CCRN study help - Critical Care Register Nurse Updated: 2024 | ||||||||
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Exam Code: CCRN Critical Care Register Nurse study help January 2024 by Killexams.com team | ||||||||
CCRN Critical Care Register Nurse A criterion-referenced standard setting process, known as the modified Angoff, is used to establish the passing point/cut score for the exam. Each candidates performance on the exam is measured against a predetermined standard. The passing point/cut score for the exam is established using a panel of subject matter experts, an exam development committee (EDC), who carefully reviews each exam question to determine the basic level of knowledge or skill that is expected. The passing point/cut score is based on the panels established difficulty ratings for each exam question. Under the guidance of a psychometrician, the panel develops and recommends the passing point/cut score, which is reviewed and approved by AACN Certification Corporation. The passing point/cut score for the exam is established to identify individuals with an acceptable level of knowledge and skill. All individuals who pass the exam, regardless of their score, have demonstrated an acceptable level of knowledge. I. CLINICAL JUDGMENT (80%) A. Cardiovascular (17%) 1. Acute coronary syndrome: a. NSTEMI b. STEMI c. Unstable angina 2. Acute peripheral vascular insufficiency: a. Arterial/venous occlusion b. Carotid artery stenosis c. Endarterectomy d. Fem-Pop bypass 3. Acute pulmonary edema 4. Aortic aneurysm 5. Aortic dissection 6. Aortic rupture 7. Cardiac surgery: a. CABG b. Valve replacement or repair 8. Cardiac tamponade 9. Cardiac trauma 10. Cardiac/vascular catheterization 11. Cardiogenic shock 12. Cardiomyopathies: a. Dilated b. Hypertrophic c. Idiopathic d. Restrictive 13. Dysrhythmias 14. Heart failure 15. Hypertensive crisis 16. Myocardial conduction system abnormalities (e.g., prolonged QT interval, Wolff-ParkinsonWhite) 17. Papillary muscle rupture 18. Structural heart defects (acquired and congenital, including valvular disease) 19. TAVR B. Respiratory (15%) 1. Acute pulmonary embolus 2. ARDS 3. Acute respiratory failure 4. Acute respiratory infection (e.g., pneumonia) 5. Aspiration 6. Chronic conditions (e.g., COPD, asthma, bronchitis, emphysema) 7. Failure to wean from mechanical ventilation 8. Pleural space abnormalities (e.g., pneumothorax, hemothorax, empyema, pleural effusions) 9. Pulmonary fibrosis 10. Pulmonary hypertension 11. Status asthmaticus 12. Thoracic surgery 13. Thoracic trauma (e.g., fractured rib, lung contusion, tracheal perforation) 14. Transfusion-related acute lung injury (TRALI) C. Endocrine/Hematology/Gastrointestinal/Renal/Integumentary (20%) 1. Endocrine a. Adrenal insufficiency b. Diabetes insipidus (DI) c. Diabetes mellitus, types 1 and 2 d. Diabetic ketoacidosis (DKA) e. Hyperglycemia f. Hyperosmolar hyperglycemic state (HHS) g. Hyperthyroidism h. Hypoglycemia (acute) i. Hypothyroidism j. SIADH 2. Hematology and Immunology a. Anemia b. Coagulopathies (e.g., ITP, DIC, HIT) c. Immune deficiencies d. Leukopenia e. Oncologic complications (e.g., tumor lysis syndrome, pericardial effusion) f. Thrombocytopenia g. Transfusion reactions 3. Gastrointestinal a. Abdominal compartment syndrome b. Acute abdominal trauma c. Acute GI hemorrhage d. Bowel infarction, obstruction, perforation (e.g., mesenteric ischemia, adhesions) e. GI surgeries (e.g., Whipple, esophagectomy, resections) f. Hepatic failure/coma (e.g., portal hypertension, cirrhosis, esophageal varices, fulminant hepatitis, biliary atresia, drug-induced) g. Malnutrition and malabsorption h. Pancreatitis 4. Renal and Genitourinary a. Acute genitourinary trauma b. Acute kidney injury (AKI) c. Chronic kidney disease (CKD) d. Infections (e.g., kidney, urosepsis) e. Life-threatening electrolyte imbalances 5. Integumentary a. Cellulitis b. IV infiltration c. Necrotizing fasciitis d. Pressure injury e. Wounds: i. infectious ii. surgical iii. trauma D. Musculoskeletal/Neurological/ Psychosocial (14%) 1. Musculoskeletal a. Compartment syndrome b. Fractures (e.g., femur, pelvic) c. Functional issues (e.g., immobility, falls, gait disorders) d. Osteomyelitis e. Rhabdomyolysis 2. Neurological a. Acute spinal cord injury b. Brain death c. Delirium (e.g., hyperactive, hypoactive, mixed) d. Dementia e. Encephalopathy f. Hemorrhage: i. intracranial (ICH) ii. intraventricular (IVH) iii. subarachnoid (traumatic or aneurysmal) g. Increased intracranial pressure (e.g., hydrocephalus) h. Neurologic infectious disease (e.g., viral, bacterial, fungal) i. Neuromuscular disorders (e.g., muscular dystrophy, CP, Guillain-Barré, myasthenia) j. Neurosurgery (e.g., craniotomy, Burr holes) k. Seizure disorders l. Space-occupying lesions (e.g., brain tumors) m. Stroke: i. hemorrhagic ii. ischemic (embolic) iii. TIA n. Traumatic brain injury (TBI): epidural, subdural, concussion 3. Behavioral and Psychosocial a. Abuse/neglect b. Aggression c. Agitation d. Anxiety e. Suicidal ideation and/or behaviors f. Depression g. Medical non-adherence h. PTSD i. Risk-taking behavior j. Substance use disorders (e.g., withdrawal, chronic alcohol or drug dependence) E. Multisystem (14%) 1. Acid-base imbalance 2. Bariatric complications 3. Comorbidity in patients with transplant history 4. End-of-life care 