CNA Gerontological Nursing for LPNs/RPNs Certification Exam — Information & Free Practice

About CNA Gerontological Nursing for LPNs/RPNs Certification Exam

CNA Gerontological Nursing for LPNs/RPNs Certification Exam · CA

Key exam facts

Provider

Canadian Nurses Association (CNA) owns the certification program and develops the specialty blueprint with nursing experts. Meazure Learning provides testing consultation and in-person delivery; ProctorU provides online proctoring.

Format

Computer-based multiple-choice examination, available through online proctoring or selected Canadian in-person centres. Approximately 55–70% independent and 30–45% case-based questions.

Exam questions

Total questions: 160–165.

Time limit

Four hours (240 minutes) to answer the examination questions.

Passing score

Criterion-referenced pass mark set by the specialty examination committee using the modified Angoff method and statistical review. The numerical pass mark is not published; results are reported as pass or unsuccessful.

Exam fee

Canadian domestic dollar fees (CAD): initial application $588 for CNA members or $780 for non-members, plus appointment fee $85 online (ProctorU) or $110 in person (Meazure Learning), plus applicable taxes. Application fee includes $130 non-refundable administration. Reduced rewrite application fee $378 member/$500 non-member for unsuccessful candidates within the next two calendar years; appointment fee additional.

Topics covered

The authority publishes percentage ranges for each content area. The practice percentages below use the midpoint of each range, normalized to 100%; they are not exact percentages published by the authority. Practice question counts may differ slightly because of rounding.

• Culture and Human Diversity — Official range: 4–9% (Practice allocation: 6.5%)

  • Ensures quality of care is individualized to the needs of older adults, including:
  • family (e.g., family composition and dynamics, intergenerational relationships, older adult as primary caregiver, geographical dispersion, surrogate families, family expectations of care);
  • diverse communities (e.g., veterans, Indigenous peoples, members of religious and/or cultural groups, immigrants, lesbian, gay, bisexual, transgender or queer (LGBTQ2) persons); and
  • vulnerable populations (e.g., developmentally delayed clients, physically challenged clients, cognitively impaired, clients with mental illness, addictions, inmate populations, homeless, economically disadvantaged populations).
  • Demonstrates an understanding that unique histories, cultures, languages, and social circumstances are manifested in the diversity of Indigenous peoples.
  • Recognizes the intergenerational impact of historical trauma on current generations of Indigenous peoples.
  • Identifies and closes the gaps in health outcomes between Indigenous and non-Indigenous communities. (e.g., Such efforts would focus on indicators such as: suicide, mental health, addictions, life expectancy, chronic diseases, illness and injury incidence, and the availability of appropriate health services).
  • Recognizes the value of Indigenous healing practices and supports them in the treatment of Indigenous clients in collaboration with Indigenous healers and Elders when requested by Indigenous clients.

• Assessment — Official range: 18–25% (Practice allocation: 21.5%)

  • Assesses older adults in the following areas:
  • physiological (e.g., age-related changes and conditions, atypical presentations, diagnostics, infectious diseases, continence, sleep);
  • functional (e.g., activities of daily living, instrumental activities of daily living, mobility, ability to communicate);
  • cognitive (e.g., memory, attention, perceptual disturbances, orientation, age-associated memory impairment, decision-making);
  • Assesses medication(s) (e.g., prescribed, over-the-counter, complimentary, supplements) in the following areas:
  • psychological (e.g., previous coping patterns, mood and affect, history of mental illness, developmental stages, response to life events, depression scales, risk of self-harm, suicidal ideation, grief and loss);
  • nutritional (e.g., food preferences, allergies, swallowing, nutritional status, weight, oral health, intake);
  • social/cultural (e.g., roles, relationships, formal/informal supports, cultural beliefs, education, leisure, literacy, income, lifestyle, intimacy, life history);
  • spiritual (e.g., religious affiliation, practices, spiritual values and beliefs, spiritual distress);
  • sexual (e.g., sexual orientation, relationships, need for intimacy and privacy, gender identity, sexual dysfunction);
  • environmental (e.g., living arrangements, living conditions, location, physical layout, accessibility, exposure to pollutants, home assessments, safety);
  • abuse (e.g., indicators of neglect, emotional, physical, sexual, psychological and financial abuse, caregiver factors, past history);
  • pain (e.g., manifestations, pain scales, pain types, impact on function and quality of life, response to non-pharmacological and pharmacological interventions); and
  • risk factors (e.g., falls, altered nutrition, tobacco, alcohol and/or other substance use, immunization status, use of restraints, comorbidities, frailty, impaired skin integrity, polypharmacy, social isolation).
  • use (e.g., adherence, polypharmacy, history, client understanding, administration methods, medication review/reconciliation, age-related changes affecting medications);
  • response to pharmacological intervention (e.g., effectiveness, interactions, adverse effects, contraindications); and
  • diagnostic results and implications related to treatment (e.g., adjustments, dosing, titration, parameters, toxicity).

