arizona? YES NO

Answer the Following Question

1. Have you ever been dismissed from any course or program? YES NO

If YES, please explain and state which program:

AZ DPS Fingerprint Clearance Card StudentCheck Online PreCheck Background Check Expiration Date: Report #: Date Completed:

(MUST provide copy of BOTH front & back of card) (MUST provide copy of FULL report)

Licensure is the sole responsibility of the Arizona State Board of Nursing. If you have been convicted of a felony, contact the Arizona State Board of Nursing to verify eligibility to be licensed prior to submitting this application.

DISCLAIMER & SIGNATURE

I understand that if accepted into the Nursing Program, I will be required to travel for class lectures and clinical experiences, and that I will be responsible for my own transportation and meals.

I understand that if accepted, if a clinical agency to which I have been assigned does not accept me based on my criminal background check it may result in my inability to complete the RN Program. I also understand that MCC Nursing department may, within its discretion, disclose to a clinical agency that I have been rejected by another clinical agency. I further understand that MCC has no obligation to place me when the reason for lack of placement is my criminal background check. Since clinical agency assignments are critical requirements for completion of the RN Program, I acknowledge that my inability to complete required clinical experience due to my criminal background check will result in non-completion of the RN Program.

I understand that if accepted, I will be required to meet the health requirements of the RN Program.

I hereby certify that the facts set forth in this Student Application are true and complete to the best of my knowledge. I understand that if accepted into the nursing program, any falsified statements on this application shall be considered cause for suspension or dismissal.

Signature: Date:

Mail COMPLETED Application To: Mohave Community College, Department Of Nursing; 1801 Detroit Ave., Kingman, AZ 86401

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RN Program ▪ 1801 Detroit Ave ▪ Kingman, AZ 86401 ▪ (928) 757-0868

RN PROGRAM

NOTICE OF NO GUARANTEE OF LICENSURE/CERTIFICATION

Admission or graduation from the RN Program does not guarantee obtaining a license or certificate to

practice nursing. Licensure and certification requirements and the subsequent procedures are the

exclusive right and responsibility of the Arizona State Board of Nursing. Students must satisfy the

requirements of the Nurse Practice Act: Statues, Rules, and Regulations independently of any college or

school requirements for graduation as they exist at the time of licensure/certification. Although this

explanation and handbook materials may provide information concerning the licensing process, the

applicant/student is solely responsible for understanding and meeting licensure/certification requirements.

MCC does not guarantee the accuracy of any of the information presented here or in any other materials

presented to the applicant/student concerning the licensure process. Verifying the accuracy of such

information is solely the responsibility of the applicant/student.

If convicted of a felony, an applicant for licensure/certification must submit proof that he/she “has received

an absolute discharge from the sentences for all felony convictions five or more years prior to the date of

filing an application” (Nursing Practice Act 202, 32-1632 and 32-1637). Such proof includes completion of

any sentence including imprisonment, probation, parole, community supervision or any form of court

supervision. Examples of unprofessional conduct, but not limited to, are felony or misdemeanor

convictions, substance abuse, conviction of an offense involving immoral behavior, or being guilty of acts

which deceive, defraud or harm the public in any way.

Fingerprinting will be part of the application process for the Nursing Assistant, LPN, and RN applicants. If there is any question about eligibility for licensure or certification, contact the Arizona State Board of Nursing (628-889-5150).

I have read and understood the above statement.

Signature Print Name Date

This statement will become part of your permanent record.

PUBLIC NOTICE OF NONDISCRIMINATION: Mohave Community is committed to providing equal employment opportunity,

educational opportunity, and advancement to individuals without regard to race, color, religion, gender, national origin, age,

mental or physical disability, sexual orientation, veteran status, or any other legally protected class in any of its policies, practices,

or procedures. The equality of employment opportunity for all persons must be consonant with all applicable provisions of state

and federal laws. The college shall promote equal opportunity and treatment on a continuing basis. See the MCC Diversity

webpage for further information. http://www.mohave.edu/about/hr/diversity-at-mcc/

Return with COMPLETED Application To: Mohave Community College, Department Of Nursing; 1801 Detroit Ave., Kingman, AZ 86401

Revised 7/2015

TEST OF ESSENTIAL ACADEMIC SKILLS (TEAS) MOHAVE COMMUNITY COLLEGE

WHAT IS THE TEAS TEST? The Test of Essential Academic Skills evaluates nursing program applicants in four (4) foundational areas which are

essential to your academic success in the Nursing Program. The Nursing Program requires you to take the TEAS Test as an

entrance examination. Basically, the test has four parts that ask you to answer multiple-choice questions covering the

following:

Reading: paragraph comprehension, passage comprehension, and inferences/conclusions.

