This book still has notes and sticky notes from when I took the Public Health Nurse National Examination. I used it a lot, with a book cover on it. The outside is very clean!! I'm offering it for sale, hoping it can help you with the national exam. *Please understand that this is a used item and has been inspected by an amateur. *Please note that the colors in the images may appear different depending on your smartphone or PC model and settings. *I am not responsible for any claims, returns, refunds, or shipping issues. *I am a non-smoker and do not have any pets.