1. Avoid Plano site. Research your choice of site and the anecdotal "pass" rate (you will NEVER get an official answer from the school) on all the sites you choose. They say they are all equal, but they are NOT. I really wish that I had done that before I just assumed that the one closest to home would be the cheapest way to go.
2. Go to the CPNE forum on network54.com, Yahoo, etc.
3. Get experience in just plain, basic skills. It is VERY unlikely that you will have a pt. with a trach, but they WILL flunk you on a blood pressure. It is that simple.
4. Memorize those elements. I spent way too much time studying and worrying about crap like "What if I have to irrigate a colostomy?" than just memorization of those silly little elements.
5. Take the workshop, or hook up with someone who has and does not mind sharing all the little "tricks" they paid for. My buddy Jennifer said it makes a big difference.