What the REx-PN is
The REx-PN (Regulatory Exam for Practical Nurses) is the exam you must pass to register as a Registered Practical Nurse (RPN) with the College of Nurses of Ontario (CNO) or as a Licensed Practical Nurse (LPN) with the British Columbia College of Nurses and Midwives (BCCNM). It has been the practical nurse exam in both provinces since January 2022. The exam is developed for the two regulators by NCSBN, and you register for it through the regulator in the province where you are applying.
How the real exam works
The real REx-PN is a computerized adaptive test (CAT). After each answer, the computer re-estimates your ability and picks the next question so that you have about a 50% chance of getting it right. So the exam feels hard for almost everyone, and each candidate gets a unique set of questions.
| Feature | The real REx-PN |
|---|---|
| Length | Variable: 90 to 150 questions, including 30 unscored pretest questions you cannot identify |
| Time limit | 4 hours, which includes the tutorial, sample items and all optional breaks |
| Question types | Mostly multiple choice, plus multiple response (select all that apply), fill-in-the-blank calculations, exhibits and graphics |
| Moving on | You must answer each question to move on, and you cannot go back |
| Result | Pass or fail, decided by comparing your ability estimate with the passing standard |
The exam stops when the computer is 95% certain that your ability is clearly above or clearly below the passing standard. If you are close to the standard, it continues to the maximum of 150 questions, and special rules apply if you run out of time. The length of your exam does not tell you whether you passed.
Our practice exam is not adaptive. It is a fixed-length, 90-question mock exam drawn from the same eight areas in the same proportions as the official test plan. Use it to build knowledge and stamina, not to predict your exact result.
What the exam covers
The official REx-PN test plan sorts questions into client-needs categories, each with a set share of the exam. Our question bank uses the same eight areas.
| Client-needs area | Share of the real exam | Examples of what we cover |
|---|---|---|
| Management of care | 18 to 24% | Prioritizing, assigning to UCPs, scope of practice, consent and capacity, privacy, documentation, mandatory reporting |
| Safety and infection control | 10 to 16% | Routine practices, contact, droplet and airborne precautions, PPE order, falls, least restraint, fire safety, sharps |
| Health promotion and maintenance | 6 to 12% | Growth and development, prenatal and postpartum care, newborn care, immunization, screening and teaching |
| Psychosocial integrity | 8 to 14% | Therapeutic communication, anxiety, depression and suicide risk, psychosis, dementia and delirium, abuse, grief, cultural safety |
| Basic care and comfort | 6 to 12% | Mobility aids, transfers, nutrition, elimination, pain, sleep, hygiene, skin care |
| Pharmacological and parenteral therapies | 14 to 20% | Dosage calculations, IV rates, insulin, anticoagulants, cardiac drugs, opioids, high-alert medications, transfusions |
| Reduction of risk potential | 8 to 14% | Lab values, post-operative complications, specimen collection, vital sign changes, diagnostic tests |
| Physiological adaptation | 6 to 12% | Shock, sepsis, stroke, respiratory distress, fluid balance, emergencies, chest tubes and ostomies |
A new test plan takes effect on January 1, 2027. It keeps the same eight areas and the same percentages, renames the second area "Safety and infection prevention and control", and comes with a new passing standard. If you write in 2027, read the 2027 test plan on the REx-PN website.
Topics that trip people up
- Prioritizing. Many questions ask which client to see first or what to do first. Think airway, breathing and circulation, then look for the change that is new, unexpected or getting worse.
- Scope and authority. Know which controlled acts RPNs are authorized to perform, that an order or regulation is needed to perform them, that you cannot sub-delegate an act delegated to you, and that employers can limit but not expand your legislated scope.
- Consent and capacity. Capacity is presumed, it is decided treatment by treatment, and a capable client can withdraw consent at any time. Learn the ranked list of substitute decision-makers.
- Dosage math. Expect weight-based doses, liquid doses and IV drip rates. Write the formula, check the units, and ask if the answer is sensible.
Ontario and BC candidates
Both provinces write the same exam, and every real question is reviewed to make sure it falls within the legal scope of practical nursing. In our bank, the clinical questions apply in both provinces. The law and professional-standards questions follow Ontario legislation and CNO practice standards. If you are applying in BC, study the BCCNM practice standards for LPNs as well, because the rules and terms differ in places.
How to prepare
Read the official test plan, then practise one area at a time to find your weak spots. Read every explanation, including on the questions you get right. When your section scores are steady, take full 90-question mock exams at an exam pace of about 1 to 1.5 minutes per question, without notes. Give extra time to the two biggest areas: management of care and pharmacology.
Aptitude Tests Canada is an independent practice platform. We are not affiliated with or endorsed by the College of Nurses of Ontario, the British Columbia College of Nurses and Midwives or NCSBN. Our questions are original practice questions written from the public test plan, legislation and practice standards, not real exam questions.
Three worked examples
One question from different sections of the full pack, with the answer and explanation.
Which task is most appropriate for the practical nurse to assign to an unregulated care provider (UCP)?
- Helping a stable client walk to the bathroom
- Evaluating whether a client's PRN analgesic was effective
- Teaching a client with new diabetes to use an insulin pen
- Assessing the pain level of a client who was just admitted
Which product should be used to clean equipment used in the care of a client with Clostridioides difficile infection?
- An alcohol-based wipe left to air dry for one minute
- Warm water with a mild dish soap and a dry cloth
- A sporicidal disinfectant, such as a bleach-based product
- A quaternary ammonium wipe used for routine cleaning
At about what age does a healthy infant's birth weight usually triple?
- 18 months
- 6 months
- 3 months
- 12 months