Fill - Free fillable 7101NursingAdvancedPlacementInformation2019 FORM LCCC Nursing Program Advance Placement Information PDF form

LARAMIE COUNTY COMMUNITY COLLEGE

NURSING PROGRAM

ADVANCED PLACEMENT

for LPNs or those who have had 2 consecutive semesters of nursing school.

Due between September 1 and September 15, 2018.

LCCC does not discriminate on the basis of race, color,

national origin, sex, age, religion, political affiliation,

or disability in admission or access to, or treatment or

employment in, its educational programs or activities.

However, applicants must be able to meet the essential

functions of a nurse. The nursing program has been

developed in accordance with criteria established by the

Accreditation Commission for Education in Nursing,

Inc. (ACEN) with assistance from the Wyoming State

Board of Nursing (WSBN). The program has received

approval as a nursing education program by the WSBN,

130 Hobbs Avenue, Suite B, Cheyenne, WY 82002;

Telephone: 307.777.7601 and is accredited by the

ACEN, 3343 Peachtree Road NE, Suite 850, Atlanta,

Georgia 30326; Telephone: 404.975.5000.

Completed applications must be submitted between

September 1-15 for the August 2018 semester. You will

be notified by the first week of November.

Note: Students who have failed more than one nursing

course with a “C-,” “D,” “F,”or “U” are ineligible

to apply.

1. Submit a college admission application to LCCC

if you have not taken courses here before or a

readmission application if you have not taken courses

in the past year. It is the student’s responsibility to

request official high school and all college transcripts

to be sent to the admissions office. NOTE: Unofficial

transcripts (student copies of all institutions

attended (including LCCC), must be attached and

submitted with the Nursing Application.

2. Achieve an acceptable score on the Advanced

Placement Test. Contact the LCCC testing center for

details and scheduling at 307.778.1105 or

dmccoy@lccc.wy.edu. The test may be taken twice

a year. There is a three-week waiting period between

tests. The results are valid for one year.

3. You must have completed the following courses with a

“C” or higher:

a. COLS 1000 – Introduction to College Success for

3 credit hours

b. Freshman English Composition I for 3 credit

hours.

c. College Algebra or higher for 3 credit hours.

Statistics, Theory of Mathematics, or Clinical

Calculations will not fulfill this requirement. ACT

scores will not satisfy the math requirement.

A college math course must be satisfactorily

completed.

d. Human Anatomy or A&P I for 4 credit hours –

If you take Human Anatomy, you must complete

the sequence with Human Physiology. If you take

A&P I, you must complete the sequence with

A&P II. Taking one course from each sequence

will not fulfill the requirement.

e. Human Physiology or A&P II for 4 credit hours

f. General Psychology for 3 credit hours

g. Medical Microbiology for 4 credit hours

h. Verify the completion of two semesters of nursing

school or the equivalent.

i. Applicant must be able to perform the Essential

Functions of a Nurse. See the attached list of

physical expectations.

Students admitted or readmitted to the nursing

program will comply with current college catalog,

current nursing program student handbook, and current

curriculum requirements.

A student will be readmitted to the program only once.

After acceptance to the nursing program, proof of the

following additional requirements must be submitted

to the Nursing Program as stipulated in the acceptance

letter:

1. A current Record of Physical Examination including

verification of current vaccinations and titers.

2. A copy of a current certification in BLS for health care

providers from the American Heart Association valid

for the entire year you will be in the program.

3. A verification form related to personal health

insurance, since all students admitted to the nursing

program are expected to carry personal health

insurance.

NOTE: Applicants who have been convicted of a

felony, treated for mental illness or substance abuse

should refer to the instructions from the Wyoming

State Board of Nursing on our website at lccc.

wy.edu/programs/nursing, select “LPN to RN,”

“Apply to the Program” and Background check

information (pdf). Our college will provide education

for those who meet our program objectives and

have an acceptable criminal background check, but

the Wyoming State Board of Nursing must protect

the public and can deny licensure regardless of our

program’s or the hospital’s criminal background

check. Any student who cannot pass the

background check will not be eligible to attend

clinical, and therefore, will be dismissed from the

program.

PRS 7101 5/18

Progression

To progress semester to semester in the nursing

program the student must:

1. Maintain a minimum grade of “C” in every required

general education and nursing course for each

semester.

