Canadian English Language Benchmark Assessment for Nurses (CELBAN) — Questions and Answers

Question 1: A CELBAN speaking scenario asks you to explain a procedure to an anxious patient. Which element is LEAST important in your initial response?

Explaining each step of the procedure in simple terms
Asking the patient if they have questions
Acknowledging the patient's anxiety
Detailing the full medical history of previous patients who had the same procedure (Correct answer)

Correct answer: Detailing the full medical history of previous patients who had the same procedure

Sharing other patients' medical histories is irrelevant and violates confidentiality; it has no place in patient education.

Question 2: A patient reports a family history of 'heart trouble.' Which follow-up question provides the most clinically useful information?

Did they recover from it?
Who in your family had heart trouble?
At what age were they diagnosed? (Correct answer)
How did it affect their daily life?

Correct answer: At what age were they diagnosed?

Age of onset is the most clinically significant detail in family history because early-onset cardiac disease (before 55 in males, 65 in females) indicates a hereditary risk factor.

Question 3: Which transition word best connects these two ideas: 'The patient refused the injection. ___, the nurse documented the refusal.'

Similarly
In addition
However
Consequently (Correct answer)

Correct answer: Consequently

'Consequently' signals a cause-and-effect relationship, appropriate when one action leads to another.

Question 4: A CELBAN listening passage describes a nurse saying: 'I noticed the patient's wound drainage has changed from serous to seropurulent over the past 24 hours, and there's some surrounding erythema.' What change is being described?

The patient's wound is fully closed and no further monitoring is needed
The wound is healing faster than expected with no concerns
The wound dressing needs to be changed to a waterproof type
The wound drainage has changed from clear/straw-coloured to cloudy with pus, and redness has appeared around the wound, suggesting possible infection (Correct answer)

Correct answer: The wound drainage has changed from clear/straw-coloured to cloudy with pus, and redness has appeared around the wound, suggesting possible infection

Seropurulent drainage (cloudy, mixed with pus) replacing serous drainage, combined with erythema, are classic early signs of wound infection requiring prompt assessment.

Question 5: A nurse ends a handover by saying: 'She'll need repeat bloodwork at 0600, and please monitor her neuro checks every two hours overnight.' Which part of SBAR is this?

Situation
Background
Recommendation (Correct answer)
Assessment

Correct answer: Recommendation

The Recommendation component specifies the actions the incoming nurse should take, including pending tests and monitoring requirements.

Question 6: A chart entry reads: 'Pt. c/o dyspnea on exertion x 3 days.' Which of the following best interprets this note?

The patient reports dizziness during exertion for three days
The patient complains of difficulty breathing during physical activity for three days (Correct answer)
The patient complains of difficulty swallowing for three days
The patient has chest pain when exercising for three days

Correct answer: The patient complains of difficulty breathing during physical activity for three days

C/o means 'complains of,' dyspnea means difficulty breathing, and 'on exertion' indicates it occurs during physical activity.

Question 7: During a CELBAN speaking task simulating a handover report, which information should a nurse prioritize communicating to the incoming nurse?

A detailed history of the patient's previous hospitalizations
Current status, recent changes, pending tasks, and safety concerns (Correct answer)
The patient's meal preferences and visiting hours
The nurse's personal opinion about the patient's behavior

Correct answer: Current status, recent changes, pending tasks, and safety concerns

An effective handover report focuses on current clinical status, significant changes, outstanding tasks, and any safety concerns.

Question 8: During a CELBAN role-play, a patient refuses a recommended treatment. As the nurse, your most appropriate action is to:

Argue persistently until the patient agrees.
Respect the refusal, explain the potential consequences, and document the discussion. (Correct answer)
Tell the patient their insurance will not cover future problems if they refuse.
Proceed with the treatment anyway to ensure patient safety.

Correct answer: Respect the refusal, explain the potential consequences, and document the discussion.

Nurses must respect patient autonomy, inform them of consequences of refusal, and document the conversation appropriately.

Question 9: A CELBAN speaking scenario involves a patient who is tearful about a recent cancer diagnosis. After the role-play, an examiner notes the candidate 'failed to demonstrate empathy.' Which response illustrates the missed empathetic language?

'Let's focus on what your treatment options are right now.'
'That must be incredibly difficult news to receive. I'm here with you, and we'll work through this together.' (Correct answer)
'Many people survive cancer these days, so try to stay positive.'
'The doctor will explain everything; I'm just the nurse.'

Correct answer: 'That must be incredibly difficult news to receive. I'm here with you, and we'll work through this together.'

Explicitly naming the patient's emotional experience and offering presence and partnership is the hallmark of empathetic clinical communication.

Question 10: During a patient round, a nurse hears a post-partum patient tell her partner: 'I love her so much but sometimes I just want to run away — is that terrible?' What is the nurse's best response?

Leave the couple to discuss the matter privately
Document that the patient is expressing thoughts of abandoning the infant
Normalize the feeling while screening for postpartum depression using a validated tool (Correct answer)
Explain to the patient that ambivalent feelings are abnormal and require psychiatric referral

Correct answer: Normalize the feeling while screening for postpartum depression using a validated tool

Ambivalent feelings are common postpartum, but the nurse should screen for postpartum depression using tools like the Edinburgh Postnatal Depression Scale.

Question 11: The physician's orders in a patient's chart state: 'Administer Gravol 50 mg IM q6h PRN for N/V.' How should the nurse interpret this order?

Administer 50 mg of Gravol into the muscle every 6 hours only if the patient complains of nausea or vomiting. (Correct answer)
Give 50 mg of Gravol by mouth every 6 hours continuously for nausea and vomiting.
Give 50 mg of Gravol intravenously every 6 hours as needed for pain.
Apply a 50 mg Gravol patch to the skin every 6 hours to prevent nausea.

Correct answer: Administer 50 mg of Gravol into the muscle every 6 hours only if the patient complains of nausea or vomiting.

This answer correctly decodes all the abbreviations. 'IM' stands for intramuscular (into the muscle). 'q6h' means every 6 hours. 'PRN' means 'pro re nata' or as needed. 'N/V' stands for nausea and vomiting. Therefore, the nurse should give the medication via injection into the muscle, only when the patient experiences nausea or vomiting, and no more frequently than every 6 hours.

Question 12: A patient's chart documents a pain score of 7/10 at 0800 and the nurse administered morphine 2 mg IV at 0810. The follow-up note at 0840 reads: 'Pain 3/10, tolerating well.' What does this charting demonstrate?

The nurse should have given a higher dose of morphine
The pain reassessment was performed too early
Medication was given too late to be effective
Proper documentation of medication administration and reassessment of effectiveness (Correct answer)

Correct answer: Proper documentation of medication administration and reassessment of effectiveness

Documenting the baseline pain score, medication given with dose/route/time, and a follow-up reassessment demonstrates proper pain management documentation practices.

Question 13: A patient is speaking to a nurse on the phone, describing a rash. The patient says, 'It started on my arms, but now I see a few spots on my chest. It's not really itchy, but it looks quite red and blotchy.' What should the nurse clarify next?

If the patient has eaten any unusual foods.
Whether the patient has health insurance.
What the patient's current body temperature is.
If the patient has taken a new medication recently. (Correct answer)

Correct answer: If the patient has taken a new medication recently.

