REx-PN Exam 2026: Format, Who Writes It and the 2027 Changes

Key facts

At a glance

Built by: NCSBN, for the Ontario and B.C. nursing regulators
Used in: Ontario and British Columbia
Where: Pearson test centres in Canada and abroad, on computer only
To pass: Reach the passing standard; there’s no set percentage
Results: From your regulator, never at the test centre

How it works

How the REx-PN exam works, from application to result

Apply to your regulator first: the College of Nurses of Ontario (CNO) or the British Columbia College of Nurses and Midwives (BCCNM). It decides whether you’re eligible to write.
Register and pay with Pearson Professional Assessments (formerly Pearson VUE). Once your regulator makes you eligible, Pearson emails your Authorization to Test (ATT).
Book a seat at a Pearson test centre, on a date inside the validity dates on your ATT.
On the day, items appear one at a time. You can change an answer until you confirm it. After that you can’t go back, and you can’t skip an item.
The computer picks each item based on your answers so far, and the exam ends once it’s 95% certain of your result, or at the maximum of 150 items, or when time runs out.
Two optional breaks are offered, after two hours and after three and a half hours. The clock keeps running during every break.
You don’t get a result at the test centre. It comes from your regulator.

Topics

What’s on the test

These areas and their shares come from the 2027 test plan, which applies from January 1, 2027. The 2022 plan uses the same eight shares. On any one exam, a share may differ by up to 3 percentage points.

Management of Care

Directing care so that clients and staff stay protected. It’s the biggest area, at 21% of the exam.

Key points (3)

The test plan lists keeping client information confidential and working within your legislated scope of practice.
You assign and supervise care given by others, such as unregulated care providers.
It also covers prioritizing care, organizing your workload and recognizing ethical dilemmas.

Safety and Infection Prevention and Control

Protecting clients and health care staff from health and environmental hazards, at 13% of the exam.

Key points (3)

The 2022 test plan calls this area Safety and Infection Control. The 2027 plan adds “Prevention” to the name.
Activities include identifying the client correctly and checking for allergies and sensitivities.
You’re expected to verify orders, and to identify errors and near misses and step in.

Health Promotion and Maintenance

Growth and development, preventing and catching health problems early, and helping clients reach their best health, at 9% of the exam.

Key points (3)

Care runs across every age group, from birth through to adults 65 and over.
The test plan covers prenatal and postpartum care, and care in labour except during active labour.
Comprehensive health assessments sit in this area.

Psychosocial Integrity

Supporting clients’ emotional, mental and social well-being, including clients with acute or chronic mental illness, at 11% of the exam.

Key points (3)

You use therapeutic communication and assess how a client is coping with life changes.
You assess the potential for violence or aggression and use safety precautions.
You assess for abuse or neglect, and for substance misuse or withdrawal, and intervene.

Basic Care and Comfort

Comfort and help with activities of daily living, at 9% of the exam.

Key points (3)

Activities include monitoring nutritional status and providing enteral nutrition.
You assess elimination, intake and output, sleep and skin, and intervene.
Non-drug comfort measures and postmortem care are both listed.

Pharmacological and Parenteral Therapies

Giving medications and parenteral therapies, at 17% of the exam. It’s the second-biggest area.

Key points (3)

You do the calculations needed to give medications. On the exam these can be fill-in-the-blank items, and the on-screen calculator is there for them.
NCSBN says the exam uses generic medication names on most occasions.
CNO says you can’t get a list of the medications on the exam.

Reduction of Risk Potential

Lowering the chance of complications from conditions, treatments or procedures, at 11% of the exam.

Key points (3)

You recognize trends and changes in a client’s condition and in vital signs, and intervene.
Procedures include inserting, maintaining or removing a urinary catheter.
You’re expected to compare client lab values with normal values. The study options page lists the ones named in the test plan.

Physiological Adaptation

Caring for clients with acute, chronic or life-threatening physical conditions, at 9% of the exam.

Key points (3)

You identify the pathophysiology of a condition and recognize signs of complications.
Emergency care includes cardiopulmonary resuscitation and using an automated external defibrillator.
Wound care and drainage devices are in this area too.

Test day

What to bring to the test centre

One physical, unexpired, government-issued ID with your name in Roman characters, a recent photo and your signature
At a test centre in Canada or the mainland United States: a passport, driver’s licence, provincial or territorial ID card, permanent residence card or military ID
At an international test centre: a passport book or card, nothing else
A second ID with your signature, if your main ID doesn’t show one
The original marriage licence, divorce decree or court name-change document, if the name you registered with differs from your ID

Before you go

Read NCSBN’s candidate bulletin before you register.
Check that your first and last names match your ID exactly. If they don’t, you’ll be turned away and have to pay again.
Take the candidate tutorial so the item types and screen aren’t a surprise.
Arrive at least 30 minutes early. If you’re more than 30 minutes late, you may lose your appointment and fee.
Expect a signature, a photo, a palm vein scan and a security scan before you’re let in.
Your phone and other devices go, powered off, into a sealed bag from Pearson. Refuse, and you won’t be allowed to write.
Leave study notes at home or locked away. You get an on-screen calculator and an erasable noteboard.

NCSBN: REx-PN registration processApply to your regulator before you register. The registration steps and Pearson links are on this page.

Study options

Where to study

NCSBN publishes a free exam preview, the test plan and a candidate tutorial, and those are the only materials from the exam’s own writers. Private companies sell books and question banks, but neither Ontario’s nor B.C.’s regulator endorses them. The study options page compares both.

