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Free Canadian Nurse Practitioner Licensure Exam Practice Questions

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Sample Practice Questions

Try these 10 sample questions from the Canadian Nurse Practitioner Licensure Exam practice bank. Each includes the answer and explanation. Continue with the interactive practice above to review the full question set.

  1. 1An adult presents with a depressive episode. To investigate possible bipolar disorder, which additional history should the nurse practitioner specifically elicit?

    1. A.Episodes of unusually euphoric mood that the patient did not regard as abnormalCorrect answer: A
    2. B.Episodes of persistently excessive worry that were accompanied by physical tension
    3. C.Episodes of persistently low mood that were accompanied by a loss of interest
    4. D.Episodes of intense social fear that were accompanied by avoidance of interactions

    Explanation: CAMH states, "It is difficult to assess for hypomania because people with bipolar disorders often do not recognize euphoric states as abnormal." Eliciting previously unrecognized euphoric episodes helps investigate bipolarity during a depressive presentation. The competing histories assess generalized anxiety, depressive symptoms and social anxiety, rather than a prior elevated episode.

    Reference: CAMH: Depression—Diagnosis — Differential Diagnosis—Bipolar Disorders

  2. 2An asymptomatic adult has an A1C of 6.2% and fasting plasma glucose of 7.2 mmol/L from the same assessment. Which test should the NP repeat to resolve these discordant diagnostic findings?

    1. A.Repeat the fasting plasma glucoseCorrect answer: A
    2. B.Repeat the A1C without repeating glucose
    3. C.Perform a random glucose as the sole confirmation
    4. D.Measure fructosamine as the sole confirmation

    Explanation: The source states, "the test whose result is above the diagnostic cut point should be repeated" The fasting glucose is above the diabetes cut point, while the A1C is below it. Repeat the abnormal diagnostic test; fructosamine is not validated for diagnosis, and the alternatives do not follow the discordance rule.

    Reference: Diabetes Canada: Definition, Classification and Diagnosis — Diagnostic criteria—discordant results

  3. 3A 4-year-old with uncomplicated AOM is alert, mildly ill, has mild ear pain and a temperature of 38.2°C. After discussing options, the family prefers observation and can return promptly. Which observation interval is supported by the CPS?

    1. A.24 to 48 hoursCorrect answer: A
    2. B.72 to 96 hours
    3. C.5 to 7 days
    4. D.10 to 14 days

    Explanation: The source states, "an observation or ‘watchful waiting’ period of 24 h to 48 h" The child's mild presentation and reliable access support a short observation option. The longer intervals delay the reassessment specified for this plan.

    Reference: Canadian Paediatric Society: Management of acute otitis media — Management of AOM based on accepted criteria

  4. 4A patient needs written medication instructions read aloud in their preferred language during counselling. Which language-access skill should the NP request for this task?

    1. A.Sight translationCorrect answer: A
    2. B.Consecutive interpretation
    3. C.Simultaneous interpretation
    4. D.Written translation

    Explanation: AHRQ states, "Sight translation is reading a written document aloud in a different language from the one in which it is written." This matches the written-to-spoken task. Consecutive and simultaneous interpretation convert spoken or signed communication; written translation produces text in another language rather than reading the document aloud.

    Reference: AHRQ: Address Language Differences, Tool 9 — Provide written materials and videos in patients' languages—sight translation

  5. 5Before discharge, an NP needs a document that communicates the prescribed medicines and which agents were started, stopped or changed in hospital. Which document serves this purpose?

    1. A.Best Possible Medication History
    2. B.Best Possible Medication Discharge PlanCorrect answer: B
    3. C.Medication Administration Record
    4. D.Medication Incident Report

    Explanation: The source states, "what medications were started, stopped or modified during the patient's previous hospital stay" The discharge plan communicates intended medication changes and complete prescribed details. A BPMH captures actual pre-transition use, an administration record records doses given, and an incident report documents a safety event.

    Reference: ISMP Canada: Primary Care MedRec Guide—Sources of information — Best Possible Medication Discharge Plans—Benefits

  6. 6An NP appraises a randomized trial using Cochrane RoB 2. What is the appropriate unit of assessment?

    1. A.A specific intervention-effect result for a particular outcomeCorrect answer: A
    2. B.An entire trial assigned one rating for all of its results
    3. C.A complete body of evidence spanning all trials and outcomes
    4. D.A systematic review assigned one rating for all included studies

    Explanation: Cochrane states, "Each assessment using the RoB 2 tool focuses on a specific result from a randomized trial." Different results can have different risks of bias; an undifferentiated trial, body of evidence or whole-review rating is not the RoB 2 assessment unit.

