CPNE,....Anyone have any neg. experiences - page 3

I am finished with the Assc. program, with the exception of completing the CPNE, which I have Frustratingly taken twice now, has anyone else "breezed" through the program, like myself, only now to be... Read More

  1. by   yvonnemuse
    I am in a holding pattern . Everything is done but the CPNE. I have sent my application in and await my date. Right now I am excited to dig in and get down to business. I am looking at this as an opportunity not something scary any more. I will probably switch back and forth a few times though!
  2. by   DutchgirlRN
    Hi all !!! I'm feeling more rested now! Here's my
    advice having
    been through CPNE twice...........Accounts of PCS's
    ended up not
    helping me at all what made the difference was
    "organization".
    Between my first and second CPNE I did not study at
    all, what I did
    was organize. OKAY.......First.......grab your
    Carpenito's, a
    highlighter, and some sticky tabs to mark your pages.
    (I passed my
    marked Carpenito's on to a student who had failed
    twice so I can't
    give you the page numbers).

    1. In the front of the book where the pages are
    marked with Roman
    Numerals, I think around page XXXViii , about 3/4 of
    the way down the
    page find and highlight these words:

    "if not managed now will deter progress to achieve
    outcomes"

    This is your "rationale for choice as a priority
    nursing diagnosis"
    for all three of your PCS no matter what dx you use!!!
    Now put a
    sticky tab on that page so you can flip to it fast
    during your
    evaluation phase.

    2. Go to the section for Infection. Find and
    highlight this
    phrase: related to a site for organism invasion
    secondary to presence
    of an.... then highlight "an invasive line",
    "surgical trauma"
    etc..... Then find and highlight "be free from
    nosocomial
    infectious processes during hospitalization" Your
    interventions then
    would be things that you do anyway 1. meticulous
    handwashing and 2
    aseptic technique. Now put your sticky tab on this
    section. So when
    you put it together it goes: Risk for Infection
    related to a site
    for organism invasion secondary to presence of an
    invasive line. Or
    you could use related to surgical incision, wound or
    whatever applies
    best.

    3. Go to the section for Injury. Find and highlight
    this phase:
    related to unfamiliar hospital enviroment. Pick an
    outcome and
    highlight it and for interventions use things you'll
    do anyway such
    as bed down, side rails up X 4. Call light at reach.


    4. Go to section for Altered Comfort and find and
    highlight this
    phrase: related to tissue trauma and reflex muscle
    spasms secondary
    to surgery or "whatever" applies. Find and highlight
    the outcome of
    your choice. I used the patient will relate relief
    after
    satisfactory relief measure as evidenced by a pain
    level of 3 on a 0-
    10 scale. Highlight your choice of interventions. I
    used Promote
    relaxation with a back rub and Provide pt. with
    optimal pain relief
    medication, return in 30 minutes to assure
    effectiveness. Remember
    you can only highlight in book. DO NOT write anything
    in book.

    5. Now the other areas to mark with sticky page tabs
    are Anxiety,
    Altered Nutrition, and Impaied Physical Mobility. I'm
    sorry I can't
    tell you what to highlight in these sections because I
    can't remember
    but you guy's are smart or you wouldn't have gotten
    this far!! Mark
    yourself a related to, an outcome, and generic type
    interventions.

    These 2 Risk for sections, Infection & Injury and 4
    Actual Dx
    sections: Comfort, Anxiety, Nutrition and Impaired
    physical
    mobility should help you cover 99% of any PCS
    situation. And since
    your pages are tabbed and phrase highlighted you can
    get to them
    fast, if you need another dx you'll just have to do
    your best.

    This is really important!!!! Everything that is
    required within the
    first 20 minutes is to be recorded on the "PCS
    Recording Form" so
    when you go into the patient's room your priority
    should be to get
    everything filled out on that "PCS Recording Form"
    even if it's only
    marking N/A. EVERY line on that page has to have
    something on it.

    Now for more organization! In your planning phase,
    turn your
    booklet over to the blank page, draw a line down the
    middle of the
    page. Actually more off to the right. On the left side
    write down
    each assigned area including Mobility and Fluid
    Management and list
    each critical element. On the right side write at the
    top of the
    page "Safety" and write down side rails up X 4 and
    whatever else is
    assigned. Then draw a line and title the next square
    "Supplies"
    write down there a list of any supplies that you will
    need. Draw a
    line and title the next square
    "meds" and write down the meds and what time they
    are due.
    The next square will be vitals signs and make a note
    as to what you
    have to do such as axillary temp, apical pulse
    etc.......
    Then have a miscellaneous section. Now go back to the
    assignment
    kardex and highlight each and everything that has been
    written down
    and make sure you have it on your planning phase page.
    When you go
    in the room and have finished the PCS Recording Form
    turn the booklet
    over and start doing everything you have written and
    cross off each
    item as you do it. Now you are taking a "open book
    test!!" My CE's
    were blown away by my planning page.

    Finally, you now have to remember things like to wash
    your hands,
    make sure have the rails up anytime you leave the
    room, sign the MAR
    as you give the meds so you won't forget, Ask the
    patient about
    level of pain on a 0-10 scale both initially and when
    asking as a
    reassessment. You'll fail if you reassess and just ask
    a number.
    Clarify to the pt you are asking for a number on a
    0-10 scale.
    If O2 is running but you are not assigned Oxygen
    Management you will
    not be expected to do the CE's but you do have to
    chart that the O2
    is running and being maintained under other
    considerations which is
    the last section in the nursing notes.