(48 items, 58 minutes)

Math: Whole numbers, metric conversion, fractions, decimals, algebraic equations, percentages, and

ratio/proportion. (34 items, 51 minutes)

Science: science reasoning, science knowledge, biology, chemistry, anatomy, physiology, basic physical

principles, and general science. (54 items, 66 minutes)

English and Language Usage: punctuation, grammar, sentence structure, contextual words and spelling.

(34 items, 34 minutes)

Total of 170 multiple choice questions.

WHO ADMINISTERS THE TEAS TEST? The Testing Centers at Mohave Community College administer the TEAS Test. The test is purchased from the

Assessment Technologies Institute (ATI). Your TEAS scores are stored by ATI and are available to you and to your

school via the Internet. You can also have TEAS results sent to other nursing schools at minimum cost through ATI.

HOW MUCH DOES THE TEAS TEST COST? The cost of taking either test is $60.00 for students and $70.00 for non-students.

HOW CAN I BEST PREPARE FOR TAKING THE TEAS TEST? A review of basic concepts and theories in mathematics, reading, science, English and language usage is

recommended. ATI has two products, the TEAS Study Manual and a TEAS Online Practice Assessment, available to

guide your review and provide feedback on your study progress. These products can be purchased online at the ATI

website which is www.atitesting.com.

CAN I USE A CALCULATOR ON THE TEAS TEST? Calculators are NOT allowed during the TEAS TEST.

WHAT DO I BRING TO THE TESTING CENTER? Photo bearing identification such as a; passport, driver’s license, student identification card.

WHAT CANNOT BE BROUGHT TO THE TESTING CENTER? Cell phones, textbooks, backpacks, calculators. Scratch paper and pencils will be provided.

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CAN YOU ACCOMMODATE STUDENTS WITH DISABILITIES? Students with documented disabilities requiring accommodations should contact the Disability Services Office at the

local campus to make arrangements to take their test. Students requiring extra time will not be able to take the

computer based test because the program is self-timing and cannot be adjusted. These students will be given a paper

and pencil test instead. This test cannot be scored locally, but must be sent back to ATI for scoring, requiring at least

a one (1) to two (2) week turnaround. Please take this into consideration when scheduling and allow sufficient time

prior to nursing program application due dates.

HOW LONG WILL IT TAKE TO GET MY TEAS TEST SCORES? If you have taken the computer administered TEAS Test, your scores are available immediately after the examination.

If you have taken the pencil/paper version of the test, your examination will be scored within 24 hours of receipt by

ATI. Note that the 24-hour window is NOT 24 hours from the time you tested, but within 24 hours of ATI’s receipt of

testing materials from Mohave Community College.

HOW DO I KNOW IF I PASSED THE TEAS TEST? The applicant’s adjusted individual total score must be at or above 60-strive for 70 to be considered for admission.

CAN I RETEST TO GET A HIGHER SCORE? Tests may be retaken after a minimum of 30 days and up to 3 times a year period.

HOW TO REGISTER YOURSELF AS A TEST CANDIDATE FOR THE TEAS. If you are not a current user on www.atitesting.com, you need to set up a new account. This will allow you access to

the testing and to complete a purchase on ATI’s online store. Please follow the steps below to setup a new account:

1. Go to www.atitesting.com. Just under the Username and Password fill-in boxes, there is a small link that

states, “New to ATI? Create an account.” Click on that link to register yourself with ATI.

2. Next, a web form will appear. Fill in all of the blue fields. Blue fields are required information necessary to

create a new account.

3. You will receive an email from ATI confirming your user login and password.

4. You will need to bring your user name and password with you when you go to the testing center to take the

TEAS.

TO SCHEDULE THE TEAS TEST, CONTACT THE TESTING COORDINATOR

AT YOUR LOCAL CAMPUS PROVIDED BELOW: Heather De Jesus: [email protected], Bullhead City Campus, 928-704-4165

Cheri Stromle: [email protected], Neal Campus Kingman Campus, 928-757-4331

Kevin Smith: [email protected], Lake Havasu City Campus, 928-302-5321

Kim Naylor: [email protected] , North Mohave Campus, 928-875-9124

MCC Toll Free: 866-664-2832

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PROFESSIONAL REFERENCE FORM

To Be Completed by Applicant (please print) Complete the following section and give this form as soon as possible to someone who has observed you in a professional

setting for a reasonable period of time. This should be an employer or community leader for whom you have worked or

volunteered, or an instructor who has had the opportunity to view your accomplishments in a classroom setting.

