The Regulatory Exam – Practical Nurse (REx-PN) is the entry-to-practice exam for applicants to become a Registered Practical Nurse (RPN) in Ontario or a Licensed Practical Nurse (LPN) in British Columbia. It tests for the knowledge, skill and judgment Practical Nurses need at the beginning of their careers to practice safely.

Registration exams such as the REx-PN contribute to patient safety. As the provincial regulator of the nursing profession, CNO is accountable for ensuring that only those who demonstrate the ability to apply nursing knowledge and provide safe care at the beginning of their careers are able to practice nursing. The registration exam helps to ensure this.

The REx-PN is based on data collected from an analysis of RPN/LPN practice, which is repeated every five years.

Before writing the REx-PN, you will have completed an educational program designed to teach you the knowledge, skills and judgment to prepare you to enter the nursing profession and practice in a variety of settings. The REx-PN will help assess whether you possess the minimal entry-level competencies to provide safe and effective care.

Yes. Nurses in Ontario and British Columbia review the content of the REx-PN. They continue to review and develop the exam to ensure it meets our needs as regulators, and the needs of the public for safe nursing care.

To meet the needs of French-speaking Canadian REx-PN candidates, the exam is offered in French. A panel of French PN academics familiar with nurse practice settings developed a lexicon that informs third-party translation. You can download the lexicon terms. The third party translates questions following the lexicon, best practice and recommended standards.

Once the questions are translated, a Canadian Translation Panel made up of French-speaking Canadian nurses reviews each translated question for accuracy and contextual equivalency. This method (referred to as a mixed-method, process-oriented approach) is a preferred method for ensuring construct equivalence in health care measurement instruments.

Regardless of the number of writes, the only way a writer will be successful on the REx-PN is if they are able to show they have the knowledge, skill and judgment to practice safely as an entry-level PN.

The REx-PN exam is a computerized adaptive test (CAT) instead of a traditional multiple-choice exam. During a CAT exam, the exam writer must sustain a pre-determined level of difficulty to show their ability. Whether they pass the exam on their first try or any subsequent try, they won’t be passing by chance or because they memorized test content. They will pass because they have sufficient ability, which helps to keep the public safe.

Each person who writes the exam will have a different set of questions. There is no risk of memorizing content because the software system behind the REx-PN knows when someone is rewriting the exam and generates a new set of questions for them each time.

No. The Canadian Practical Nurse Registration Exam (CPNRE) is no longer an option for Ontario applicants. On January 4, 2022, the REx-PN became the registration exam for Ontario Practical Nurses.

If you passed the CPNRE by the end of 2021 as part of your CNO application, you will meet CNO’s registration exam requirement, even if you had not completed the other requirements of your registration by that time.

No. You can write the REx-PN at any Pearson Professional Assessments (previously Pearson VUE) test centre that offers the exam. However, there will be an additional fee if you write the exam outside of Canada or the United States.

Check the Application & Registration Fees page for the latest information on examination fees and other fees that apply to your RPN application and registration in the General class. Exam fees are non-refundable and you will need to pay a separate fee each time you attempt the exam.

Yes, the REx-PN tests competencies that nurses need at the beginning of their nursing careers to practice safely in Ontario, as covered by your nursing program’s curriculum.

Yes, resources to help you prepare are listed on the Registered Practical Nurse (RPN) Registration Examination page. 

There is information about prep courses on the Registered Practical Nurse (RPN) Registration Examination page.

The REx-PN Test Plan (available in English and French) is an excellent guide to preparing for the exam. It’s a concise summary of the content areas on the exam and scope of what is tested. It also includes:

• definitions for each Client Needs category
• nursing activity statements
• sample REx-PN questions
• information about the format of the exam and how it will be scored.

The lab values an exam writer is expected to know are on page 36 of the REx-PN Test Plan (available in English and French). They include the lab values for ABGs (pH, PO2, PCO2, SaO2, HCO3), BUN, cholesterol (total), creatinine, glucose, glycosylated hemoglobin (HgbA1C), hematocrit, hemoglobin, INR, platelets, potassium, PT, PTT & APTT, sodium, and WBC. All other values will be provided.

The REx-PN is available to write at any time in permanent and temporary centres run by the exam provider, Pearson Professional Assessments. 

There is no time limit for each question. However, there is a limit of four hours to complete the overall exam. On similar exams, candidates generally take 60–90 seconds per question. You should not feel the need to rush. For more information on the time limit, please see the “Examination Length” section in the REx-PN Test Plan.

Use Pearson Professional Assessments’ Test Site Locator to find the test centre nearest you.

There is no limit on the number of times you can write the exam before you pass. You have to wait at least 60 days between attempts, which allows you a maximum of six attempts per year.

