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Adult CCRNCertification ReviewThink in Questions, Learn by RationaleKendra Menzies Kent
This is a sample from ADULT CCRN CERTIFICATION REVIEW: THINK IN QUESTIONS, LEARN BY RATIONALEVISIT THIS BOOK’S WEB PAGEBUY NOWREQUEST AN EXAM OR REVIEW COPYeviewAdult CCRN Certification Review Springer Publishing CompanyKent 98334 PTR 00 i-viii FM 04-21-14.indd viiii4/21/2014 5:57:495:57:48 PM
This is a sample from ADULT CCRN CERTIFICATION REVIEW: THINK IN QUESTIONS, LEARN BY RATIONALEVISIT THIS BOOK’S WEB PAGEBUY NOWREQUEST AN EXAM OR REVIEW COPYKendra Menzies Kent, MS, RN-BC, CCRN, CNRN, SCRN, is currently a staff nurse in the intensivecare unit at St. Mary’s Hospital, West Palm Beach, Florida. She is a highly experienced critical carenurse and an accomplished critical care registered nurse (CCRN) instructor, with multiple specialtycertifications within critical care. She also has extensive clinical experience in the majority of thesespecialty areas. She is an accomplished clinician and nurse educator and manager, having workedas a staff nurse, unit manager, nurse educator, and director of critical care at Parkland Hospital inDallas, as well as at other notable acute care facilities. She received her BSN degree from Universityof Texas, Arlington, and her MSN as a clinical nurse specialist in medical–surgical nursing from TexasWomen’s University. She is currently an educational consultant for Med Ed Seminars in Charlotte,North Carolina, having served as a speaker for Health and Sciences Television Network (HSTN)and HSTN videos. An accomplished author, Kendra has edited or contributed to various books oncritical care. Springer Publishing CompanyKent 98334 PTR 00 i-viii FM 04-21-14.indd viiiii4/21/2014 5:57:495:57:48 PM
This is a sample from ADULT CCRN CERTIFICATION REVIEW: THINK IN QUESTIONS, LEARN BY RATIONALEVISIT THIS BOOK’S WEB PAGEBUY NOWREQUEST AN EXAM OR REVIEW COPYeviewAdult CCRN Certification ReviewThink in Questions, Learn by RationaleKendra Menzies Kent, MS, RN-BC, CCRN, CNRN, SCRN Springer Publishing CompanyKent 98334 PTR 00 i-viii FM 04-21-14.indd viiiiii4/21/2014 5:57:495:57:48 PM
This is a sample from ADULT CCRN CERTIFICATION REVIEW: THINK IN QUESTIONS, LEARN BY RATIONALEVISIT THIS BOOK’S WEB PAGEBUY NOWREQUEST AN EXAM OR REVIEW COPYCopyright 2014 Springer Publishing Company, LLCAll rights reserved.No part of this publication may be reproduced, stored in a retrieval system, or transmitted in anyform or by any means, electronic, mechanical, photocopying, recording, or otherwise, without theprior permission of Springer Publishing Company, LLC, or authorization through payment of theappropriate fees to the Copyright Clearance Center, Inc., 222 Rosewood Drive, Danvers, MA 01923,978–750-8400, fax 978–646-8600, info@copyright.com or on the Web at www.copyright.com.Springer Publishing Company, LLC11 West 42nd StreetNew York, NY10036www.springerpub.comAcquisitions Editor: Elizabeth NieginskiComposition: Newgen ImagingISBN: 978-0-8261-9833-4e-book ISBN: 978-0-8261-9834-114 15 16 17 / 5 4 3 2 1Publisher’s AcknowledgmentsSpringer Publishing Company recognizes that the Adult CCRN Certification Exam is a registeredservice mark of the American Association of Critical-Care Nurses (AACN) and has applied thisservice mark to the first mention of the exam in each of the chapters in this book and on its cover.The publisher sincerely thanks and acknowledges Bimbola F. Akintade PhD, ACNP-BC, MBA,MHA, and Liza Marmo RN-BC, MSN, CCRN, ANP-C, for their careful and thoughtful review of themanuscript.The author and the publisher of this Work have made every effort to use sources believed to be reliable to provide information that is accurate and compatible with the standards generally accepted atthe time of publication. The author and publisher shall not be liable for any special, consequential, orexemplary damages resulting, in whole or in part, from the readers’ use of, or reliance on, the information contained in this book. The publisher