Pass the CPNE the First Time

Are you really ready for your CPNE weekend?

You might not be as prepared as you think and the closer you get to your date, the more your nerves will begin to escalate and cause you to second guess yourself.

How do you know it’s the right time to test?  What if you are missing something?

Here is a 21 point check list to guide you in making the decision as to whether you are really ready for your CPNE or not.  This is not intended to be an all inclusive check list of everything you need to know to pass.

These 21 points are a carefully designed and proven formula that we have used to accurately asses thousands of ATL Clinical Workshop students on their readiness and help them realize where they need to improve before making the final commitment to attempt the CPNE.

You can use this to assess your own readiness.  At the very least you should be able check off all 21 of these points before you test.

If you can’t, keep studying because you’re not ready.

Let’s see how ready you are…are you ready

  • I can practically pack the wound blind folded and in any direction that it’s facing.

The wound is very intimidating to students.  Creating and maintaining a sterile field is of utmost importance at this station.  No contamination of any kind will be acceptable.  The packing must have the right amount of moisture and use the acceptable technique to cover the appropriate wound area, all while not contaminating and completing in 15 minutes.canstockphoto0600294

  • I can almost count the drops per minute on the IV mini bag in 15 seconds without using a watch.

The first important component of counting the drops is to have the correct formula to obtain the right drops per minute and then in order to save time, it is best to determine the amount of drops in not just 1 minute but in 15 seconds as well.ATL - 600x300 v5

  • When I hear “sub Q” the two things that come to mind are “roll” and “pinch.”

SubQ injections are in the fatty tissue and it is important to pinch up the tissue so you can inject in the correct location.  Insulin is the subcutaneous injection ordered at that station and it is imperative that the cloudy or NPH insulin be rolled prior to drawing up and administrating.

  • When I hear the word IM, I immediately think “1 inch needle for vastus lateralis” and “1 ½ inch needle for ventral gluteal.

Landmarks are a major factor for this station but so is needle size.  There are two sites allowed to demonstrate injections at this station and each one has a specified needle size based on the mannequin being the size of a small adult.canstockphoto6599210

  • I can pull up my flushes and meds for the IV push station without bubbles.

Oh the bubble conspiracy!  Slow and steady.  Don’t show the amount you draw up if it has bubbles in it.  Champagne bubbles are okay but do you know what they look like?

  • When I hear IV push station, I automatically think “aspirate”

Although aspirating is no longer required for the IM injectable medication station, it is still required for the IV push station prior to the first flush only.  It is one of the most missed critical elements at this station.canstockphoto28859690

  • When someone says EWIIG, I know that it is not a Halloween Costume to scare the patient with and you start singing “Happy Birthday to Me.”

EWIIG is what you do when you first go into the patient’s room. It is a mnemonic that is often used to help you remember the critical elements. Mnemonics are a great way to remember the critical elements.  The happy birthday to me helps you wash your hands for 15 seconds if you sing it all the way through.

  • When you hear HIPPICOWS, you automatically thing 1st 20 minutes of the PCS not a crossbreed of hippos and cows.

This is another mnemonic often used to help the student remember what to do in the first 20 minutes of the PCS after EWIIG.  This is the first part of your fluid management that is required when you first walk into the room which is your patient’s hydration status, the IV, enteral feedings, etc.infusionsets_mhi_default

  • SCABS or SPELLS reminds me of safety for my patient.

These are the last mnemonics you use in the patient’s room.  It pertains to all of the safety critical elements that you need to cover before leaving the room. These are things like locking the bed and putting it into the lowest position, placing the required number of side rails up, and putting the call light within reach of the patient.

  • I can recite my mnemonics backwards and forwards.

There are so many mnemonics out there on the internet so if you cannot come up with your own, you can find plenty.  Just make sure that the mnemonics cover all of the critical elements so that you don’t miss anything when caring for the patient.ATL - 600x300 v5

  • I can name all 20 of the most commonly used Nanda labels.

EC gives you a list of most commonly used Nanda Labels in your study guide. Those should be the first ones you study when preparing to write care plans.  Tab those specific Nanda labels in your nursing diagnosis book if you so choose to.

