Child Health Enhanced Role Registered Nurses (CHERRN) who do not meet the required 20 hours of approved continuing education hours and 100 hours of clinical practice for annual re-rostering must complete the challenge process to be rostered. Only rostered CHERRNs may provide and bill for pediatric preventative services.


Challenge candidates will complete a Challenge Application and submit it to their Regional Child Health Nurse Consultant (RCHNC) (click here to find your RCHNC). When the application is approved, the RCHNC will send to NCIPH. NCIPH office staff will send a link for online REGISTRATION.

Registration and Fee Process

The fee to take the challenge exam is $250.00. Once your fee has been received by NCIPH your exam will be emailed to your DON. Payment can be made by credit card at the time of online registration. Check payments should be made payable to The University of North Carolina at Chapel Hill and mailed to:

Attn: Registrar
Campus Box 165
Chapel Hill NC 27599

Written Exam

Challenge candidates must complete a 75 question multiple choice exam and one clinical practice scenario. Both must be proctored. The exam will be sent to the agency Director of Nursing (DON) who will be responsible for assuring that the exam is appropriately supervised. The candidate will have two and half hours to complete the exam and scenario. The completed exam must be scanned and emailed to Lori Rhew at within one week of it being sent to the agency. The candidate must score a minimum of 80% on the exam to proceed with the challenge process.

Onsite Clinical Check-Off

The RCHNC will schedule an onsite visit to the agency to observe the candidate complete a preventative visit on a client. The visit will be scheduled within three weeks of notification of successful completion of the written exam.

Visit Documentation

The candidate will submit to the RCHNC complete documentation of the check off visit. The visit can be provided in POHR, or printed and scanned Bright Futures Tool and Resource Kit forms. The RCHNC will provide feedback within one week of receiving the documentation.


Once the candidate has successfully completed the three components of the challenge process, NCIPH will provide required rostering documentation to the Public Health Nursing and Professional Development (PHNPD). PHNPD staff will notify the DON in writing within one week that the candidate is officially rostered and can resume providing and billing preventative services.

For More Information

For more information, contact Lori Rhew,, 919-843-0836.