2. Take nursing courses (NURS courses) in sequence.

3. Take general education courses as outlined in the

curriculum, within or prior to the semester they are

printed.

Estimated Expenses

See college catalog for general school expenses.

Additional estimated expenses for the nursing department are:

Physical Exam, Immunizations, Titers ........... (varies with number and types of immunizations necessary)

Background check and drug test ...........................................$ 159

Books ................................................................$ 1,750

Required clinical course fee for the Nursing Program .............................$ 500 per semester

Scissors, watch, stethoscope ..............................................$ 75

Licensure Exam Fees

NCLEX-RN ........................................................$ 200

WSBN Application Fees ..............................................$ 190

Student Services

See college catalog for information.

Student Employment

Due to the demands of the full-time nursing program,

student employment should be approached with caution.

This personal decision should be based on individual

performance in the classroom, clinical areas, and

personal health. It is the desire of the nursing faculty

that students be successful in this program and that

essential learning not be compromised. Students will

not be excused from class or clinical assignments for

personal work schedules or elective classes. Alternative

sources of funding may be found by contacting the

Financial Aid Office at the college (307.778.1215).

Clinical experiences in hospitals, clinics and other

facilities may be scheduled as early as 6 a.m. or as late

as midnight, including weekends. Clinical sites are held

in a variety of communities. The student is required to

participate in the clinical experience as it is scheduled.

Childcare arrangements, work schedules and

transportation are the responsibility of the student.

Classroom attendance is expected and accountability

for knowledge and assignments is the student’s

responsibility.

Skills labs are required to prove competency and

are part of the required clinical experience. Failure to

comply with attendance or assignments could result in

dismissal from the program.

Other Information

LCCC website: lccc.wy.edu

See lccc.wy.edu/programs/nursing for LCCC’s Nursing Program website.

Nursing Program

Laramie County Community College

1400 E. College Drive

Cheyenne, WY 82007

307.778.1267

Laramie County Community College is committed to providing a safe and nondiscriminatory educational and employment environment. The college does not discriminate on the basis of race, color,

national origin, sex, disability, religion, age, veteran status, political afliation, sexual orientation or other status protected by law. Sexual harassment, including sexual violence, is a form of sex

discrimination prohibited by Title IX of the Education Amendments of 1972. The college does not discriminate on the basis of sex in its educational, extracurricular, athletic or other programs or in the

context of employment.

The College has a designated person to monitor compliance and to answer any questions regarding the college’s non-discrimination policies. Please contact: Title IX and ADA Coordinator, Suite 205,

Clay Pathnder Building, 1400 E. College Drive, Cheyenne, WY 82007, 307.778.1217, TitleIX_ADA@lccc.wy.edu.

CURRICULUM PLAN OF THE LCCC NURSING PROGRAM

PREREQUISITES Credit Hours Clock Hours

COLS 1000 – Intro to College Success .......................... 3 hrs 45 hrs

ENGL 1010 – English I: Composition ........................... 3 hrs 45 hrs

MATH 1400 – College Algebra (or higher) ........................ 3 hrs 45 hrs

ZOO 2015 – Human Anatomy (or A&P I) ....................... 4 hrs 75 hrs

_______ _______

13 hrs 210 hrs

Passing score for the Kaplan Nurse Entrance Exam

Accumulative GPA of 2.5 for courses taken in the nursing curriculum.

Semester Course Number Title Credit Hours Clock Hours

1st

NURS 1100 Professional Nursing Care in Health Promotion 5 hrs 75 hrs

NURS 1115 Professional Nursing Care in Health Promotion Clinical 5 hrs 225 hrs

ZOO 2025 Human Physiology (or A&P II) 4 hrs 75 hrs

Total Hours 14 hrs 375 hrs

2nd

NURS 1200 Professional Nursing Care of Pt w/Chronic Illness 5 hrs 75 hrs

NURS 1215 Professional Nursing Care of Pt w/Chronic Illness Clinical 5 hrs 225 hrs

PSYC 1000 General Psychology 3 hrs 45 hrs

MICR 2240 Medical Microbiology 4 hrs 75 hrs

Total Hours 17 hrs 420 hrs

The above courses must be successfully completed to progress to the second year.