5. Healthcare-associated conditions (e.g., VAE, CAUTI, CLABSI) 6. Hypotension 7. Infectious diseases: a. Influenza (e.g., pandemic or epidemic) b. Multi-drug resistant organisms (e.g., MRSA, VRE, CRE) 8. Life-threatening maternal/fetal complications (e.g., eclampsia, HELLP syndrome, postpartum hemorrhage, amniotic embolism) 9. Multiple organ dysfunction syndrome (MODS) 10. Multisystem trauma 11. Pain: acute, chronic 12. Post-intensive care syndrome (PICS) 13. Sepsis 14. Septic shock 15. Shock states: a. Distributive (e.g., anaphylactic, neurogenic) b. Hypovolemic 16. Sleep disruption (including sensory overload) 17. Thermoregulation 18. Toxic ingestion/inhalations (e.g., drug/alcohol overdose) 19. Toxin/drug exposure (including allergies) II. PROFESSIONAL CARING 7 ETHICAL PRACTICE (20%) A. Advocacy/Moral Agency B. Caring Practices C. Response to Diversity D. Facilitation of Learning E. Collaboration F. Systems Thinking G. Clinical Inquiry CLINICAL JUDGMENT General • Recognize normal and abnormal: o developmental assessment findings and provide developmentally appropriate care o physical assessment findings o psychosocial assessment findings • Recognize signs and symptoms of emergencies, initiate interventions, and seek assistance as needed • Recognize indications for, and manage patients requiring: o capnography (EtCO2) o central venous access o medication reversal agents o palliative care o SvO2 monitoring • Manage patients receiving: o complementary/alternative medicine and/or nonpharmacologic interventions o medications (e.g., safe administration, monitoring, polypharmacy) • Monitor patients and follow protocols for pre- and postoperative care • Assess pain • Evaluate patients response to interventions • Identify and monitor normal and abnormal diagnostic test results • Manage fluid and electrolyte balance • Manage monitor alarms based on protocols and changes in patient condition Cardiovascular • Apply leads for cardiac monitoring • Identify, interpret and monitor cardiac rhythms • Recognize indications for, and manage patients requiring: o 12-lead ECG o arterial catheter o cardiac catheterization o cardioversion central venous pressure monitoring o defibrillation o IABP o invasive hemodynamic monitoring o pacing: epicardial, transcutaneous, transvenous o pericardiocentesis o QT interval monitoring o ST segment monitoring • Manage patients requiring: o endovascular stenting o PCI Respiratory • Interpret blood gas results • Recognize indications for, and manage patients requiring: o modes of mechanical ventilation o noninvasive positive pressure ventilation (e.g., BiPAP, CPAP, high-flow nasal cannula) o oxygen therapy delivery devices o prevention of complications related to mechanical ventilation (ventilator bundle) o prone positioning o pulmonary therapeutic interventions related to mechanical ventilation: airway clearance, extubation, intubation, weaning o therapeutic gases (e.g., oxygen, nitric oxide, heliox, CO2 ) o thoracentesis o tracheostomy Hematology and Immunology • Manage patients receiving transfusion of blood products • Monitor patients and follow protocols: o pre-, intra-, post-intervention (e.g., plasmapheresis, exchange transfusion, leukocyte depletion) o related to blood conservation Neurological • Recognize indications for, and manage patients requiring neurologic monitoring devices and drains (e.g., ICP, ventricular or lumbar drain) • Use a swallow evaluation tool to assess dysphagia • Manage patients requiring: o neuroendovascular interventions (e.g., coiling, thrombectomy) o neurosurgical procedures (e.g., pre-, intra-, post-procedure) o spinal immobilization Integumentary • Recognize indications for, and manage patients requiring, therapeutic interventions (e.g. wound VACs, pressure reduction surfaces, fecal management devices, IV infiltrate treatment) Gastrointestinal • Monitor patients and follow protocols for procedures pre-, intra-, post-procedure (e.g., EGD, PEG placement) • Intervene to address barriers to nutritional/fluid adequacy (e.g., chewing/swallowing difficulties, alterations in hunger and thirst, inability to self-feed) • Recognize indications for, and manage patients requiring: o abdominal pressure monitoring o GI drains o enteral and parenteral nutrition Renal and Genitourinary • Identify nephrotoxic agents • Monitor patients and follow protocols pre-, intra-, and post-procedure (e.g., renal biopsy, ultrasound) • Recognize indications for, and manage patients requiring, renal therapeutic intervention (e.g., hemodialysis, CRRT, peritoneal dialysis) Musculoskeletal • Manage patients requiring progressive mobility • Recognize indications for, and manage patients requiring, compartment syndrome monitoring Multisystem • Manage continuous temperature monitoring • Provide end-of-life and palliative care • Recognize risk factors and manage malignant hyperthermia • Recognize indications for, and manage patients undergoing: o continuous sedation o intermittent sedation o neuromuscular blockade agents o procedural sedation - minimal o procedural sedation - moderate o targeted temperature management (previously known as therapeutic hypothermia) Behavioral and Psychosocial • Respond to behavioral emergencies (e.g., nonviolent crisis intervention, de-escalation techniques) • Use behavioral assessment tools (e.g., delirium, alcohol withdrawal, cognitive