Given the description of a new rash spreading on the body, a common and important cause to investigate is an allergic reaction to a new medication. This is a priority question for patient safety. While the other questions might be relevant eventually, identifying a potential drug allergy is most critical.

Question 14: During shift change report, a nurse states: 'Mr. Chen keeps refusing his evening medications — says they make him feel foggy.' What should the oncoming nurse investigate first?

How to administer the medications without the patient's knowledge
The specific medications involved and whether cognitive side effects are documented or expected (Correct answer)
Whether the physician can order the medications in a different form
Whether Mr. Chen has the cognitive capacity to refuse medication

Correct answer: The specific medications involved and whether cognitive side effects are documented or expected

Identifying which medications cause fogginess allows the nurse and provider to review the regimen for dose timing changes or alternatives before more complex steps.

Question 15: A chart progress note reads: 'Crackles auscultated bilaterally at lung bases, O2 sat 91% on 2L NC.' What should the nurse do first?

Encourage the patient to cough and deep breathe
Document findings and reassess in one hour
Increase oxygen flow rate and reassess oxygen saturation (Correct answer)
Notify the physician of worsening respiratory status

Correct answer: Increase oxygen flow rate and reassess oxygen saturation

An O2 saturation of 91% is below the acceptable threshold of 95%; increasing the oxygen delivery and reassessing is the immediate nursing action.

Question 16: Which sentence avoids the use of a double negative?

The patient denied having any pain. (Correct answer)
There wasn't no change in the patient's condition.
The patient didn't report nothing unusual.
The patient didn't deny having no pain.

Correct answer: The patient denied having any pain.

'Denied having any pain' uses a single negative ('denied') and the correct indefinite pronoun 'any,' avoiding a double negative.

Question 17: Everyone knows that getting into bed early has a significant impact on our fitness. Researchers claim to have found the best time of day to go to bed. British researchers. The ideal bedtime, according to Biobank, is between 10 and 11 p.m. People who sleep between these hours are said to be less likely to develop heart disease. The researchers collected information on the sleeping habits of eighty thousand individuals six years ago. For seven days, the volunteers were required to wear a unique watch that allowed the researchers to record their sleeping and waking hours. The volunteers' level of fitness was then observed by the investigators. Approximately 3,000 volunteers experienced cardiac issues. They either went to bed before or after the "healthy" 10 o'clock or 11 o'clock period. <br> <br> Dr. David Plans, one of the study's authors, made observations about the effects of sleep patterns on heart health in his research. He said, "Although our study does not allow us to conclude on causality, the results suggest that early or late bedtimes may disrupt the body clock, with [negative] outcomes for cardiovascular fitness." However, he added, "Changing into is able to reduce the probability of seeing morning light, which resets the body clock." If our body clock isn't always reset correctly, we run the risk of developing cardiovascular disease. <br> <br> How many volunteers were part of the research?

88,000
28,000
86,000
80,000 (Correct answer)

Correct answer: 80,000

The passage states: 'The researchers collected information on the sleeping habits of eighty thousand individuals,' which equals 80,000. The other numbers (88,000, 86,000, 28,000) are close numerical distractors that do not appear in the text.

Question 18: A passage reads: 'The patient is a 68-year-old male presenting with diaphoresis, pallor, and substernal chest pain radiating to the left arm. 12-lead ECG reveals ST-segment elevation in leads II, III, and aVF.' Based on this, which area of the heart is most likely affected?

Anterior wall
Inferior wall (Correct answer)
Posterior wall
Lateral wall

Correct answer: Inferior wall

ST-segment elevation in leads II, III, and aVF indicates an inferior myocardial infarction, typically caused by right coronary artery occlusion.

Question 19: Which speaking strategy helps a CELBAN candidate avoid long, awkward silences when they need a moment to think during a role-play?

Repeating the question word for word three times before answering
Using natural fillers and stalling phrases such as 'That's a great question. Let me make sure I explain this clearly...' (Correct answer)
Switching topics to something you are more comfortable with
Staring silently at the examiner for up to 30 seconds

Correct answer: Using natural fillers and stalling phrases such as 'That's a great question. Let me make sure I explain this clearly...'

Natural stalling phrases maintain conversational flow and demonstrate composure while the speaker formulates a thoughtful clinical response.

Question 20: A patient newly diagnosed with Type 2 diabetes tells her husband during your assessment: 'I guess I just have to give up everything I enjoy eating.' What does this statement suggest to the nurse?

The patient is in denial and not ready to engage with her care plan
The patient holds a misconception about diabetes management that requires education (Correct answer)
The patient has already received thorough dietary counseling
The patient's cultural food preferences conflict with medical guidelines

Correct answer: The patient holds a misconception about diabetes management that requires education

The patient's all-or-nothing thinking suggests a misconception; a dietitian referral and education about balanced meal planning are indicated.

Question 21: A nursing textbook passage states: 'The Glasgow Coma Scale (GCS) assesses three areas: eye opening (scored 1–4), verbal response (scored 1–5), and motor response (scored 1–6). A total score of 15 indicates full consciousness, while a score of 8 or below indicates severe impairment requiring airway protection.' A patient scores: eyes open to voice (3), confused verbal response (4), localizes pain (5). What is this patient's GCS score?

10
12 (Correct answer)
11
13

Correct answer: 12

Eyes to voice = 3, confused speech = 4, localizes pain = 5; total GCS = 3 + 4 + 5 = 12.

Question 22: A patient tells an interpreter during a translated consultation: 'I don't want to tell the doctor everything because I'm afraid they will judge me.' The interpreter relays this verbatim. How should the nurse respond?

Ask the interpreter to encourage the patient to be more open
Acknowledge the patient's concern and reassure them that disclosures are confidential and non-judgmental (Correct answer)
Proceed with the assessment using only the information the patient volunteers
Document that the patient is withholding information and flag for psychiatric review

Correct answer: Acknowledge the patient's concern and reassure them that disclosures are confidential and non-judgmental

Building trust by validating the patient's fear and affirming confidentiality encourages open disclosure and supports accurate assessment.

Question 23: A patient chart shows: 'Last bowel movement 4 days ago, abdomen firm and distended, patient reports bloating.' Which intervention would the nurse expect to implement based on these chart findings?

Restrict oral fluid intake
Initiate bowel care protocol, including laxative or enema as ordered (Correct answer)
Administer an antiemetic
Place a nasogastric tube

Correct answer: Initiate bowel care protocol, including laxative or enema as ordered

Four days without a bowel movement, abdominal distension, and firmness indicate constipation requiring bowel care interventions such as stool softeners, laxatives, or enemas.

Question 24: A patient's lab results section shows: 'Hgb 95 g/L'. The normal range for an adult male is 135-175 g/L. Based on this result, which of the following conditions should the nurse be most concerned about?

Anemia (Correct answer)
Hyperglycemia
Infection
Dehydration

Correct answer: Anemia

Hgb stands for Hemoglobin. A result of 95 g/L is significantly below the normal range of 135-175 g/L for an adult male. Low hemoglobin is the primary indicator of anemia, a condition characterized by a deficiency of red blood cells or hemoglobin in the blood.

Question 25: A patient in a CELBAN speaking role-play asks: 'What happens if I don't take my blood thinners?' The best nurse response is:

'That's not really my area — ask your doctor.'
'That is a very risky question to even ask.'
'You could develop a dangerous blood clot, which might block blood flow to your heart or brain. It's important we understand your concerns about the medication.' (Correct answer)
'You'll probably be fine; lots of people stop taking medications.'

