The Kangoshi (Japanese National Nursing) exam uses a dual-pass system, and the 必修 (hisshu) 80% rule is the part that eliminates otherwise well-prepared candidates. To pass, you must score at least 80% on the 必修問題 section — a fixed 50-question block — regardless of how well you perform on the remaining general and situational questions. Miss this threshold and you fail outright, even if your overall score would otherwise qualify.

What Exactly Is the 必修 80% Rule?

The 必修問題 section consists of 50 questions worth 1 point each, for a maximum of 50 points. To clear the hisshu threshold, you must earn at least 40 of those 50 points — that is, answer at least 40 questions correctly. Scoring 39 or below means automatic disqualification, no matter what you achieve in the general (一般問題) or situational (状況設定問題) sections.

The 必修 questions are designed to test the absolute minimum competencies every practicing nurse must possess: fundamental anatomy, basic pharmacology, essential nursing procedures, legal and ethical frameworks, and core patient safety principles. The Ministry of Health, Labour and Welfare publishes an explicit content outline (出題基準) that governs these questions, so the scope is defined — but deceptively broad.

How Is the Rest of the Kangoshi Exam Scored?

Outside the 必修 block, the exam divides into 一般問題 (general questions, 1 point each) and 状況設定問題 (situational questions, 2 points each). The combined passing mark for these two sections is set around 65% of the available points, though the exact cut score shifts slightly year to year based on an adjusted norm. In recent sittings, the combined general/situational threshold has typically landed between 155 and 165 points out of approximately 250.

This means a candidate must independently clear two separate bars: 40/50 on hisshu and the adjusted threshold on general/situational. Excelling in one cannot compensate for shortfall in the other. A candidate who scores 248/250 on the general and situational sections but only 39/50 on 必修 receives the same outcome as someone who guessed randomly — a fail.

Why Do Strong Candidates Fail the 必修 Rule?

The failure pattern is consistent and well-documented among exam coaches. Candidates who study intensively from qestion banks and mock exams tend to over-index on complex situational scenarios — the multi-paragraph clinical vignettes that feel challenging and reward deep analysis. The 必修 questions, by contrast, look elementary. This creates four predictable failure modes.

1. Underestimating question precision: Hisshu questions use simple language, but the correct answer often hinges on a single precise number (e.g., normal adult respiratory rate range), exact legal definition, or a specific procedural step order. Candidates who skim these topics lose single points repeatedly until they fall below 40.
2. Skipping foundational review: Students who graduated several years before sitting the exam frequently under-review basic nursing science, assuming they retained it. Questions on normal vital sign ranges, standard drug dosages, or the Nursing Act article numbers are answered from memory that has drifted.
3. Careless errors under time pressure: The full exam runs across two days, with 必修 appearing in the morning of day one. Test anxiety and fatigue cause misreads on short, direct questions — candidates choose an answer that looks right at a glance rather than reading every option.
4. Ignoring the 出題基準 content map: The official 出題基準 lists every major topic category for 必修. Candidates who do not explicitly cross-check their revision against this map leave predictable gaps — typically in health promotion, community nursing law, and disaster nursing fundamentals, which appear annually.

What Topics Appear Most Frequently in 必修問題?

Analysis of publicly released past exams (第100回 through the most recent sitting) reveals consistent topic clusters. Memorising these areas and their exact reference values is the single highest-return activity for hisshu preparation.

• Normal physiological values: adult blood pressure, heart rate (60–100 bpm), respiratory rate (12–20/min), body temperature, SpO2 (≥96%), and urine output (≥0.5 mL/kg/hr)
• Nursing Act (保健師助産師看護師法): nurse scope of practice, license requirements, duty of confidentiality articles
• Basic pharmacology: insulin administration routes, anticoagulant reversal agents, analgesic classification
• Fundamental nursing procedures: aseptic technique steps, nasogastric tube insertion confirmation methods, proper hand hygiene moments (WHO 5 moments)
• Health statistics and demographics: Japan's leading causes of death (cancer, heart disease, cerebrovascular disease in rank order), aging rate figures updated each exam cycle
• Patient rights and ethics: informed consent requirements, the concept of self-determination, advance directive basics
• Disaster and community nursing: triage color categories and criteria (immediate/red, delayed/yellow, minimal/green, expectant/black)

How to Build a 必修-Safe Study Plan

Given the binary, no-compensation nature of the 必修 threshold, your study plan should treat hisshu as a non-negotiable daily component rather than a topic you revisit only in the final weeks. The following structure applies whether you have three months or six months before your exam date.

1. Audit the 出題基準: Download the current official content outline from the Ministry of Health, Labour and Welfare website. Print the 必修 topic list and use it as a physical checklist — tick each area only after you can answer three consecutive past-exam questions in that area without error.
2. Set a personal target of 45/50: Aiming for exactly 40 gives you zero buffer. Test anxiety alone can cost you one or two questions. Set your private target at 45 (90%) so that even a bad exam day still clears 80%.
3. Do 10 timed 必修 questions every single study day: Consistency matters more than volume. Ten targeted questions daily accumulates over 900 hisshu repetitions across a three-month period — enough to internalize precision on normal values and legal definitions.
4. Review errors immediately and categorically: When you miss a question, identify whether the error was a knowledge gap, a value-range memory error, or a misread. Each type requires a different fix — flashcard, value table review, or slow re-reading practice respectively.
5. Run two full timed mock exams in the final month: Simulate the day-one morning conditions (必修 first, under time pressure, in a single sitting) to expose careless-error patterns before the real exam.

The 必修 80% rule is not an arbitrary hurdle — it reflects the principle that certain foundational competencies are non-negotiable for patient safety. Treating it with that seriousness, rather than as a formality before the 'real' exam questions, is what separates candidates who pass cleanly from those who fail despite months of sincere preparation.