impairment) • Recognize indications for, and manage patients requiring: o behavioral therapeutic interventions o medication management for agitation o physical restraints I. CLINICAL JUDGMENT (80%) A. Cardiovascular (14%) 1. Cardiac infection and inflammatory diseases 2. Cardiac malformations 3. Cardiac surgery 4. Cardiogenic shock 5. Cardiomyopathies 6. Cardiovascular catheterization 7. Dysrhythmias 8. Heart failure 9. Hypertensive crisis 10. Myocardial conduction system defects 11. Obstructive shock 12. Vascular occlusion B. Respiratory (18%) 1. Acute pulmonary edema 2. Acute pulmonary embolus 3. Acute respiratory distress syndrome (ARDS) 4. Acute respiratory failure 5. Acute respiratory infection 6. Air-leak syndromes 7. Apnea of prematurity 8. Aspiration 9. Chronic pulmonary conditions 10. Congenital airway malformations 11. Failure to wean from mechanical ventilation 12. Pulmonary hypertension 13. Status asthmaticus 14. Thoracic and airway trauma 15. Thoracic surgery C. Endocrine/Hematology/Gastrointestinal/Renal/Integumentary (20%) 1. Endocrine a. Adrenal insufficiency b. Diabetes insipidus (DI) c. Diabetic ketoacidosis (DKA) d. Diabetes mellitus, types 1 and 2 e. Hyperglycemia f. Hypoglycemia g. Inborn errors of metabolism h. Syndrome of inappropriate secretion of antidiuretic hormone (SIADH) 2. Hematology and Immunology a. Anemia b. Coagulopathies (e.g., ITP, DIC) c. Immune deficiencies d. Myelosuppression (e.g., thrombocytopenia, neutropenia) e. Oncologic complications f. Sickle cell crisis g. Transfusion reactions 3. Gastrointestinal a. Abdominal compartment syndrome b. Abdominal trauma c. Bowel infarction, obstruction and perforation d. Gastroesophageal reflux e. GI hemorrhage f. GI surgery g. Liver disease and failure h. Malnutrition and malabsorption i. Necrotizing enterocolitis (NEC) j. Peritonitis 4. Renal and Genitourinary a. AKI b. Chronic kidney disease (CKD) c. Hemolytic uremic syndrome (HUS) d. Kidney transplant e. Life-threatening electrolyte imbalances f. Renal and genitourinary infections g. Renal and genitourinary surgery 5. Integumentary a. IV infiltration b. Pressure injury c. Skin failure (e.g., hypoperfusion) d. Wounds D. Musculoskeletal/Neurological/Psychosocial (15%) 1. Musculoskeletal a. Compartment syndrome b. Musculoskeletal surgery c. Musculoskeletal trauma d. Rhabdomyolysis 2. Neurological a. Acute spinal cord injury b. Agitation c. Brain death d. Congenital neurological abnormalities e. Delirium f. Encephalopathy g. Head trauma h. Hydrocephalus i. Intracranial hemorrhage j. Neurogenic shock k. Neurologic infectious disease l. Neuromuscular disorders m. Neurosurgery n. Pain: acute, chronic o. Seizure disorders p. Space-occupying lesions q. Spinal fusion r. Stroke s. Traumatic brain injury (TBI) 3. Behavioral and Psychosocial a. Abuse and neglect b. Post-traumatic stress disorder (PTSD) c. Post-intensive care syndrome (PICS) d. Self-harm e. Suicidal ideation and behavior E. Multisystem (13%) 1. Acid-base imbalance 2. Anaphylactic shock 3. Death and dying 4. Healthcare-associated conditions (e.g., VAE, CAUTI, CLABSI) 5. Hypovolemic shock 6. Post-transplant complications 7. Sepsis 8. Submersion injuries (i.e. near drowning) 9. Hyperthermia and hypothermia 10. Toxin and drug exposure II. Professional Caring & Ethical Practice (20%) A. Advocacy/Moral Agency B. Caring Practices C. Response to Diversity D. Facilitation of Learning E. Collaboration F. Systems Thinking G. Clinical Inquiry CLINICAL JUDGMENT General • Manage patients receiving: o continuous sedation o extracorporeal membrane oxygenation (ECMO) o nonpharmacologic interventions o pharmacologic interventions o intra-procedural and post-procedural care o post-operative care o vascular access • Conduct physical assessment of critically ill or injured patients • Conduct psychosocial assessment of critically ill or injured patients • Evaluate diagnostic test results and laboratory values • Manage patients during intrahospital transport • Manage patients undergoing procedural sedation • Manage patients with temperature monitoring and regulation devices • Provide family-centered care Cardiovascular • Manage patients requiring: o arterial catheterization (e.g., arterial line) o cardiac catheterization o cardioversion o CVP monitoring o defibrillation o epicardial pacing o near-infrared spectroscopy (NIRS) o umbilical catheterization (e.g., UVC, UAC) • Manage patients with: • cardiac dysrhythmias • hemodynamic instability Respiratory • Manage patients requiring: o artificial airways (e.g., endotracheal tubes, tracheotomy) o assistance with airway clearance chest tubes o high-frequency oscillatory ventilation (HFOV) o mechanical ventilation o noninvasive positive-pressure ventilation (e.g., CPAP, nasal IMV, high-flow nasal cannula) o prone positioning o respiratory monitoring devices (e.g., SpO2, SVO2, EtCO2) o therapeutic gases (e.g., oxygen, nitric oxide, heliox, CO2) o thoracentesis Hematology and Immunology • Manage patients receiving: o plasmapheresis, exchange transfusion or leukocyte depletion o transfusion Neurological • Conduct pain assessment of critically ill or injured patients • Manage patients with seizure activity • Provide end-of-life and palliative care • Manage patients requiring: o neurologic monitoring devices and drains (e.g., ICP, ventricular drains, grids) o spinal