Correct answer: 'You could develop a dangerous blood clot, which might block blood flow to your heart or brain. It's important we understand your concerns about the medication.'

The nurse should clearly explain the clinical risks of non-adherence and explore the patient's underlying concerns in a non-judgmental way.

Question 26: "Would you kindly remember if this had occurred previously?"

Examples of clarifying questions are:
Once you have a good understanding of the patient's needs, let them know when they can expect to have their symptoms resolved. This can be as simple as saying:
You can also ask probing questions that will help you obtain more information such as: (Correct answer)
Better Probing question

Correct answer: You can also ask probing questions that will help you obtain more information such as:

Asking 'Would you kindly remember if this had occurred previously?' is a probing question because it digs deeper into the patient's history to gather more relevant details about their condition. Probing questions go beyond surface-level facts to uncover context, unlike clarifying questions which resolve misunderstandings or expectation-setting statements.

Question 27: You hear a nurse giving instructions to a patient: "Please take this medication after meals, twice a day." What should the patient do?

Take the medication after meals. (Correct answer)
Take the medication only once a day.
Take the medication before meals.
Take the medication with meals.

Correct answer: Take the medication after meals.

The nurse's instruction, "Please take this medication after meals," directly specifies the timing for the medication. This means the patient should consume food first, then take the medicine, not before or with meals.

Question 28: A patient says, 'I understand' after medication instructions but cannot demonstrate the correct technique. What should the nurse do?

Re-teach using a different method and reassess (Correct answer)
Document that teaching was completed
Ask the patient to sign the teaching form
Refer the patient to a pharmacist only

Correct answer: Re-teach using a different method and reassess

Verbal confirmation alone is insufficient; the nurse must re-teach and use return demonstration to verify understanding.

Question 29: During a shift briefing the manager announces: 'Effective Monday we're implementing a new fall-prevention bundle — hourly rounding, bed alarms on for all patients flagged as high risk, and non-slip footwear to be applied before ambulation.' What is the FIRST preventive action listed?

Activating bed alarms for high-risk patients
Hourly rounding on all patients (Correct answer)
Reviewing fall history in the patient chart
Applying non-slip footwear before any ambulation

Correct answer: Hourly rounding on all patients

The manager lists hourly rounding as the first element of the fall-prevention bundle, followed by bed alarms and then non-slip footwear.

Question 30: A patient's chart shows the following medication order: 'Heparin 5,000 units SC q8h.' What route does 'SC' indicate?

Spinal catheter
Subcutaneous injection (Correct answer)
Slow IV drip
Sublingual administration

Correct answer: Subcutaneous injection

SC (also written as SQ or subcut) refers to the subcutaneous route, meaning injection into the fatty tissue layer beneath the skin.

Question 31: During a home care assessment, a nurse notices a patient whisper to their spouse: 'Don't tell her about the falls — she'll want to put me in a home.' What risk does this withholding behavior create?

The patient is violating the terms of their home care agreement
The patient's behavior suggests cognitive impairment requiring formal assessment
The spouse is legally obligated to report falls to the care team
Unreported falls prevent the nurse from implementing fall prevention strategies, increasing injury risk (Correct answer)

Correct answer: Unreported falls prevent the nurse from implementing fall prevention strategies, increasing injury risk

Concealing fall history deprives the care team of information needed to assess fall risk and implement safety measures, putting the patient in danger.

Question 32: A patient's lab results in the chart show: 'K+ 2.9 mEq/L.' What clinical manifestation should the nurse monitor for given this result?

Polydipsia and polyuria
Muscle weakness and cardiac arrhythmias (Correct answer)
Seizures and hyperreflexia
Hypertension and flushed skin

Correct answer: Muscle weakness and cardiac arrhythmias

A potassium level of 2.9 mEq/L indicates hypokalemia, which can cause muscle weakness, cramping, and life-threatening cardiac dysrhythmias.

Question 33: A policy on restraint use reads: 'Physical restraints may only be applied when less restrictive alternatives have been attempted and failed, a physician order has been obtained, and patient safety cannot otherwise be ensured. Reassessment must occur every 2 hours.' A nurse applies a wrist restraint without a physician order because the patient keeps pulling at their IV line. What should happen next?

The restraint can remain for up to 8 hours before an order is needed
The restraint is acceptable since patient safety was at risk
The nurse must obtain a physician order immediately and document the emergent application (Correct answer)
The family must be notified before any order is sought

Correct answer: The nurse must obtain a physician order immediately and document the emergent application

Even in emergent situations, a physician order must be obtained as soon as possible after applying a restraint, as required by policy and legislation.

Question 34: During a CELBAN speaking task, a patient mentions they have been taking a herbal supplement and asks if it is safe with their prescribed blood thinner. The best nurse response is:

'I'm glad you told me. Some herbal supplements can interact with blood thinners, so I'll note this and make sure the doctor or pharmacist reviews it with you.' (Correct answer)
'That is the pharmacist's job, not mine.'
'Herbal supplements are natural, so they are definitely safe.'
'Stop taking the supplement immediately until we figure this out.'

Correct answer: 'I'm glad you told me. Some herbal supplements can interact with blood thinners, so I'll note this and make sure the doctor or pharmacist reviews it with you.'

Acknowledging the patient's disclosure, noting the potential for interactions, and escalating to the appropriate professional is the correct nursing response.

Question 35: A patient's chart allergy section lists: 'PCN — Anaphylaxis.' Which antibiotic should the nurse question before administration?

Azithromycin
Vancomycin
Ampicillin (Correct answer)
Ciprofloxacin

Correct answer: Ampicillin

Ampicillin is a penicillin-class antibiotic (PCN), and administering it to a patient with a documented PCN anaphylaxis allergy would be dangerous.

Question 36: You hear a pediatric patient tell their parent: 'The nurse gave me a needle but I didn't cry because she told me to squeeze your hand.' What does this dialogue reveal about effective nursing technique?

Distraction and comfort strategies reduce procedural distress in pediatric patients (Correct answer)
Parental presence during procedures is discouraged in hospital settings
The patient's coping was entirely self-directed without nursing input
Children should not be warned before painful procedures to avoid anticipatory anxiety

Correct answer: Distraction and comfort strategies reduce procedural distress in pediatric patients

The nurse's use of a coping instruction (hand-squeezing as distraction) demonstrates evidence-based non-pharmacological pain management in pediatrics.

Question 37: "What is the duration of this occurrence?"

Level setting of expectations with empathy
Revalidation phrase
Probing question (Correct answer)
examples of clarifying questions are:

Correct answer: Probing question

Asking how long the occurrence lasts is a probing question because it digs deeper into the timeline and persistence of the symptom to elicit more specific information. It is not expectation-setting, a revalidation phrase, or a generic clarifying question.

Question 38: A medication administration record (MAR) notes: 'Metformin 500 mg PO BID with meals — HOLD if patient is NPO or scheduled for contrast imaging.' A nurse finds the patient is scheduled for a CT scan with contrast at 1400. What should the nurse do with the 1200 metformin dose?

Administer it as scheduled since the scan is after the dose time
Substitute with insulin coverage instead
Crush and dissolve in water to give before NPO begins
Hold the dose and document the reason per the MAR instruction (Correct answer)

Correct answer: Hold the dose and document the reason per the MAR instruction

The MAR explicitly instructs to hold metformin before contrast imaging due to the risk of contrast-induced nephropathy and lactic acidosis.

