Computerized Clinical Simulation Testing (CST) 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. It is designed to evaluate the application of the clinical decision-making process to the management of client care. The authors describe how CST works, the case development and scoring key development processes, and the plans for the CST pilot study scheduled for spring 1998.