AACN News—October 1998—Certification

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Vol. 15, No. 10, OCTOBER 1998

CCNS Testing Begins in January 1999

Testing for the new CCNS� certification for clinical nurse specialists (CNSs) in acute and critical care begins in January 1999.

Applications will be available November 1998. A resource bibliography is included in the application.

The exam, which is computer based, will be administered by the AACN Certification Corporation in conjunction with Professional Examination Service. Questions were developed using the Synergy Model framework that matches patient needs to nurse competencies.

Following are the eligibility requirements for CCNS certification:
1. An active RN license
2. A master’s degree in nursing
3. 500 hours in direct clinical practice (either within a master’s program or as a CNS within the past year)
4. Evidence of expertise in clinical knowledge, skills,
and judgment (directly linked to your specialty
area of expertise), as demonstrated by one of
the following:
a) Current entry level/basic or advanced certification in nursing
b) Publication(s) (within last 5 years) demonstrating expert knowledge in your identified clinical field

c) Presentation(s) (within last 5 years) at a local, regional, or national conference on a clinical nursing topic in your field of expertise
d) Participation in a clinical research project (within last 5 years) in your clinical field of expertise

To receive an application for the CCNS certification exam, call (800) 899-2226. Additional information is available on the AACN Certification Corporation home page at http://www.certcorp.org.

Sample Questions Help to Prepare for CCRN Exam

Are you considering taking the CCRN� certification exam? The CCRN Certification Sample Exam Questions book can help you prepare for the 200-question exam in either neonatal, pediatric, or adult practice. The sample questions are also available on CD ROM.

The sample questions are actual questions that have been retired from previous exams.

The book is available to AACN members for $8.50 ($10 for nonmembers), plus shipping and handling. The CD-ROM version, which includes the book, is $17 ($20 for nonmembers), plus shipping and handling.

Order forms are included in the Certification Examination Application, which contains general test and eligibility information. To obtain an application or to order the CCRN Certification Sample Exam Questions, call (800) 899-2226.

Following are examples of the questions that are included:

Adult Questions
A 50-year-old male is admitted to the ICU because of fever, nausea, vomiting, and general confusion. Ten days previous, bacterial pneumonia had been diagnosed, and he was treated then with erythromycin and acetaminophen (Tylenol). On admission, the patient’s laboratory findings are:
Hgb 11.5 g/dl
HCT 32.6%
Serum sodium 120 mEq/L
Serum chloride 84 mEq/L
Serum potassium 3.3 mEq/L
Plasma osmolality 228 mOsm/L
Urine specific gravity 1.075

1. Based on the laboratory results, the patient’s primary problems would be categorized as:
A. Hyperchloremia and decreased urine osmolality
B. Hyperchloremia and increased urine osmolality
C. Hypernatremia and increased serum osmolality
D. Hyponatremia and decreased serum osmolality

2. Which of the following would probably be included in this patient’s initial therapy?
A. Hypertonic saline, furosemide (Lasix), and fluid restriction
B. Dextrose and water, mannitol (Osmitrol), and fluid restriction
C. Vasopressin (Pitressin), sodium chloride IV, and rapid fluid replacement
D. Thiazides, potassium chloride IV, and rapid fluid replacement

Adult Answers: 1. (D), 2. (A)

Pediatric Questions
A 2-month-old presents with a history of Tetralogy of Fallot spells. Surgical intervention is anticipated.

1. Two cardiac anomalies associated with Tetralogy of Fallot are:
A. VSD and pulmonary stenosis
B. PDA and interrupted aortic arch
C. Atrial septal defect and patent foramen ovale
D. Transposition of the great vessels and aortic stenosis

2. While intravenous access is attempted, the infant begins to cry. Cyanosis, diaphoresis and tachypnea are noted. Nursing interventions are aimed at:
A. Increasing the pulmonary flow and relaxing the infundibulum
B. Decreasing the systemic flow and increasing the pulmonary vascular resistance
C. Decreasing the pulmonary flow and increasing the SVR
D. Increasing the systemic flow and relaxing the left ventricular outflow tract

Postoperatively, a transthoracic PA catheter is placed. On removal of this line, the PA pressure is 29 mm/Hg systolic. As the line is “pulled back” into the right ventricle, the pressure measures 72 mm/Hg systolic. RA Sat = 72,
PA Sat = 72.

3. This change in measurement may indicate a/an:
A. Pulmonary vascular reactivity
B. Residual VSD
C. Incompetent pulmonic valve
D. Residual right ventricular outflow obstruction

Pediatric Answers: 1. (A) 2. (A) 3. (D)

Neonatal Questions

1. Which of the following indicates appropriate fluid restriction management of an infant with acute renal
A. Serum Cr < 1.5mg/dl; BUN < 30mg/dl
B. Specific gravity = 1.002
C. Weight gain = 100g; BUN > 45
D. UO = 0.5cc/kg/hr

2. An infant is admitted to the ICU after resuscitation, following abruptio placentae. Initial ABG analysis of a sample from an umbilical artery catheter yields the following data:
pH 7.20
pCO2 56
pO2 46
HCO3- 18

The infant has no spontaneous respirations and is pale, lethargic, and hypotensive.

Which of the following additional findings can be expected in this patient?

A. Low pulmonary vascular resistance
B. Pulmonary vasodilation
C. Alveolar cell stimulation
D. Pulmonary hypoperfusion

Neonatal Answers: 1. (A), 2. (D)

CERPs for Volunteering

CCRNs can now earn continuing education recognition points (CERPs) for volunteer activities with an established program or nonprofit group. Eligible activities must be performed outside the nurse’s salaried position.

Activities will be considered for CERPs on an individual basis. The type of activity, not the number of hours, will determine the award.

For more information about these new CERP awards, call (800) 899-2226.

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