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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Important ConceptsImportant Concepts
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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Important ConceptsImportant Concepts
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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