NRST 1980 PN Exploration 2 hrs 30 hrs

Optional course to become eligible to take NCLEX-PN Exam

Public Speaking must be completed in order to earn the certificate in nursing.

Semester Course Number Title Credit Hours Clock Hours

3rd

NURS 2300 Professional Nursing Care of Pt w/Acute Illness 5 hrs 75 hrs

NURS 2315 Professional Nursing Care of Pt w/Acute Illness Clinical 5 hrs 225 hrs

CO/M 2010 Public Speaking 3 hrs 45 hrs

Total Hours 13 hrs 345 hrs

4th

NURS 2400 Professional Nursing Care of Pt w/Complex Illness 5 hrs 75 hrs

NURS 2415 Professional Nursing Care of Pt w/Complex Illness Clinical 5 hrs 225 hrs

+POLS 1000 American & WY Government OR

+HIST 1211 US History to 1865 OR

+HIST 1221 US History from 1865 OR

+HIST 1251 Wyoming History OR

+ECON 1200 Economics, Law, and Govt 3 hrs 45 hrs

Total Hours 13 hrs 345 hrs

TOTAL CREDITS for ADN Curriculum 70 hrs 1695 hrs

TOTAL CREDITS if Optional PN Exploration course is Completed 72 hrs 1725 hrs

+ If any of these courses have been accepted for transfer at LCCC from an out-of-state institution,

a one-credit hour course of Wyoming Constitution (POLS 1100) is required. Refer to your degree

requirements in the college catalog for more specific guidelines.

The above credit hours use a 50-minute hour. One credit of theory class = 15 clock hours;

one credit of lab = 30 clock hours and one credit of clinical = 45 clock hours.

Note: All courses must be completed prior to or during the semester it is listed. Students may not progress to

the next semester without having satisfactorily completed all courses listed in the current semester.

LARAMIE COUNTY COMMUNITY COLLEGE

NURSING PROGRAM

ADVANCED PLACEMENT APPLICATION

for LPNs or those who have had 2 consecutive semesters of nursing school

Due between September 1 and 15, 2018 for the class beginning January 2019

(Print or Type – All items MUST be completed)

First Name: ___________________________ Middle Initial:______ Last Name: __________________________

Address: ________________________________________________ Primary Phone: ______________________

City, State, ZIP: ___________________________________________ Secondary Phone: ____________________

Last four digits of SS#: ______________ LCCC Student ID #: ________________________________________

Personal Email: _______________________________________________________________________________

Please indicate which option you would like to be considered.

LPN Spin-off Option (for those who have completed two semesters

of a nursing program and want to take the LPN NCLEX Boards).

LPN to RN. (For those who want to complete their RN and take the NCLEX-RN Boards)

Step 1: I submitted an LCCC college admission application (when)___________________________________

and requested official transcripts official transcripts from other schools (if applicable) to be

sent to the Admissions Office.

Unofficial transcripts from ALL institutions (including LCCC) are attached to this application.

Institutions attended: ________________________________________________________________

________________________________________________________________

Step 2: I have taken the Advanced Placement Test and attached the score.

Date test was taken____________ Score_____________

Step 3: Where did you complete 2 semesters of nursing classes?

Institution, City and State_______________________________________________________________

Have you ever been ineligible to continue in a nursing program? Yes No

If yes, where and why___________________________________________________________________

I am currently enrolled in the following courses:

COURSE COURSE NUMBER INSTITUTION

In order to enter into the third semester or PN exploration course of the nursing program, all of the courses

listed in the first table must be completed with a grade of “C” or better.

The courses listed below are all of the general education requirements for the Associate Degree in Nursing (ADN).

If a grade for a course cannot be determined on any transcript, no points will be given and the course will need to be

successfully completed.

Please complete the table below using the following point system. No points are given for COLS 1000.

Grade of: A = 12 points B = 8 points C = 5 points

COURSE COURSE # COURSE NAME INSTITUTION SEMESTER GRADE POINTS

COLS 1000:

Intro to College Success

ENGL 1010:

Freshman English Composition I

MATH 1400: College Algebra

ZOO 2015:

Human Anatomy or A&P I

ZOO 2025:

Human Physiology or A&P II

PSYC: 1000: General Psychology

MICR 2240: Medical Microbiology

The following courses can be completed while you are enrolled in the program.

