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CANADIAN REX-PN QUESTION BANKWITH VERIFIED
ANSWERS DETAILED RATIONALES GRADED A+
Canadian REx-PN Question Bank
Section 1: Safe and Effective Care Environment – Management of Care (Questions 1–30)
1. A practical nurse is caring for four patients. Which task can be delegated to an unregulated
care provider?
A. Administering oral acetaminophen to a patient
B. Assisting a stable patient with feeding
C. Assessing a new complaint of chest pain
D. Developing the nursing care plan
Rationale: B. Unregulated care providers may assist with activities of daily living such as
feeding a stable patient under the direction and supervision of the practical nurse.
Assessment, medication administration, and care planning remain within the regulated nurse
scope of practice as defined by the CNO.
2. A practical nurse is delegating tasks to an unregulated care provider (UCP/PSW). Which task
is appropriate to assign to the UCP?
A. Performing the initial admission assessment on a new client
B. Assisting a stable client with bathing and oral hygiene
C. Administering a scheduled oral medication to a client
D. Evaluating a client's response to a new pain protocol
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Rationale: B. Delegation to unregulated care providers is appropriate for stable, predictable
tasks within their role, such as assisting a stable client with personal hygiene and activities of
daily living. Assessment, medication administration, and evaluation require nursing judgment
and cannot be delegated.
3. A newly licensed practical nurse (LPN) delegates the task of ambulating a stable post-
operative client to an unregulated care provider (UCP). Which action by the LPN demonstrates
appropriate delegation?
A. Telling the UCP to ambulate the client whenever they have time.
B. Asking the UCP if they are comfortable ambulating clients before giving the task.
C. Informing the UCP about the client's fall risk and verifying their understanding of the task.
D. Documenting that the UCP ambulated the client in the medical record.
Rationale: C. The five rights of delegation include the right task, circumstances, person,
direction/communication, and supervision/evaluation. Providing specific information (like fall
risk) and verifying the UCP's understanding fulfills the right direction/communication. Asking
if they are "comfortable" is not a substitute for verifying competency.
4. A charge nurse is making client assignments for a medical-surgical unit. Which client should
be assigned to the most experienced LPN?
A. A client with a urinary tract infection requiring a urinalysis.
B. A client with diabetes mellitus requiring a blood glucose check before breakfast.
C. A client who is 24-hours post-hip replacement and needs reinforcement of discharge
teaching.
D. A client with a newly inserted chest tube requiring frequent assessment.
Rationale: D. Assignment should be based on client acuity and staff competency. A client with
a newly inserted chest tube is unstable and requires frequent, skilled assessment. The most
experienced LPN is best suited for this client. Other tasks are more stable and can be assigned
to less experienced staff.
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5. A practical nurse is assigned to care for four clients. After receiving morning report, which
client should the nurse assess FIRST?
A. A 55-year-old client with diabetes whose blood glucose level is 110 mg/dL.
B. A 70-year-old client with pneumonia who is febrile with a new onset of confusion.
C. A 45-year-old client with a colostomy who needs assistance with a pouch change.
D. A 60-year-old client with hypertension scheduled for discharge in two hours.
Rationale: B. The nurse should use principles of prioritization (ABCs, acute vs. chronic,
Maslow's hierarchy). A new onset of confusion in an elderly client with pneumonia is a sign of
decreased cerebral oxygenation and potential sepsis, making this the most acute and unstable
condition. The other clients are stable or require non-urgent care.
6. A practical nurse is caring for four patients. Which task can be delegated to an unregulated
care provider?
A. Administering oral acetaminophen to a patient
B. Assisting a stable patient with feeding
C. Assessing a new complaint of chest pain
D. Developing the nursing care plan
Rationale: B. Unregulated care providers may assist with activities of daily living such as
feeding a stable patient under the direction and supervision of the practical nurse.
Assessment, medication administration, and care planning remain within the regulated nurse
scope of practice as defined by the CNO.
7. A practical nurse calls the health care provider (HCP) regarding a new medication
prescription. The dosage prescribed is higher than the recommended dosage, however, the
nurse is unable to locate the HCP for an explanation. Which action should the nurse take if the
medication is due to be administered at this moment?
A. Contact the nursing supervisor
B. Administer the dose prescribed
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C. Hold the medication until the HCP can be contacted
D. Administer the recommended dose until the HCP can be located
Rationale: C. The practical nurse must clarify any unclear or unsafe order with the prescriber
or pharmacist before administration and must never administer a dose believed to be
incorrect. Holding the medication is the safest action until clarification is obtained.
8. A practical nurse is preparing to administer a medication and notices the prescribed dose
seems unusually high. The next action is to:
A. Administer the dose as ordered.
B. Ask the patient if they took it before.
C. Verify the order with the prescriber or pharmacist
D. Skip the dose and document it was not given
Rationale: C. The practical nurse must clarify any unclear or unsafe order with the prescriber
or pharmacist before administration and must never administer a dose believed to be
incorrect.
9. A practical nurse is caring for four patients. Which task can be delegated to an unregulated
care provider?
A. Administering oral acetaminophen to a patient
B. Assisting a stable patient with feeding
C. Assessing a new complaint of chest pain
D. Developing the nursing care plan
Rationale: B. Unregulated care providers may assist with activities of daily living such as
feeding a stable patient under the direction and supervision of the practical nurse.
Assessment, medication administration, and care planning remain within the regulated nurse
scope of practice as defined by the CNO.
10. A practical nurse is assigned to care for four clients. After receiving morning report, which
client should the nurse assess FIRST?