  • I catch myself saying “If it is wet and it is not yours…”

If you are familiar with standard precautions then you should really understand this quote and know that it pertains to wearing gloves and when to wear gloves.  If you don’t know this then go read about standard precautions.wetnotyours

  • I can recite the Evaluation Rationale statement in my sleep no matter what Nanda I choose.

The final form you are filling out during your PCS is the evaluation form which requires you to write a rationale for why you picked that specific care plan for your primary care plan and what physiological complications can occur if you don’t fix the problem.

  • When I hear GRID, I can picture it in my head and write one in under 15 minutes.

A GRID is a very important strategic organizational tool that has helped thousands of students during their PCS.  A GRID is simply a set of boxes but it is the information that you place in each of those boxes that is crucial to mastering those critical elements while nervous in the patient’s room.

  • I can put together a care plan in my head and write it in 15 to 30 minutes.

Time management is another important aspect when testing.  You only have 2 ½ hours with each patient and the longer it takes you in the planning phase writing your care plans, the less amount of time you actually have with your patient in the room.canstockphoto18593969

  • I can place the stethoscope on the spot for a heart rate without even finding the landmark.

Finding accurate locations for the apical heart rate, for bowel sounds, anterior or posterior breath sounds is the key for a proper assessment.  Practicing muscle memory will help you with the landmark techniques.  Remember that you can review in your Fundamentals of Nursing book as well.

Doctor holding stethoscope (with shallow depth of field)

  • When I think of patient teaching, I think, “there is so much to teach, where do I begin?” not, “I have no idea what to teach.”

Teaching is where you utilize your memory from the nursing concepts you have been taking tests on over the last several months.  You can also utilize reference books on the floor at the hospital, any handouts they have, or use of the intranet at the hospital or even the drug guide book you will be bringing with you to the test.

  • When I see ambulation assigned, I immediately think of any assistive devices needed and put nonskid socks on before I get them up.

Safety is of utmost importance when you are ambulating so you need to make sure the bed is low and locked, side rails are up, you have the nonskid socks on the patient prior to getting the patient up, have them dangle on the side of the bed to make sure they are not dizzy, gather the assistive devices you are told to get, and walk the patient where they are against the wallTS_on_Toes_web

  • When I see "encourage fluids" on the kardex, I know that means I better offer fluids to the patient twice during my pcs.

On the kardex under fluid management, when you see ‘ad lib’ fluids assigned, that means when the patient wants fluids,but you have to offer fluids at least once to them during the pcs.  When you see the word encourage assigned, encourage is a nicer word for “push” fluids so you want to offer fluids to the patient at least two times during your pcs.

  • I know the 3 items required for my evaluation rationale are; the basic physiological need, why that is my priority care plan, and what two physiological complications can occur if I don’t fix the problem.

The basic physiological need is simply opposite of the Nanda label because the Nanda is the problem.  Make the physiological complications specific to your patient.  For example, if the Nanda is Ineffective Airway Clearance then the basic need is a clear airway and two complications could be pneumonia and atelectasis.

  • If I am assigned skin assessment the number 2 comes to mind.

For skin assessment, it is required that you observe two areas.  If the body naturally has two of those parts like elbows for example, then you know that counts as one and you need to also pick another

Are You Really Ready?

How did you do?  Did you feel comfortable with everything or do you feel like you need to study more?  If you don’t feel like you hit all 21 points, don’t fret about it.  At least now you know where you need to focus before you go test so you can fill in any knowledge gaps you’ve discovered through this exercise.

Use all the bullets that you fell short on as a personalized study plan.  Study and practice until you feel confident that all of the points are skills you can do with ease.

The last thing you want to do is rush into the CPNE before you’re ready.  Take the time to be prepared so you know the CPNE is only something you’ll have to do once.

Need help doing that?

Check out this video presentation where we explain a proven method that can quickly and effectively prepare you for the CPNE from home.  With this method you’ll not only be able to check off all 21 points but could increase your chance of passing by 45%.

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Good luck on your CPNE!  We’re always standing by to help.

Disclaimer: ATL Clinical Workshop is a private training company and is not affiliated with Excelsior College.    The purpose of our workshops is to prepare EC students to pass the CPNE and no college credit will be earned for attending either our online or hands-on workshop.

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