Because the REx-PN is a computerized adaptive test (CAT), the system knows if you are retaking the exam. The system supplies different questions than the ones you had in previous attempts. Regardless of the number of attempts, the only way you will successfully pass the REx-PN is if you are able to show you have the knowledge, skill and judgment to practice safely as an entry-level RPN.

If you do not pass, CNO will send you a Candidate’s Performance Report (CPR). This document provides information about how you did in each section of the exam, indicating whether you performed above, near or below the passing standard. Find more information about CPRs on the REx-PN website. You can take the exam again 60 days or more after your previous attempt.

If you fail, you will receive a Candidate’s Performance Report (CPR). This is a breakdown of your results including content areas that had deficiencies on the exam. You can then use this information to determine additional learning you may need to complete to increase your ability and overall competence. For example, this could mean studying more in one area, getting additional academic help, or taking a continuing education course on a specific topic to improve your knowledge.

Yes. If you meet the exam eligibility requirements, you can write the REx-PN.

First, re-apply to CNO. CNO will determine whether you meet the current requirements for registration. You will still have to pass the exam and meet the other requirements for registration.

You do not need to complete a new nursing program to re-apply. CNO will determine if your education program meets the requirements.

If you graduated from a nursing program in Canada, you can apply directly to CNO. We will assess your credentials and let you know whether you’re eligible to write the REx-PN.

If you graduated from a nursing program in another country, your credentials need to be verified by an approved educational credential assessment (ECA) service provider. Once CNO has received your credential verification report from the ECA service provider, you can begin your application with CNO. We will assess your credentials and let you know whether you are eligible to write the REx-PN.

The REx-PN does not test everything that is taught in a PN program. Rather, it tests entry-level skills, knowledge and judgment — what nurses need to know to provide safe care at the beginning of their careers. The REx-PN Test Plan describes what is tested.

No. The REx-PN does not test knowledge of health care systems, history, cultural issues, or government policy and laws. These items vary by province and territory in Canada. While nurses must know about the health care system they work in, including its legislation, testing for that knowledge is not the purpose of the REx-PN.

You will need to write a Jurisprudence Exam that tests for this knowledge.

The exam format is computerized adaptive testing (CAT). Using CAT, the system determines the level of difficulty of the question it presents to the writer based on how well they responded to the preceding question. For example, if a writer responded correctly to a question of medium difficulty, the next question presented will be slightly more difficult. A candidate must achieve a certain ability level on the exam to pass.

This video provides you with more information about the CAT format of the REx-PN.

The number of questions exam writers receive ranges from a minimum of 90 to a maximum of 150. The actual number of questions you must answer depends on how long it takes the exam’s algorithm to determine whether you are consistently performing above or below passing level. Of all the questions you receive, 60 to 120 questions count in your score. The remaining 30 are being pre-tested for possible inclusion on future exams and do not count in your score. You will not be able to distinguish between an unscored pre-test question and a scored question on the REx-PN, so you should give each question your best effort.

The exam provider uses pre-testing to ensure the CAT exam functions properly. By administering pre-test items to a large sample of REx-PN writers, they can determine the degree of difficulty of each question.

At this time, the REx-PN uses generic medication names only, in most cases. This is because generic names are more consistent, while brand/trade names may vary. Some items may refer to general classifications of medications. You cannot get a list of medications that are on the exam.

No. The exam states practice settings if they are relevant to the question.

Since the exam is a computerized adaptive test (CAT), there is no specific number of correct answers that equals a pass. A CAT is designed to measure the writer’s ability: their entry-level nursing knowledge, skill and judgment. Each question is rated at a different level of difficulty. Some questions are easier to answer than others.

Every time you answer a question, the computer re-estimates your ability level based on all previous answers and the difficulty of those questions. This gives the computer as much information as possible about your ability to provide safe care. With each question answered, the computer’s estimate of your ability becomes more precise.

Using this method, a writer passes the exam when the computer determines they are above the passing standard, which is a cut point that marks the minimum ability level required to practice nursing safely and effectively as an entry-level RPN in today’s health care environment. To learn more about the passing standard, including how it is determined, visit  REx-PN Passing Standard | NCSBN.

As described in the REx-PN test plan, there are many different types of questions on the REx-PN. Most of the questions are multiple choice, while others are multiple response, fill-in-the-blank calculation, exhibit and graphic. You can access the Candidate Tutorial to familiarize yourself with each type.

Yes. Exam questions are numbered so you will know how many questions you’ve responded to.

No. You cannot go back to previous questions or skip questions. With a computerized adaptive test every time you answer a question on the exam, the computer re-estimates your ability based on all previous answers and the difficulty level of those questions. As a result, you cannot go back and change the answer to a previous question because your first answer has already been assessed and incorporated into the testing process.

Visit National Council of State Boards of Nursing’s website for more FAQs.