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WHY DOES THE REX PN TEST NATIONAL, AND NOT LOCAL KNOWLEDGE OF NURSING?

Different health authorities can and/or do have very different rules and regulations in regard to safety, scope of practice, and legal issues. The REX PN is designed to test overall nursing knowledge, NOT knowledge of individual nursing health authorities

WHO WRITES AND AUDITS THE REX PN?

Registered Nurses and Practical Nurses in various roles of nursing (e.g. educators, acute care, home health, extended/residential care, etc.) from every province/territory in Canada both write and audit questions which are deemed fair to test students knowledge

IS THE ENTIRE REX PN MULTIPLE CHOICE?

Yes, the entire REX PN is in a scenario and/or question and answer based, multiple choice format

WHAT IS THE MAIN COMPETENCY THE REX PN TRYING TO ESTABLISH

Basic knowledge of the principles of nursing in order to practice safely for an entry level nurse

HOW MUCH OF THE REX PN IS SCENARIO BASED?

Approximately 60% of the REX PN is scenario based

HOW MUCH OF THE REX PN IS INDEPENDENTLY BASED (NON SCENARIO)?

Approximately 40% of the REX PN is independently based (non scenario)

HOW MUCH OF THE REX PN IS EXPERIMENTAL (OMITTED FOR MARKS)?

Approximately 5% of questions are experimental (omitted for marks)

HOW LONG DOES EACH STUDENT HAVE TO WRITE THE REX PN?

Approximately 4 hours

HOW MANY QUESTIONS DOES THE REX PN ADMINISTER?

Approximately 165-170

HOW MUCH OF THE REX PN EXAMINES KNOWLEDGE AND/OR COMPREHENSIVE LEVEL QUESTIONS?

Approximately 10%

HOW MUCH OF THE REX PN EXAMINES APPLICATION OF KNOWLEDGE LEVEL QUESTIONS?

Approximately 40%

HOW MUCH OF THE REX PN EXAMINES CRITICAL THINKING LEVEL QUESTIONS?

Approximately 40%

HOW MUCH OF THE REX PN EXAMINES THE CHILD (0-18 YEARS OF AGE) DEMOGRAPHIC? 

Approximately 20-30%

HOW MUCH OF THE REX PN EXAMINES THE ADULT (19-64 YEARS OF AGE) DEMOGRAPHIC? 

Approximately 54-70%

HOW MUCH OF THE REX PN EXAMINES THE OLDER ADULT (65-80 YEARS OF AGE) DEMOGRAPHIC? 

Approximately 13-28%

WHAT ARE THE MAIN COMPETENCIES REVIEWED ON THE REX PN? 

  1. Professional practice
  2. Nurse-Patient relationship
  3. Health and wellness
  4. Changes to health

WHAT DOES THE TERM “PROFESSIONAL PRACTICE” REFER TO? 

  1. Responsibility for personal/professional growth
  2. Responsibility to deliver safe, competent, and ethical nursing care
  3. Code of Ethics: Provincial/Territorial standards of practice, scope of practice, legislation, and common law practical nursing practice
  4. Intraprofessional, interprofessional, and intersectoral practice

WHAT DOES THE TERM “NURSE/PATIENT RELATIONSHIP” REFER TO? 

  1. Purposeful and goal directed
  2. Directed at advancing the best interest and health outcome
  3. Self awareness, trust, respect, openness, empathy, and sensitivity to diversity
  4. Collaboration with patient to achieve identified health goals

WHAT DOES THE TERM “HEALTH AND WELLNESS” REFER TO? 

  1. Population health and the principles of health care
  2. Detriments of health, life phases, demographics, health trends, economics, political factors, and evidence based practice

WHAT DOES THE TERM “CHANGES TO HEALTH” REFER TO? 

