Write Exam 05

8/9/2019 Write Exam 05

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Writing the CNCC(C)Writing the CNCC(C)ExaminationExamination

Brenda Morgan RN BScN CNCC(C)Brenda Morgan RN BScN CNCC(C)Clinical Educator: CCTC, London, OntarioClinical Educator: CCTC, London, Ontario


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Why Become Certified?Why Become Certified?

Affirms specialized skill and knowledgeProvides open recognitionDemonstrates commitment to ourspecialtyEncourages professional growth and

developmentRenews interest in professionPersonal pride and accomplishment


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Why Become Certified?Why Become Certified?

Nationally recognized standardIncreased marketability

Benefits will increase as morenurses certify across all specialtiesSome provinces have provided paydifferentialsPreferred job hiring


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Greatest benefitsGreatest benefitsachieved throughachieved through

process of preparationprocess of preparation make the choice for make the choice for

your own personalyour own personalreasons.reasons.


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CompetencyCompetency -- BasedBased

Multiple Choice ExamMultiple Choice Exam


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ExamExam

Adult patient population onlyONE correct answer from 4 options

No double negatives (e.g. all theabove except)No multiple options (e.g. a and b; b, c,and d; or all the above)Competency based questions


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Competency BasedCompetency Based

Focus on appropriate behaviourComponents of a well written questionIf you know the content, you will selectthe correct responseIf you dont know the content, you will

select an incorrect responseIt should not be a test of your readingskills


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Important ConceptsImportant Concepts1. Cardiac cycle2. Determinants of cardiac output3. Basic rhythm analysis4. Arterial lines, PA catheters5. Hemodynamic waveforms6. 12 lead interpretation

7. Mixed venous oxygen (SVO2), lactate8. Shocks: hypovolemic,cardiogenic, septic,

neurogenic,anylphylaxis9. Alpha and beta receptor responses


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Important ConceptsImportant Concepts

10. ACLS protocols11. Sympathetic drugs

12. Anti-arrhythmics13. Temporary pacemakers, VVI

14. Basic Principles of balloon pumping15. Blood gas interpretation

16. Minute volume


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17. Standard ventilator parameters18. Fixing PaO2s and PaCO2s19. Chest tubes20. Cardiac tamponade, tension pneumothorax,

myocardial contusion

21. Major areas of neuro function22. Intracranial hypertension23. ICP monitoring


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24. Basic seizure management25. Inflammation26. Coagulation and anticoagulants27. Renal failure28. Renal replacement therapy

29. Electrolyte imbalance and treatment(Calcium, magnesium, phosphate,potassium, sodium, chloride)


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C t


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Competency

The critical care nurse recognizes potential-life threatening alterations in

renal function Mr. AbelMr. Abel ss creatininecreatinine rises from 72 to 165 in 24rises from 72 to 165 in 24hours. This lab result is consistent with whichhours. This lab result is consistent with which

one of the following problems?one of the following problems?a) Liver failureb) Renal failurec) Myocardial infarctiond) Dehydration


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ExaminationExamination

Approximately 170 itemsIndependent and case based items

Type of questions:Knowledge and comprehensionApplicationCritical thinking


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Independent Item Stem


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Identify the following rhythm?Identify the following rhythm?

Independent Item Stem

a) Ventricular rhythm with PVCsb) Junctional rhythm with PJCsc) Junctional rhythm with PACsd) Controlled atrial fibrillation

Distracters

Response

Case Based


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Case-Based

Steven is a 45 year old man who was admitted 24hours ago with pneumonia. At 0800 hrs, hedevelops a sudden onset of crushing chest pain.

At 0845 hrs, despite morphine and nitroglycerine,the pain is unresolved.

Item One: Stevens 12-lead ECG reveals 2 mm ST elevation in V3-V4. These findings are consistentwith which one of the following?a) Lateral wall ischemiab) Anterior wall infarctionc) Anterior wall ischemia

d) Lateral wall ischemia

Knowledge and Comprehension


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Knowledge and Comprehension

PaO2 75PaCO

232

pH 7.49

Interpret the following blood gasInterpret the following blood gas

a) Respiratory alkalosisb) Respiratory acidosisc) Metabolic alkalosisd) Metabolic acidosis

HCO3 22BE -1SaO 2 .96

Application


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Application

Mrs Jones developsMrs Jones develops torsadestorsades de pointes. Whichde pointes. Whichone of the following interventions would theone of the following interventions would thecritical care nurse anticipate?critical care nurse anticipate?