Question 39: When preparing a patient for a colonoscopy, the nurse must explain the bowel preparation protocol. What is the most critical piece of information to emphasize?

The procedure will help the doctor visualize the colon.
The patient should arrange for transportation home after the procedure.
The importance of drinking the entire preparation solution to ensure the colon is clean. (Correct answer)
The patient may feel some cramping during the preparation.

Correct answer: The importance of drinking the entire preparation solution to ensure the colon is clean.

While all points are relevant, the success of the colonoscopy depends entirely on the bowel being thoroughly cleaned out. If the patient does not complete the preparation, the procedure may be ineffective and need to be repeated. Therefore, emphasizing the importance of finishing the solution is the most critical instruction for a successful medical outcome.

Question 40: A nurse is speaking with an elderly patient who is hard of hearing. Which communication strategy is most appropriate for the CELBAN Speaking scenario?

Speak as fast as possible to save time.
Shout loudly to ensure the patient hears every word.
Face the patient, speak clearly, and use simple sentences at a moderate pace. (Correct answer)
Ask a family member to relay all information to the patient.

Correct answer: Face the patient, speak clearly, and use simple sentences at a moderate pace.

Facing the patient, speaking clearly and slowly, and using plain language are best practices for communicating with hearing-impaired patients.

Question 41: A patient's family member asks to receive all discharge instructions instead of the patient. What should the nurse do?

Include the patient in the teaching session and share information with the family member with the patient's consent (Correct answer)
Refuse to involve the family member entirely
Delay discharge until the patient agrees to receive instructions alone
Provide all instructions exclusively to the family member

Correct answer: Include the patient in the teaching session and share information with the family member with the patient's consent

Respecting patient autonomy requires obtaining consent before sharing information, while still including the patient in their own care education.

Question 42: A CELBAN listening section features a pharmacist counselling a patient: 'This antibiotic needs to be taken with a full glass of water and you should remain upright for at least 30 minutes afterward — it can cause esophageal irritation if you lie down too soon.' Which antibiotic class is most likely being described?

Bisphosphonates — wait, this is a tetracycline or doxycycline, which causes esophageal irritation when the patient reclines after dosing (Correct answer)
Fluoroquinolones, which should be taken with antacids for best absorption
Macrolides, which must always be taken on an empty stomach
Penicillins, which require refrigeration to maintain stability

Correct answer: Bisphosphonates — wait, this is a tetracycline or doxycycline, which causes esophageal irritation when the patient reclines after dosing

The instruction to stay upright for 30 minutes and use a full glass of water is a hallmark counselling point for tetracyclines (especially doxycycline) to prevent pill-induced esophagitis.

Question 43: A nurse reads in a patient's progress note: 'Wound site shows erythema, warmth, and purulent discharge.' What condition does this describe?

A wound infection (Correct answer)
Wound dehiscence
An allergic reaction to dressing material
Normal wound healing

Correct answer: A wound infection

Erythema (redness), warmth, and purulent (pus-containing) discharge are classic signs of a wound infection.

Question 44: A patient with limited English proficiency says through a phone interpreter: 'The nurse yesterday told me to push the button if the pain is bad, but I don't want to bother anyone.' What barrier is this patient describing?

A language barrier preventing understanding of pain management instructions
Cultural or social reluctance to request help, potentially leading to undertreated pain (Correct answer)
Distrust of the nursing staff based on a prior negative experience
Inability to operate the call bell device

Correct answer: Cultural or social reluctance to request help, potentially leading to undertreated pain

Reluctance to 'bother' staff is a well-documented barrier to adequate pain reporting, particularly in patients from cultures that value stoicism or deference.

Question 45: In clinical writing, which expression is the most appropriate substitute for 'a lot of'?

Plenty of
Tons of
Loads of
Significant (Correct answer)

Correct answer: Significant

'Significant' is the formal, clinical term used to describe a notable or important quantity or degree in medical documentation.

Question 46: When communicating a pain assessment to a physician over the phone during a CELBAN speaking task, which structured communication tool is most appropriate?

WILDA mnemonic
ADPIE
SBAR (Situation, Background, Assessment, Recommendation) (Correct answer)
SOAP note format

Correct answer: SBAR (Situation, Background, Assessment, Recommendation)

SBAR is the standard structured communication tool used for verbal reporting to physicians in Canadian healthcare settings.

Question 47: During a CELBAN speaking scenario, you must explain the purpose of a blood pressure cuff to a patient who has never used one before. The best approach is to use:

Avoid any explanation and just proceed with the measurement.
Simple language and a brief analogy, such as 'This cuff gently squeezes your arm to measure the force of your blood flow.' (Correct answer)
A technical explanation using advanced cardiovascular terminology.
Medical abbreviations like 'BP cuff for recording systolic and diastolic readings.'

Correct answer: Simple language and a brief analogy, such as 'This cuff gently squeezes your arm to measure the force of your blood flow.'

Simple language with a relatable analogy makes medical equipment less intimidating and supports patient health literacy.

Question 48: Which detail about witnesses should be included in an incident report?

Whether the witness liked the patient involved
Witnesses' personal contact information including home addresses
Names and roles of any individuals who observed the incident (Correct answer)
Only witness opinions about who caused the incident

Correct answer: Names and roles of any individuals who observed the incident

Recording witness names and roles provides accountability and allows follow-up during investigation.

Question 49: A doctor says, "We'll monitor your blood pressure for the next 24 hours." What does the doctor mean?

Blood pressure will be checked once.
Blood pressure will be checked weekly.
Blood pressure will be observed continuously for 24 hours. (Correct answer)
Blood pressure will not be checked.

Correct answer: Blood pressure will be observed continuously for 24 hours.

To "monitor" something for a specific duration, like "the next 24 hours," means to observe it continuously or at regular intervals throughout that entire period. It implies ongoing assessment rather than a single check or weekly observation.

Question 50: Which sentence correctly uses a gerund as the subject?

Documented vital signs accurately is a core nursing responsibility.
Documenting vital signs accurately is a core nursing responsibility. (Correct answer)
To document vital signs accurately is a core nursing responsibility.
Document vital signs accurately is a core nursing responsibility.

Correct answer: Documenting vital signs accurately is a core nursing responsibility.

A gerund (verb + -ing) functions as a noun and can serve as the subject of a sentence, as in 'Documenting … is …'.

Question 51: When documenting an incident, which piece of information is considered 'subjective' data?

The patient's blood pressure reading of 140/90 mmHg.
The patient stating, "I feel dizzy." (Correct answer)
A 3 cm laceration observed on the patient's forehead.
The patient's bed was found in the lowest position with side rails up x2.

Correct answer: The patient stating, "I feel dizzy."

Subjective data is information reported by the patient that cannot be directly measured or observed by the healthcare provider. The patient's feeling of dizziness is their personal experience. The other options are objective data, which are measurable and observable facts.

Question 52: Which statement by a patient indicates CORRECT understanding of instructions to take antibiotics?

'I'll stop taking them once I feel better.'
'I can share leftover pills with my family if they get sick.'
'I should take all the pills even if my symptoms improve.' (Correct answer)
'I should double the dose to finish faster.'

Correct answer: 'I should take all the pills even if my symptoms improve.'