immobilization Integumentary • Manage patients requiring wound prevention and/or treatment (e.g., wound VACs, pressure reduction surfaces, fecal management devices, IV infiltrate treatment) Gastrointestinal • Manage patients with inadequate nutrition and fluid intake (e.g., chewing and swallowing difficulties, alterations in hunger and thirst, inability to self-feed) • Manage patients receiving: o enteral and parenteral nutrition o GI drains o intra-abdominal pressure monitoring Renal and Genitourinary • Manage patients requiring: o electrolyte replacement o renal replacement therapies (e.g., hemodialysis, CRRT, peritoneal dialysis) Multisystem • Manage patients requiring progressive mobility Behavioral and Psychosocial • Conduct behavioral assessment of critically ill or injured patients (e.g., delirium, withdrawal) • Manage patients requiring behavioral and mental health interventions • Respond to behavioral emergencies (e.g., nonviolent crisis intervention, de-escalation techniques) I. CLINICAL JUDGMENT (80%) A. Cardiovascular (5%) 1. Acute pulmonary edema 2. Cardiac surgery (e.g., congenital defects, patent ductus arteriosus) 3. Dysrhythmias 4. Heart failure 5. Hypovolemic shock 6. Structural heart defects (acquired and congenital, including valvular disease) B. Respiratory (21%) 1. Acute respiratory distress syndrome (ARDS) 2. Acute respiratory failure 3. Acute respiratory infection (e.g., pneumonia) 4. Air-leak syndromes 5. Apnea of prematurity 6. Aspiration 7. Chronic conditions (e.g., chronic lung disease/bronchopulmonary dysplasia) 8. Congenital anomalies (e.g., diaphragmatic hernia, tracheoesophageal fistula, choanal atresia, tracheomalacia, tracheal stenosis) 9. Failure to wean from mechanical ventilation 10. Meconium aspiration syndrome 11. Persistent pulmonary hypertension of the newborn (PPHN) 12. Pulmonary hemorrhage 13. Pulmonary hypertension 14. Respiratory distress (RDS) 15. Thoracic surgery 16. Transient tachypnea of the newborn C. Endocrine/Hematology/Gastrointestinal/Renal/Integumentary (27%) 1. Endocrine a. Adrenal insufficiency b. Hyperbilirubinemia c. Hyperglycemia d. Hypoglycemia e. Inborn errors of metabolism 2. Hematology and Immunology a. Anemia b. Coagulopathies (e.g., ITP, DIC) c. Immune deficiencies d. Leukopenia e. Polycythemia f. Rh incompatibilities, ABO incompatibilities, hydrops fetalis g. Thrombocytopenia 3. Gastrointestinal a. Bowel infarction/obstruction/perforation (e.g., mesenteric ischemia, adhesions) b. Feeding intolerance c. Gastroesophageal reflux d. GI abnormalities (e.g., omphalocele, gastroschisis, volvulus, imperforate anus, Hirshsprung disease, malrotation, intussusception, hernias) e. GI surgeries f. Hepatic failure (e.g., biliary atresia, portal hypertension, esophageal varices) g. Malnutrition and malabsorption h. Necrotizing enterocolitis (NEC) i. Pyloric stenosis 4. Renal and Genitourinary a. Acute kidney injury (AKI) b. Chronic kidney disease c. Congenital genitourinary conditions (e.g., hypospadias, polycystic kidney disease, hydronephrosis, bladder exstrophy) d. Genitourinary surgery e. Infections f. Life-threatening electrolyte imbalances 5. Integumentary a. Congenital abnormalities (e.g., epidermolysis bullosa, skin tags) b. IV infiltration c. Pressure injury/ulcer (e.g., device, incontinence, immobility) d. Wounds: i. non-surgical ii. surgical D. Musculoskeletal/Neurological/Psychosocial (13%) 1. Musculoskeletal a. Congenital or acquired musculoskeletal conditions b. Osteopenia 2. Neurological a. Agitation b. Congenital neurological abnormalities (e.g., AV malformation, myelomeningocele, encephalocele) c. Encephalopathy d. Head trauma (e.g., forceps and/or vacuum injury) e. Hemorrhage: i. intracranial (ICH) ii. intraventricular (IVH) f. Hydrocephalus g. Ischemic insult (e.g., stroke, periventricular leukomalacia) h. Neurologic infectious disease (e.g., viral, bacterial, fungal) i. Neuromuscular disorders (e.g., spinal muscular atrophy) j. Neurosurgery k. Pain (acute, chronic) l. Seizure disorders m. Sensory impairment (e.g., retinopathy of prematurity, hearing impairment, visual impairment) n. Stress (e.g., noise, overstimulation, sleep disturbances) o. Traumatic brain injury (e.g., epidural, subdural, concussion, physical abuse) 3. Behavioral and Psychosocial a. Abuse and neglect b. Families in crisis (e.g., stress, grief, lack of coping) E. Multisystem (14%) 1. Birth injuries (e.g., hypoxic-ischemic encephalopathy, brachial plexus injury, lacerations) 2. Developmental delays 3. Failure to thrive 4. Healthcare-associated conditions (e.g., VAE, CAUTI, CLABSI) 5. Hypotension 6. Infectious diseases (e.g., influenza, respiratory syncytial virus, multidrugresistant organisms) 7. Life-threatening maternal/fetal complications (e.g., eclampsia, HELLP syndrome, maternal-fetal transfusion, placental abruption, placenta previa) 8. Low birth weight/prematurity 9. Sepsis 10. Terminal conditions (e.g., end-of-life, palliative care) 11. Thermoregulation 12. Toxin/drug exposure (e.g., neonatal abstinence syndrome, fetal alcohol syndrome, maternal or iatrogenic). II. Professional Caring & Ethical Practice (20%) A. Advocacy/Moral Agency B. Caring Practices C. Response to Diversity D. Facilitation of Learning E. Collaboration F. Systems Thinking G. Clinical Inquiry CLINICAL JUDGMENT General • Assess pain considering patients gestational