COURSE COURSE # COURSE NAME INSTITUTION SEMESTER GRADE POINTS

CO/M 2010: Public Speaking

US & Wyoming Government or

History Requirements*

*If a history or government class is accepted as a transfer course from an out-of-state institution,

a one-hour course, POLS 1100 – Wyoming Constitution is required.

Passed all general education courses required for the Nursing Program on the rst attempt = 20 pts.

Only one or two failing grades in any general education or nursing course = 10 pts.

More than two failing grades in any general education or nursing course(s) = 0 pts.

(Note: A “C-,” “D,” “F,” or “U” is considered a failing grade.

Any failing grade in a general education course prior to 10 yrs. will be disregarded.)

Wyoming Resident = 4 pts

The following courses are prerequisite courses for the BSN program at UW.

Grade of: A = 12 points B = 8 points C = 5 points

COURSE COURSE # COURSE NAME INSTITUTION SEMESTER GRADE POINTS

BIOL 1010: Biology I

(BSN Requirement)

HOEC 1140: Nutrition

(BSN Requirement)

Human Culture Elective

(BSN Requirement)

CHEM 1000: Introductory

Chemistry (BSN Requirement)

STAT 2050 or 2070: Statistics

(BSN Requirement)

Total Possible Points: 180 Total Applicant Points __________

Detach and submit completed application form, copies of transcripts (including LCCC), exam scores, and

Statement of Understanding Concerning Licensure to:

Nursing Program

Laramie County Community College

1400 E. College Drive

Cheyenne, WY 82007

STATEMENT OF UNDERSTANDING CONCERNING LICENSURE

The following questions are asked on the State of Wyoming application for licensure as an LPN/RN;

therefore, it is for your information and written answers are not required.

1. Have you ever been denied a nursing license, permit or permission to take a nursing

examination by any licensing authority?

2. Have you ever had a nursing license or permit encumbered in any way (revoked, suspended,

surrendered, censured, restricted, limited, denied, placed on probation)?

3. Are charges pending against you for professional misconduct, unprofessional conduct or

negligence in any state or country?

4. Have you ever been convicted of, or are charges pending against you, for a crime (felony/

misdemeanor) in any state or in federal court, other than minor traffic violations?

5. Have you ever had a court accept a plea of nolo contender (no contest) to a felony/

misdemeanor, other than minor traffic violations?

6. Do you have any physical impairment or disability that could interfere with your ability to

practice nursing?

7. Are you now or have you in the past five years habitually used or been addicted to alcohol,

narcotics, barbiturates or habit-forming drugs?

8. Have you ever been admitted (voluntarily or otherwise) to any facility for treatment of mental

or emotional illness, drug or alcohol addiction?

If you answer ‘yes’ to any of the above, refer to www.lccc.wy.edu/programs/nursing, select “Apply to the

Program” and Background check information (pdf). LCCC will provide education for those who meet our

program requirements and have an acceptable background check/drug screens, but the Wyoming State

Board of Nursing must protect the public and can deny licensure regardless of our program’s background

check/drug screens.

Clinical agencies may require drug screening, abuse clearances and/or criminal background checks prior

to allowing students into a clinical setting. Students are advised that the inability to gain clinical educational

experiences can result in the inability to meet program objectives and outcomes. The circumstances may

prevent progression through the program and ultimately result in dismissal from the program.

I have read and understand the above statement regarding nursing licensure in Wyoming.

Signature________________________________________________________ Date________________________

PRS 5324 04/11

NURSING ADVANCED PLACEMENT CHECKLIST

Before submitting your application, make sure you have

included the following:

1. Submitted an application to the college and

OFFICIAL Transcripts to the Student Records Office.

2. Submitted the Advanced Placement Nursing

Application to the Nursing Office

3. Attached required test score.

4. Completed prerequisite courses.

5. Attached a copy of all transcripts including LCCC.

6. Signed and included “Statement of Understanding

Concerning Licensure.”

If any of these items are missing, the application will be

considered incomplete and will not be considered for

acceptance.

