My family member passed the national exam in February of this year, so this item is no longer needed. I purchased it last spring. The box case is warped. I used the mandatory subjects and past questions. There are no writings. There may be minor stains. How about using it to solve past questions and build your basic skills? #Igakushoin #book #nature/medical_science/health #national_exam #nursing_student #national_exam_preparation