Professional Ethical Legal
15-25%of exam
AccountabilityConsentConfidentialityDocumentationLegal scope
Foundations of Practice
60-70%of exam
Collaborative Practice
10-20%of exam
DelegationTeamworkAdvocacyCommunicationDischarge
Quick Facts
- Exam
- CPNRE/REx-PN
- Credential
- LPN/RPN
- Time
- 240 min
- Pass
- Pass/fail
- Questions
- 160-170/90-150
- Fee
- CA$350-650
- Blueprint
- 2022-2026
Professional Accountability
- Accountability
- Answer for acts
- Responsibility
- Duty to act
- Quality improvement
- Safer care
- Mandatory reporting
- Report abuse/neglect
- Professional boundaries
- Therapeutic limit
Legal + Ethical Practice
- Informed consent
- Voluntary agreement
- Advance directives
- Wishes ahead
- Confidentiality
- Keep info private
- Privacy law
- PHIPA/PIPEDA
- Client rights
- Autonomy + dignity
- Capacity
- Understand decisions
Rights of Med Admin
Patient | Drug | Dose | Route | Time | Reason | Site | Doc
Patient: 2 IDsDrug: check MARDose: calculateRoute: verifyTime: scheduleDoc: sign
CPNRE vs REx-PN
CPNRE
- Most provinces
- Fixed 160-170 Qs
- Yardstick/ASI
REx-PN
- ON + BC only
- Adaptive 90-150
- NCSBN/Pearson
Province vs format
Which Client First
- Airway compromised→Assess first(ABCs)
- Breathing distress→O2 + position(SpO2)
- Circulation unstable→Fluids + monitor(BP/HR)
- Acute vs chronic→Acute first(Maslow)
- Unstable vs stable→Unstable first(Safety)
- Time-sensitive→Now(Priority)
- Routine care→Later(Delegate)
Assessment Priorities
- ABCs
- Airway breathing circulation
- Maslow
- Physio before psych
- Vital signs
- T/HR/RR/BP/SpO2
- Head-to-toe
- Systematic survey
- Pain assessment
- PQRST scale
- Neuro check
- GCS + pupils
- Admission assessment
- Baseline data
ABC Priority
Airway > Breathing > Circulation
Airway: firstBreathing: O2/RRCirculation: BP/pulse
Acute vs Chronic
Acute
- Sudden onset
- Life threat
- Priority first
Chronic
- Ongoing
- Manage stable
- Teaching focus
Urgent vs ongoing
Med Safety Checks
- Right patient→2 identifiers(Name + DOB)
- Right drug→Check MAR(Allergy?)
- Right dose→Calculate(Double-check)
- Right route→Verify order(PO/IM/SC/IV)
- Right time→Schedule(Frequency)
- Document→After giving(Sign MAR)
Pharmacology + Meds
- Rights of admin
- 8 rights
- Dosage calc
- Dose = wt × rate
- Routes
- PO/IM/SC/IV/SL
- Adverse effects
- Monitor response
- High-alert meds
- Insulin/heparin/opioids
- Controlled substances
- Count + lock
- Drug interactions
- Check compatibility
- Parenteral therapy
- IV medications
Maslow Priority
Physio > Safety > Love > Esteem > Self
Physio: ABCsSafety: injury/fearLove: supportEsteem: respect
Standard vs Transmission
Standard
- All clients
- Hand hygiene
- PPE always
Transmission
- Specific bugs
- Contact/droplet/air
- Private room
All vs specific
Infection Control
- Hand hygiene
- #1 prevention
- PPE
- Gloves/mask/gown
- Contact precautions
- Private room
- Droplet precautions
- Mask + distance
- Airborne precautions
- Negative pressure
- Sterile technique
- Aseptic field
Basic Care + Comfort
- Mobility
- Transfer/ambulate
- Nutrition
- Diet + swallowing
- Hygiene
- Bath/oral care
- Elimination
- Toileting/catheter
- Rest/sleep
- Comfort measures
Safety + Risk Reduction
- Fall risk
- Bed alarm + rails
- Aspiration risk
- Head up
- Restraints
- Least restrictive
- Fire safety
- RACE/PASS
- Sharps safety
- No recapping
- Med error
- Report + document
Physiological Adaptation
- Fluid/electrolyte
- Na/K/Ca/Mg
- Acid-base
- pH/PaCO2/HCO3
- Shock
- Hypovolemic/septic
- Hemorrhage
- Bleeding control
- Lab values
- CBC/electrolytes
- Complication recognition
- Early signs
Wound Care
- Wound assessment
- Size/depth/exudate
- Dressing change
- Clean technique
- Pressure injury
- Stage 1-4
- Healing stages
- Inflammatory/repair
- Infection signs
- Redness/warmth/pus
SBAR Handover
Situation | Background | Assessment | Recommendation
S: current issueB: historyA: findingsR: what needed
LPN/RPN vs RN
LPN/RPN
- Diploma entry
- Stable clients
- Delegates to UCP
RN
- Degree entry
- Complex/unstable
- Delegates to LPN
Scope vs complexity
Delegate or Not
- Stable client?→May delegate(Predictable)
- Routine task?→May delegate(Bathing/feeding)
- Assessment?→Keep nurse(Judgment)
- Med admin?→Keep nurse(Regulated)
- Evaluation?→Keep nurse(Judgment)
- Teaching?→Keep nurse(Knowledge)
Delegation + Teamwork
- 5 rights delegation
- Task/circumstance/person
- UCP/PSW scope
- Bathing/feeding
- Assignment
- Within scope match
- Handover
- SBAR report
- Interprofessional
- Collaborate care
- Discharge planning
- Transition coord
Five Rights Delegation
Task | Circumstance | Person | Communication | Supervision
Right taskRight circumstanceRight personRight communicationRight supervision
Delegation vs Assignment
Delegation
- To UCP/PSW
- Shared task
- Nurse accountable
Assignment
- To regulated nurse
- Within scope
- Individual owns
Transfer vs match
Therapeutic Communication
- Therapeutic comm
- Listen + reflect
- Active listening
- Eye contact/nod
- Cultural safety
- Humility + respect
- Client teaching
- Assess readiness
- Crisis intervention
- Calm + support
- Grief/loss
- Presence + empathy
Common Traps
Prioritization Traps
ABCs over Maslow ≠ Unstable over teaching
Delegation Traps
No delegating assessment ≠ UCP cannot give meds
Pharmacology Traps
High-alert = double check ≠ Always verify allergies
Infection Traps
Hand hygiene before PPE ≠ Remove gloves last
Communication Traps
Why before what ≠ Avoid false reassurance
Legal Traps
Competent can refuse ≠ Document objectively
Exam Format Traps
CPNRE is not REx-PN ≠ Both pass/fail
Last Minute
- 1.Weights: 15-25/60-70/10-20
- 2.ABCs = always first
- 3.Maslow: physio before psych
- 4.8 rights of medication
- 5.UCP: bath/feed only
- 6.Hand hygiene = #1
- 7.SBAR for handover
- 8.Document objectively + timely
- 9.Competent client can refuse
- 10.Pass/fail, no percentage
- 11.Dosage calc: double check
- 12.Stable before teaching
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