    Reference: Cochrane Handbook, Chapter 8: Assessing risk of bias — Key Points; 8.1 Introduction

  7. 7An NP leads a PDSA test of a new follow-up process. The small pilot has been completed and the data collected. Which phase now involves analyzing what the pilot showed?

    1. A.Plan
    2. B.Do
    3. C.StudyCorrect answer: C
    4. D.Act

    Explanation: The source states, "Study: Set aside time to analyze the data and study the results." Analysis belongs to Study. Plan designs the test, Do carries it out, and Act refines the change based on the learning.

    Reference: IHI Open School: QI 102 Course Summary — p. 2, Lesson 5—Testing Changes

  8. 8An NP compares patient handouts for both understandability and actionability, rather than reading difficulty alone. Which assessment tool was specifically designed for these two dimensions?

    1. A.Patient Education Materials Assessment ToolCorrect answer: A
    2. B.Simple Measure of Gobbledygook
    3. C.Flesch-Kincaid Grade Level
    4. D.Flesch Reading Ease

    Explanation: AHRQ states, "The Patient Education Materials Assessment Tool (PEMAT) is a systematic method to evaluate and compare the understandability and actionability of patient education materials." This matches both requested dimensions. The other instruments are readability formulas. The guide cautions that readability formulas are not substitutes for PEMAT, and that PEMAT does not by itself assess factual accuracy.

    Reference: AHRQ: Patient Education Materials Assessment Tool and User's Guide — Introduction—What Is the PEMAT?

  9. 9An NP repeatedly examines personal assumptions, beliefs and privilege and seeks feedback throughout practice. Which term do the national competencies use for this lifelong self-reflective and self-critical process?

    1. A.Cultural humilityCorrect answer: A
    2. B.Cultural awareness
    3. C.Cultural competence
    4. D.Cultural sensitivity

    Explanation: Under cultural humility, the national competencies state, "A life-long process of self-reflection and self-critique." The emphasis on ongoing examination of the provider’s own position identifies cultural humility. Awareness, competence and sensitivity are related cultural-care concepts, but are not the term used for this defined self-critical process.

    Reference: CCRNR National Entry-Level Competencies for Nurse Practitioners — p. 15, Description of Key Terms—Cultural humility

  10. 10An adult reports newly depressed mood. The nurse practitioner is evaluating whether symptoms could be substance-induced. Which question most directly investigates that possibility?

    1. A.How has your ability to concentrate changed during this episode?
    2. B.How did symptom onset relate to medication changes or substance use?Correct answer: B
    3. C.How have your relationships changed since the symptoms began?
    4. D.How does your mood vary between the morning and evening?

    Explanation: CAMH states, "Many medications as well as alcohol and other substance use can cause a patient to present with depressive symptoms during intoxication or withdrawal." A timeline of exposure and mood change directly tests this cause. Concentration, relationships and diurnal variation characterize the episode but do not establish its relationship to substances.

    Reference: CAMH: Depression—Diagnosis — Differential Diagnosis—Substance Use and Substance-Induced Disorders

Exam Review

About Canadian Nurse Practitioner Licensure Exam

Canadian Nurse Practitioner Licensure Exam · CA

Key exam facts

Provider
Developed by Meazure Learning with CCRNR, participating provincial/territorial nursing regulators and Canadian NP experts; delivered by Meazure Learning through participating regulators.
Format
Computer-based linear-on-the-fly; primarily multiple choice, case-based and independent. Audio, video and other workplace material formats may appear. In-person and remote access depend on regulator.
Exam questions
Total questions: 180–185; Scored questions: 160–165; Unscored questions: 20–25; The total includes the scored and unscored questions.
Time limit
Four hours of actual examination answering time; individual approved accommodations may modify timing.
Passing score
Criterion-referenced entry-level competence standard. CNO's official technical briefing describes modified-Angoff setting by experts with a psychometrician. Results are pass/fail. No numerical CNPLE threshold or score scale is published in the reviewed blueprint, current study guide, candidate FAQ/resources or regulator result information. The former CNPE scale is not applied.
Exam fee
BCCNM publishes CAD $887.50 plus tax per attempt, payable to Meazure Learning when scheduling, excluding BCCNM application/licensing fees. This is a B.C. published condition, not a verified uniform national tariff. CNNB states applicable exam fees are communicated directly by the vendor.

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.