Completing the full antibiotic course prevents treatment failure and antibiotic resistance.

Question 53: A patient is asked about allergies and states, 'Penicillin makes me nauseous.' How should the nurse classify this response?

No clinical significance — omit from the record
Intolerance — note it but no allergy band is required
True drug allergy — document and apply allergy band
Adverse drug reaction — document separately from true allergies (Correct answer)

Correct answer: Adverse drug reaction — document separately from true allergies

Nausea is an adverse drug reaction or side effect, not an immune-mediated allergy, and should be documented as such to avoid unnecessary withholding of penicillin.

Question 54: During a CELBAN speaking role-play, a patient says they are confused about why they need to take a medication. What is the best opening response to address their concern?

Advise them to ask the pharmacist when they get home.
Acknowledge their concern and offer to explain the medication's purpose clearly. (Correct answer)
Tell them the doctor ordered it and they must comply.
Reassure them it is a routine medication and nothing to worry about.

Correct answer: Acknowledge their concern and offer to explain the medication's purpose clearly.

Acknowledging the patient's concern first demonstrates therapeutic communication, a key criterion in the CELBAN speaking assessment.

Question 55: A nurse listening to a recorded nursing lecture hears: 'When assessing pain, remember the mnemonic OLDCART — Onset, Location, Duration, Character, Aggravating factors, Relieving factors, and Treatment.' Which component is captured by the letter 'C'?

Complications — associated signs and symptoms
Consent — patient agreement to pain assessment
Circulation — blood flow to the affected area
Character — the quality or nature of the pain, such as burning, stabbing, or aching (Correct answer)

Correct answer: Character — the quality or nature of the pain, such as burning, stabbing, or aching

In OLDCART, 'C' stands for Character, which describes the quality of pain (e.g., sharp, dull, burning, throbbing).

Question 56: A nurse listens to a patient education audio clip: 'Take your lisinopril every morning with or without food, but avoid potassium supplements and salt substitutes unless your doctor approves them.' What is a key dietary restriction mentioned?

The patient must take lisinopril only with a high-fat meal
The patient should stop lisinopril if they feel dizzy
The patient should avoid potassium supplements and salt substitutes without physician approval (Correct answer)
The patient must follow a strict low-sodium diet and avoid all fruits

Correct answer: The patient should avoid potassium supplements and salt substitutes without physician approval

Lisinopril (an ACE inhibitor) can raise potassium levels, so the instruction warns against potassium supplements and potassium-containing salt substitutes without approval.

Question 57: A patient is being discharged with instructions for wound care. The patient seems anxious and repeatedly asks questions about topics the nurse has already covered. What is the nurse's most appropriate initial response?

Re-explain the entire process from the beginning more loudly.
Tell the patient that all the information is in the printed handout.
Suggest that a family member perform the wound care instead.
Acknowledge their concern and ask, "What part of the process is worrying you the most?" (Correct answer)

Correct answer: Acknowledge their concern and ask, "What part of the process is worrying you the most?"

The patient's repetition likely stems from anxiety, which is a barrier to learning. By acknowledging their feelings and asking a focused, open-ended question, the nurse can identify the specific source of anxiety and address it directly. This is more effective than simply repeating information the patient is too anxious to absorb.

Question 58: A patient declines pain medication, explaining that enduring pain is part of their cultural belief. What should you say?

"Pain relief is important, and you should reconsider."
"If you refuse, I can’t help you further."
"That’s not a practical approach to pain management."
"I respect your choice. Please let me know if you change your mind." (Correct answer)

Correct answer: "I respect your choice. Please let me know if you change your mind."

This response respects the patient's autonomy and cultural beliefs regarding pain management. It acknowledges their decision without judgment while still offering support and ensuring they know that help is available if their needs or preferences change, maintaining a patient-centered approach.

Question 59: A nurse is performing an initial assessment on an elderly patient who says, "I've just been feeling all topsy-turvy lately." Which of the following is the most appropriate clarifying question for the nurse to ask?

"Are you saying you've been feeling dizzy or lightheaded?"
"Have you taken anything to help with the 'topsy-turvy' feeling?"
"When did this 'topsy-turvy' feeling start?"
"Can you tell me more about what 'topsy-turvy' feels like to you?" (Correct answer)

Correct answer: "Can you tell me more about what 'topsy-turvy' feels like to you?"

This open-ended question encourages the patient to describe their symptoms in their own words without the nurse imposing their own interpretation. It is the best way to gather more specific and accurate assessment data about a vague complaint.

Question 60: A nurse observes that a patient's urine output has dropped to less than 30 mL per hour over the past two hours. What is the most appropriate response?

Document the finding and reassess in four hours
Increase the patient's oral fluid intake independently
Assume the urinary catheter is blocked and change it without assessment
Assess for other signs of deterioration and notify the physician promptly (Correct answer)

Correct answer: Assess for other signs of deterioration and notify the physician promptly

Oliguria may indicate renal compromise or hemodynamic instability and requires prompt clinical assessment and physician notification.

Question 61: A statement of urgency

Let the patient know that you are aware of the urgency/complexity of the issue. It is often reassuring to the patients when you communicate an understanding of the importance of their issue/situation. When it is an urgent matter, reassure them that you know it is. You can say:
"In this case, time is of the essence. I am going to speak with Dr. Brown or my Nurse Supervisor to help me expedite this issue." (Correct answer)
You can also ask probing questions that will help you obtain more information such as:
Once you have a good understanding of the patient's needs, let them know when they can expect to have their symptoms resolved. This can be as simple as saying:

Correct answer: "In this case, time is of the essence. I am going to speak with Dr. Brown or my Nurse Supervisor to help me expedite this issue."

This statement is a statement of urgency because it both acknowledges that time is critical and states a clear plan of action — escalating to Dr. Brown or the Nurse Supervisor to expedite the issue. The other options only express empathy, ask probing questions, or set resolution expectations without combining urgency with a concrete next step.

Question 62: In the CELBAN Speaking section, which task type requires you to listen to a recorded scenario and then respond as if speaking directly to a patient or colleague?

Picture description task
Role-play task (Correct answer)
Reading aloud task
Monologue task

Correct answer: Role-play task

The role-play task in CELBAN Speaking presents a recorded prompt to which candidates respond as they would in a real clinical situation.

Question 63: "The nurse ___ the patient how to use the inhaler."

teaching
taught (Correct answer)
teaches
teach

Correct answer: taught

The sentence describes a completed action in the past – the nurse already instructed the patient on how to use the inhaler. "Taught" is the simple past tense of the verb "to teach," making it the correct form to describe this past event. The other options are incorrect verb forms for a past action.

Question 64: A CELBAN speaking role-play involves a patient who is crying and refuses to talk. What is the first action the nurse should take?

Ask a series of yes/no questions to gather assessment data immediately.
Call the doctor right away to report the patient is uncooperative.
Leave the room and return in 10 minutes.
Sit quietly beside the patient and offer a compassionate presence without forcing conversation. (Correct answer)

Correct answer: Sit quietly beside the patient and offer a compassionate presence without forcing conversation.

Offering a calm, compassionate presence without pressure allows the patient to feel safe and supported before they are ready to communicate.

Question 65: A discharge teaching handout reads: 'Signs of wound infection include increased redness, warmth, swelling, purulent discharge, and fever above 38°C. Contact your healthcare provider if any of these signs appear within 30 days of surgery.' A patient calls 10 days post-op reporting the wound feels warm and there is yellow drainage. What should the nurse advise?