has no responsibility for the persistence or accuracy ofURLs for external or third-party Internet websites referred to in this publication and does not guarantee that any content on such websites is, or will remain, accurate or appropriate.Library of Congress Cataloging-in-Publication DataCIP data is available from the Library of Congress.Special discounts on bulk quantities of our books are available to corporations, professional associations, pharmaceutical companies, health care organizations, and other qualifying groups. If youare interested in a custom book, including chapters from more than one of our titles, we can provide that service as well.For details, please contact:Special Sales Department, Springer Publishing Company, LLC11 West 42nd Street, 15th Floor, New York, NY 10036–8002Phone: 877-687-7476 or 212-431-4370; Fax: 212-941-7842E-mail: sales@springerpub.comPrinted in the United States of America by Bradford & Bigelow. Springer Publishing CompanyKent 98334 PTR 00 i-viii FM 04-21-14.indd viiiiv4/21/2014 5:57:49 PM
This is a sample from ADULT CCRN CERTIFICATION REVIEW: THINK IN QUESTIONS, LEARN BY RATIONALEVISIT THIS BOOK’S WEB PAGEBUY NOWREQUEST AN EXAM OR REVIEW COPYTo my wonderful husband, Robby, and to my parents, Sid and Judy,for all the love and support they have given me. Springer Publishing CompanyKent 98334 PTR 00 i-viii FM 04-21-14.indd viiiv4/21/2014 5:57:49 PM
This is a sample from ADULT CCRN CERTIFICATION REVIEW: THINK IN QUESTIONS, LEARN BY RATIONALEVISIT THIS BOOK’S WEB PAGEBUY NOWREQUEST AN EXAM OR REVIEW COPY Springer Publishing CompanyKent 98334 PTR 00 i-viii FM 04-21-14.indd viiivi4/21/2014 5:57:49 PM
This is a sample from ADULT CCRN CERTIFICATION REVIEW: THINK IN QUESTIONS, LEARN BY RATIONALEVISIT THIS BOOK’S WEB PAGEBUY NOWREQUEST AN EXAM OR REVIEW COPYwContentsShare Adult CCRN Certification Review: Think in Questions, Learn by RationaleIntroduction11. Cardiovascular System ReviewQuestions922. Pulmonary System ReviewQuestions16391033. Endocrine System ReviewQuestions1881694. Hematology/Immunology System ReviewQuestions2065. Neurological System ReviewQuestions2422096. Gastrointestinal System ReviewQuestions2997. Renal System ReviewQuestions3258. Multisystem ReviewQuestions3631912473013279. Behavioral/Psychological ReviewQuestions41136710. Professional Caring and Ethical PracticeQuestions443Adult CCRN Review Answers and RationaleIndex491413451 Springer Publishing CompanyKent 98334 PTR 00 i-viii FM 04-21-14.indd viiivii4/21/2014 5:57:49 PM
This is a sample from ADULT CCRN CERTIFICATION REVIEW: THINK IN QUESTIONS, LEARN BY RATIONALEVISIT THIS BOOK’S WEB PAGEBUY NOWREQUEST AN EXAM OR REVIEW COPY Springer Publishing CompanyKent 98334 PTR 00 i-viii FM 04-21-14.indd viii4/21/2014 5:57:49 PM
This is a sample from ADULT CCRN CERTIFICATION REVIEW: THINK IN QUESTIONS, LEARN BY RATIONALEVISIT THIS BOOK’S WEB PAGEBUY NOWREQUEST AN EXAM OR REVIEW COPYwIntroductionWelcome to the journey toward certification. This book was written to help guide thereader on the pathway of the journey. It is written in a question/answer format toencourage you to think in questions when studying for the examination. When youstudy, I encourage you to ask yourself, “What can be asked about this particular topic?”“What would be a good question?” “What is important in this disease?” “What makesit different from other disorders?” This prepares you to anticipate the kinds of questions that might be asked and not just attempt to memorize content for the certificationexamination.The book also provides multiple-choice questions similar to the questions that are foundon the Adult Critical-Care Registered Nurse (CCRN ) examination. These questions allowthe nurse to practice taking an examination and also assist the nurse in determining areasthat require further study prior to taking the CCRN examination. The answers and rationale, including some test-taking skills, are provided for each question, further preparingthe nurse for the real examination.WHY CERTIFICATION?The most important