CPNRE CORE EXAM TEST 2026 QUESTIONS AND ANSWERS
GRADED A+
✔✔Mr. Spencer, 52 yr old with schizophrenia,lives in an apartment building. The PN
visits daily for med admin and a mental status assessment. Lately, there have been
reports from other tenants that Mr. Spencer hammers on the walls and yells for the
noises to go away.Mr. Spencer risks being evicted if he does not stop. During today`s
visit, Mr. Spencer is pacing,stating that the noises in his head are loud, and he had his
hands over his ears. He has not bathed lately and his apartment has garbage on the
floor.
The PN needs to advocate for the client. What is the best way to accomplish this?
1. Request that a social worker meet with Mr. Spencer about his situation.
2. Go to the landlord, apologize on behalf of the client and propose a new plan of care.
3. Ask the landlord to allow more time before evicting Mr. Spencer
4. Inform Mr. Spencer that he must apologize to the landlord immediately - ✔✔1.
Request that a social worker meet with Mr. Spencer about his situation.
✔✔Mr. Spencer, 52 yr old with schizophrenia,lives in an apartment building. The PN
visits daily for med admin and a mental status assessment. Lately, there have been
reports from other tenants that Mr. Spencer hammers on the walls and yells for the
noises to go away.Mr. Spencer risks being evicted if he does not stop. During today`s
visit, Mr. Spencer is pacing,stating that the noises in his head are loud, and he had his
hands over his ears. He has not bathed lately and his apartment has garbage on the
floor.
While visiting Mr. Spencer, the PN wants to discuss concerns with the client regarding
his mental status and current living situation. Which is the best approach to use with Mr.
Spencer?
1. Explain to Mr. Spencer that his behavior is very inappropriate, it is going to get him
evicted and he will end up homeless again
2. Inform him that the voices need to be addressed by the psychiatrist and explain that
the other - ✔✔4. Validate that the noises are bothersome and a visit to the psychiatrist
may help. Explain that other tenants are troubled by the banging.
✔✔Mr. Spencer, 52 yr old with schizophrenia,lives in an apartment building. The PN
visits daily for med admin and a mental status assessment. Lately, there have been
reports from other tenants that Mr. Spencer hammers on the walls and yells for the
noises to go away.Mr. Spencer risks being evicted if he does not stop. During today`s
visit, Mr. Spencer is pacing,stating that the noises in his head are loud, and he had his
hands over his ears. He has not bathed lately and his apartment has garbage on the
floor.
Which plan of care would be most appropriate for the PN to implement for Mr. Spencer?
1. Notify the physician of Mr. Spencer's behavioral changes and request immediate
hospitalization.
,2. Suggest to Mr. Spencer that he move to an assisted living facility before he gets
evicted.
3. Advocate for a psychiatric assessment and increased daily visits by an appropriate
health-care provider
4. Advise Mr. Spencer that if - ✔✔3. Advocate for a psychiatric assessment and
increased daily visits by an appropriate health-care provider
✔✔Mrs. Proud, 32 years old, is pregnant for the third time. Her first pregnancy ended at
17 weeks gestation and her second child was delivered at 36 weeks gestation.
Mrs. Proud is full term and in early labour. How should the PN record her obstetrical
history?
1. Gravida 2, Para 3
2. Gravida 2, Para 2
3. Gravida 3, Para 2
4. Gravida 3, Para 1 - ✔✔4. Gravida 3, Para 1
Gravida indicates the number of times the woman has been pregnant, regardless of
whether these pregnancies were carried to term. A current pregnancy, if any, is included
in this count.[citation needed]
Parity, or "para" indicates the number of >20-week births (including viable and non-
viable; i.e., stillbirths). Pregnancies consisting of multiples, such as twins or triplets,
count as one birth for the purpose of this notation.[citation needed]
Abortus is the number of pregnancies that were lost for any reason, including induced
abortions or miscarriages. The abortus term is sometimes dropped when no
pregnancies have been lost. Stillbirths are not included
✔✔Mrs. Proud, 32 years old, is pregnant for the third time. Her first pregnancy ended at
17 weeks gestation and her second child was delivered at 36 weeks gestation.