  • Clinician — Assessment — Official range: 25–35% (Practice allocation: 27.4%)

    • Establish the reason for the client encounter
    • Obtain informed consent according to legislation and regulatory requirements
    • Use critical inquiry to analyze and synthesize information to identify client needs, and to inform assessment and diagnosis
    • Conduct an assessment that is relevant to the client’s presentation to inform diagnostic decisions
    • Ask pertinent questions to establish the presenting issues
    • Evaluate information relevant to the client’s presenting concerns
    • Prioritize routine, urgent, emergent and life-threatening situations
    • Perform initial assessment of the client’s condition
    • Support client to make informed decisions, discussing risks, benefits, alternatives and consequences
    • Obtain informed consent for the collection, use and disclosure of personal and health information
    • Integrate information specific to the client’s biopsychosocial, behavioural, cultural, ethnic, spiritual, circumstances, current developmental life stage, gender expression and social determinants of health considering epidemiology and population-level characteristics
    • Integrate findings from past and current health history and investigations
    • Apply current, credible, and reliable research, literature and standards to inform decision-making
    • Incorporate pharmacological history
    • Integrate client’s wishes and directions related to advanced care planning, and palliative and end-of-life care
    • Determine the need for conducting a focused or comprehensive assessment
    • Conduct an assessment using valid and reliable techniques and tools
    • Conduct an assessment with sensitivity to client’s culture, lived experiences, gender identity, sexuality and personal expression
    • Conduct a mental health assessment, applying knowledge of emotional, psychological and social measures of well-being
    • Conduct a review of systems to identify pertinent presenting findings
    • Order and perform screening and diagnostic investigations, applying principles of resource stewardship

  • Clinician — Diagnosis — Official range: 8–12% (Practice allocation: 9.13%)

    • Integrate critical inquiry and diagnostic reasoning to formulate differential and most likely diagnoses
    • Interpret the results of investigations
    • Formulate differential diagnoses
    • Ascertain the client’s understanding of assessment findings, diagnosis, anticipated outcomes and prognosis
    • Determine the most likely diagnoses based on clinical and diagnostic reasoning

  • Clinician — Management — Official range: 20–30% (Practice allocation: 22.83%)

    • Use clinical reasoning to create a care plan based on diagnoses and the client’s informed consent, preferences and goals
    • Prescribe and counsel clients on pharmacological and non-pharmacological interventions, across the life span
    • Perform invasive and non-invasive interventions as indicated by the care plan
    • Examine, and explore with the client, options for managing the diagnoses
    • Consider availability, cost, determinants of health, clinical efficacy, and potential client adherence to determine feasibility and sustainability of the care plan
    • Address barriers that interfere with client’s goals
    • Determine and prioritize interventions integrating client goals and preferences, resources, and clinical urgency
    • Provide and seek consultation from other professionals and organizations to support the care plan
    • Complete accurate prescriptions in accordance with applicable jurisdictional and organizational requirements
    • Select evidence-informed pharmacological interventions based on diagnoses, concurrent client therapies, and available medication history, using drug-information systems
    • Complete medication reconciliation to make clinical decisions based on an analysis of the client’s current pharmacological and non-pharmacological therapy
    • Analyze polypharmacy to identify unnecessary and unsafe prescribing, and deprescribing where possible
    • Incorporate principles of pharmacological stewardship
    • Establish a monitoring plan for pharmacological and non-pharmacological interventions
    • Counsel client on indications, benefits, cost, potential adverse effects, interactions, contraindications, precautions, adherence, required monitoring and follow-up
    • Explain procedures, including indications, potential risks and benefits, adverse effects, anticipated aftercare and followup care
    • Perform procedures using evidence-informed techniques
    • Monitor and evaluate clinical findings, aftercare and follow up
    • Perform interventions to stabilize the client in urgent, emergent, and life-threatening situations

  • Clinician — Counselling — Official range: 5–10% (Practice allocation: 6.85%)

    • Create a therapeutic relationship that is conducive to optimal health outcomes
    • Provide therapeutic interventions as indicated by the care plan
    • Apply harm-reduction strategies and evidence-informed practice to support clients with substance use disorder, while adhering to federal and provincial/territorial legislation and regulation
    • Utilize developmentally, socio-demographically, and culturally relevant strategies, communication and counselling techniques and tools
    • Evaluate effectiveness of therapeutic relationship and refer to appropriate professionals, as needed
    • Address impacts of potential and real biases on the creation of safe spaces
    • Integrate therapeutic counselling techniques to facilitate an optimal experience and outcome for the client
    • Recognize and respond to the expression of intense emotions in a manner that facilitates a safe and effective resolution
    • Provide trauma and violence informed care
    • Identify the presence of trauma, including intergenerational trauma, with the client
    • Identify potential risks and signs of substance use disorders
    • Develop a harm-reduction care plan, considering treatment and intervention options
    • Apply evidence-informed and safe prescribing practices when initiating and managing pharmacological and non-pharmacological interventions
    • Adhere to legislation, regulation, and organizational policy related to the safe storage and handling of controlled drugs and substances
    • Provide education on the safe storage and handling of controlled drugs and substances

