PNCB Exam Ethics Violation Tip Reporting Form

Each of us has a personal commitment to support and uphold exam ethics because employers, patients, and families count on the integrity of nursing care and the credentials that validate specialized practice knowledge.

PNCB’s Code of Ethics states you cannot act dishonestly or unfairly to personally gain advantage or provide advantage to another during the examination or recertification process.

If you observe any type of exam-related or recertification misconduct at any time, it is your responsibility to report it either here anonymously or by contacting PNCB by email at exam@pncb.org or by phone at 1-888-641-2767 then press 4. Misconduct is not limited to the time of an exam appointment. Misconduct can occur before and after testing too.

Examples include but are not limited to:

Attempt to share content in actual exam questions or copyrighted practice test questions
Attempt to purchase exam questions
Discussion of exam questions and/or their answer options
False identity
Theft or photography/recording of exam questions
Unauthorized materials during the exam appointment
Other

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* 1. Type of PNCB exam involved:

CPNP-AC: Certified Pediatric Nurse Practitioner – Acute Care

CPNP-PC: Certified Pediatric Nurse Practitioner – Primary Care

CPN: Certified Pediatric Nurse

PMHS: Pediatric Primary Care Mental Health Specialist

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* 2. Please describe the situation in as much detail as possible:

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* 3. How did you discover this information?

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* 4. Where did the incident occur? Please include city, state, and physical address.

Address *

City/Town *

State/Province *

Country

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* 5. Relationship to the incident location:

Nurse

Student

Faculty

Supervisor

Mentor or preceptor

University staff

Review course instructor

Other (please specify)

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* 6. Please provide the specific or approximate date and time of the incident.

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* 7. What can you tell us about the person(s) involved, such as their name(s) and title, if applicable? If you do not know this information, please type I don’t know.

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* 8. School or employer/hospital name, if applicable:

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* 9. If applicable/available, please upload a copy or images of any documents, emails, etc. involved in the incident.

PDF, DOC, DOCX, PNG, JPG, JPEG, GIF file types only.

Choose File

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* 10. If applicable/available, please provide the web link of any resources involved (e.g., Quizlet).

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* 11. If you have already reported this incident to another party (e.g., school/faculty, employer/supervisor), to whom and when?

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* 12. Is there anything else we should know about what occurred?

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* 13. I affirm that the statements and information in this report are correct, complete, and truthful to the best of my knowledge and belief.

Yes

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* 14. Do you wish to remain anonymous for this report?

Yes