age • Follow protocol for newborn car seat testing, hearing and congenital heart disease screening • Follow protocol for feeding and supplementation • Identify and monitor normal and abnormal diagnostic test results • Implement interventions to keep neonates safe (e.g., transponder use, safe sleep) • Manage monitor alarms based on protocol and change in patient condition • Manage patients receiving complementary alternative medicine and/or nonpharmacologic interventions • Manage patients receiving medications (e.g., safe administration, monitoring, polypharmacy) • Monitor patients and follow protocols for pre- and postoperative care • Recognize indications for, and manage patients requiring, central venous access • Recognize normal and abnormal: o developmental assessment findings and provide developmentally appropriate care o family psychosocial assessment findings o physical assessment findings • Recognize signs and symptoms of emergencies, initiate interventions, and seek assistance as needed Cardiovascular • Apply leads for cardiac monitoring • Identify, interpret and monitor cardiac rhythms • Monitor hemodynamic status and recognize signs and symptoms of hemodynamic instability • Recognize early signs of decreased cardiac output • Recognize normal fetal circulation and transition to extra-uterine life Recognize indications for, and manage patients requiring: o 12-lead ECG o arterial catheter o cardioversion o invasive hemodynamic monitoring Respiratory • Interpret blood gas results • Manage medications and monitor patients requiring rapid sequence intubation (RSI) • Recognize indications for, and manage patients with, tracheostomy • Recognize indications for, and manage patients requiring: o assisted ventilation o bronchoscopy o chest tubes o endotracheal tubes o non-invasive positive pressure ventilation (e.g., bilevel positive airway pressure, CPAP, high-flow nasal cannula) o oxygen therapy delivery device o prone positioning (lateral rotation therapy) o rescue airways (e.g., laryngeal mask airway [LMA]) o respiratory monitoring devices (e.g., SpO2, EtCO2) and report values o therapeutic gases (e.g., oxygen, nitric oxide, heliox, CO2) o thoracentesis Hematology and Immunology • Manage patients receiving transfusion of blood products • Monitor and manage patients with bleeding disorders • Monitor patients and follow protocols: o pre-, intra-, post-intervention (e.g., exchange transfusion) o related to blood conservation Neurological • Manage patients with congenital neurological abnormalities | ||||||||
Critical Care Register Nurse Medical Critical study help | ||||||||
Other Medical examsCRRN Certified Rehabilitation Registered NurseCCRN Critical Care Register Nurse CEN Certified Emergency Nurse CFRN Certified Flight Registered Nurse CGFNS Commission on Graduates of Foreign Nursing Schools CNA Certified Nurse Assistant CNN Certified Nephrology Nurse CNOR Certified Nurse Operating Room DANB Dental Assisting National Board Dietitian Dietitian EMT Emergency Medical Technician EPPP Examination for Professional Practice of Psychology FPGEE Foreign Pharmacy Graduate Equivalency NBCOT National Board for Certification of Occupational Therapists - 2023 NCBTMB National Certification Board for Therapeutic Massage & Bodywork NET Nurse Entrance Test NPTE National Physical Therapy Examination OCN Oncology Certified Nurse - 2023 PANCE Physician Assistant National Certifying VTNE Veterinary Technician National Examination (VTNE) CNS Clinical Nurse Specialist NBRC The National Board for Respiratory Care AHM-540 AHM Medical Management AACN-CMC Cardiac Medicine Subspecialty Certification AAMA-CMA AAMA Certified Medical Assistant ABEM-EMC ABEM Emergency Medicine Certificate ACNP AG - Acute Care Nurse Practitioner AEMT NREMT Advanced Emergency Medical Technician AHIMA-CCS Certified Coding Specialist (CPC) (ICD-10-CM) ANCC-CVNC ANCC (RN-BC) Cardiac-Vascular Nursing ANCC-MSN ANCC (RN-BC) Medical-Surgical Nursing ANP-BC ANCC Adult Nurse Practitioner APMLE Podiatry and Medical BCNS-CNS Board Certified Nutrition Specialis BMAT Biomedical Admissions Test CCN CNCB Certified Clinical Nutritionist CCP Certificate in Child Psychology CDCA-ADEX Dental Hygiene CDM Certified Dietary Manager CGRN ABCGN Certified Gastroenterology Registered Nurse CNSC NBNSC Certified Nutrition Support Clinician COMLEX-USA Osteopathic Physician CPM Certified Professional Midwife CRNE Canadian Registered Nurse Examination CVPM Certificate of Veterinary Practice Management DAT Dental Admission Test DHORT Discover Health Occupations Readiness Test DTR Dietetic Technician Registered FNS Fitness Nutrition Specialist MHAP MHA Phlebotomist MSNCB MSNCB Medical-Surgical Nursing Certification NAPLEX North American Pharmacist Licensure Examination NCCT-TSC NCCT Technician in Surgery NCMA-CMA Certified Medical Assistant NCPT National Certified Phlebotomy Technician (NCPT) NE-BC ANCC Nurse Executive Certification NNAAP-NA NNAAP Nurse Aide NREMT-NRP NREMT National Registered Paramedic NREMT-PTE NREMT Paramedic Trauma Exam OCS Ophthalmic Coding Specialist PANRE Physician Assistant National Recertifying Exam PCCN AACN Progressive Critical Care Nursing RDN Registered Dietitian VACC VACC Vascular Access WHNP Women Health Nurse Practitioner AACD American Academy of Cosmetic Dentistry RPFT Registered Pulmonary Function Technologist ACLS Advanced Cardiac Life Support - 2023 GP-Doctor General Practitioner (GP) Doctor GP-MCQS Prometric MCQS for general practitioner (GP) Doctor INBDE Integrated National Board Dental Examination (Day 1 exam) Podiatry-License-Exam-Part-III Podiatry License Exam Part III - 2023 | ||||||||