Apply an over-the-counter antibiotic ointment and monitor
Contact the healthcare provider as these are signs listed in the handout (Correct answer)
Go directly to the emergency department without calling first
Wait another week to see if symptoms resolve on their own

Correct answer: Contact the healthcare provider as these are signs listed in the handout

Warmth and purulent (yellow) drainage within 30 days match the listed infection signs, and the handout instructs patients to contact their provider.

Question 66: A patient's chart contains a note: 'Braden Scale score 14.' How should the nurse interpret this finding?

The patient has moderate-to-severe cognitive impairment
The patient is at mild risk for pressure injury and preventive measures should be implemented (Correct answer)
The patient has already developed a stage 2 pressure injury
The patient has no risk of pressure injury development

Correct answer: The patient is at mild risk for pressure injury and preventive measures should be implemented

The Braden Scale ranges from 6 to 23; a score of 15–18 indicates mild risk for pressure injuries, warranting preventive skin care and repositioning protocols.

Question 67: You are reviewing a patient's medication administration record (MAR). Which of the following entries requires immediate clarification from the prescriber?

Digoxin .125 mg PO daily. Hold for HR < 60. (Correct answer)
Tylenol 650 mg PO q4h PRN pain
Furosemide 20 mg PO daily
Insulin Sliding Scale ac hs

Correct answer: Digoxin .125 mg PO daily. Hold for HR < 60.

The order 'Digoxin .125 mg PO daily. Hold for HR < 60.' contains a trailing zero and a leading decimal, which are on the 'Do Not Use' list of abbreviations by organizations like ISMP Canada to prevent medication errors. The correct way to write this is 'Digoxin 0.125 mg...'. The period before the number could be missed, leading to an overdose. The other orders use standard and safe abbreviations.

Question 68: Which of the following is the LEAST appropriate strategy when caring for a patient with low health literacy from a different cultural background?

Confirming understanding through teach-back methods
Using medical acronyms to save time during patient education (Correct answer)
Using plain language and visual aids
Providing translated written materials at an appropriate reading level

Correct answer: Using medical acronyms to save time during patient education

Medical acronyms increase confusion for patients with low health literacy and are not appropriate in patient education, especially across language barriers.

Question 69: A patient's chart shows 'NPO after midnight.' What does this instruction mean for the nursing staff?

The patient should only drink water after midnight
The patient should receive IV fluids after midnight
The patient can have clear fluids but no solid food after midnight
The patient must not eat or drink anything after midnight (Correct answer)

Correct answer: The patient must not eat or drink anything after midnight

NPO stands for 'nil per os' (nothing by mouth), meaning the patient must not consume anything orally after midnight.

Question 70: Select the sentence with correct subject-verb agreement:

The result of the lab tests were normal.
The results of the lab test were normal. (Correct answer)
The results of the lab test are been normal.
The results of the lab test was normal.

Correct answer: The results of the lab test were normal.

The subject is 'results' (plural), so the plural verb 'were' is correct despite the intervening prepositional phrase.

Question 71: Steer clear of: Cold greetings without feeling

"Hi, I'm Toni your nurse for today. You can call me anytime you need help" (Correct answer)
Level setting of expectations with empathy
"In this case, time is of the essence. I am going to speak with Dr. Brown or my Nurse Supervisor to help me expedite this issue."
You can also ask probing questions that will help you obtain more information such as:

Correct answer: "Hi, I'm Toni your nurse for today. You can call me anytime you need help"

The correct answer demonstrates a warm, personal greeting by introducing the nurse by name and offering open availability, which immediately builds rapport and trust with the patient. The other options either set expectations without warmth, escalate an issue, or describe a questioning technique — none of which qualify as a greeting at all.

Question 72: Which sentence uses the word 'contraindicated' correctly?

Aspirin is contraindicated to relieve mild headaches.
The nurse contraindicated the prescription before administering the drug.
Aspirin is contraindicated in patients with active bleeding disorders. (Correct answer)
Contraindicated aspirin was the patient's request.

Correct answer: Aspirin is contraindicated in patients with active bleeding disorders.

'Contraindicated' means a treatment should not be used; it is correctly used with 'in patients with' to specify the condition that makes it unsafe.

Question 73: A patient says, "I feel short of breath when I walk upstairs." What is the patient experiencing?

Chest pain.
Difficulty breathing. (Correct answer)
Fatigue.
Dizziness.

Correct answer: Difficulty breathing.

To feel "short of breath" is a common medical term for dyspnea, which describes the sensation of having difficulty breathing or not being able to get enough air. This symptom is often exacerbated by physical exertion, such as walking upstairs. Thus, the patient is experiencing difficulty breathing.

Question 74: During a CELBAN listening task a triage nurse hears a paramedic report: 'We have a 67-year-old male, GCS 13, brought in after a witnessed fall. Wife reports he's on warfarin for atrial fibrillation. No visible head wounds but he was briefly confused at scene.' What is the most critical piece of history to highlight for the receiving team?

The patient had no visible external head wounds, ruling out serious injury
The fall was witnessed, confirming the mechanism of injury
The patient's age and marital status
The patient is anticoagulated on warfarin, which dramatically increases the risk of intracranial bleeding following a fall with brief confusion (Correct answer)

Correct answer: The patient is anticoagulated on warfarin, which dramatically increases the risk of intracranial bleeding following a fall with brief confusion

Warfarin anticoagulation in a head-injury patient with altered GCS and brief confusion creates a high risk for intracranial hemorrhage, making this the most critical historical detail.

Question 75: A nurse reads the following in a patient's chart: 'Advance diet as tolerated from clear liquids to full liquids, then soft diet.' What does this order require from the nursing staff?

Consult dietary before making any diet changes
Progress the diet stepwise based on the patient's ability to tolerate each stage without complications (Correct answer)
Keep the patient on clear liquids for the full hospital stay
Give the patient a full diet immediately

Correct answer: Progress the diet stepwise based on the patient's ability to tolerate each stage without complications

An 'advance as tolerated' order means the nurse assesses the patient's ability to tolerate each diet stage before progressing to the next level.

Question 76: A CELBAN speaking task requires you to counsel a patient about smoking cessation. Which motivational interviewing principle best supports this conversation?

'You really should quit—it's your own fault if you get lung cancer.'
Instructing the patient to use nicotine patches immediately.
Exploring the patient's own reasons for change by asking open-ended questions. (Correct answer)
Telling the patient all the negative consequences of smoking repeatedly.

Correct answer: Exploring the patient's own reasons for change by asking open-ended questions.

Motivational interviewing relies on eliciting the patient's own motivation for change through open-ended questions rather than lecturing.

Question 77: During a medication teaching session, a patient says: 'My last pharmacist said this drug was dangerous, so I looked it up online and now I'm scared to take it.' What is the nurse's most effective first response?

Dismiss the online information as unreliable and reinforce the prescription
Explore the specific concerns the patient read about and address them with accurate, evidence-based information (Correct answer)
Contact the prescribing physician to consider switching the medication
Advise the patient to call the pharmacist directly rather than using the internet

Correct answer: Explore the specific concerns the patient read about and address them with accurate, evidence-based information

Acknowledging the patient's concern and addressing the specific information they found builds trust and supports informed medication adherence.

