CRNE June 2012 - Page 4

what is the difference between no CPR and do not resuscitate request? Any samaritan nurse out there to explain. Thanks in advance?

Do not resuscitate (DNR) basically means no life saving measures will be undertaken (intubation, ACLS protocols etc) in the event of a code. Someone with a no CPR (chest compressions) order is giving consent to all life saving measures sans chest compressions.

thank you eh!

Any techniques in differentiating

Primary prevention versus secondary prevention?

Health promotion somehow, I intertwined it with primary prevention.

Think of health promotion as enabling someone to increase control over improving their health.

There are 3 levels of prevention.

Primary: Prevention of health problems or diseases before their onset and promoting health. IE) Immunizations, wearing seat belts, bike safety classes, safe driving classes

Secondary: The earliest possible identification of disease or health problems in asymptomatic persons. IE) Screening

Tertiary: Reduce the negative impact and complications in persons who already have a disease/health problem.

I am very much confuse on this issue... Are we going to give Regular insulin before a major surgery? Why and why not?

number 2...Mosby comprehensive review book says child's first teeth are the upper central incisors then on the other page it says first to appear are lower central incisors...which is which

more quick challenging issues .... what could be the CRNE's point of view when it comes to medication administration. Are we going to give them on time, I mean the exact time or thinking that we are allowed to have 30 minutes before and 30 minutes after rule?

what could be the ideal time of medication administration?

Regular insulin is short-acting. Think about what stress does to the diabetic person's metabolism.

That type of question is SO unlikely to appear on the CRNE. But in response, most children cut their lower central incisors first.

It is absolutely impossible to give ALL medications at EXACTLY the ordered time. when you have 6 patients in 6 different rooms, all of whom have 6 medications due at 0800, it takes organization and efficiency to get all of them given within the 30-minutes-before-to-30-minutes-after window. Where I work, I only have 1 patient most of the time and it's still impossible to get all meds given at the exact time they're ordered for.

Scenario: Just my imagination.

I am a nurse handling a MRSA patient and I am about to give a medication in liquid form. I am handing it to the patient. Suddenly on the other room I heard someone screaming for help. What to do?

delimma: patient safety
accountability
infection control

Any opinions?

Another imagination scenario of mine

A long term patient who is spinal cord injury. Insist that he wanted to have his favorite pin up nude photo of a woman in his room. What am I going to do?

Delimma: respect patient's rights?
confront the patient to have some decency in the institution
report to the unit manager
make a compromise like instead of nude why not a fully dress woman as a poster.

Think about this guys...and gals....

pete, i agree with you. 1 was my answer as well. I crossed out 4 immediately based on the R-sided HF. shockingly, 4 was the answer. i have done almost 3000 practice questions and this one still bothers me, i am just going to note this one off as an error. the rationale in the book says "elevation of an extremity promotes venous and lymphatic drainage by gravity" and the rationale as to why 1 was wrong is that "this action is taken cautiously and should be the decision of a physician."

what gets me is that there was another similar question just before this question in the same book that states Mr. Mars has CHF and pulmonary edema. Which of the following nursing actions would help to alleviate his respiratory distress?

1. elevate lower extremities
2. encourage frequent coughing
3. place him in an orthopneic position
4. prepare him for modified postural drainage







Answer. 3 in case anyone is wondering HOWEVER, the rationale as to why #1 is wrong? (which i crossed out first) is that elevation of extremities should be avoided because it increases venous return, placing an increased workload on the heart! so wouldn't elevating the patient's extremities essentially be contraindicated in patient's with HF? confusing! if anyone agrees with the initial question + answer please share as to why you agree.

with that said thanks pete for your active involvement in this thread. i think you will blow this exam out of the water!

Exam is in 7 days! How do you all feel?

Thanks Alli.. I'm doing the CRNE readiness test right now. Feeling pretty good with everything except for some the nurse-patient relationship stuff

Yeah I work on a cardiac unit and totally disagree with 4 being the answer in that question. I even resourced my educator and she concurred.

Good luck in the final week of studying!

Few last min tips

-Remember Pt safety: ABC's
-Nursing process. Assess always before an intervention.
-Maslow: Physical before psychosocial