Essential Functions of a Nurse

• Lift 10-25 lbs Frequently

• Lift 26-50 lbs Occasionally

• Carry 10-25 lbs Occasionally

• Push/Pull up to 50 lbs Occasionally

• Squat/Kneel Occasionally

• Wrist Pronation/Supination Constantly

• Wrist Flexion/Extension Constantly

• Sit Occasionally

• Stand/Walk Constantly

• Crawl Infrequently

• Back Flexion Constantly

• Back Extension Occasionally

• Back Rotation Constantly

• Neck Flexion Constantly

• Neck Extension Occasionally

• Neck Rotation Frequently

• Reaching Above Shoulder Frequently

• Use of Fingers and Hands Constantly

• Repeated Bending and Reaching Frequently

• Ability for Rapid Mental & Muscular Coordination Simultaneously Constantly

• Near Vision Required

• Hearing (aid permitted)

LCCC Nursing Program Technical Standards

Please read the following information as you will be required to abide by its content. All nursing students

admitted to Laramie County Community College Nursing Program must be able to meet these standards with

or without accommodation(s).

• Observation/Sensory-motor: Students must be able to observe demonstrations and learn from

experiences in the basic sciences, including but not limited to, anatomy, physiology and microbiology

laboratory situations. Students must be able to observe and learn from experiences in the clinical nursing

laboratory such as the following examples: accurately read gradients/calibrations on a syringe; measure

medications accurately; accurately recognize color changes on chemical reaction strips; assess heart,

breath, abdominal sounds; assess normal and abnormal color changes in the skin; observe pupil changes;

and observe digital or waveform readings.

• Communication: Communications include not only speech but also reading, writing and computer usage,

including handheld digital access. Students must be able to communicate accurately and effectively with

patients, caregivers, physicians, other health professionals, clinical facility staff, faculty and staff, peers, and

the community in general in order to elicit information, describe changes in mood, activity and posture,

and perceive nonverbal communications.

• Psychomotor: Students should have sufficient motor function to elicit information from patients by

palpation, auscultation, percussion, and other diagnostic maneuvers. Students should be physically able to

collect specimens and perform basic tests (such as glucose finger stick, urine dipstick). Students should be

able to execute motor movements reasonably required to provide general care and emergency treatment to

patients. Example of emergency treatment reasonably required of nurses are cardiopulmonary resuscitation

(CPR), administration of intravenous (IV) medication, application of pressure to stop bleeding, and assist in

moving and lifting patients using proper body mechanics. Such actions require coordination of both gross

and fine muscular movements, equilibrium and using tactile and visual senses.

• Intellectual-Conceptual, Integrative, and Quantitative: Students must be able to comprehend and

interpret documents written in English. Students should have cognitive abilities including measurements,

calculation, reasoning, analysis, and synthesis. Critical thinking is the ability to synthesize knowledge and

integrate the relevant aspects of a client’s history, physical exam findings and diagnostic studies. Problem

solving, the critical skill demanded of nurses, requires all of these intellectual abilities. In addition, the

student should be able to comprehend three dimensional relationships and to understand the spatial

relationships of structures in order to understand normal and abnormal anatomy and physiology.

• Behavioral and Social Attributes: Students must possess the emotional health required to utilize

their intellectual abilities fully, exercise good judgment, complete all responsibilities attendant to the

nursing diagnosis and care of patients promptly, and the development of mature, sensitive and effective

relationships with patients and their families. Students must be able to tolerate physically taxing workloads

and to function effectively under stress. They must be able to adapt to changing environments, to

display flexibility, and to learn to function in the face of uncertainties inherent in the clinical problems of

many patients. Compassion, integrity, concern for others, interpersonal communication skills, interest

and motivation are all personal qualities that should be assessed during the education process. As a

component of nursing education, a student must demonstrate ethical behavior including adherence to the

professional nursing code and the LCCC and LCCC Nursing Program students conduct codes.

These standards were adapted from the University of Kansas School of Nursing Technical Standards for

Admission.

The physical form does not need to be

submitted with the application.

We will request this to be submitted

after acceptance to the nursing program.

Medical Release

Any student undergoing surgery, pregnancy, or an acute or chronic process, or who is on any

medication that could affect clinical performance, must submit a written medical release from a

health care provider to the clinical instructor to be placed in the student le to attend clinical.

