A licensed practical nurse (LPN), in much of the United States and Canada, is a nurse who cares for people who are sick, injured, convalescent, or disabled. In the United States, LPNs work under the direction of physicians. In Canada, LPNs/RPNs work autonomously like the Registered Nurse in providing care and are responsible for their individual actions and practice. In California and Texas, such a nurse is referred to as a licensed vocational nurse (LVN). Another title provided is "registered practical nurse" (RPNs) in the Canadian province of Ontario. A person can generally become an LPN with two years of training; all U.S state and territorial boards also require passage of the NCLEX-PN exam. In Canada, the education program ranges from two to three years of post-secondary and students must pass the intensive Canadian Practical Nurse Registration Exam (CPNRE).