Registered nurse Susan Levandowski, a clinical manager at Banner Boswell Medical Center, never thought a casual conversation with a patient two years ago would lead to an invitation this year to be one of six nurses in the country to sit on the national nursing board exam question review panel in Chicago.

Levandowski was caring for a patient on the progressive care unit who also was a former nurse. As the two discussed their shared love of nursing, the patient told Levandowski about her own experience as a volunteer contributor to the National Council Nurse Licensure Examinations and encouraged Levandowski to apply for the opportunity. All nurses in the United States are required to pass the NCLEX to earn a nursing license and practice nursing at the entry level. Each year, the National Council of State Boards of Nursing chooses a select number of qualified nurses to serve on the exam writing, editing and review panels.

Levandowski applied online that night. Two years later, and with just three weeks' notice, she received word that she was chosen as one of six nurses in the country to be on this year's question review panel in Chicago.

For three days in May, Levandowski and five other nurses reviewed thousands of new and existing exam questions. They look at the results of existing questions to see how nursing students fared.

"If everyone got the question wrong, we knew that there was a problem with how it was worded," Levandowski said. "Conversely, if everyone got the question correct, it may need to be revised to make it more challenging."

The NCLEX is designed to test knowledge, skills and abilities essential to the safe and effective practice of nursing at the entry level.

Levandowski said the process of writing, editing and reviewing exam questions can take one to two years before the questions end up on an exam.

"It seems so easy to write a test, but it takes a long time and a lot of research. One word can change the entire meaning of a question," she said.

For Levandowski, the experience was personally and professionally fulfilling, she said.

"I was so pleased to be chosen. It was such an honor. I had never heard of this kind of opportunity before, and I just loved it," she said. "I highly encourage other nurses to apply. I learned so much about so many aspects of nursing. So much work goes into each question. It's a wide-eye opening experience."

For information about the NCLEX item development panels, visit www.ncsbn.org.