a) Magnesium sulphate and calcium gluconateb) Defibrillation and amiodarone infusionc) Lidocaine and fluidd) Magnesium sulphate and cardiac pacing

Critical Thinking


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Critical Thinking

Joe develops aJoe develops a bradycardiabradycardia with a radial arterialwith a radial arterialpressure of 42/29. Which one of the followingpressure of 42/29. Which one of the following

interventions is the priority?interventions is the priority?

a) Atropineb) Epinephrinec) Pacemakerd) Compressions


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Developing a Study PlanDeveloping a Study Plan


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Study PlanStudy Plan

Obtain copy of exam blueprint(competencies)Identify areas of strengths andweaknessesIdentify major versus minor contentDetermine where the largest studytime is needed


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Make the most of your investment;Make the most of your investment;

use this time to broaden youruse this time to broaden yourknowledge and explore newknowledge and explore new

research evidence.research evidence.


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Review the rationales forReview the rationales forinterventions and practices.interventions and practices.

Focus on the whys.Focus on the whys.


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You are not starting from You are not starting fromscratch!scratch!


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Use multiple resources orUse multiple resources orlearning strategies for complexlearning strategies for complex

concepts.concepts.


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Consider your learningConsider your learningstyle?style?

30 minutes per day versus 8 hourpower studyGroup versus independent studySelf-directed versus review classformatHands-on opportunities for learning


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Develop an organized andDevelop an organized andprogressive study schedule.progressive study schedule.


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Make aMake acommitmentschedule yourcommitmentschedule yourstudy time into your plannerstudy time into your planneras if you were attending aas if you were attending a

class.class.


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The cost of procrastinationThe cost of procrastinationis high!is high!


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Enlist the help of your familyEnlist the help of your family

and friends.and friends.


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Set realistic limits forSet realistic limits forstudy times. Consider timesstudy times. Consider times

of the day when you couldof the day when you couldfit in your review andfit in your review andfactor in lifestyle.factor in lifestyle.


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Reward yourself when youReward yourself when you

stick to your plan.stick to your plan.


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Obtain sample questionsObtain sample questionswith caution!with caution!


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Tips for Writing the ExamTips for Writing the Exam


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3 Steps Response3 Steps Response1. Read any introductory text, then

read the stem carefullyCover the answers until you are clear

on what is being askedImagine the correct response2. Read each option carefully3. Select the best response

Reread the stem before finalizing


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Read carefully; dont jump toRead carefully; dont jump to

quick conclusions!quick conclusions!


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Be sure you read the stemBe sure you read the stem

correctlycorrectly


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Read distracters carefully.Read distracters carefully.

Th i ht iTh ight i


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The right answer isThe right answer ismissing!missing!

Reread the stem carefully to make sureread it correctlyWork backwards, eliminating incorrectresponsesIf more than one correct answer ispresent look for the MOST correctresponseIf more than one correct answer ispresent, look for what you would do

FIRST


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When in doubt, remember toWhen in doubt, remember to

guess!guess!


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Study PitfallsStudy PitfallsInsufficient preparationMemorizing or inactive learningConfusing experience with knowledge

Use of inaccurate resources; be waryof using others notes!

Over-reliance on sample questions; theyshould complement rather than replacelearning of concepts


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Exam PitfallsExam PitfallsReading errorsChanging answersLosing your spot

Spending too much time on one questionRushing

Lack of preparationStress, hunger, fatigue


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Enter the exam roomEnter the exam room

relaxed.relaxed.


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The answer that seemsThe answer that seems

obvious probably is!obvious probably is!


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What is theWhat is the passmarkpassmark ??


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Ignore everyone else in theIgnore everyone else in theroom..they are probablyroom..they are probablywriting a different exam.writing a different exam.


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It is not a race!It is not a race!


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Summary; Tips for SuccessSummary; Tips for SuccessPerform a realistic needsassessment and allow adequatetime for review

RehearseCome prepared (pencils, photo ID,exam identification card, snack)Know where you are going andarrive early


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Summary; Tips for SuccessSummary; Tips for SuccessDont talk about the exam beforeor afterit just causesunnecessary stress!Plan a rewardTake slow deep breaths and focus

on each question; allow a maximumof 2 minutes before moving on


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Summary; Tips for SuccessSummary; Tips for SuccessIgnore other writersStretch if neededDont leave blanksguess!

Move on if you get stuckbut dont loseyour place when recording your score.Dont let your mind wonderStick to the 3 step approachKeep moving!


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Should you writeShould you writedefinitely definitely

but do it for yourself! but do it for yourself!


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Documents

Write Exam 05