REx-PN: Frequently Asked Questions

What is the REx-PN™?

The Regulatory Exam – Practical Nurse (REx-PN™) is an entry-to-practice exam for those applying to become a Registered Practical Nurse (RPN) in Ontario or Licensed Practical Nurse (LPN) in British Columbia. When implemented on January 4, 2022, it will tests for knowledge, skills and judgment nurses need at the beginning of their careers.

Why do we have a registration exam?

A registration exam, such as the REx-PN, tests whether the writer has the knowledge, skills and judgment to provide safe care at the beginning of their careers. Completing and passing a registration exam is a requirement to register with CNO and BCCNP. As provincial regulators of the nursing profession, CNO and BCCNP are accountable for ensuring that only those who demonstrate the ability to apply nursing knowledge and provide safe care are able to practice.

When will the REx-PN be implemented?

The new exam will be implemented January 4, 2022. We established this timing with nursing education programs in Ontario and British Columbia to give educators time to include the revised entry-to-practice competencies in their curriculum and support students in preparing for the REx-PN.

How do the Canadian Entry-to-Practice (ETP) competencies relate to the items that will be on the exam?

The REx-PN is based on data collected from an analysis of RPN/LPN practice conducted in early 2019, and which will be repeated every five years. In addition, revised national entry-to-practice competencies were mapped to the practice analysis to ensure the competencies essential for safe nursing practice are included on the exam.

Prior to writing the REx-PN, Practical Nursing students will have completed an educational program designed to teach them the knowledge, skills and judgment to prepare them to enter the nursing profession. Nursing candidates’ academic preparation provides a starting point for them to practice in a variety of settings. In complement, the REx-PN is developed to assess whether practical nursing candidates possess the minimal entry-level competence to provide safe and effective care.

What will the REx-PN test?

The REx-PN will not test all competencies that are taught during a Practical Nursing program; this is true for past exams as well. Rather, the exam will focus on testing entry-level competencies that are essential to providing safe care at the beginning of the candidates’ RPN/LPN careers.

Are you developing a new exam or using the NCLEX-PN?

The REx-PN is a new exam being developed by CNO and BCCNP.  Candidates will not be writing the NCLEX-PN.

How will the exam be translated into French?

To meet the needs of French-speaking Canadian REx-PN candidates, we will offer the exam in French. A third party will translate questions following best practice and recommended standards. Following this forward translation, a Canadian Translation Panel made up of French-speaking Canadian nurses will review each translated question for accuracy and contextual equivalency. This method, referred to as a mixed-method, process-oriented approach, is supported in the literature as a preferred method for ensuring construct equivalence in health-care measurement instruments.

What format will the new exam take?

The exam format will be 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.

Will you be testing the exam before it is implemented?

We are working with Practical Nursing programs in Ontario and B.C. to pretest the exam items with student volunteers who are preparing to graduate in 2020 and 2021. The results will be used to determine the difficulty level for each question, which is a critical feature of a CAT exam. In addition, questions may be flagged that need to be revised and retested or possibly removed from the bank of questions. Once the new exam has been implemented in 2022, all new questions that are developed will be pretested on the REx-PN™.

Will there be REx-PN resources for students?

Yes, we are working on ensuring there are resources for students, including:

  • REx-PN Tutorial, in English and French
  • REx-PN Candidate Bulletin, in English and French
  • Test plan, in English and French
  • Computerized Adaptive Test (CAT) educational video and presentations
  • Frequently Asked Questions (FAQs), in English and French
  • One practice exam, in English and French

How many times will applicants be able to write the REX-PN?

Applicants will have no limit on the number of times they can write the exam in order to pass. If an applicant fails the REx-PN, they will have to wait a minimum of 60 days before they can write the exam again (a maximum of six attempts per year). 

Will I have unlimited chances to write the current (CPNRE) exam as well?

No. The current practical nurse exam, the Canadian Practical Nurse Registration Exam (or CPNRE for short), is limited to three writes due to the type it is — a multiple-choice exam using classical test theory. It was developed using “classical test theory” in which the mark a writer has at the end of the exam can includes some measurement error. For example, a person could get an answer correct by guessing. If they fail the exam and retake it later, they may see the same questions again and could have memorized the answers. The exam would then be scoring their memorization skill rather than their ability. 

For a classical test theory exam, the more often a person writes the exam, the more likely they are to pass because of measurement error. This is why Council limits the number of writes on this type of exam to three times; it supports the final exam result as being a valid and reliable measure. 

How is it safe for the public if an applicant has unlimited writes on an exam?

The REx-PN is being developed using “item response theory,” where each person who writes the exam has 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. 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 practical nurse.

Item response theory used in the REx-PN is the same theory applied to the NCLEX-RN. Rather than a traditional multiple-choice exam, the REx-PN will be a Computerized Adaptive Test (CAT-exam), where the exam writer must sustain a pre-determined level of difficulty to show their ability. This type of exam controls for measurement error. In other words, 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 the ability, which helps to keep the public safe.

How can I improve my chances of passing if I retake the REx-PN exam?

After a fail, you will receive a breakdown of your results, including content areas in which you had deficiencies on the exam. You can then use this information to determine additional learning you may need to complete in order to increase your ability and overall competence. For example, this could mean studying more in this area, getting additional academic help, or taking a continuing education course on a specific topic to improve your knowledge in that area.

I'm applying for registration in Ontario. Will I be able to write the CPNRE and the REx-PN?

The CPNRE will remain the registration exam for practical nurses in Ontario until the end of 2021. On Tuesday, Jan. 4, 2022, the REx-PN will become the registration exam for Ontario practical nurses, and the CPNRE will no longer be an option for Ontario applicants.

If you pass the CPNRE by the end of 2021, it will count as you meeting the regulatory exam requirement, even if you have not completed the other requirements of your registration by that time.

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Page last reviewed July 08, 2020