- REx-PN has 90-150 items (60-120 scored) in a four-hour Pearson appointment with breaks.
- Management of Care (18-24%) and Pharmacological and Parenteral Therapies (14-20%) carry the heaviest weight.
- Passing standard is −0.32 logits through December 31, 2026.
- Registration is CAD $350 before local taxes; international scheduling adds CAD $150 plus VAT.
Quick Facts Snapshot
Before you memorize a single lab value, get the mechanics of the exam straight. This is the one-page reference you can glance at the night before your Pearson appointment. For the full breakdown of any line item, our REx-PN Study Guide 2026 walks through preparation in depth, while this page stays strictly to the numbers.
| Fact | Detail |
|---|---|
| Regulators using REx-PN | College of Nurses of Ontario (CNO) and BC College of Nurses and Midwives (BCCNM) |
| Developed with | NCSBN; administered by Pearson Professional Assessments |
| Item count | 90-150 total items, including 30 unscored pretest items (60-120 scored) |
| Appointment length | Four hours, including breaks |
| Item formats | Multiple choice, multiple response, fill-in-the-blank calculation, exhibit, graphic |
| Calculator | On-screen calculator provided |
| Item navigation | Answered items cannot be revisited |
| Partial credit | Effective January 2026, select-all-that-apply items receive partial credit |
| Passing standard | −0.32 logits through December 31, 2026 |
| Registration fee | CAD $350, excluding local taxes |
| International scheduling add-on | CAD $150 plus VAT where applicable |
| Change fee | CAD $50 to change regulatory body or exam language after registration |
| Languages | English and French |
| Retake rule | 60 test-free days between attempts, six attempts maximum per year |
Domain-by-Domain Cheat Sheet
The eight content domains determine how items are distributed across your test. Memorize the ranges below so you know where to invest review time. For a deep dive into what each domain actually tests, see the REx-PN Exam Domains 2026 guide.
Domain 1: Management of Care (18-24%)
The single largest domain. Covers care coordination, delegation to unregulated care providers, advocacy, informed consent, and continuity of care across shifts and settings.
- Know delegation limits for practical nurses versus RNs
- Prioritization across multiple client assignments
Domain 2: Safety and Infection Control (10-16%)
Focuses on error prevention, hazardous materials, use of restraints, and standard/transmission-based precautions.
- Chain of infection and PPE sequencing
- Reporting and documenting safety incidents
Domain 3: Health Promotion and Maintenance (6-12%)
Covers growth and development, disease prevention, and health screening across the lifespan.
- Immunization schedules and teaching moments
- Antepartum and newborn care basics
Domain 4: Psychosocial Integrity (8-14%)
Tests coping mechanisms, therapeutic communication, grief, abuse recognition, and mental health support.
- Therapeutic communication versus blocking responses
- Recognizing signs of crisis or self-harm risk
Domain 5: Basic Care and Comfort (6-12%)
Everyday nursing skills: mobility, nutrition, elimination, rest, and non-pharmacological comfort measures.
- Positioning and skin integrity prevention
- Assistive device use for ADLs
Domain 6: Pharmacological and Parenteral Therapies (14-20%)
The second-heaviest domain. Covers medication administration, IV therapy, dosage calculations, and adverse effects.
- Practice fill-in-the-blank calculation items using the on-screen calculator
- High-alert medication monitoring parameters
Domain 7: Reduction of Risk Potential (8-14%)
Covers monitoring for complications, lab value interpretation, and diagnostic test follow-up.
- Recognizing trends that indicate deterioration
- Pre- and post-procedure monitoring
Domain 8: Physiological Adaptation (6-12%)
Tests management of acute, chronic, and life-threatening physiological conditions.
- Fluid and electrolyte imbalance recognition
- Responding to unexpected physiological changes
Key Takeaway
Management of Care and Pharmacological and Parenteral Therapies together can represent up to 44% of scored items - allocate your heaviest review blocks there first.
Registration and Fee Mechanics
REx-PN is not a self-serve exam you can just book. You must first apply to CNO or BCCNM and receive exam eligibility before you're permitted to register with Pearson. Skipping this step is the most common scheduling mistake candidates make. Full prerequisite details live in our REx-PN Requirements guide.
- Base registration: CAD $350, excluding local taxes.
- International test-centre scheduling: adds CAD $150 plus VAT where applicable.