Six hours later, Mrs. Proud's cervix is 100% effaces and 9cm dilated. She is restless
and crying out in discomfort. In which stage of labour is Mrs. Proud?
1. First stage of labour in the latent phase
2. Early in the third stage of labour
3. Early in the second stage of labour
4. First stage of labour in the transition phase - ✔✔4. First stage of labour in the
transition phase
1st Stage: Latent - onset of uterine contractions (20-40sec), ends with cervical
dilation/effacement (0-3cm)
Active - rapid cervical dilation (4-7cm), longer contractions (40-60sec), increased show
(vaginal secretions) and chance of spontaneous rupture of membranes ("water
breaking" rupture of amniotic sac from contractions)
Transition - contractions peak (every 2-3min for 60-90sec), max cervical dilation (8-
10cm) full effacement
2nd Stage: from full dilation and full effacement to birth
-pushing phase
,-crowning: as fetal head pushes against perineum the vagina opens in a slit, then an
oval, and finally a circle; from a dime to a quarter and then half a dollar.
3rd Stage: placental stage from birth to delivery of placenta
Placental Separation - after birth uterus palpable as firm, round mass inferior to
umbilicus
-contractions start again and uterus is a discoid shape
-uterus presses down and placenta starts to separate, bleeding internally helps push
placenta away from uterine lining
Placental Expulsion - placenta delivered via bearing-down or by Dr or midwife gently
pressing on CONTRACTED uterine fundus (pressure on non contracted uterus causes
evert (turn inside out) and hemorrhage)
✔✔Mrs. Proud, 32 years old, is pregnant for the third time. Her first pregnancy ended at
17 weeks gestation and her second child was delivered at 36 weeks gestation.
Mrs. Proud spontaneously delivers a living female. At 1 minute age, the newborn is
pink, has acrocyanosis, flexed tone, an apical pulse rate of 140 beats/min and responds
with a vigorous cry to a tap on the sole of her foot. Which Apgar score would the baby
receive?
1. 7
2. 8
3. 9
4. 10 - ✔✔3. 9
Appearance {skin color}
Pulse {heart rate}
Grimace {reflex irritability}
Activity {muscle tone}
Respiration {breath rate/effort}
✔✔Mrs. Proud, 32 years old, is pregnant for the third time. Her first pregnancy ended at
17 weeks gestation and her second child was delivered at 36 weeks gestation.
Two hours after delivery, Mrs. Proud's fundus is firm, three finger breadths above the
umbilicus, displaced to the right side, the size of a large grapefruit and slightly tender.
She has a moderate amount of lochia rubra. What is the best action for the PN to take?
1. Ask Mrs. Proud to void and re-assess the fundus
2. Check when Mrs. Proud last received analgesic medication
3. Notify the physician of the findings and monitor closely
4. Massage the fundus until it returns midline - ✔✔1. Ask Mrs. Proud to void and re-
assess the fundus
Suggestive of full bladder displacement
Only massage fundus to midline AFTER voiding
✔✔Mr. Manne, 45 years old, is admitted with weight loss not yet diagnosed. He reports
a loss of appetite and a general feeling of fatigue.
, Mr. Manne is experiencing bloody diarrhea. What diagnostic tests would be ordered if
colorectal cancer is suspected?