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CANADIAN REX-PN QUESTION BANKWITH VERIFIED
ANSWERS DETAILED RATIONALES GRADED A+
Canadian REx-PN Question Bank
Section 1: Safe and Effective Care Environment – Management of Care (Questions 1–30)
1. A practical nurse is caring for four patients. Which task can be delegated to an unregulated
care provider?
A. Administering oral acetaminophen to a patient
B. Assisting a stable patient with feeding
C. Assessing a new complaint of chest pain
D. Developing the nursing care plan
Rationale: B. Unregulated care providers may assist with activities of daily living such as
feeding a stable patient under the direction and supervision of the practical nurse.
Assessment, medication administration, and care planning remain within the regulated nurse
scope of practice as defined by the CNO.
2. A practical nurse is delegating tasks to an unregulated care provider (UCP/PSW). Which task
is appropriate to assign to the UCP?
A. Performing the initial admission assessment on a new client
B. Assisting a stable client with bathing and oral hygiene
C. Administering a scheduled oral medication to a client
D. Evaluating a client's response to a new pain protocol
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Rationale: B. Delegation to unregulated care providers is appropriate for stable, predictable
tasks within their role, such as assisting a stable client with personal hygiene and activities of
daily living. Assessment, medication administration, and evaluation require nursing judgment
and cannot be delegated.
3. A newly licensed practical nurse (LPN) delegates the task of ambulating a stable post-
operative client to an unregulated care provider (UCP). Which action by the LPN demonstrates
appropriate delegation?
A. Telling the UCP to ambulate the client whenever they have time.
B. Asking the UCP if they are comfortable ambulating clients before giving the task.
C. Informing the UCP about the client's fall risk and verifying their understanding of the task.
D. Documenting that the UCP ambulated the client in the medical record.
Rationale: C. The five rights of delegation include the right task, circumstances, person,
direction/communication, and supervision/evaluation. Providing specific information (like fall
risk) and verifying the UCP's understanding fulfills the right direction/communication. Asking
if they are "comfortable" is not a substitute for verifying competency.
4. A charge nurse is making client assignments for a medical-surgical unit. Which client should
be assigned to the most experienced LPN?
A. A client with a urinary tract infection requiring a urinalysis.
B. A client with diabetes mellitus requiring a blood glucose check before breakfast.
C. A client who is 24-hours post-hip replacement and needs reinforcement of discharge
teaching.
D. A client with a newly inserted chest tube requiring frequent assessment.
Rationale: D. Assignment should be based on client acuity and staff competency. A client with
a newly inserted chest tube is unstable and requires frequent, skilled assessment. The most
experienced LPN is best suited for this client. Other tasks are more stable and can be assigned
to less experienced staff.
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5. A practical nurse is assigned to care for four clients. After receiving morning report, which
client should the nurse assess FIRST?
A. A 55-year-old client with diabetes whose blood glucose level is 110 mg/dL.
B. A 70-year-old client with pneumonia who is febrile with a new onset of confusion.
C. A 45-year-old client with a colostomy who needs assistance with a pouch change.
D. A 60-year-old client with hypertension scheduled for discharge in two hours.
Rationale: B. The nurse should use principles of prioritization (ABCs, acute vs. chronic,
Maslow's hierarchy). A new onset of confusion in an elderly client with pneumonia is a sign of
decreased cerebral oxygenation and potential sepsis, making this the most acute and unstable
condition. The other clients are stable or require non-urgent care.
6. A practical nurse is caring for four patients. Which task can be delegated to an unregulated
care provider?
A. Administering oral acetaminophen to a patient
B. Assisting a stable patient with feeding
C. Assessing a new complaint of chest pain
D. Developing the nursing care plan
Rationale: B. Unregulated care providers may assist with activities of daily living such as
feeding a stable patient under the direction and supervision of the practical nurse.
Assessment, medication administration, and care planning remain within the regulated nurse
scope of practice as defined by the CNO.
7. A practical nurse calls the health care provider (HCP) regarding a new medication
prescription. The dosage prescribed is higher than the recommended dosage, however, the
nurse is unable to locate the HCP for an explanation. Which action should the nurse take if the
medication is due to be administered at this moment?
A. Contact the nursing supervisor
B. Administer the dose prescribed
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C. Hold the medication until the HCP can be contacted
D. Administer the recommended dose until the HCP can be located
Rationale: C. The practical nurse must clarify any unclear or unsafe order with the prescriber
or pharmacist before administration and must never administer a dose believed to be
incorrect. Holding the medication is the safest action until clarification is obtained.
8. A practical nurse is preparing to administer a medication and notices the prescribed dose
seems unusually high. The next action is to:
A. Administer the dose as ordered.
B. Ask the patient if they took it before.
C. Verify the order with the prescriber or pharmacist
D. Skip the dose and document it was not given
Rationale: C. The practical nurse must clarify any unclear or unsafe order with the prescriber
or pharmacist before administration and must never administer a dose believed to be
incorrect.
9. A practical nurse is caring for four patients. Which task can be delegated to an unregulated
care provider?
A. Administering oral acetaminophen to a patient
B. Assisting a stable patient with feeding
C. Assessing a new complaint of chest pain
D. Developing the nursing care plan
Rationale: B. Unregulated care providers may assist with activities of daily living such as
feeding a stable patient under the direction and supervision of the practical nurse.
Assessment, medication administration, and care planning remain within the regulated nurse
scope of practice as defined by the CNO.
10. A practical nurse is assigned to care for four clients. After receiving morning report, which
client should the nurse assess FIRST?
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