Name: Date:

Address:

(Street or P.O. Box) (City) (State) (Zip)

The Family Educational Rights and Privacy Act of 1974 permits a matriculated student to have access to his/her file unless a waiver of that right has been signed. If you wish to waive your right to access your file, sign your name in the space provided. The waiver is NOT required as a condition of admission.

I hereby waive my right of access to this letter of recommendation.

Applicant’s Signature: Date:

To be Completed by Evaluator This student is applying for admission to Mohave Community College RN Nursing Program. Evaluations are invaluable to the decision making process. Please include any information that you feel is pertinent, and remember that the sooner you return this form to MCC, the sooner we can give this student our admission decision. Thank you.

Please rate the applicant in each of the following areas: Excellent Good Average Poor

Do Not Know

Ability to work with others

Conceptual ability

Dependability

Leadership ability

Integrity / Honesty

Initiative / Motivation

Maturity

Empathy / Caring

Judgment

Overall Potential for Nursing Program

*Any additional comments you feel might be of value to the Nursing Department, please state them on the back.

Name:

Agency Represented: Title:

Address:


Signature: Date:

PLEASE RETURN TO Department Of Nursing Mohave Community College 1801 Detroit Ave. Kingman, AZ 86401

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Name: Date:

Address:







Do Not Know


Conceptual ability

Dependability

Leadership ability

Integrity / Honesty


Maturity

Empathy / Caring

Judgment



Name:


Address:


Signature: Date:


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Name: Date:

Address:







Do Not Know


Conceptual ability

Dependability

Leadership ability

Integrity / Honesty


Maturity

Empathy / Caring

Judgment



Name:


Address:


Signature: Date:


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TRANSCRIPT REQUEST (DO NOT SEND FOR MCC OFFICIAL TRANSCRIPTS)

Institution Name

Mailing Address

City

State Zip

Please send one (1) OFFICIAL COPY of my transcript to:

Department Of Nursing

Mohave Community College

1801 Detroit Ave.

Kingman, AZ 86401

____I do not know the Transcript fee, please bill me.

____I am enclosing the transcript fee of $_____ for (number) _____ transcripts.

PLEASE PRINT

Student Name

Social Security Number

Mailing Address

City

State Zip

Maiden or Previous Name(s)

Address While attending your institution

If there is a charge against my account, I hereby agree to clear all indebtedness before this record will be released.

“STUDENT is responsible for mailing this form” Student Signature

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Essential Skills & Functional Abilities for Nursing Mohave Community College

Individuals who apply for admission to the Mohave Community College Nursing Program must be able to perform

essential skills. Any applicant who has met the necessary prerequisites and who can perform the essential

functions will be considered for admission. If a student believes that he or she cannot meet one or more of the

standards without accommodations, the nursing program must determine, on an individual basis, whether a

reasonable accommodation can be made.

Functional Ability Standard EXAMPLES of required activities

Motor Abilities Skills

Gross Motor Skills

Physical abilities and mobility sufficient to execute

gross motor skills, physical endurance, and

strength, to provide patient care.

Mobility sufficient to carry out patient

care procedures such as assisting with

ambulation of clients, administering

CPR, assisting with turning and lifting

patients, providing care in confined

spaces such as treatment room or

operating suite etc.

Manual Dexterity

Fine Motor Skills

Demonstrate fine motor skills sufficient for

providing safe nursing care.

Motor skills sufficient to handle small

equipment such as insulin syringe and

administer medications by all routes,

perform tracheotomy suctioning,

insert urinary catheter, etc.

Perceptual

Sensory Ability

Visual

Tactile

Smell

Sensory / perceptual / Auditory ability to monitor

and assess clients

Normal or corrected visual ability sufficient for

accurate observation and performance of nursing

care.

Tactile ability sufficient for physical monitoring and

assessment of health care needs.

Olfactory ability sufficient to detect significant

environmental and client orders.

Sensory abilities sufficient to

hear alarms, auscultatory

sounds, cries for help, hears

normal speaking levels

sounds, etc.

Visual acuity to read

calibrations on 1cc syringe,

assess color, see objects up

to 20 ft. away (cyanosis,

pallor, etc.)

Tactile ability to feel pulses,

temperature, palpate veins,

etc.

