Computerized Clinical Simulation Testing is under research and development by the National Council of State Boards of Nursing for potential use as a component of the National Council Licensure Examination for Registered Nurses. This interactive software permits the realistic assessment and management of client needs through free-text entry of requests for nursing activities, each of which elicit a response from the client. The efficiency and accuracy of system recognition of the free-text requests depends on the careful structuring of a comprehensive nursing activity database. This article describes and illustrates the processes and challenges encountered in building a system-compatible nursing activity database from a very unstructured, unstandardized nursing language.