Whenever we approach a policy change or revision, it is important to consider the impact of mental models and path dependency on our ability to consider a full range of options. The need for an entry-to-practice (ETP) or pre-licensing nursing examination may well fit the description of an entrenched mental model that results in path dependency. In this commentary, the objectives and purpose of nursing ETP examinations are explored within Canadian historical context, jurisdictional comparisons are considered and questions raised that could inform a national discussion on why Canada may or may not need an ETP examination for nursing.