The research used quantitative study with natural experiment design for analysis of respondent performance in INP 3 exam procedures in CPR, Heimlich maneuver, insertion of catheter and NGT, and identification of instruments which will be referred as advance nursing procedures. Study participants are 4th year students of INP 3 of College of Nursing from Tobruk University. Result of the study shows that the students are competent enough in advance nursing procedures and fit to work as nurses in the future with an overall mean of 67.13, were repeaters has a mean of 59.97 and 70.59 for regular students. A significant difference were observe with a p-value of 0.000669 between the two groups.