Question 78: A chart note reads: 'Patient refuses blood transfusion on religious grounds. Patient is alert, oriented x3, and has demonstrated understanding of the risks including death from continued blood loss. Patient has signed a refusal of treatment form.' A family member demands the nurse give the blood anyway. What is the ethically and legally correct response?

Call security to remove the family and then give the blood
Honor the family's wishes since they have the patient's best interest in mind
Administer the blood since preventing death overrides patient choice in this situation
Uphold the patient's documented informed refusal; the patient is competent to decide (Correct answer)

Correct answer: Uphold the patient's documented informed refusal; the patient is competent to decide

A competent adult patient has the right to refuse any treatment, including life-saving blood transfusions; the documented informed refusal must be respected.

Question 79: In a CELBAN speaking role-play, a patient becomes upset and says, 'No one ever listens to me!' What is the best immediate response?

'I understand you feel unheard. I'm here now and I want to listen to you.' (Correct answer)
'Let me get the charge nurse to speak with you.'
'I listen to all my patients equally.'
'Please calm down so we can talk properly.'

Correct answer: 'I understand you feel unheard. I'm here now and I want to listen to you.'

Validating the patient's feelings and expressing willingness to listen de-escalates the situation and demonstrates empathic communication.

Question 80: A CELBAN speaking task involves explaining an insulin injection technique to a newly diagnosed diabetic patient. Which phrase best checks patient readiness to learn?

'You need to learn this today before you go home.'
'I'll show you this quickly so we can get it done.'
'Is this a good time for us to go over how to give yourself your insulin injection?' (Correct answer)
'Your doctor told me you need to know this.'

Correct answer: 'Is this a good time for us to go over how to give yourself your insulin injection?'

Asking whether the patient is ready respects their autonomy and ensures they are in the right mindset to receive new information.

Question 81: "The doctor ___ the patient to stay in bed for two days."

advises
advise
advised (Correct answer)
advising

Correct answer: advised

The sentence describes a past action by the doctor, indicating that the advice has already been given. "Advised" is the simple past tense of the verb "to advise," correctly fitting the context of a completed action. The other options are incorrect verb forms for this context.

Question 82: A chart consultation note states: 'Recommend strict I&O monitoring and daily weights for fluid management.' Why would daily weights be ordered alongside I&O monitoring?

To assess the patient's mobility and ability to stand
To detect fluid retention or loss more accurately than I&O alone (Correct answer)
To monitor nutritional status and caloric intake
To calculate the correct medication dosage based on body weight

Correct answer: To detect fluid retention or loss more accurately than I&O alone

Daily weights provide an objective measure of total body fluid changes, as 1 kg of body weight change approximately equals 1 liter of fluid retained or lost.

Question 83: A chart notation reads: 'PRN Acetaminophen 650 mg PO q4-6h for pain rated >4/10.' When should the nurse administer this medication?

Every 4 to 6 hours regardless of pain level
Every 4 hours when the patient reports any pain
Only when the patient reports pain at a score greater than 4 out of 10 (Correct answer)
Only at bedtime when pain is at its worst

Correct answer: Only when the patient reports pain at a score greater than 4 out of 10

PRN means 'as needed' and the condition specified is pain rated greater than 4 on a 10-point scale.

Question 84: A chart entry reads: 'PT/INR: 3.8. Patient on warfarin.' What action should the nurse anticipate?

Administer vitamin K immediately without physician order
Increase the warfarin dose as the level is therapeutic
Notify the physician as the INR is above the typical therapeutic range of 2.0–3.0 (Correct answer)
Document the finding and continue current warfarin dose

Correct answer: Notify the physician as the INR is above the typical therapeutic range of 2.0–3.0

An INR of 3.8 is above the typical therapeutic range of 2.0–3.0 for most indications, increasing the patient's risk of bleeding and requiring physician notification.

Question 85: A nurse is reviewing the following entry in a patient's chart: 'Pt. c/o sharp, stabbing pain to RUQ, rated 8/10. Skin is diaphoretic and clammy. V/S: BP 150/90, HR 110, RR 22, T 37.8 C. NPO since midnight. Awaiting ultrasound.' Which of the following is the most accurate summary of the patient's condition?

The patient has a low-grade fever and is being kept without food or drink as a precaution.
The patient is experiencing significant pain and showing signs of distress, requiring further investigation. (Correct answer)
The patient is dehydrated and needs immediate fluid replacement before any diagnostic tests.
The patient is stable with minor abdominal discomfort and will be discharged soon.

Correct answer: The patient is experiencing significant pain and showing signs of distress, requiring further investigation.

The correct answer accurately synthesizes all the key information. The patient's complaint ('c/o') of 'sharp, stabbing pain' rated 8/10 indicates severe pain, not minor discomfort. The vital signs (V/S) are elevated (hypertension, tachycardia, tachypnea), and the skin is 'diaphoretic and clammy,' which are signs of distress. The patient is being kept 'NPO' (nothing by mouth) and is 'awaiting ultrasound,' which points to the need for further diagnostic investigation.

Question 86: A patient says to a nurse: 'Every time I use this inhaler I get a bit shaky and my heart races for about twenty minutes.' Which CELBAN listening skill is most directly being tested when the nurse must summarize this back accurately?

Extracting specific detail about medication side effects and their duration (Correct answer)
Identifying the speaker's professional role
Understanding idiomatic Canadian slang
Recognizing the genre of a formal lecture

Correct answer: Extracting specific detail about medication side effects and their duration

The CELBAN Listening section frequently tests the ability to extract precise clinical detail — here the side effect (tremor, tachycardia) and its timeframe (20 minutes).

Question 87: A nurse hears a patient tell an occupational therapist: 'I used to cook every day — it was my whole life. Now I can't even open a jar.' The patient's voice cracks. What does this exchange reveal?

The patient is being hyperbolic about their disability for sympathy
Occupational therapy goals should be revised to exclude cooking tasks
The patient is experiencing grief over a loss of functional independence and identity, requiring emotional acknowledgment (Correct answer)
The patient requires a stronger grip-strength rehabilitation program

Correct answer: The patient is experiencing grief over a loss of functional independence and identity, requiring emotional acknowledgment

Loss of a meaningful activity signals grief and a threat to identity, which should be acknowledged therapeutically before focusing on skill rebuilding.

Question 88: A patient's son says during a visit: 'My mother keeps saying her pain is a 3 out of 10, but she's clearly grimacing and barely moving. Should I be worried?' What does this dialogue indicate?

The numeric pain scale is the most reliable measure available
There may be a discrepancy between the patient's self-report and observable pain cues (Correct answer)
The family member is over-interpreting normal post-operative behavior
The patient is exaggerating her discomfort to her family

Correct answer: There may be a discrepancy between the patient's self-report and observable pain cues

When verbal self-report and non-verbal cues conflict, nurses must assess both and investigate possible reasons such as stoicism or fear of medication.

Question 89: "Our resident physician, Mr. McAvinue, is presently analyzing your MRI to see whether you require any additional testing. You should expect to wait for at least thirty minutes, and then he will meet with you to go over the results and any other testing that may be required."