- Post-registration changes: switching regulatory body or exam language costs CAD $50.
For a line-by-line cost comparison, including how these fees stack for candidates testing outside Canada, check the REx-PN Certification Cost breakdown.
Exam Format Essentials
REx-PN uses a computerized adaptive testing (CAT) model. The exam pulls from 90-150 total items, 30 of which are unscored pretest items, leaving 60-120 items that count toward your result. You won't know which items are scored, so treat every question as if it matters - because most of them do.
- Item types: multiple choice, multiple response, fill-in-the-blank calculation, exhibit-based, and graphic items.
- Calculator: an on-screen calculator is available for dosage and IV rate calculations - practice using it, not a physical calculator.
- No backtracking: once you submit an answer, you cannot return to it. Read each stem fully before selecting.
- Partial credit update: starting January 2026, select-all-that-apply multiple-response items award partial credit rather than an all-or-nothing score, which changes how you should approach eliminating options.
A deeper analysis of why this adaptive format feels tougher than a standard fixed-form test is available in How Hard Is the REx-PN Exam?
Passing Standard and Scoring
The current passing standard is −0.32 logits, and it remains in effect through December 31, 2026. Because the test is adaptive, there's no fixed number of correct answers that guarantees a pass - the difficulty of the items you answer correctly shapes your ability estimate. For a full explanation of how logit scoring translates into a pass/fail decision, see REx-PN Passing Score 2026.
If you want context on how many candidates clear this standard, the REx-PN Pass Rate 2026 report covers the CNO-reported first-attempt results for Ontario-educated RPN exam writers.
Retake Rules
If you don't pass on your first attempt, plan around these fixed constraints:
- Waiting period: 60 test-free days must pass before you can sit the exam again.
- Annual cap: a maximum of six attempts per year.
- Re-registration: you'll need to register (and pay applicable fees) again through Pearson for each new attempt.
Use the mandatory 60-day gap productively - it's enough time to re-target weak domains rather than simply rescheduling and repeating the same mistakes.
Final-Week Review Plan
Generic study techniques only help if they're mapped to REx-PN's actual domain weighting. Here's how to spend the last stretch before your Pearson appointment without wasting time on low-yield content.
Heavy-weight domains
- Management of Care scenarios (delegation, prioritization)
- Pharmacological and Parenteral Therapies calculations using the on-screen calculator
Mid-weight domains
- Safety and Infection Control precautions and reporting
- Reduction of Risk Potential lab-value trends
Remaining domains
- Psychosocial Integrity communication scripts
- Health Promotion, Basic Care and Comfort, and Physiological Adaptation quick-review
Full-length simulation
- Timed practice covering all eight domains under exam-style conditions
- Review calculator workflow and item-format familiarity
Run at least one full timed simulation before test day at our REx-PN practice test platform, so the adaptive pacing and no-revisit rule feel familiar rather than jarring.
Who Hires REx-PN Registrants
Passing REx-PN and completing provincial registration opens practical nursing roles regulated by CNO in Ontario or BCCNM in British Columbia - long-term care, community health, hospital medical-surgical units, and rehabilitation settings commonly hire practical nurses who hold this credential. Note that the exam itself is not renewable; it's a one-time entry-to-practice requirement, while your provincial registration carries its own separate, ongoing renewal obligations.
If you're weighing whether the credential fits your career plans, our ROI analysis and salary guide break down the practical value, while REx-PN Jobs surveys typical employers and settings.
FAQ
Between 90 and 150 total items, including 30 unscored pretest items, so 60-120 items actually count toward your score. The exact count depends on how the adaptive algorithm responds to your answers.
The passing standard is −0.32 logits, and this standard is in effect through December 31, 2026. It's an ability-based cutoff, not a percentage of correct answers.
Registration is CAD $350 excluding local taxes. Testing internationally adds CAD $150 plus VAT where applicable, and changing your regulatory body or exam language after registering costs CAD $50.
Yes. You must wait 60 test-free days before your next attempt, and you're limited to six attempts per year.
Management of Care (18-24%) and Pharmacological and Parenteral Therapies (14-20%) carry the largest share of scored items, so they deserve the earliest and heaviest review.
Keep this cheat sheet handy alongside a full practice run at REx-PN Exam Prep, and cross-reference the linked guides above whenever you need more depth on a specific number or rule.