  1. Acute, chronic, rehabilitative, palliative, or end of life care across a lifespan
  2. Critical inquiry, safety, solution focused approaches, reflective practice, and evidence informed decision making
  3. Collaboration with patients and health care providers to identify health priorities, and empower patients to improve their own health

WHAT ARE THE MOST OFTEN CORRECT ANSWERS FOR CULTURALLY BASED QUESTIONS? 

The answer which best displays sensitivity and respect for the patient’s culture

WHAT DOES THE EXAM CONSIDER “STEREOTYPING” WITH REGARDS TO CULTURE? 

Dietary restrictions

WHAT IS CONSIDERED A “HEALTH CARE ENVIRONMENT”? 

Anywhere nursing is practiced

WHAT IS THE BEST WAY TO DETERMINE WHAT A REX PN QUESTION IS ASKING? 

Read the last sentence of the scenario, paragraph, and/or question

WHAT IS THE BEST WAY TO DETERMINE BETWEEN 2 SEEMINGLY CORRECT REX PN QUESTIONS? 

Eliminate the obviously wrong answers first. Choose the answer, which seems safest for the patient and/or nurse

WHAT PHRASES INDICATE A “PRIORITY SEQUENCE” QUESTION? 

Priority questions tests the student nurses knowledge of urgency. Statements such as “most helpful”, “most suitable”, “safest”, “next”, “first”, or “immediate” give student nurses a clue that the question will have multiple seemingly correct answers, but only 1 correct priority answer

WHAT IS THE CORRECT ANSWER TO A “NURSING INTERVENTION” QUESTION? 

Any answer, which involves “assessment” as this is the first step of the Nursing Process, will always be the correct answer

WHAT IS THE CORRECT ANSWER TO A “PATIENT NEED” QUESTION? 

Any answer, which involves “Maslow’s Hierarchy of Needs” will always be the correct answer

WHAT IS THE CORRECT ANSWER TO A “THERAPEUTIC COMMUNICATION” QUESTION? 
Any answer, which involves telling a patient what to do, asks a question which can be answered with “yes” or “no”, involves expression of disapproval, or contains false assurance is an INCORRECT answer. Any answer, which involves allowing a patient to think and reflect, encourages a patient to express feelings or talk more, or shows that the nurse has listened by paraphrasing what the patient has explained is a CORRECT answer

WHAT IS THE CORRECT ANSWER TO AN “EMERGENCY SITUATION” QUESTION? 

Any answer, which involves “airway, breathing, and circulation” will always be the correct answer

WHAT IS THE CORRECT ANSWER TO A “FURTHER LEARNING” QUESTION?  WHAT IS THE CORRECT METHOD TO ASSESS FOR DEHYDRATION IN AN INFANT?

Any answer, which involves the patient being wrong or not fully understanding will always be the correct answer. These questions are designed to fool students who don’t fully read questions and are awkward to say the least. Whatever the wrong answer seems to be, is the correct answer because of the way “further learning” questions are worded. The REX PN will try to fool students with this question and/or scenario multiple times. Watch for this!

WHAT IS THE CORRECT ANSWER TO A QUESTION, WHICH ASKS THE STUDENT NURSE TO CHOOSE BETWEEN A PATIENT AND EQUIPMENT? 

The patient is always more important than equipment (even if the equipment is malfunctioning)

WHAT ARE THE STEPS OF THE NURSING PROCESS? 

Assessment, Planning, Intervention/Implementation, and Evaluation (in that exact order)

WHAT ARE THE STEPS OF MASLOW’S HIERARCHY OF NEEDS?

Physiological needs, safety needs, love and belonging needs, self-esteem needs, self-actualization (in that exact order) starting with the most basic of needs. Each need must be adequately met before the next need can be adequately met

WHAT DOES THE “TEST WORLD, NOT REAL WORLD” ADVICE REFER TO? 