  • Clinician — Transition of Care, Discharge Planning and Documentation — Official range: 5–10% (Practice allocation: 6.85%)

    • Lead admission, transition of care, and discharge planning that ensures continuity and safety of client care
    • Conduct record keeping activities, according to legislation and jurisdictional regulatory requirements
    • Provide safe, ethical, and competent services as a self-employed practitioner
    • Employ evidence-informed virtual care strategies
    • Collaborate with client to facilitate access to required resources, drug therapy, diagnostic tests, procedures, and follow up to support the continuum of care
    • Facilitate transfer of information to support continuity of care
    • Facilitate client’s access to community services and other system resources
    • Modify the care plan based on the client’s transition needs
    • Document all client encounters and rationale for actions
    • Collect, disclose, use, and destroy health information according to privacy and confidentiality legislation, regulations and provincial/territorial regulatory standards
    • Apply relevant security measures to records and documentation
    • Recognize role as a health information custodian to ensure client information is secure and remains confidential
    • Employ accurate, honest, and ethical billing and advertising practices
    • Articulate the risks and benefits of virtual care to confirm the client’s informed consent to participate in a virtual care visit
    • Maintain client’s privacy during virtual encounters, and when transferring data and providing medical documents electronically
    • Determine when the client’s health concern can be managed virtually without delaying or fragmenting care
    • Demonstrate an understanding of the limitations of virtual care when determining the need for in-person assessment and management
    • Adapt history-taking and assessment techniques to effectively complete the virtual client assessment
    • Use effective communication approaches in the virtual care environment
    • Integrate health-care technologies and communication platforms to deliver virtual care
    • Adhere to requirements for communication and documentation for virtual client encounters

  • Quality Improvement and Research/Scholar — Official range: 5–10% (Practice allocation: 6.85%)

    • Identifies gaps, appraises and applies evidence-informed resources, understands research methodologies
    • Discusses the practical benefits and possible applications of research with teams and partners
    • Recommends where research findings can be integrated into practice
    • Applies ethical principles and analyzes the context when implementing evidence-informed practice
    • Disseminates knowledge and evidence-informed findings with clients, teams and partners
    • Uses data and available forms of technology to identify risks and create opportunities to mitigate harm

  • Leader — Official range: 5–10% (Practice allocation: 6.85%)

    • Engages in leadership to contribute to a culture of continuous improvement, safety and excellence
    • Builds partnerships to optimize health-care delivery
    • Uses principles of team dynamics, conflict resolution and change management to support effective collaboration and communication
    • Demonstrates awareness of tools and resources, and contributes to strategies for responding to disasters and unpredictable situations

  • Educator — Official range: 3–7% (Practice allocation: 4.57%)

    • Develops and provides educational resources
    • Evaluates learning and delivery methods to improve outcomes
    • Develops and uses evidence-informed strategies and technologies to enhance learning

  • Advocate — Official range: 7–12% (Practice allocation: 8.68%)

    • Demonstrates self-awareness and cultural humility to mitigate risk based on personal bias
    • Contributes to a practice environment that is diverse, equitable, inclusive and culturally safe
    • Promotes equitable care and service delivery
    • Advocates for client access to resources and system changes
    • Navigates various systems affecting client care acknowledging the interdependence of policy, practice and systemic issues
    • Identifies and manages potential and real conflicts of interests, always acting in the client’s best interest

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

What is the exam format?

Computer-based linear-on-the-fly; primarily multiple choice, case-based and independent. Audio, video and other workplace material formats may appear. In-person and remote access depend on regulator.

How many questions are on the exam?

Total questions: 180–185; Scored questions: 160–165; Unscored questions: 20–25; The total includes the scored and unscored questions.

How long is the exam?

Four hours of actual examination answering time; individual approved accommodations may modify timing.

What is the passing score?

Criterion-referenced entry-level competence standard. CNO's official technical briefing describes modified-Angoff setting by experts with a psychometrician. Results are pass/fail. No numerical CNPLE threshold or score scale is published in the reviewed blueprint, current study guide, candidate FAQ/resources or regulator result information. The former CNPE scale is not applied.

How much does the exam cost?

BCCNM publishes CAD $887.50 plus tax per attempt, payable to Meazure Learning when scheduling, excluding BCCNM application/licensing fees. This is a B.C. published condition, not a verified uniform national tariff. CNNB states applicable exam fees are communicated directly by the vendor.

Official sources and references

Confirm current exam arrangements with the exam provider.