1. Upper GI series and electrolytes
2. Colposcopy and stool for occult blood
3. Colonoscopy and hemoglobin
4. Lower GI series and creatinine - ✔✔3. Colonoscopy and hemoglobin : Colonoscopy
used to view the rectum and lining for growths to diagnose rectal cancer and
hemoglobin should be monitored because of blood loss
For colon cancer upper GI series is unnecessary
Colposcopy is not required and neiter is an occult stool test if stools are obviously
bloody
Creatinine is used to assess kidney function and is not relevant if colorectal cancer is
suspected
✔✔Mr. Manne, 45 years old, is admitted with weight loss not yet diagnosed. He reports
a loss of appetite and a general feeling of fatigue.
Mr. Manne has surgery for colorectal cancer with the formation of a colostomy. While
performing a dressing change, the PN notices that Mr. Manne's stoma is swollen and
bluish in colour. What should the PN do first?
1. Continue with the dressing change
2. Request that the surgeon be notified
3. Leave a message with the physician's office
4. Document these findings and report at change of shift - ✔✔4. Document these
findings and report at change of shift : Change in Color (Ischemia/Necrosis): Caused by
an inadequate blood supply to the stoma. Sometimes a stoma will "pink up" as swelling
decreases. If the stoma continues to darken--turns dusky blue, dark brown or black, you
should report this to your physician immediately.
Normal: Red or pink, moist appearance. Slight bleeding is normal with cleansing.
Swelling should decrease over a period of 6-8 weeks after surgery. Movement of the
stoma is normal, and it may move in and out with changes in your position.
✔✔Mr. Manne, 45 years old, is admitted with weight loss not yet diagnosed. He reports
a loss of appetite and a general feeling of fatigue.
MR. Manne tells the PN that his father died at the age of 50 from colon cancer and
states "I am going to end up like my father." How should the PN respond to Mr. Manne?
1. "You are not your father. You were diagnosed early."
2. "You think you are going to die, don't you?"
3. "You seem upset. Tell me what the physician has told you"
4. "Let's discuss getting you home. That will cheer you up, don't you think?" - ✔✔3.
"You seem upset. Tell me what the physician has told you" : open ended questions help
to express the pt's feelings
False reassurance doesn't help genetic inclination
Leading questions don't acknowledge the pt's true feelings
Avoiding the topic is not helpful
GRADED A+
✔✔Mr. Spencer, 52 yr old with schizophrenia,lives in an apartment building. The PN
visits daily for med admin and a mental status assessment. Lately, there have been
reports from other tenants that Mr. Spencer hammers on the walls and yells for the
noises to go away.Mr. Spencer risks being evicted if he does not stop. During today`s
visit, Mr. Spencer is pacing,stating that the noises in his head are loud, and he had his
hands over his ears. He has not bathed lately and his apartment has garbage on the
floor.
The PN needs to advocate for the client. What is the best way to accomplish this?
1. Request that a social worker meet with Mr. Spencer about his situation.
2. Go to the landlord, apologize on behalf of the client and propose a new plan of care.
3. Ask the landlord to allow more time before evicting Mr. Spencer
4. Inform Mr. Spencer that he must apologize to the landlord immediately - ✔✔1.
Request that a social worker meet with Mr. Spencer about his situation.
✔✔Mr. Spencer, 52 yr old with schizophrenia,lives in an apartment building. The PN
visits daily for med admin and a mental status assessment. Lately, there have been
reports from other tenants that Mr. Spencer hammers on the walls and yells for the
noises to go away.Mr. Spencer risks being evicted if he does not stop. During today`s
visit, Mr. Spencer is pacing,stating that the noises in his head are loud, and he had his
hands over his ears. He has not bathed lately and his apartment has garbage on the
floor.
While visiting Mr. Spencer, the PN wants to discuss concerns with the client regarding
his mental status and current living situation. Which is the best approach to use with Mr.
Spencer?
1. Explain to Mr. Spencer that his behavior is very inappropriate, it is going to get him
evicted and he will end up homeless again
2. Inform him that the voices need to be addressed by the psychiatrist and explain that
the other - ✔✔4. Validate that the noises are bothersome and a visit to the psychiatrist
may help. Explain that other tenants are troubled by the banging.