Are you searching internet for CCRN Dumps online? We give most updated and valid CCRN Dumps that are made of real CCRN exam questions and answers called CCRN braindumps. We have arranged a database of CCRN Dumps from actual exams with a specific end goal to give you a chance to get ready and pass CCRN exam on the first attempt. | ||||||||
Medical CCRN Critical Care Register Nurse https://killexams.com/pass4sure/exam-detail/CCRN Answer: D Section 20: Sec Twenty (351 to 355) Details:Critical Care Nursing Neonatal Exam Question: 351 If a newborn's stroke volume is about 5 mL, what is the average pulse required to ensure adequate cardiac output? A. 100 bpm. B. 145 bpm. C. 180 bpm. D. 195 bpm. Answer: B Question: 352 A neonate has a differential diagnosis of congenital muscular dystrophy (CMD) (laminin alpha-2 deficiency) and exhibits hypotonia at birth with poor feeding and mild respiratory distress. Which tests are necessary to establish the diagnosis? A. Creatinine kinase. B. Electromyogram, nerve conduction studies, and muscle biopsy. C. Muscle biopsy only. D. MRI only. Answer: B Question: 353 The nurse is inserting a PICC for an infant who requires extended IV therapy because of very low birth weight. During the procedure, the infant must be monitored for which of the following? A. Tachycardia and tachypnea. B. Bradycardia and hypoxia. C. Atrial fibrillation. D. Blood pressure. Answer: B Question: 354 A mixed venous oxygen saturation (SvO2) level of less than 60% can indicate which of the following? A. Increased hemoglobin, PaO2, and/or cardiac output. B. Decreased hemoglobin, PaO2, and/or cardiac output. C. Decreased oxygen consumption. D. Sepsis. Answer: B Question: 355 A 21-day-old neonate develops green-bronze jaundice, dark urine, claycolored stools, abdominal distention with distended abdominal veins, and hepatosplenomegaly with firm liver. Liver biopsy and test shows extrahepatic biliary atresia, and a hepatoportoenterostomy (Kasai procedure) is done to create a conduit between the liver and small intestine. Which added vitamin(s) or minerals should the baby receive postoperatively? A. Water-soluble vitamins (B-complex, C). B. Fat-soluble vitamins (A, D, E, K). C. Calcium. D. Potassium. Answer: B Section 21: Sec Twenty One (356 to 360) Details:Progressive Care Certified Nurse (PCCN) Practice Question: 356 Thoracic electrical bioimpedence monitoring with 4 sets of bioimpedence electrodes and 3 ECG electrodes is used to evaluate hemodynamic status of a postsurgical cardiac patient. Where are the bioimpedence electrodes placed? A. One set on the arms, one set on the legs, and one set on the sides of the chest. B. Two sets bilaterally at the base of the neck and two sets on each side of the chest. C. One set on the legs and three sets on each side of the chest. D. One set on the arms, one set bilaterally at the base of the neck, and two sets on each side of the chest. Answer: B Question: 357 A 52-year-old female with a history of bipolar disease is one-day post-operative following a hip replacement. The patient slept only one or two hours during the night and is speaking rapidly, throwing her belongings at the nurses, and insisting she is going to leave the hospital against medical advice. The nurse should notify: A. The mental health crisis team B. Social services C. A home health agency D. The patient's husband Answer: A Question: 358 If all patients who develop urinary infections are evaluated per urine culture and sensitivities for microbial resistance, but only those with clinically-evident infections are included, then those with subclinical infections may be missed, skewing results. This is an example of: A. Information bias B. Selection bias C. Hypothesis testing D. Generalizability Answer: B Question: 359 A 28-year-old male with extensive second and third-degree burns develops abdominal discomfort and vomits coffee ground emesis and frank blood. The most likely cause is: A. A peptic ulcer B. The erosion of the esophagus from burns C. Paralytic ileus D. Stress-related erosive syndrome Answer: D Question: 360 Beck's triad (increased central venous pressure with distended neck veins, muffled heart sounds, and hypotension) is indicative of which condition? A. Myocardial infarction B. Aortic valve prolapse C. Cardiac tamponade D. Pulmonary embolism Answer: C For More exams visit https://killexams.com/vendors-exam-list Kill your exam at First Attempt....Guaranteed! | ||||||||