Olfactory ability to detect

smoke or noxious odor, foul

smelling drainage, alcohol,

etc.

Behavioral

Interpersonal

Emotional

Emotional/Behavioral

Ability to relate to colleagues, staff and patients

with honesty, integrity, and nondiscrimination.

Capacity for development of mature, sensitive and

effective therapeutic relationships.

Establish rapport with clients,

instructors and members of

health care team.

Work with teams and

workgroups.

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Professional Attitudes

and Interpersonal

Skills

Interpersonal abilities sufficient for interaction with

individuals, supervisors, members of health care

team, families and groups from various social,

emotional, cultural and intellectual backgrounds,

achieve a positive and safe work environment.

Ability to work constructively in stressful and

changing environments with the ability to modify

behavior in response to constructive criticism.

Follow instructions and safety protocols.

Capacity to demonstrate ethical behavior, including

adherence to the professional nursing and student

honor codes.

Honesty and integrity beyond reproach.

Establish and maintain

therapeutic boundaries.

Emotional skills sufficient to

remain calm in an emergency

situation and maintain

behavioral decorum in

stressful situations.

Behavioral skills sufficient to

demonstrate the exercise of

good judgment and prompt

completion of all

responsibilities attendant to

the diagnosis and care of

clients.

Adapt rapidly to

environmental/stress

changes and multiple task

demands.

Exhibit ethical behaviors and

exercise good judgment.

Communication Ability to communicate in English with accuracy,

clarity and efficiency with patients, their families

and other members of the healthcare team

(including spoken and nonverbal communication,

such as interpretation of facial expressions, affect

and body language.)

Required communication abilities, including

speech, hearing, reading, writing, language skills

and computer literacy.

Gives verbal directions to or

follows verbal directions

from other members of the

healthcare team and

participates in healthcare

team discussions of client

care.

Elicits and records

information about health

history, current health state

and responses to treatment

from clients or family

members.

Conveys information to

clients and others as

necessary to teach, direct

and counsel individuals in an

accurate, effective and timely

manner.

Establishes and maintain

effective working relations

with clients and co-workers.

Recognizes and reports

critical client information to

other caregivers.

Cognitive

Conceptual

Quantitative Abilities

Ability to read and understand written documents

in English and solve problems involving

Calculates appropriate

medication dosage given

specific client parameters.

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measurement, calculation, reasoning, analysis and

synthesis.

Ability to gather data, to develop a plan of actions,

establish priorities and monitor and evaluate

treatment plans and modalities.

Ability to comprehend three-dimensional and

spatial relationships.

Ability to react effectively in an emergency

situation.

Analyzes and synthesize data

and development of an

appropriate plan of care.

Collects data, prioritize needs

and anticipate reactions.

Comprehend spatial

relationships adequate to

properly administer

injections, start intravenous

lines or assess wounds of

varying depths.

Recognizes an emergency

situation and responds

effectively to safeguard the

client and other caregivers.

Transfers knowledge from

one situation to another.

Accurately processes

information on electronic

medical records (EMR),

medication container,

physicians’ orders, and

monitor equipment

calibrations, printed

documents, flow sheets,

graphic sheets, medication

administration records, other

medical records and policy

and procedure manuals.

Safe environment for

patients, families, and

co-workers

Ability to accurately identify patients.

Ability to effectively communicate with other

caregivers.

Ability to administer medications safely and

accurately.

Ability to operate equipment safely in the clinical

area.

Ability to recognize and minimize hazards that

could increase healthcare associated infections.

Ability to recognize and minimize accident hazards

in the clinical setting including hazards that

contribute to patient, family, and co-worker falls.

Prioritizes tasks to ensure

client safety and standard of

care.

Maintains adequate

concentration and attention

in inpatient care settings.

Seeks assistance when

clinical situation requires a

higher level or

expertise/experience.

Responds to monitor alarms,

emergency signals, call bells

from clients, and orders in a

rapid and effective manner.

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Computer and

Internet Use

Ability to use a computer, including common

software applications.

Ability to access the community college’s intranet

programs.

Ability to access and use the Internet.

Proficient in using word

processing software to

prepare assignments.

Use computer to access

Mohave Community

College’s student email

system, College Learning

Management System

(Schoology) and other

software programs as

assigned by instructor.

Use computer to access

websites on the

Internet/World Wide Web to

obtain references, take tests,

access learning materials and

other assigned uses.

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Documents

AAS NURSING PROGRAM - Mohave Community College€¦ · The nursing program is a countywide program with classes being offered for the southern part of the County in Kingman, Lake