✔✔Mr. Spencer, 52 yr old with schizophrenia,lives in an apartment building. The PN
visits daily for med admin and a mental status assessment. Lately, there have been
reports from other tenants that Mr. Spencer hammers on the walls and yells for the
noises to go away.Mr. Spencer risks being evicted if he does not stop. During today`s
visit, Mr. Spencer is pacing,stating that the noises in his head are loud, and he had his
hands over his ears. He has not bathed lately and his apartment has garbage on the
floor.
Which plan of care would be most appropriate for the PN to implement for Mr. Spencer?
1. Notify the physician of Mr. Spencer's behavioral changes and request immediate
hospitalization.
,2. Suggest to Mr. Spencer that he move to an assisted living facility before he gets
evicted.
3. Advocate for a psychiatric assessment and increased daily visits by an appropriate
health-care provider
4. Advise Mr. Spencer that if - ✔✔3. Advocate for a psychiatric assessment and
increased daily visits by an appropriate health-care provider
✔✔Mrs. Proud, 32 years old, is pregnant for the third time. Her first pregnancy ended at
17 weeks gestation and her second child was delivered at 36 weeks gestation.
Mrs. Proud is full term and in early labour. How should the PN record her obstetrical
history?
1. Gravida 2, Para 3
2. Gravida 2, Para 2
3. Gravida 3, Para 2
4. Gravida 3, Para 1 - ✔✔4. Gravida 3, Para 1
Gravida indicates the number of times the woman has been pregnant, regardless of
whether these pregnancies were carried to term. A current pregnancy, if any, is included
in this count.[citation needed]
Parity, or "para" indicates the number of >20-week births (including viable and non-
viable; i.e., stillbirths). Pregnancies consisting of multiples, such as twins or triplets,
count as one birth for the purpose of this notation.[citation needed]
Abortus is the number of pregnancies that were lost for any reason, including induced
abortions or miscarriages. The abortus term is sometimes dropped when no
pregnancies have been lost. Stillbirths are not included
✔✔Mrs. Proud, 32 years old, is pregnant for the third time. Her first pregnancy ended at
17 weeks gestation and her second child was delivered at 36 weeks gestation.
Six hours later, Mrs. Proud's cervix is 100% effaces and 9cm dilated. She is restless
and crying out in discomfort. In which stage of labour is Mrs. Proud?
1. First stage of labour in the latent phase
2. Early in the third stage of labour
3. Early in the second stage of labour
4. First stage of labour in the transition phase - ✔✔4. First stage of labour in the
transition phase
1st Stage: Latent - onset of uterine contractions (20-40sec), ends with cervical
dilation/effacement (0-3cm)
Active - rapid cervical dilation (4-7cm), longer contractions (40-60sec), increased show
(vaginal secretions) and chance of spontaneous rupture of membranes ("water
breaking" rupture of amniotic sac from contractions)
Transition - contractions peak (every 2-3min for 60-90sec), max cervical dilation (8-
10cm) full effacement
2nd Stage: from full dilation and full effacement to birth
-pushing phase
,-crowning: as fetal head pushes against perineum the vagina opens in a slit, then an
oval, and finally a circle; from a dime to a quarter and then half a dollar.
3rd Stage: placental stage from birth to delivery of placenta
Placental Separation - after birth uterus palpable as firm, round mass inferior to
umbilicus
-contractions start again and uterus is a discoid shape
-uterus presses down and placenta starts to separate, bleeding internally helps push
placenta away from uterine lining
Placental Expulsion - placenta delivered via bearing-down or by Dr or midwife gently
pressing on CONTRACTED uterine fundus (pressure on non contracted uterus causes
evert (turn inside out) and hemorrhage)
✔✔Mrs. Proud, 32 years old, is pregnant for the third time. Her first pregnancy ended at
17 weeks gestation and her second child was delivered at 36 weeks gestation.