AI Integration in the Fight Against Age-Related Macular DegenerationWen Hwa Lee In this interview, Wen Hwa Lee, CEO, and Chief Scientist at Action Against Age-Related Macular Degeneration (AAAMD), offers an enlightening perspective on merging AI with ophthalmology to forge new paths in healthcare and drug discovery. The imaging technique, described in the journal Nature Biotechnology, would allow doctors to see cancer cells that might otherwise have been virtually invisible, the researchers said. This tool can be used to determine whether safe margins were achieved through cancer surgeries and automatically provide annotation for microscopic images, paving the way for molecular disease diagnosis at that level, they said. The researchers said iStar has the ability to automatically detect critical anti-tumor immune formations called "tertiary lymphoid structures," whose presence correlates with a patient's likely survival and favourable response to immunotherapy, which is often given for cancer and requires high precision in patient selection. This means that iStar could be a powerful tool for determining which patients would benefit most from immunotherapy, they said. "The power of iStar stems from its advanced techniques, which mirror, in reverse, how a pathologist would study a tissue sample," said Mingyao Li, a professor at the University of Pennsylvania. "Just as a pathologist identifies broader regions and then zooms in on detailed cellular structures, iStar can capture the overarching tissue structures and also focus on the minutiae in a tissue image," Li explained. To test the efficacy of the tool, the researchers evaluated iStar on many different types of cancer tissue, including breast, prostate, kidney, and colorectal cancers, mixed with healthy tissues. Within these tests, iStar was able to automatically detect tumour and cancer cells that were hard to identify just by eye, according to the researchers. Clinicians in the future may be able to pick up and diagnose more hard-to-see or hard-to-identify cancers with iStar acting as a layer of support, they said. In addition to the clinical possibilities presented by the iStar technique, the tool moves extremely quickly compared to other, similar AI tools. For example, when set up with the breast cancer dataset the team used, iStar finished its analysis in just nine minutes. By contrast, the best competitor AI tool took more than 32 hours to come up with a similar analysis, making iStar 213 times faster. "The implication is that iStar can be applied to a large number of samples, which is critical in large-scale biomedical studies," Li added. Photo: Westend61/Getty Images Pediatric telehealth for mental health needs filled a critical deficit in the immediate period following the emergence of COVID-19, and continues to account for a substantial portion of pediatric mental health service utilization and spending, according to a new research letter in JAMA Network Open. Because of that, commercial health insurers should use telehealth to make up for the lack of mental health providers focusing on youth, the research determined. Focusing on children and youths younger than 19 who have received common pediatric mental health diagnoses (anxiety, adjustment disorder, attention-deficit/hyperactivity disorder, etc.), the team quantifies trends and changes in monthly utilization and spending rates between three phases of COVID-19: pre-pandemic, the midst of the pandemic before vaccine availability, and post-pandemic. Monthly medical claims data provided by Castlight Health were used to measure trends in utilization per 1,000 beneficiaries and spending (accounting for inflation by indexing 2020 to 2022 rates to 2019) per 10,000 beneficiaries among roughly 1.9 million children and youths with commercial insurance throughout the U.S. Utilization and spending trends were generally consistent across pediatric mental health diagnoses. Compared with pre-pandemic, in-person pediatric mental health services declined by 42% during the pandemic's acute phase, while pediatric telehealth services increased 30-fold (3,027%), representing a 13% relative increase in overall utilization. By August 2022, in-person services returned to 75% of pre-pandemic levels and telemental health utilization was 2,300% higher than pre-pandemic levels. During the post-pandemic period, there was a gradual increase in spending rates compared with pre-pandemic for in-person, telehealth and total visits. From January 2019 to August 2022, mental health service utilization increased by 21.7%, while mental health spending rates increased by 26.1%. WHAT'S THE IMPACT? The COVID-19 pandemic severely tested the mental health of children and youths due to unprecedented school closures, social isolation and distancing, and COVID-19-related mortality among families, according to research in JAMA Pediatrics. In response, health systems offered telehealth to increase access to pediatric mental healthcare, but the extent to which telehealth availability led to greater utilization and spending was largely unknown. As it turns out, utilization and spending increased over the entire timeframe. ADHD, anxiety disorders, and adjustment disorder accounted for most visits and spending in all phases. Supported by evidence that telehealth can effectively deliver mental health treatment for children and youths, the findings have important implications for telehealth sustainability beyond the effects of COVID-19, authors said. THE LARGER TREND A stark generation gap has emerged between millennials and baby boomers when it comes to telehealth, with younger patients driving the highest overall satisfaction scores and older patients experiencing significantly lower levels of satisfaction, according to the J.D. Power 2023 U.S. Telehealth Satisfaction Study, published last month. The satisfaction gap is widest in digital channels and appointment scheduling, suggesting that older telehealth users are having