CPNRE EXAM | CANADIAN PRACTICAL NURSE REGISTRATION EXAMINATION (CPNRE) EXAM
PREP QUESTIONS & ANSWERS| 2025-2026 LATEST UPDATE
Wound care of a burn is delayed until a patent airway, adequate circulation, and adequate
fluid replacement have been established
Emergent phase nursing considerations - routine blood work is important
- early ROM exercises to prevent contractures
- analgesics and sedatives given, as well as tetanus immunization
- antimicrobial agents both topical and systemic are used
- start oral intake once bowel sounds are back
- the client will need high calories with vitamin and mineral supplements
Acute phase of burns Diuresis ends and wounds healed.
- necrotic tissues sloughs off and granulation tissue will cover
- a partial thickness wound will heal from the edges
- full thickness wounds must be covered by skin grafts
- full thickness require debridement
Acute phase of a burn interventions - daily observation, cleansing, and debridement
- analgesics and sedation are needed
- passive and active ROM exercises should be performed
- splints help prevent deformities
- a high protein, high carbohydrate diet helps meet the clients increased metabolic needs
Rehabilitation phase of a burn Begins when the wounds are covered by skin and healed
,- wound will heal by primary intervention or by grafting
- mature healing is reached in 6 months- 2 years
Following nursing interventions for the rehabilitation phase of a burn - an emollient water
based cream is recommended
Causes of cardiogenic shock - mi, cardiomyopathies, blunt cardiac injury
- severe systemic or pulmonary. hypertension
- severe sepsis
-
cardiomyopathies diverse group of diseases that primarily affect the myocardium itself
Early signs of cardiogenic shock tachycardia, hypotension/narrowed pulse pressure,
increased SVR, increased myocardial oxygen consumption, tachypnea, pulmonary congestion,
crackles
- Since the CO2 is low, renal blood flow and urine output decrease
- anxiety (lack of blood flow to tissues)
Hypovolemic shock Loss of intravascular fluid, either an absolute or relative volume loss
Absolute hypovolemia can be due to the following; hemorrhage, GI loss, fistula drainage,
diuresis
*occurs when fluid moves out of the intravascular space into an extravascular space (third
spacing)
*decreased venous return to the heart, decreased preload, and decreased CO2
*when the loss is more than 30% of total volume, blood replacement is needed
,Neurogenic shock occurs after SCI, at T5 or above
*massive dilation, leading to pooling of blood into the vessels
*clinical signs; bradycardia, hypotension
This type of shock is the only type of shock to have bradycardia Neurogenic shock
Spinal shock decreased reflexes, loss of sensation, flaccid paralysis below the level of injury,
Most common precipitating factor of autonomic dysreflexia distended bladder or rectum
Anaphylactic shock Acute life-threatening hypersensitivity reaction that causes massive
vasodilation, increased capillary permeability, and release of mediators. This can lead to
respiratory distress and circulatory failure
sudden symptoms of anaphylactic shock= anxiety, confusion, and sense of impending doom
Septic shock A systemic inflammatory response to infection,
- primary causatives= gram positive and negative bacteria
- increased coagulation and inflammation
- SVR will decrease, leading to hypotension
- The client will be tachypneic and have temperature dysregulation, decreased urinary output,
altered neurological status, GI dysfunction and respiratory failure.
Tachypneic very rapid respiration
Shock manifestations - the bodys extremities will be cool ad clammy due to blood going to
vital organs
- increase CO and blood pressure
, - The impaired GI motility can lead to paralytic ileus
- The decreased arterial oxygen levels can result in increased respirations
-
Shock nursing considerations to control or eliminate the cause of decreased perfusion and to
protect the organs from dysfunction - ensure patent airway, optimize oxygen delivery
- possible blood transfusions or other fluid replacement therapy
- an in-dwelling catheter allows for frequent checks of output
- vital signs and ABG's must be monitored frequently
- vasopressor agents may be given for hypotension
- vasodilators may be given
-cardiac monitoring
- a pulmonary catheter may be used to monitor venous pressures
- chest and bowel sounds assessed frequently
Treatment of life-threatening autonomic dysreflexia includes the following - raising the head
of the bed to 45 degrees
- immediate urinary catheterization if the bladder is distended
- a digital examination with topical anaesthesia may be needed, if the client is constipated
- constrictive clothing and tight shoes need to be removed to prevent excessive skin stimulation
- BP must be monitored and treated with an alpha-adrenergic blocker or an arteriolar
vasodilator
Autonomic Dysreflexia patients with spinal cord injuries are at risk for developing autonomic
dyreflexia (T-7 or above)
preoperative care - interviewing the client
PREP QUESTIONS & ANSWERS| 2025-2026 LATEST UPDATE
Wound care of a burn is delayed until a patent airway, adequate circulation, and adequate
fluid replacement have been established
Emergent phase nursing considerations - routine blood work is important
- early ROM exercises to prevent contractures
- analgesics and sedatives given, as well as tetanus immunization
- antimicrobial agents both topical and systemic are used
- start oral intake once bowel sounds are back
- the client will need high calories with vitamin and mineral supplements
Acute phase of burns Diuresis ends and wounds healed.