Mrs. Proud spontaneously delivers a living female. At 1 minute age, the newborn is
pink, has acrocyanosis, flexed tone, an apical pulse rate of 140 beats/min and responds
with a vigorous cry to a tap on the sole of her foot. Which Apgar score would the baby
receive?
1. 7
2. 8
3. 9
4. 10 - ✔✔3. 9
Appearance {skin color}
Pulse {heart rate}
Grimace {reflex irritability}
Activity {muscle tone}
Respiration {breath rate/effort}
✔✔Mrs. Proud, 32 years old, is pregnant for the third time. Her first pregnancy ended at
17 weeks gestation and her second child was delivered at 36 weeks gestation.
Two hours after delivery, Mrs. Proud's fundus is firm, three finger breadths above the
umbilicus, displaced to the right side, the size of a large grapefruit and slightly tender.
She has a moderate amount of lochia rubra. What is the best action for the PN to take?
1. Ask Mrs. Proud to void and re-assess the fundus
2. Check when Mrs. Proud last received analgesic medication
3. Notify the physician of the findings and monitor closely
4. Massage the fundus until it returns midline - ✔✔1. Ask Mrs. Proud to void and re-
assess the fundus
Suggestive of full bladder displacement
Only massage fundus to midline AFTER voiding
✔✔Mr. Manne, 45 years old, is admitted with weight loss not yet diagnosed. He reports
a loss of appetite and a general feeling of fatigue.
, Mr. Manne is experiencing bloody diarrhea. What diagnostic tests would be ordered if
colorectal cancer is suspected?
1. Upper GI series and electrolytes
2. Colposcopy and stool for occult blood
3. Colonoscopy and hemoglobin
4. Lower GI series and creatinine - ✔✔3. Colonoscopy and hemoglobin : Colonoscopy
used to view the rectum and lining for growths to diagnose rectal cancer and
hemoglobin should be monitored because of blood loss
For colon cancer upper GI series is unnecessary
Colposcopy is not required and neiter is an occult stool test if stools are obviously
bloody
Creatinine is used to assess kidney function and is not relevant if colorectal cancer is
suspected
✔✔Mr. Manne, 45 years old, is admitted with weight loss not yet diagnosed. He reports
a loss of appetite and a general feeling of fatigue.
Mr. Manne has surgery for colorectal cancer with the formation of a colostomy. While
performing a dressing change, the PN notices that Mr. Manne's stoma is swollen and
bluish in colour. What should the PN do first?
1. Continue with the dressing change
2. Request that the surgeon be notified
3. Leave a message with the physician's office
4. Document these findings and report at change of shift - ✔✔4. Document these
findings and report at change of shift : Change in Color (Ischemia/Necrosis): Caused by
an inadequate blood supply to the stoma. Sometimes a stoma will "pink up" as swelling
decreases. If the stoma continues to darken--turns dusky blue, dark brown or black, you
should report this to your physician immediately.
Normal: Red or pink, moist appearance. Slight bleeding is normal with cleansing.
Swelling should decrease over a period of 6-8 weeks after surgery. Movement of the
stoma is normal, and it may move in and out with changes in your position.
✔✔Mr. Manne, 45 years old, is admitted with weight loss not yet diagnosed. He reports
a loss of appetite and a general feeling of fatigue.
MR. Manne tells the PN that his father died at the age of 50 from colon cancer and
states "I am going to end up like my father." How should the PN respond to Mr. Manne?
1. "You are not your father. You were diagnosed early."
2. "You think you are going to die, don't you?"
3. "You seem upset. Tell me what the physician has told you"
4. "Let's discuss getting you home. That will cheer you up, don't you think?" - ✔✔3.
"You seem upset. Tell me what the physician has told you" : open ended questions help
to express the pt's feelings
False reassurance doesn't help genetic inclination
Leading questions don't acknowledge the pt's true feelings
Avoiding the topic is not helpful