• Health Promotion and Risk Reduction — Official range: 22–30% (Practice allocation: 26%)

  • Utilizes evidence-informed practice to promote health and prevent illness (e.g., immunizations, self-care management, teaching, healthy eating, health screening, lifestyle counselling, habits, exercise promotion).
  • Selects evidence-informed interventions regarding the following:
  • functional abilities (e.g., exercise programs, referrals to formal and informal resources, diet modifications, adaptive clothing, strength and balance exercises);
  • cognitive functioning (e.g., cueing, reminiscing, validation, behavioural response approaches, pharmacological, mental stimulation activities, program referrals);
  • environment (e.g., structural modifications, home adaptations, exit alarms, lighting, thermoregulation, emergency preparedness planning, removal of hazards);
  • falls prevention (e.g., transfer aids, exercise program, lighting, education, medication, proper clothes and footwear, protectors, bed/seat alarms, lifelines);
  • spiritual and cultural well-being (e.g., basic understanding and/or facilitation of spiritual and cultural practices, referrals, attentive listening, instilling hope, life review);
  • sleep/rest (e.g., sleep routine, accommodating lifelong patterns, pharmacological);
  • emotional well-being and coping (e.g., counselling, support groups, stress reduction, conflict resolution, life changes, attentive listening, pharmacological, loss of independence);
  • addictions/substance use (e.g., referral to support groups/programs, treatment centres, counselling, smoking cessation programs, psychosocial support, community resources, harm reduction strategies);
  • urinary and bowel elimination (e.g., continence strategies, diet, hydration, mobility, hygiene, pharmacology);
  • sexual function (e.g., education, safety, acceptance, resources, advocacy);
  • abuse (e.g., safety plans, respite for caregiver, counselling, resources);
  • iatrogenesis (e.g., infection, deconditioning, adverse effects of therapeutic and diagnostic regimens, relocation stress syndrome, “age-friendly” environments, medication review);
  • integumentary (e.g., healthy skin practices, pressure reduction strategies, environmental modification to avoid trauma, referrals);
  • nutrition (e.g., affordable and nutritious food, supplements, dysphagia management, hydration, weight management, bariatrics, teaching, referrals);
  • pharmacological and non-pharmacological therapies (e.g., medication reconciliation, counselling regarding safe practices, polypharmacy, complementary therapies, referrals, collaboration with other team members);
  • least restraint use (e.g., physical, chemical, environmental, alternatives to restraints, regular review and monitoring, restraint reduction, teaching);
  • end-of-life transitions (e.g., advance directives, culturally sensitive care and communication, pain/symptom management, advance care wishes, palliative care); and
  • MAID (e.g., provide documentation, information, facilitate referral).
  • Supports client to engage in safer forms, patterns, quantity, environment and routes of substance use at their own pace and level of ability when delivering harm-reduction and safer-use education (e.g., overdose prevention strategies).
  • Describes the differences between the concepts substance use related harm and substance use disorder.
  • Advocates for appropriate pain control interventions for clients who use substances.

• Illness and Disease Management — Official range: 22–30% (Practice allocation: 26%)

  • Selects evidence-based interventions in the following areas:
  • sensory (e.g., macular degeneration, diabetic retinopathy, cataracts, glaucoma, tinnitus, chronic sinusitis, retinal detachment, hearing impairment);
  • integumentary (e.g., lesions, wounds, cellulitis, psoriasis, fungal, rash, eczema);
  • gastrointestinal (e.g., diarrhea, nausea, vomiting, constipation, bleeds, ulcers, obstructions, reflux disease, hemorrhoids, inflammatory bowel disease, pernicious ostomy, anemia, cholecystitis, enteral feeds);
  • musculoskeletal (e.g., osteoporosis, osteoarthritis, rheumatoid arthritis, extremity deformities, degenerative disc disease, fractures, prosthesis, contractures);
  • cardiovascular (e.g., congestive heart failure, pulmonary edema, hypertension, blood disorders, myocardial infarction, coronary artery disease, peripheral vascular disease, deep vein thrombosis, oedema);
  • respiratory (e.g., chronic obstructive pulmonary disease (COPD), asthma, acute bronchitis, tuberculosis, pneumonia, sleep apnea, emphysema, pulmonary fibrosis, influenza);
  • genitourinary (e.g., incontinence, renal failure, vaginal prolapses, benign prostatic hypertrophy, vaginitis, sexually transmitted infections, sexual dysfunction)
  • endocrine/metabolic (e.g., thyroid dysfunction, diabetes mellitus, metabolic syndrome) ;
  • neurological (e.g., acquired brain injuries, cerebrovascular disorders, Parkinson’s disease, multiple sclerosis, seizures, vertigo, neuropathy, infections, Amyotrophic lateral sclerosis [ALS]);
  • delirium (e.g., risk, prevention, hypo/hyperactive, causes, manifestations, consequences);
  • dementia (e.g., types, stages, behavioural manifestations);
  • mental illness (e.g., anxiety, depression, post-traumatic stress disorder, schizophrenia, personality disorders, bipolar disorder);
  • cancer (e.g., prostate, breast, lung, skin, colon, bladder, lymphoma, leukemia, brain, pancreas); and
  • infections control (e.g., prevention, hand-washing, isolation, surveillance, personal protective equipment (PPE), outbreaks/epidemics, mandatory reporting, antibiotic-resistant organisms, immunology).
  • Evaluates the outcomes of the intervention to determine effectiveness.

