Updated for 2026
REx-PN care planning: PN contributions to nursing care plans
Care planning on the REx-PN tests the Canadian RPN/PN's ability to contribute to and implement evidence-based nursing care plans within their scope. While care plan development is primarily an RN responsibility, the PN contributes assessment data, implements established interventions, and evaluates patient responses.
Educational purpose: This content is for exam preparation and professional development only. It is not intended for clinical decision-making. Always follow current guidelines, institutional policies, and scope of practice.
PN role in care planning within collaborative practice
In Canadian collaborative practice, the RPN/PN contributes to care planning through systematic data collection, identifying actual and potential problems within their assessment scope, implementing established interventions, and reporting evaluation findings to the RN.
Data contribution: The PN provides objective assessment data: vital signs trends, wound appearance changes, mobility status, pain reports, dietary intake, output measurements, patient behaviour, and patient and family concerns. This data informs the RN's comprehensive assessment and care plan development.
Intervention implementation: The PN implements the nursing interventions specified in the care plan: medication administration, personal hygiene, wound care, mobility assistance, oral care, patient education per established teaching plan, and comfort measures. Deviations from the care plan must be communicated to the RN.
Evaluation and reporting: After implementing care, the PN assesses and documents the patient's response. Unexpected or concerning responses are escalated to the RN immediately, not at the end of the shift.
Common nursing diagnoses relevant to PN practice
The REx-PN tests knowledge of NANDA-I nursing diagnoses within PN practice contexts. Key diagnoses frequently tested:
- Impaired gas exchange — related to V/Q mismatch, COPD, pneumonia. Interventions: positioning, oxygen, deep breathing exercises, nebuliser treatments.
- Risk for infection — related to invasive lines, wounds, immunosuppression. Interventions: aseptic technique, wound care, hand hygiene education.
- Impaired physical mobility — related to post-surgery, neurological deficit. Interventions: repositioning schedule, ROM exercises, ambulation assistance, fall prevention.
- Imbalanced nutrition: less than body requirements — related to decreased intake, nausea, dysphagia. Interventions: meal assistance, positioning, anti-emetic administration, calorie count.
- Risk for falls — related to age, medications, altered mobility. Interventions: fall prevention bundle, call light, non-slip footwear, bed alarm.
Frequently asked questions
- Can the RPN/PN independently develop a nursing care plan on the REx-PN?
- No — independent comprehensive care plan development is within RN scope, not PN scope. The REx-PN tests the PN's ability to contribute to care planning: collecting and reporting assessment data, implementing established care plan interventions, identifying when care plan updates are needed and reporting this to the RN, and evaluating and documenting patient responses. If a care plan question on the REx-PN asks who should develop the comprehensive care plan for a complex patient, the correct answer involves the RN. The PN's role is collaborative and implementational.
Clinically reviewed by NurseNest Clinical Review Team · Last updated 2026-06-10 · For educational purposes only · Review policy