1|Page
REx-PN Exam Evaluation – Canadian Practical
Nurse Registration Examination – 2026/2027
Academic Year Verified Questions and Answers for
Practical Nurses
About This Exam Guide
This comprehensive examination preparation resource has been developed for
candidates preparing for the Regulatory Exam – Practical Nurse (REx-PN) for the
2026/2027 academic year.
The REx-PN is the national licensure examination for Practical Nurses in Canada,
developed in collaboration with the British Columbia College of Nurses and
Midwives (BCCNM) and the College of Nurses of Ontario (CNO) . Successful
completion of the REx-PN is required to qualify for registration as a Licensed
Practical Nurse (LPN) in participating provinces and territories .
The REx-PN assesses the knowledge, skills, and abilities essential for safe and
effective entry-level nursing practice . The examination is based on a Test Plan that
is updated every five years to reflect fair, comprehensive, current, and entry-level
nursing competency measurement . The latest REx-PN Test Plan will take effect on
January 1, 2027 .
The REx-PN Test Plan is aligned with the entry-level competencies for
Licensed/Registered Practical Nurses in Canada and the specific requirements of
BCCNM and CNO . The test plan includes an in-depth overview of the content
categories, details about the administration of the exam, and sample REx-PN style
items .
The examination covers the following key competency categories:
Professional, Ethical, and Legal Practice (approximately 25-30% of the exam):
Accountability, advocacy, legislation, ethics, confidentiality, scope of practice
Foundations of Practice: Health assessment, pathophysiology, pharmacology, client
teaching, wound care, medication administration, IV therapy, enteral feeds,
tracheostomy care, ECG interpretation, lab values, fall prevention, infection control
,2|Page
Collaborative Practice: Interprofessional communication, delegation, referral
processes, hand-off communication, conflict resolution, team dynamics, discharge
planning, quality improvement
The current passing standard for the REx-PN is set at -0.32 Logits, effective
January 4, 2022 through December 31, 2026 . The passing standard is evaluated
every five years by the Practical Nurse Examination Committee (PNEC) using a
criterion-referenced standard-setting method with input from expert panels .
This guide contains 300 exam-style questions organized by core competency areas
aligned with the REx-PN Test Plan. Each question includes the Correct Answer, a
detailed Rationale explaining why that answer is correct, and an explanation of why
alternative options are incorrect. The content reflects the essential competencies
required for entry-level practical nursing practice in Canada.
SECTION A: PROFESSIONAL, ETHICAL, AND LEGAL PRACTICE (Questions 1-
75)
1. A Practical Nurse is providing discharge teaching to a client with a new
prescription for furosemide (Lasix), a loop diuretic. Which statement by the client
indicates a correct understanding of the teaching?
a) "I should take this medication at night so I don't feel dizzy during the day."
b) "I need to increase my intake of potassium-rich foods like bananas and oranges."
c) "I will weigh myself once a week to check for fluid loss."
d) "I should limit my fluid intake to less than 1 litre per day."
Correct Answer: b) "I need to increase my intake of potassium-rich foods like
bananas and oranges."
Rationale: This question evaluates knowledge of pharmacology and client
education . Furosemide is a potassium-wasting diuretic. Clients need to be educated
on preventing hypokalemia by increasing dietary potassium. Furosemide should be
taken in the morning to prevent nocturia .
Why others are wrong:
Option a (Take at night): Taking furosemide at night would cause nocturia,
disrupting sleep.
Option c (Weigh once a week): Daily weights are crucial for monitoring fluid balance
in clients on diuretics.
,3|Page
Option d (Limit fluids): Fluid is usually not restricted unless indicated for other
conditions such as heart failure.
2. A PN is assessing a 2-day-old newborn. Which finding is expected and requires no
further intervention?
a) Yellowish tinge to the skin on the face and chest.
b) Absence of a startle reflex when the cot is bumped.
c) Respiratory rate of 70 breaths per minute with nasal flaring.
d) A raised, pale red bump on the skin with a small white dot in the center.
Correct Answer: a) Yellowish tinge to the skin on the face and chest.
Rationale: This tests knowledge of normal newborn variations . Physiological
jaundice appearing after 24 hours of life is common and typically resolves without
intervention. The yellowish tinge results from normal newborn red blood cell
breakdown and immature liver function .
Why others are wrong:
Option b (Absent startle reflex): An absent Moro reflex is abnormal and requires
further assessment.