• Ethical, Legal and Health System Issues — Official range: 8–12% (Practice allocation: 10%)

  • Demonstrates an understanding of the implications of ethical, legal and health system issues in the following areas:
  • client decision-making (e.g., end-of-life issues, autonomy, capacity, informed consent, substitute decision-makers, advance directives, guardianship, allocation of resources, right to live at risk, negotiating goals of care, decisions regarding nutrition and hydration, resuscitation status, symptom management, complimentary medicine);
  • substance uses (e.g., opioids, alcohol, tobacco, cannabis, fentanyl, recreational drugs)
  • least restraints (e.g., chemical, physical, environmental);
  • abuse (e.g., crime, fraud, neglect, exploitation, coercion, mandatory reporting)
  • inclusive care (e.g., human rights, demographics of aging, geographical- and climate-related influences, biases/prejudices, ageism); and
  • confidentiality (e.g., use of social media, breaches of privacy, privacy legislation).
  • Demonstrates an understanding of the implications of ethical, legal and health system issues in Medical Assistance in Dying (MAID) (e.g., informed consent, facilitate access, conscious objector, legislation requirements, professional standard, non-disclosure).
  • Understands that nurses must not impose their own views and values about MAiD onto others nor use their position to influence, judge or discriminate against others whose values are different from their own.
  • Respects the privacy and confidentiality of sensitive information about MAiD as the cause of death and of all individuals who are involved in the process.

• Professional Practice — Official range: 3–7% (Practice allocation: 5%)

  • Recognizes the implications of interprofessional practice:
  • scope of practice (e.g., education, delegation, assignment, supervision, role clarity); and
  • collaboration (e.g., effective and respectful communication, collaborative problem-solving, team- building, negotiating responsibilities, advocacy, stakeholder engagement).
  • Engages in professional growth (e.g., certification, membership in professional associations, reflective practice, continuing education, lifelong learning, mentorship, preceptorship, teaching).
  • Demonstrates cultural competency and cultural sensitivity in interaction with Indigenous clients.
  • Demonstrates authentic, supportive, and inclusive behaviour in all exchanges with Indigenous clients, health care workers, and communities.
  • Understands the correlation between individuals’ substance use behaviors and larger social and structural conditions (e.g., poverty, gender inequity, post-colonization, racism, criminalization and prohibition) that contribute to the risk for substance use related harm and substance use disorder.
  • Advocates for the inclusion of people with lived experience of substance use and substance use disorders in the design, delivery and evaluation of services.
  • Identifies the nurse’s role and professional responsibilities related to MAiD.
  • Understands MAiD may have a personal impact that may affect their practice, and takes steps to seek support as needed.
  • Provides support for the person and family during the process and the family following the death.

• Information and Health Technologies — Official range: 3–7% (Practice allocation: 5%)

  • Uses relevant technologies such as:
  • assistive/adaptive devices (e.g., communication devices, alerting devices, hearing aids, portable talking keyboards, ergonomic equipment);
  • health informatics (e.g., tele-practice, information resources, electronic assessments, electronic health records, coding of data); and
  • emergency and disaster preparedness (e.g., emergency response planning, fire prevention, evacuation, power outage, violence).

How to prepare

Work through the topics, read the explanation after each answer, and revisit the areas where you miss questions. Use the official outline and reference materials below to guide your study.

These independent practice questions are not actual exam items and do not guarantee a passing result.

Frequently asked questions

Official sources and references

• CNA Gerontological Nursing for LPNs/RPNs Blueprint

  p. 1

• CNA Gerontological Nursing for LPNs/RPNs Blueprint

  p. 5, Table 1

• CNA Gerontological Nursing for LPNs/RPNs Blueprint

  p. 8

• CNA CBT Exam Tips

  CBT exam tips

• CNA Exam Results and Retesting

  Exam Results and Retesting

• CNA Initial Exam Fees

  Initial Exam Fees, table and footnotes

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