- necrotic tissues sloughs off and granulation tissue will cover
- a partial thickness wound will heal from the edges
- full thickness wounds must be covered by skin grafts
- full thickness require debridement
Acute phase of a burn interventions - daily observation, cleansing, and debridement
- analgesics and sedation are needed
- passive and active ROM exercises should be performed
- splints help prevent deformities
- a high protein, high carbohydrate diet helps meet the clients increased metabolic needs
Rehabilitation phase of a burn Begins when the wounds are covered by skin and healed
,- wound will heal by primary intervention or by grafting
- mature healing is reached in 6 months- 2 years
Following nursing interventions for the rehabilitation phase of a burn - an emollient water
based cream is recommended
Causes of cardiogenic shock - mi, cardiomyopathies, blunt cardiac injury
- severe systemic or pulmonary. hypertension
- severe sepsis
-
cardiomyopathies diverse group of diseases that primarily affect the myocardium itself
Early signs of cardiogenic shock tachycardia, hypotension/narrowed pulse pressure,
increased SVR, increased myocardial oxygen consumption, tachypnea, pulmonary congestion,
crackles
- Since the CO2 is low, renal blood flow and urine output decrease
- anxiety (lack of blood flow to tissues)
Hypovolemic shock Loss of intravascular fluid, either an absolute or relative volume loss
Absolute hypovolemia can be due to the following; hemorrhage, GI loss, fistula drainage,
diuresis
*occurs when fluid moves out of the intravascular space into an extravascular space (third
spacing)
*decreased venous return to the heart, decreased preload, and decreased CO2
*when the loss is more than 30% of total volume, blood replacement is needed
,Neurogenic shock occurs after SCI, at T5 or above
*massive dilation, leading to pooling of blood into the vessels
*clinical signs; bradycardia, hypotension
This type of shock is the only type of shock to have bradycardia Neurogenic shock
Spinal shock decreased reflexes, loss of sensation, flaccid paralysis below the level of injury,
Most common precipitating factor of autonomic dysreflexia distended bladder or rectum
Anaphylactic shock Acute life-threatening hypersensitivity reaction that causes massive
vasodilation, increased capillary permeability, and release of mediators. This can lead to
respiratory distress and circulatory failure
sudden symptoms of anaphylactic shock= anxiety, confusion, and sense of impending doom
Septic shock A systemic inflammatory response to infection,
- primary causatives= gram positive and negative bacteria
- increased coagulation and inflammation
- SVR will decrease, leading to hypotension
- The client will be tachypneic and have temperature dysregulation, decreased urinary output,
altered neurological status, GI dysfunction and respiratory failure.
Tachypneic very rapid respiration
Shock manifestations - the bodys extremities will be cool ad clammy due to blood going to
vital organs
- increase CO and blood pressure
, - The impaired GI motility can lead to paralytic ileus
- The decreased arterial oxygen levels can result in increased respirations
-
Shock nursing considerations to control or eliminate the cause of decreased perfusion and to
protect the organs from dysfunction - ensure patent airway, optimize oxygen delivery
- possible blood transfusions or other fluid replacement therapy
- an in-dwelling catheter allows for frequent checks of output
- vital signs and ABG's must be monitored frequently
- vasopressor agents may be given for hypotension
- vasodilators may be given
-cardiac monitoring
- a pulmonary catheter may be used to monitor venous pressures
- chest and bowel sounds assessed frequently
Treatment of life-threatening autonomic dysreflexia includes the following - raising the head
of the bed to 45 degrees
- immediate urinary catheterization if the bladder is distended
- a digital examination with topical anaesthesia may be needed, if the client is constipated
- constrictive clothing and tight shoes need to be removed to prevent excessive skin stimulation
- BP must be monitored and treated with an alpha-adrenergic blocker or an arteriolar
vasodilator
Autonomic Dysreflexia patients with spinal cord injuries are at risk for developing autonomic
dyreflexia (T-7 or above)
preoperative care - interviewing the client