Option c (RR 70 with nasal flaring): A respiratory rate of 70 with nasal flaring
indicates respiratory distress in a newborn.
Option d (Raised pale red bump with white dot): While erythema toxicum is a
normal newborn rash, the question asks for the most definitively expected finding;
mild jaundice is the clearer example of a common, expected finding .
3. A client with type 1 diabetes mellitus has a blood glucose level of 2.6 mmol/L. The
client is conscious and able to swallow. What should the PN do first?
a) Administer 15-20 grams of a fast-acting carbohydrate.
b) Administer glucagon intramuscularly.
c) Recheck the blood glucose in 15 minutes.
d) Give a complex carbohydrate like cheese and crackers.
Correct Answer: a) Administer 15-20 grams of a fast-acting carbohydrate.
, 4|Page
Rationale: This addresses a common emergency situation: hypoglycemia . For a
conscious client who can swallow, the immediate treatment is the "Rule of 15" —
give 15g of fast-acting carbohydrate (e.g., juice, glucose tablets, regular soft drink) .
Why others are wrong:
Option b (Glucagon IM): Glucagon is for unconscious clients who cannot swallow
safely.
Option c (Recheck in 15 minutes): Rechecking is done after treatment, not before.
Option d (Complex carbohydrates): Complex carbs are given after the client has
responded to the fast-acting sugar to sustain blood glucose levels.
4. A client at the end of life has a "Do Not Resuscitate" (DNR) order. The client's
family member requests that CPR be initiated if the client's heart stops. What is the
PN's appropriate response?
a) Initiate CPR as requested by the family.
b) Explain that the DNR order must be respected.
c) Call the healthcare provider to change the order.
d) Ask the family to leave the room.
Correct Answer: b) Explain that the DNR order must be respected.
Rationale: A DNR order is a legal document that must be respected . The PN must
uphold the client's right to self-determination and follow the advance directive. The
client's wishes, expressed through the DNR, take precedence over family requests .
Why others are wrong:
Option a (Initiate CPR): This would violate the client's legal directive and is
unethical.
Option c (Call to change): Only the healthcare provider can change the order, but
the PN should not initiate this without the client's consent.
Option d (Ask family to leave): This is dismissive and does not address the family's
concern.
REx-PN Exam Evaluation – Canadian Practical
Nurse Registration Examination – 2026/2027
Academic Year Verified Questions and Answers for
Practical Nurses
About This Exam Guide
This comprehensive examination preparation resource has been developed for
candidates preparing for the Regulatory Exam – Practical Nurse (REx-PN) for the
2026/2027 academic year.
The REx-PN is the national licensure examination for Practical Nurses in Canada,
developed in collaboration with the British Columbia College of Nurses and
Midwives (BCCNM) and the College of Nurses of Ontario (CNO) . Successful
completion of the REx-PN is required to qualify for registration as a Licensed
Practical Nurse (LPN) in participating provinces and territories .
The REx-PN assesses the knowledge, skills, and abilities essential for safe and
effective entry-level nursing practice . The examination is based on a Test Plan that
is updated every five years to reflect fair, comprehensive, current, and entry-level
nursing competency measurement . The latest REx-PN Test Plan will take effect on
January 1, 2027 .
The REx-PN Test Plan is aligned with the entry-level competencies for
Licensed/Registered Practical Nurses in Canada and the specific requirements of
BCCNM and CNO . The test plan includes an in-depth overview of the content
categories, details about the administration of the exam, and sample REx-PN style
items .
The examination covers the following key competency categories:
Professional, Ethical, and Legal Practice (approximately 25-30% of the exam):
Accountability, advocacy, legislation, ethics, confidentiality, scope of practice
Foundations of Practice: Health assessment, pathophysiology, pharmacology, client
teaching, wound care, medication administration, IV therapy, enteral feeds,
tracheostomy care, ECG interpretation, lab values, fall prevention, infection control
,2|Page
Collaborative Practice: Interprofessional communication, delegation, referral
processes, hand-off communication, conflict resolution, team dynamics, discharge
planning, quality improvement
The current passing standard for the REx-PN is set at -0.32 Logits, effective
January 4, 2022 through December 31, 2026 . The passing standard is evaluated
every five years by the Practical Nurse Examination Committee (PNEC) using a
criterion-referenced standard-setting method with input from expert panels .