problems using telehealth providers' digital interfaces. Also in September, Epic Research determined that despite being able to be reimbursed for telehealth services at the higher facility rate for another year, providers are frequently billing for these virtual visits at a lower level-of-service code, a trend that holds true for both primary and specialty care. Telehealth visits are more frequently coded with a lower level-of-service billing code than in-person office visits of the same specialty. In October 2022, after three months of relative stability, national telehealth utilization declined 3.7%. Looking at one specific metric, telehealth went from 5.4% of medical claim lines in September, to 5.2% in October, according to FAIR Health's Monthly Telehealth Regional Tracker. Twitter: @JELagasse Researchers found that applying gentle, non-invasive electrical stimulation to the brain during virtual reality training helped budding surgeons to more easily transfer the skills they’d learned to a real-life setting. In addition to training better future surgeons, the approach could help skill acquisition in other industries. Motor learning allows us to develop new skills, like mastering a tennis serve or, in the case of a surgeon, developing precision suturing skills. These days, surgeons are likely to learn these types of skills in a virtual reality (VR) environment before they transition to the real world. Researchers at Johns Hopkins University in the US have developed a method of improving how medicos learn surgical skills in a virtual environment so that their learned skills are transferred more effectively to a real-life scenario. “Training in virtual reality is not the same as training in a real setting, and we’ve shown with previous research that it can be difficult to transfer a skill learning in a simulation into the real world,” said Jeremy Brown, a study co-author. “It’s very hard to claim statistical exactness, but we concluded people in the study were able to transfer skills from virtual reality to the real world much more easily when they had this stimulation.” By “this stimulation”, Brown is talking about a gentle electric current delivered to the head, more specifically, the cerebellum, a part of the brain that plays a critical role in error-based learning. Non-invasive brain stimulation (NIBS) has been used before in attempts to improve motor learning. One form of NIBS, the one that was used in the current study, is anodal transcranial direct current stimulation (atDCS), the application of a constant electric current to specific areas of the brain. Anodal stimulation depolarizes the neurons, increasing the probability of an action potential – a rapid sequence of voltage changes – occurring. The action potential and subsequent neurotransmitter release enable one neuron to communicate with others. The researchers recruited 36 participants, 17 females and 19 males, with a mean age of 27. While 12 had medical backgrounds, none had prior experience with laparoscopy, robotic surgery, or any other teleoperation device. Each was asked to perform a complex visuomotor surgical training task in a real or virtual environment and then switch to the opposite training environment. The task involved driving a curved surgical needle through three rings with a 2 mm radius distributed at 45-degree increments inside the vertical plane. ‘Real’ training environment in the context of this study meant performing the task using the da Vinci Research Kit (dVRK), an open-source research robot, to control the surgical instruments. Participants received either atDCS or sham cerebellar stimulation during the training task, which they had to perform at three speeds: fast, medium, and slow. While all participants showed improvement from baseline, groups receiving cerebellar atDCS showed significantly improved skill transfer from the virtual to the real environment at fast and moderate speeds, whereas groups receiving the sham stimulation did not. “The group that didn’t receive stimulation struggled a bit more to apply the skills they learned in virtual reality to the actual robot, especially the most complex moves involving quick motions,” said Guido Caccianiga, the study’s lead and corresponding author. “The groups that received brain stimulation were better at those tasks.” The researchers say validating their findings using a larger sample could significantly impact robotic surgery training programs. Enhancing skill transfer through NIBS could speed up training time and shorten the learning curve. Outside of training surgeons, the approach could help with skill acquisition in other industries or learning more generally. “What if we could show that with brain stimulation, you can learn new skills in half the time?” Caccianiga said. “That’s a huge margin on the costs because you’d be training people faster; you could save a lot of resources to train more surgeons or engineers who will deal with these technologies frequently in the future.” The study was published in the journal Nature Scientific Reports, and the below video, produced by Johns Hopkins, shows a participant receiving cerebellar atDCS during training. Could an Electric Nudge to the Head Help Your Doctor Operate a Surgical Robot? Source: Johns Hopkins University | ||||||||
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