reason for certification is to do it for yourself (Box I.1). Certification isviewed as a mark of excellence in an area of specialty. It is an achievement and qualification that can be seen by peers, physicians, leaders of health care institutes, and patients/families. Becoming certified takes a certain dedication to critical care nursing and demonstrates a level of competency. The CCRN examination is developed to verify knowledge incritical care nursing.Box I.1 Reasons to Become CertifiedValidates your knowledge of critical care to your hospital and peersValidates your knowledge of critical care to the patientsValidates your knowledge of critical care to the physicianPromotes continuing excellence in the nursing professionDemonstrates competencyAssists with hospital credentialingProvides monetary benefit (from some hospitals) Springer Publishing CompanyKent 98334 PTR 01 1-8 Intro 04-21-14.indd viiiKent 98334 PTR 00 i-viii FM 04-21-14.indd14/21/2014 5:57:495:59:21 PM
This is a sample from ADULT CCRN CERTIFICATION REVIEW: THINK IN QUESTIONS, LEARN BY RATIONALEVISIT THIS BOOK’S WEB PAGEBUY NOWREQUEST AN EXAM OR REVIEW COPYADULT CCRN EXAMINATION INFORMATIONThe CCRN examination follows the blueprint developed by the American Association ofCritical Care Nurses (AACN). The test is developed and reviewed by experts in criticalcare. The CCRN Application Handbook can be accessed from the website www.certcorp.org.The examination application may be completed online or can be printed and mailed orfaxed to the AACN Certification Corporation. The Adult CCRN provides a 3-year certification for critical care nurses.EXAMINATIONThe Adult CCRN examination consists of 150 multiple-choice questions, of which 25questions will not count for or against you. These 25 questions are being tested for usein future examinations. You will not know which questions count, so complete all 150questions as if they count. The test is not arranged per system, and it is randomized.You may have one question on the renal system and the next one is on the cardiovascular system. The time allowed to complete the examination is 3 hours (50 questionsper hour).Eligibility requirements to take the Adult CCRN examination are RN licensure and 1,750hours of direct bedside care of critically ill patients during the previous 2 years with 875of those hours obtained in the year preceding application to take the examination. Or, onemust have been practicing as an RN for 5 years with a minimum of 2,000 hours of directcare of critically ill patients with 144 of those hours logged during the preceding year.Nurse educators and managers in the adult critical care areas may apply hours spent at thebedside supervising nurses and nursing students.The Adult CCRN examination is offered year-round as a computer-based test (CBT)and is also given as paper–pencil in certain circumstances. Once AACN receives yourapplication and approves it, they send a confirmation e-mail and postcard. Once confirmed, there is a 90-day window to take the examination. You will need to schedule yourexamination at an approved testing center. These centers can be found at www.goAMP.com. Immediate test results with score breakdown are available with the CBT. Obtainingscores from a paper–pencil test will take 3 to 4 weeks. Following successful completionof the exam (which everyone will have done), a certificate will be sent by mail within 3to 4 weeks.❯ HINTDo not schedule your exam at the end of the 90-day window. If forsome reason you are unable to take the examination on the scheduleddate, you will have to pay an extra 100 to reschedule.Renewal of your CCRN license can be made through continuing education recognitionpoints (CERPs) or retaking the examination. The CERP requirement is 100 hours in various Springer Publishing CompanyKent 98334 PTR 01 1-8 Intro 04-21-14.indd viiiKent 98334 PTR 00 i-viii FM 04-21-14.indd24/21/2014 5:57:495:59:21 PM