The REX PN is designed to be a textbook exam, not a real world exam. DO NOT use past experience, peer advice, or anecdotal answers to any question on the exam. DO NOT use shortcut answers. Always choose the safest, and best answer (even if it is not practical in the real world)

WHAT IS THE BEST WAY TO NARROW DOWN THE CORRECT ANSWER OF A SCENARIO AND/OR QUESTION? 

Use the “stem” approach. Often times the correct answer contains a word used in the initial question. 1 answer is correct and 3 answers are distractors. 1-2 answers are usually similar in their approach, but 1 answer is best because it is safer and/or follows proper nursing procedure more closely than the other(s). Each scenario and/or question has a key concept of a nursing competency being reviewed and tested. Always answer what a novice, beginning nurse would do. Always remember that safety, urgency, and meeting patient needs are more important than anything else (regardless of how correct an answer may seem)

WHAT MUST BE ASSESSED BEFORE TEACHING A PATIENT? 

The patient’s readiness to learn

WHAT STATUS SHOULD BE ASSESSED AS PART OF THE NURSING PROCESS? 

Emotional status

WHAT IS THE MOST IMPORTANT PRIORITY IN AN EMERGENCY SITUATION? 

Maintaining an open airway

WHAT IS THE MOST COMMONLY OVERLOOKED CORRECT ANSWER BEFORE INTERVENTION? 

Assessment of the situation and/or patient

WHAT PHRASES INDICATE AN ANSWER IS INCORRECT? 

Absolute phrases such as “always”, “never”, “all of”, “every”, or “only”

WHAT IS THE BEST WAY TO ELIMINATE INCORRECT ANSWERS? 

Identify incorrect statements in the scenario and/or question. Any answers containing the same information are always incorrect

What are the 12 cranial nerves and what do they control (including type of sensory)?

I – Olfactory (smell) SOMATIC
II – Optic (sight) SOMATIC
III – Oculomotor (external eye muscles) MOTOR
IV – Trochlear (external eye muscles) MOTOR
V – Trigeminal (chewing and facial sensation) BOTH
VI – Abducent (lateral eye movement) MOTOR
VII – Facial (muscles of facial expression, taste buds, blinking, fingers and toes) BOTH
VIII – Vestibulocochlear (sound and balance) SOMATIC
IX – Glossopharyngeal (taste and swallowing) BOTH
X – Vagus (organs in the chest and abdomen) BOTH
XI – Accessory (neck muscles) MOTOR
XII – Hypoglossal (tongue and neck muscles) MOTOR

What is the most common treatment for chronic obstructive pulmonary disease?

Oxygen therapy 2L/minute or less. Must keep patient between hypoxic and hypercapnic. Constantly monitor oxygen saturation. Partial pressure of oxygen saturation (Pao2) should be >60 and arterial oxygen saturation (Sao2) should be >90% because of chronic carbon dioxide retention

​WHAT INTERVENTION IS NECESSARY IF A HYPOGLYCEMIC PATIENT IS FOUND CONSCIOUS BUT DROWSY AND NAUSEOUS?

Glucagon tabs (usually between 3 - 6 tabs)

WHAT INTERVENTION IS NECESSARY IF A HYPOGLYCEMIC PATIENT IS FOUND UNCONSCIOUS? 

Glucagon IV is started

WHAT IS REYE SYNDROME?

​Common condition presenting in children with fever after Acetylsalicylic Acid administration. Symptoms include persistent vomiting and nausea

​WHAT PROCEDURE IS NECESSARY IF UNFAMILIAR WITH A DISEASE (E.G. FETAL ALCOHOL SYNDROME)? 

Leave the patients room, read about the disease, and check facility protocol, procedure, and policy

​WHAT EFFECT DOES ANY DRUG (ESPECIALLY ANTIBIOTICS) HAVE IF TAKEN TOO FREQUENTLY? 

Accumulative effect

WHAT IS A COMMON SYMPTOM OF ARTERIAL INSUFFICIENCY?

​The extremity is cold to the touch and pedal pulses are not felt 

​FINISHED LEARNING?

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