Option	Price	Free to use	Links
Official
REx-PN exam previewA downloadable set of 125 items similar to the real exam, from the National Council of State Boards of Nursing (NCSBN)In English and French. It’s static and not scored, it doesn’t predict your result, and its items won’t appear on the exam.	Free	Yes. NCSBN calls it a free download, and the Ontario and B.C. regulators call it free	NCSBN: Exam preview ↗NCSBN: Prepare for the REx-PN ↗
REx-PN test planNCSBN’s description of what’s tested, with activities for each of the eight areas and sample itemsThe 2022 plan applies through December 31, 2026, and the 2027 plan from January 1, 2027. Both are published in English and French.	No cost	Yes. The bulletin says it can be downloaded at no cost	NCSBN: Test plan page ↗
REx-PN candidate tutorialA walk-through of Pearson’s exam software and each item type, with practice itemsIn English and French. It teaches the screen and item types and doesn’t test your nursing knowledge.	No cost	Yes. NCSBN’s FAQ lists it among resources available free of charge	NCSBN: Candidate tutorial ↗
Books
Mosby’s Prep Guide for the Canadian PN ExamA practice-question book for the REx-PN and the Canadian Practical Nurse Registration Examination (CPNRE), by Marianne Langille and Karen Katsademas, with REx-PN format questions on EvolveFirst edition, copyright 2022, so it predates the 2027 test plan. Prices are Elsevier’s, on its U.S. store.	US$59.99 for the book on Elsevier’s U.S. store; the eBook shows US$35.69, reduced from US$50.99	No free version listed	Elsevier: Mosby’s Prep Guide ↗
Apps and websites
ExamPrepHeroAn independent Canadian exam-prep site with REx-PN practice exams, flashcards and a study guideIts practice exams have 150 questions each, with unlimited attempts and one year of access. It says it isn’t affiliated with or endorsed by any regulator. Its guide is labelled 2025, and its breakdown shows the 2022 plan’s ranges.	$77.95 CAD on sale (from $97.95) for 8 practice exams; $97.95 CAD on sale (from $137.95) with 300 flashcards and the study guide	Sample questions and sample flashcards are on its site, with no price shown	ExamPrepHero: REx-PN practice exams ↗ExamPrepHero: Exams, flashcards and guide ↗
Archer ReviewA nursing and medical exam prep company. Its REx-PN article sends readers to its program for the National Council Licensure Examination for Practical Nurses (NCLEX-PN)The article points to a program sold for the NCLEX-PN, a different exam, not to a REx-PN product, so compare it with the REx-PN test plan before you buy. Prices are as shown on its page, which doesn’t say which currency.	Question bank from $59 for one month; combos start from $79	No free plan on the page	Archer Review: REx-PN article ↗Archer Review: NCLEX-PN plans ↗

Prices and ratings checked November 2026.

Explore

Everything else, in one place

Study options

Booking Passing score Results Ontario RPNs B.C. LPNs Canada’s exams

FAQ

Common questions

What is the REx-PN exam?

It’s the entry-to-practice exam for practical nurses in two provinces, testing the knowledge, skill and judgment you need at the start of your career to practise safely. The British Columbia College of Nurses and Midwives (BCCNM) and the College of Nurses of Ontario (CNO) partnered with NCSBN to develop it. It became the registration exam in both provinces on January 4, 2022.

What’s different on the REx-PN from January 1, 2027?

Two things. The 2027 test plan takes the place of the 2022 plan, and a revised passing standard takes the place of the one set in 2021. The exam keeps the same eight content shares, the 90 to 150 item range and the four-hour limit. BCCNM says to prepare from the plan in effect on the date you write.

Is rexpn.com the official REx-PN website?

Yes. www.rexpn.com is NCSBN’s candidate site, and NCSBN’s own address for the exam forwards to it. Other sites use the exam’s name in their web address and aren’t run by NCSBN. BCCNM warns that no third party has access to the REx-PN question bank and tells you to be wary of anyone claiming they do.

Can you write the REx-PN in French?

NCSBN says the French version is for Ontario only. You pick the language when you register, and NCSBN lists a $50 CAD fee to change it after that. The test plan, candidate bulletin, tutorial and FAQs are all available in French, and Pearson has a French support line.

Does the REx-PN test Canadian law or the health care system?

No. CNO says it doesn’t test health care systems, history, cultural issues, government policy or laws, because those vary by province and territory. In Ontario, a separate jurisprudence exam covers nursing law. BCCNM also says the REx-PN won’t test health care systems, history or government policies and laws.

Can you write the REx-PN outside your province?

Yes. You can write at any Pearson test centre that offers it, wherever you’re applying for registration. That includes other Canadian provinces and territories, the mainland United States and a list of other countries, where an extra scheduling fee applies.

Sources: NCSBN · CNO · BCCNM and 7 more. Checked November 2026.

Rules and fees can change, so check the official site before your test.

The REx-PN exam: the licensing test for practical nurses in Ontario and B.C.

At a glance

How the REx-PN exam works, from application to result

What’s on the test

Management of Care

Safety and Infection Prevention and Control

Health Promotion and Maintenance

Psychosocial Integrity

Basic Care and Comfort

Pharmacological and Parenteral Therapies

Reduction of Risk Potential

Physiological Adaptation

What to bring to the test centre

Before you go

Where to study

Everything else, in one place

Common questions

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