Once you start working on the issue, keep the patient informed about your progress. Let them know what you are doing and why you are doing it. Also, let them know how much longer they can expect to wait. (Correct answer)
Let the patient know that you are aware of the urgency/complexity of the issue. It is often reassuring to the patients when you communicate an understanding of the importance of their issue/situation. When it is an urgent matter, reassure them that you know it is. You can say:
Once you have a good understanding of the patient's needs, let them know when they can expect to have their symptoms resolved. This can be as simple as saying:
Keep the patient informed about the progress

Correct answer: Once you start working on the issue, keep the patient informed about your progress. Let them know what you are doing and why you are doing it. Also, let them know how much longer they can expect to wait.

This statement keeps the patient informed of progress: it explains what is being done (the resident is reviewing the MRI), why, and how long the wait will be, which is best practice during waiting periods. The other options focus only on setting resolution expectations or acknowledging urgency rather than giving an ongoing progress update.

Question 90: You hear an announcement: "Attention, all staff. The emergency drill will begin at 3:00 PM in the main lobby." What is the purpose of the announcement?

To inform staff of a meeting.
To remind staff about a training exercise. (Correct answer)
To request staff to report to the emergency room.
To notify staff of an actual emergency.

Correct answer: To remind staff about a training exercise.

The announcement explicitly mentions an "emergency drill," which is a planned practice or training exercise, not an actual emergency. Its purpose is to inform and remind staff about this upcoming scheduled event, ensuring they are prepared for the simulation.

Question 91: A 16-year-old patient tells a nurse, "I've been feeling really down and I'm worried I might have depression, but please promise you won't tell my parents." In Canada, which response by the nurse is most ethically and legally appropriate?

"It's best if you tell your parents yourself, so I'll wait until you're ready to do that."
"I promise I won't tell them anything you don't want me to."
"Let's talk more about how you're feeling. I will keep our conversation confidential, unless I'm worried you're at risk of harming yourself or others." (Correct answer)
"I am required by law to tell your parents everything about your health."

Correct answer: "Let's talk more about how you're feeling. I will keep our conversation confidential, unless I'm worried you're at risk of harming yourself or others."

This response builds trust and respects the patient's confidentiality under the 'mature minor' doctrine, which is recognized in Canadian common law. It also clearly and honestly states the legal and ethical limits of that confidentiality, specifically regarding risk of harm.

Question 92: Identify the error in the sentence: "The nurse will gave the medication at 6 PM."

The word "nurse" is incorrect.
There is no error.
The time "6 PM" is incorrect.
The word "gave" should be "give." (Correct answer)

Correct answer: The word "gave" should be "give."

The auxiliary verb "will" is used to form the future tense and must always be followed by the base form of the main verb. "Gave" is the past tense form of the verb. Therefore, "gave" should be corrected to "give" to form the grammatically correct future tense: "will give."

Question 93: During a care conference, a family member states: 'We want everything done — we can't just let him go.' The patient previously told a nurse he did not want aggressive interventions. What should the nurse do?

Follow the family's wishes since they are the legal decision-makers
Ask the family to leave the conference so the team can decide independently
Advocate for the patient's expressed wishes and raise the need to clarify goals of care (Correct answer)
Defer entirely to the attending physician without contributing to the discussion

Correct answer: Advocate for the patient's expressed wishes and raise the need to clarify goals of care

Nurses are obligated to advocate for the patient's expressed wishes and facilitate a goals-of-care conversation that honors patient autonomy.

Question 94: During a CELBAN speaking scenario involving a patient from a different cultural background who declines physical contact during assessment, the nurse should:

Skip the physical assessment entirely to avoid discomfort.
Acknowledge the preference, explain the clinical necessity, and ask for the patient's consent before proceeding. (Correct answer)
Ask a nurse from the same background to perform all assessments.
Proceed with the assessment without acknowledging the patient's preferences.

Correct answer: Acknowledge the preference, explain the clinical necessity, and ask for the patient's consent before proceeding.

Culturally competent care requires acknowledging preferences, explaining clinical needs, and seeking informed consent before any contact.

Question 95: A nurse overhears two nurses at the station discussing a patient's HIV status by name in front of visitors in the hallway. What is the immediate concern?

This is a breach of patient confidentiality and privacy that must be addressed immediately (Correct answer)
The conversation should be allowed to continue if it is clinically relevant
The nurses may have incorrect information about the patient's diagnosis
The visitors likely do not understand medical terminology, so no harm has occurred

Correct answer: This is a breach of patient confidentiality and privacy that must be addressed immediately

Discussing a patient's sensitive diagnosis by name in a public area violates confidentiality and must be stopped and addressed according to facility policy.

Question 96: In the CELBAN Speaking section, candidates are scored on several criteria. Which of the following is NOT one of the main scoring dimensions?

Spelling accuracy (Correct answer)
Lexical resource (vocabulary range)
Fluency and coherence
Pronunciation

Correct answer: Spelling accuracy

CELBAN Speaking is scored on fluency, coherence, vocabulary, grammar, and pronunciation — spelling is assessed in the Writing section, not Speaking.

Question 97: An elderly patient says quietly to a nurse during bathing: 'My daughter-in-law controls all my money and I'm not allowed to call anyone.' What type of concern does this statement raise?

The patient is experiencing normal family conflict
The nurse should encourage the patient to resolve family issues independently
This may indicate financial abuse and/or social isolation requiring a safeguarding assessment (Correct answer)
The patient needs a social work referral for caregiver respite only

Correct answer: This may indicate financial abuse and/or social isolation requiring a safeguarding assessment

Statements suggesting financial control and restricted communication are red flags for elder abuse that mandate a safeguarding assessment.

Question 98: In a CELBAN speaking scenario, a family member asks you for the patient's confidential diagnosis without the patient's consent present. The correct response is:

Tell the family member to wait in the hall and then share all details.
Refer them to the hospital website's privacy policy.
'I'm sorry, I can only discuss your family member's health information with their permission.' (Correct answer)
Share the information briefly since family members always have the right to know.

Correct answer: 'I'm sorry, I can only discuss your family member's health information with their permission.'

Patient confidentiality must be maintained; health information cannot be shared with family members without explicit patient consent.

Question 99: When preparing to speak in a CELBAN role-play, a key strategy for improving coherence is to:

Repeat the same sentence in different words to fill the time.
Use discourse markers such as 'first,' 'however,' 'as a result,' and 'in addition' to link ideas. (Correct answer)
Focus solely on pronunciation and ignore logical flow.
Speak without pausing to demonstrate fluency.

Correct answer: Use discourse markers such as 'first,' 'however,' 'as a result,' and 'in addition' to link ideas.

Discourse markers help organize spoken information logically, which directly improves the coherence score on CELBAN Speaking.

Question 100: Which phrase best describes 'ambulating' in a nursing care plan?

Walking or moving about (Correct answer)
Receiving intravenous fluids
Performing wound care
Resting in bed

Correct answer: Walking or moving about

Ambulating refers to the act of walking or moving about, and encouraging ambulation is a key nursing intervention for recovery.

Canadian English Language Benchmark Assessment for Nurses (CELBAN)

CELBAN assesses the English language proficiency of internationally educated nurses (IENs) who wish to practice nursing in Canada.

100

Questions

180 min

Time Limit

70%

To Pass

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Exam Rules

You can skip questions and return to them later
Flag questions for review before submitting
No feedback shown until you submit the entire exam
Unanswered questions count as wrong — answer everything
10 pretest questions are mixed in and don't affect your score
Timer auto-submits when time runs out
Your progress is auto-saved every 30 seconds