Canadian Practical Nurse Registration Examination (CPNRE) / Regulatory Exam

A practical nurse is assigned to care for four clients. Which client should the nurse assess first at the start of the shift?

• AA client with COPD whose oxygen saturation has dropped from 92% to 85%
• BA client who is 1 day post-op reporting incisional pain rated 5/10
• CA client with a new diagnosis of type 2 diabetes awaiting teaching
• DA client requesting discharge paperwork before leaving in the afternoon

A practical nurse is delegating tasks to an unregulated care provider (UCP/PSW). Which task is appropriate to assign to the UCP?

• APerforming the initial admission assessment on a new client
• BAssisting a stable client with bathing and oral hygiene
• CAdministering a scheduled oral medication to a client
• DEvaluating a client's response to a new pain protocol

A client tells the practical nurse, "I don't want any more chemotherapy. I'm done." The client is alert and oriented. What is the nurse's most appropriate response?

• A"You should keep fighting; your family needs you."
• B"I will let the doctor know you are refusing treatment right away."
• C"Tell me more about what is leading you to this decision."
• D"Your physician knows what is best, so let's continue the plan."

A practical nurse witnesses a colleague documenting vital signs that were not actually taken. What is the nurse's most appropriate initial action?

• AReport the colleague to the provincial regulatory college immediately
• BRe-take the vital signs and document them under the nurse's own name
• CIgnore it because the client appears stable at this time
• DSpeak privately with the colleague about the falsified documentation

Which situation requires the practical nurse to obtain a new informed consent before proceeding?

• AA client signed consent but the surgical approach has been significantly changed
• BA client previously consented and the procedure is now being rescheduled to a later time
• CA client asks a routine question about post-operative pain management
• DA family member requests to be present during the procedure

A practical nurse is reviewing the personal health information of a client who is not assigned to the nurse's care, out of curiosity. This action is a violation of which principle?

• ABeneficence
• BConfidentiality and privacy legislation
• CVeracity
• DDistributive justice

During shift report, the off-going nurse provides handover for a post-operative client. Which piece of information is the highest priority to communicate?

• AThe client prefers to have the curtains open during the day
• BThe client's spouse will visit in the evening after work
• CThe client's last analgesic dose was given 30 minutes ago and remains in pain
• DThe client had a regular bowel movement two days ago before surgery

A practical nurse is caring for a client who speaks limited English. Which action best supports culturally safe and effective communication?

• AAsk the client's adult son to interpret medical information
• BSpeak loudly and slowly using simple English words
• CProvide written English instructions for the client to read later
• DArrange for a professional interpreter to assist with the discussion

A practical nurse identifies that a client's prescribed medication dose appears unusually high and potentially unsafe. What is the nurse's most appropriate action?

• AWithhold the medication and clarify the order with the prescriber
• BAdminister the dose as written because the prescriber ordered it
• CReduce the dose to what the nurse believes is safe and administer it
• DAsk another nurse to administer the medication instead

Which of the following best describes the practical nurse's role within the interprofessional health care team?

• ATo take direction only from physicians and avoid independent judgment
• BTo collaborate and contribute nursing knowledge while respecting each member's scope
• CTo supervise all other regulated and unregulated team members
• DTo work independently without consulting other disciplines

A client with a do-not-resuscitate (DNR) order suddenly stops breathing and has no pulse. What is the nurse's appropriate action?

• ABegin full cardiopulmonary resuscitation immediately
• BCall a code blue and start chest compressions until help arrives
• CProvide comfort measures and notify the appropriate team members per the DNR order
• DWait for family permission before withholding resuscitation

A practical nurse is asked to perform a procedure that the nurse has never been trained to do. What is the most appropriate response?

• APerform the procedure to avoid appearing incompetent
• BDelegate the procedure to an unregulated care provider
• CAttempt the procedure while reading the instructions
• DDecline and explain the nurse lacks the necessary competence and training

A practical nurse is coordinating discharge for a client with new mobility limitations. Which referral best supports a safe transition home?

• AA referral to occupational therapy for a home safety assessment
• BA referral to a dietitian for meal planning
• CA referral to social work for funeral planning
• DA referral to a chaplain for spiritual support

A practical nurse receives a verbal order from a physician during an emergency. After the situation stabilizes, what must the nurse do?

• ANothing further, as the verbal order is sufficient documentation
• BDocument the verbal order and have it verified and signed by the prescriber per policy
• CDiscard the order since it was given verbally
• DHave a family member witness and co-sign the verbal order

A practical nurse is assigning client care for the shift. Which factor is most important when matching clients to care providers?

• AThe personal preferences of each staff member
• BThe seniority of each staff member regardless of client needs
• CThe acuity of each client matched to the competence and scope of the provider
• DEqual numbers of clients assigned to every team member