This is a sample from ADULT CCRN CERTIFICATION REVIEW: THINK IN QUESTIONS, LEARN BY RATIONALEVISIT THIS BOOK’S WEB PAGEBUY NOWREQUEST AN EXAM OR REVIEW COPYcategories (A, B, & C). For more details on renewal, use the AACN’s website for renewal bythe CERPs brochure.TEST PLANThe Adult CCRN test plan is a blueprint for the exam content. Each major system isdivided into subheadings and topics, and clinical judgment, professional caring, and ethical practice.The amount of coverage in each of the systems is: Cardiovascular, 20%Pulmonary, 18%Endocrine, 5%Hematology/Immunology 2%Neurology, 12%Gastroenterology, 6%Renal, 6%Multisystem, 8%Behavioral/Psychosocial, 4%Professional Caring Practice, 20%The CCRN blueprint also has a list of “testable nursing actions,” which are nursingactions under each body system that may be tested. Nursing assessment, monitoring, andpharmacology are included in each body system and should be reviewed in preparationfor the examination.For additional, detailed information, please consult the Adult CCRN Exam Handbook(www.aacn.org).PREPARATIONBe positive!! Avoid any negative thoughts about passing the examination. These thoughtscan cause a self-fulfilling prophecy. Set the test date, then establish a realistic schedulefor preparing for the examination. Set your priorities; study those areas you are lessfamiliar with first. Look at the percentage of each body system and establish timelinesbased on the largest to smallest percentage. Know how you study best, by yourself orin study groups. Study in a manner that works best for you. There are flash cards, practice questions, review courses, and study books in outline format and narrative formatavailable for studying. Practice your test questions within a set time limit to familiarizeyourself with the time limitations. Allow 2 minutes or less per question (remember the50-questions-per-hour rule).When using the practice test questions to study, determine several things when theanswers and rationale are being reviewed. Analyze why you missed the question: Did yousimply not know the content? Go back and restudy this section. Did you misread the question? Did you misread the answers? Did you miss an important element in the question orscenario? Was there a clue based on age, timeline, or symptoms? Springer Publishing CompanyKent 98334 PTR 01 1-8 Intro 04-21-14.indd viiiKent 98334 PTR 00 i-viii FM 04-21-14.indd34/21/2014 5:57:495:59:21 PM
This is a sample from ADULT CCRN CERTIFICATION REVIEW: THINK IN QUESTIONS, LEARN BY RATIONALEVISIT THIS BOOK’S WEB PAGEBUY NOWREQUEST AN EXAM OR REVIEW COPYStudy those areas that you are least comfortable with, or those that are not in your specialty area. As adult learners, we tend to want to read and study what we like, or what wecan use on a daily basis. For this examination, do not spend as much time in your area ofspecialty (you already know it) but focus on other areas you are not familiar with in yourclinical practice.DAY OF THE TESTBefore the examination eat a healthy meal and limit the amount of liquids (to avoid theneed for breaks during the exam). Remember, restroom breaks are allowed but the testingtime does not stop!Do not try to cram immediately before the test; this will increase your anxiety. After theexam, make plans to do something special for yourself.Know where you have to go for the test before the actual day of the test, and alsoknow how long it will take you to get there at the appointed time. Running late andfeeling hurried will increase your anxiety and can poorly affect your test-taking skills.Remember, if you are more than 15 minutes late, you will not be allowed to take theexamination.Bring your letter of approval and two forms of identification (one picture ID). You cannot bring any personal effects into the testing room, so leave everything in the car or athome (usually a locker is provided for you to put your personal items in).You are allowed to do a tutorial on the computer before you start your exam if youneed some assistance with CBT. The test time begins as soon as you start the first question of the actual exam. Leaving the testing site without authorization