This guide contains 300 exam-style questions organized by core competency areas
aligned with the REx-PN Test Plan. Each question includes the Correct Answer, a
detailed Rationale explaining why that answer is correct, and an explanation of why
alternative options are incorrect. The content reflects the essential competencies
required for entry-level practical nursing practice in Canada.
SECTION A: PROFESSIONAL, ETHICAL, AND LEGAL PRACTICE (Questions 1-
75)
1. A Practical Nurse is providing discharge teaching to a client with a new
prescription for furosemide (Lasix), a loop diuretic. Which statement by the client
indicates a correct understanding of the teaching?
a) "I should take this medication at night so I don't feel dizzy during the day."
b) "I need to increase my intake of potassium-rich foods like bananas and oranges."
c) "I will weigh myself once a week to check for fluid loss."
d) "I should limit my fluid intake to less than 1 litre per day."
Correct Answer: b) "I need to increase my intake of potassium-rich foods like
bananas and oranges."
Rationale: This question evaluates knowledge of pharmacology and client
education . Furosemide is a potassium-wasting diuretic. Clients need to be educated
on preventing hypokalemia by increasing dietary potassium. Furosemide should be
taken in the morning to prevent nocturia .
Why others are wrong:
Option a (Take at night): Taking furosemide at night would cause nocturia,
disrupting sleep.
Option c (Weigh once a week): Daily weights are crucial for monitoring fluid balance
in clients on diuretics.
,3|Page
Option d (Limit fluids): Fluid is usually not restricted unless indicated for other
conditions such as heart failure.
2. A PN is assessing a 2-day-old newborn. Which finding is expected and requires no
further intervention?
a) Yellowish tinge to the skin on the face and chest.
b) Absence of a startle reflex when the cot is bumped.
c) Respiratory rate of 70 breaths per minute with nasal flaring.
d) A raised, pale red bump on the skin with a small white dot in the center.
Correct Answer: a) Yellowish tinge to the skin on the face and chest.
Rationale: This tests knowledge of normal newborn variations . Physiological
jaundice appearing after 24 hours of life is common and typically resolves without
intervention. The yellowish tinge results from normal newborn red blood cell
breakdown and immature liver function .
Why others are wrong:
Option b (Absent startle reflex): An absent Moro reflex is abnormal and requires
further assessment.
Option c (RR 70 with nasal flaring): A respiratory rate of 70 with nasal flaring
indicates respiratory distress in a newborn.
Option d (Raised pale red bump with white dot): While erythema toxicum is a
normal newborn rash, the question asks for the most definitively expected finding;
mild jaundice is the clearer example of a common, expected finding .
3. A client with type 1 diabetes mellitus has a blood glucose level of 2.6 mmol/L. The
client is conscious and able to swallow. What should the PN do first?
a) Administer 15-20 grams of a fast-acting carbohydrate.
b) Administer glucagon intramuscularly.
c) Recheck the blood glucose in 15 minutes.
d) Give a complex carbohydrate like cheese and crackers.
Correct Answer: a) Administer 15-20 grams of a fast-acting carbohydrate.
, 4|Page
Rationale: This addresses a common emergency situation: hypoglycemia . For a
conscious client who can swallow, the immediate treatment is the "Rule of 15" —
give 15g of fast-acting carbohydrate (e.g., juice, glucose tablets, regular soft drink) .
Why others are wrong:
Option b (Glucagon IM): Glucagon is for unconscious clients who cannot swallow
safely.
Option c (Recheck in 15 minutes): Rechecking is done after treatment, not before.
Option d (Complex carbohydrates): Complex carbs are given after the client has
responded to the fast-acting sugar to sustain blood glucose levels.
4. A client at the end of life has a "Do Not Resuscitate" (DNR) order. The client's
family member requests that CPR be initiated if the client's heart stops. What is the
PN's appropriate response?
a) Initiate CPR as requested by the family.
b) Explain that the DNR order must be respected.
c) Call the healthcare provider to change the order.
d) Ask the family to leave the room.
Correct Answer: b) Explain that the DNR order must be respected.
Rationale: A DNR order is a legal document that must be respected . The PN must
uphold the client's right to self-determination and follow the advance directive. The
client's wishes, expressed through the DNR, take precedence over family requests .
Why others are wrong:
Option a (Initiate CPR): This would violate the client's legal directive and is
unethical.
Option c (Call to change): Only the healthcare provider can change the order, but
the PN should not initiate this without the client's consent.
Option d (Ask family to leave): This is dismissive and does not address the family's
concern.