LCCC NURSING PROGRAM PHYSICAL FORM

TO BE SUBMITTED AFTER ACCEPTANCE

TO BE COMPLETED BY APPLICANT

Name of Applicant _____________________________________________________________________________

(Print Name)

Date of Birth _____________________________________________

Childhood diseases ____________________________________________________________________________

Hospitalizations (why and when) _________________________________________________________________

_____________________________________________________________________________________________

Have you ever had: Yes No

a) Heart problems ..................................

b) Rheumatic fever ..................................

c) Epilepsy or seizures ...............................

d) Tuberculosis .....................................

e) Hepatitis ........................................

f) Difficult breathing past moderate exertion ..............

g) Asthma .........................................

h) High Blood Pressure ...............................

i) Fainting Spells ...................................

j) Allergy to drugs, foods, etc. .........................

k) Diabetes ........................................

l) Hearing problems .................................

m) Back problems that prevent lifting more than 40 pounds ...

n) Arthritis .........................................

o) Vision problems (Other than corrected by lenses) .........

Do you have any limitations that require accommodations to be successful in the program?

_____________________________________________________________________________________________

Are you currently receiving any medical treatment or taking any medications? Yes No

If so, please describe treatment and list medications ________________________________________________

Have you ever been treated for any psychological issues? Yes No If yes, when _______________

_____________________________________________________________________________________________

How would you describe your general state of health? _______________________________________________

I have revealed my medical history truthfully and wholly. I authorize my medical provider to give information to

the LCCC Nursing Department regarding my ability to participate in clinical rotations.

________________________________________________________ ____________________________________

Applicant's Signature Date

Once both pages are completed, please submit this form to: Nursing Program

Laramie County Community College

1400 E. College Drive

Cheyenne, WY 82007

1 of 2

HEALTH CARE PROVIDER TO COMPLETE THIS SIDE Student Name____________________________

Please check Yes if the applicant’s past or present medical history indicated any of the below. Explain if “Yes.”

Yes No

Chronic Illness ____________________________________________________________________

Physical disability __________________________________________________________________

Acute Illness ______________________________________________________________________

Recurring Physical or Mental health concerns __________________________________________

Visual Impairment _________________________________________________________________

Hearing Loss _____________________________________________________________________

Neck, Shoulder, Back Problems ______________________________________________________

Significant medical history of applicant ____________________________________________________________

_____________________________________________________________________________________________

REQUIRED IMMUNIZATIONS

1. 2-Step PPD (Mantoux) (within one year) Date_______ Reaction________ Date________ Reaction________

Chest x-ray if PPD is positive: Date___________________ Results ______________________________

2. Diphtheria-Tetanus Toxoid (TdaP) (within 10 years) Date__________________

3. Flu Vaccine (October-March) Date__________________

4. MMR – All students admitted to the nursing program are required to verify two doses of the MMR vaccine

or have a positive titer drawn to show immunity. Having had the disease does not constitute immunity.

Rubella Titre – Date__________________ Immune Yes No

Rubeola Titre – Date__________________ Immune Yes No

Mumps Titre – Date__________________ Immune Yes No

MMR Titre – Date__________________ Immune Yes No

OR 2 doses MMR vaccine – Date__________________ Date__________________

5. Varicella Titre – Date__________________ Immune Yes No

OR 2 doses Varicella vaccine – Date__________________ Date__________________

Note: Having had the disease does not constitute immunity.

6. Hepatitis B: Submit proof from health care provider that student is in the process of receiving vaccine.

Dates: (1)________________ (2)________________ (3)________________ Completed__________________

Hepatitis B Titer – Date_____________ Immune Yes No Date_____________

7. Color Vision: Distinguishes all colors Yes No If not, what colors are involved? _____________

(Color Vision Testing can be done in LCCC’s nursing office.)

8. Applicant can perform essential functions of a nurse. Yes No

RECOMMENDATION: From the preceding exam, do you believe _____________________________________

is capable to undertake all the demands placed on a health care provider?

(Name)

Remarks _____________________________________________________________________________________

_____________________________________________________________________________________________

__________________________________________

Health Care Provider’s Signature

PRINT Health Care Provider’s Name ______________________________________________________________

Address ______________________________________________________________________________________

Phone___________________________________________________ Date________________________________

PRS 5324 11/16

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