results in anautomatic voiding of the test. You will be allowed only 3 hours from the time the test isstarted.Results of the examination will be presented onsite at the completion of your exam following a test evaluation.TEST-TAKING SKILLSFrequently, the difference between pass or fail depends on one’s test-taking skills. Animportant reminder: Do not read into the questions; take the question and informationprovided at face value. Answer all questions; do not leave any questions blank. A blankanswer will be counted against you. Answering the question, even if it is an “educated”guess, will give you a one out of four chance of being correct.Key words are important phrases or words used to focus attention on what the questionis specifically asking. Examples include always, earliest, first, on admission, best, least, immediately, and initial.❯ HINTIf the question asks for the “best” response, this is an indication that allanswers are probably correct and you will have to determine the bestanswer for that particular scenario. Springer Publishing CompanyKent 98334 PTR 01 1-8 Intro 04-21-14.indd viiiKent 98334 PTR 00 i-viii FM 04-21-14.indd44/21/2014 5:57:495:59:21 PM
This is a sample from ADULT CCRN CERTIFICATION REVIEW: THINK IN QUESTIONS, LEARN BY RATIONALEVISIT THIS BOOK’S WEB PAGEBUY NOWREQUEST AN EXAM OR REVIEW COPYEliminate incorrect options first. Sometimes, you will immediately see an answerthat is incorrect. Mark through it to narrow down your choices and improve your odds.Frequently you can get the choices down to two that are more correct than others.❯ HINTEliminating options gives a 50/50 chance for an educated guess of thecorrect answer.Avoid those answers with words such as “always” or “never.” There is rarely a time inthe medical field in which you will always or never take a particular action. If three of thefour answers are similar, choose the answer that does not sound similar.Do not change answers unless absolutely sure. You can “bookmark” a question that youare not sure about and return to it at the end of the test. Sometimes, you will feel morecomfortable with the answer after you come back to it.❯ HINTFirst impressions are usually good! Do not spend too much time on anyone question.Do not let it worry you if you do not know all the answers. Take a deep breath and keepgoing. Rejoice in those answers you know and find easy!❯ HINTYou are not really supposed to know all the answers.Do not try to establish patterns, such as using “two As in a row” for answers.If there is a long scenario with a large amount of data, read the question first, then readthe scenario, then reread the question. Sometimes there will be erroneous data that is notrequired to answer the question. Too much time may be spent on trying to comprehendthe whole scenario.❯ HINTDo not forget to reread the question to make sure you read it correctlythe first time.Read all answers before you make a choice; there may be more than one correct answer,but one will be the better answer for the question. Springer Publishing CompanyKent 98334 PTR 01 1-8 Intro 04-21-14.indd viiiKent 98334 PTR 00 i-viii FM 04-21-14.indd54/21/2014 5:57:495:59:21 PM
This is a sample from ADULT CCRN CERTIFICATION REVIEW: THINK IN QUESTIONS, LEARN BY RATIONALEVISIT THIS BOOK’S WEB PAGEBUY NOWREQUEST AN EXAM OR REVIEW COPY❯ HINTDo not choose the first one that appears to be correct. Use the mostcorrect answer.Read the question carefully and answer only the question asked. Do not read into thequestion or think you need more information/data to answer the question.❯ HINTThe question will provide you with all the information needed tocorrectly answer the question.Time frame questions are frequently used in the test. Use the time frame to assist withmaking the
of Texas, Arlington, and her MSN as a clinical nurse specialist in medical–surgical nursing from Texas Women’s University. She is currently an educational consultant for Med Ed Seminars in Charlotte, . OPZ is a sample from ADULT CCRN CERTIFICATION REVIEW: THINK IN QUESTIONS,