    For the section continue plan I used this for each
    PCS:

    "requires on going management gradually decreasing as"


    So it looks like this: Acute Pain requires on going
    management
    gradually decreasing as less pain medication is needed
    and level of
    pain decreases. You just start with your diagnosis
    and end with
    whatever is appropriate.

    Well this is my story and I'm sticking to it! This is
    what got me
    through with no repeats and with far less anxiety than
    the first
    time!!!!!! Practice making your planning page over
    and over so
    you'll be able to do it out of habit. I took about 30
    minutes to do
    each planning phase during the PCS. That 30 minutes
    was the key to
    success!!!!! Finally have faith in yourself and have
    everyone put
    you on their prayer list. GOD BLESS and GOOD
    LUCK......
  3. by   mentalhealthman
    Great advice.
  4. by   Jo Dirt
    Quote from drawtj
    I am with Excelsior College. I know the critical elements--it's nerves and stupid mistakes. Any suggestions on a good place to test at next???

    Thanks for your input!

    drawtj
    It's not necessarily nerves and stupid mistakes, but many times that is the case.

    Amarillo was a wonderful place to test. The people were laid back and not uptight like in the northeast.
    I'm not slamming northerners, but I went to a workshop with mostly northerners and they were talking about how they would never go to Texas because the people were so backward and redneck.
    I guess I was with my own kind.
  5. by   hsieh
    remember THIS IS A TEST. i went in the second time thinking i'm going to WORK HARD. instead of focusing on passing focus on working hard. and wash your hands like mad. i was at racine and they have a little cabinet outside the room any time i touched that cabinet before or after i washed my hands.
  6. by   yvonnemuse
    I took the CPNE in the "uptight northeast" Syracuse. The CA and CEs were outstanding, friendly and fair.We had 5 in our group and all 5 passed.By Sunday the students had bonded and we prayed together before commencing peds.Controlling stress and a proactive confident attitude was helpful.Act like you are there to take what is rightfully yours!Reflecting back on the CPNE I think it gets so built up in our minds because it is the end of our education journey,expensive and has a degree of subjectivness...not like an exam where the computer says right/wrong.I literally needed two weeks after the CPNE to decompress, not looking at any book,or even thinking past "what is for dinner" .I would not enjoy subjecting myself to the stress of the CPNE but it IS doable.
  7. by   traumahawk99
    i failed my first cpne. that was a very negative experience. however, i took it very lightly and my preparation was a joke. i never practiced a single lab or pcs before i went to a seminar in albany. i took the cpne the very next day after the seminar. not a good choice. in retrospect, i deserved to fail.

    i rescheduled and nailed it 3 months later in atlanta.
  8. by   anticoagulationurse
    Thank you Dutchgirl RN! I have been so daunted by the CPNE study guide I haven't known where to start. I highlighted your suggested areas and even some more like; Acute Pain, Ineffective Thermoregulation; Risk for injury, Imparied Physical Mobility, Impaired Oral Mucous Membranes. That should cover an abundance of med/surg PCS. I like how the book pretty much spells it out step by step. That will really help in developing a care plan. I am not looking forward to he CPNE, but I am eager to get it over with.

    You mentioned to highlight in pafe XXViii regarding priority Nursing Dx... "Prioority Nursing Dx are those that if not managed now, will deter progress to achieve outcomes or will negatively affect the client's funcional status." In the 10th Edition anyway, it is 1/3 of the way down p. xxxv. I don't think much more explaination will be needed in proving my rational for nursing interventions, etc.

    You have been most hepful.
  9. by   samba urban
    I just failed feb.20-22, @ Albany med center.I am still upset. I became very nervous, but I can honestly say I was not ready. I only studied for about 30 days and I did not take the workshop. I think some of the little things got me, for example opening the sterile 4x4s,not touching the edge of the wound on the dressing dummy. I was very nervous. My main failure was that in checking level of conciousness I did not ask the patient if she knew where she was. We talked about being in the hospital but I did not ASK her.I am working in a hospital and the only thing I can think of to do,is practice on my patients to the point where it becomes a habit instead of having to think about every single mneumonic.Ther are time limits of 20 minutes for this,30 minutes for that and it gets very confusing.
    good luck
  10. by   NURSET2007
    I am just beginning Excelsior and from what I have read about the CPNE really has me wondering if they are this tough why are all these BONs questioning Excelsior? Texas being the latest. I find it ridiculous on some of the things that they can fail you for, but what can you do?!?
  11. by   pedinurse05
    Quote from NURSET2007
    I am just beginning Excelsior and from what I have read about the CPNE really has me wondering if they are this tough why are all these BONs questioning Excelsior? Texas being the latest. I find it ridiculous on some of the things that they can fail you for, but what can you do?!?
    The CPNE is not hard.....People make it hard by not preparing or letting their nerves take control. Just study your critical elements and prepare for about 3 months prior to taking the test. I think reading a bunch of negative information stresses people out. My experience was good--I passed everything on the first try. I studied and passed. The test was just as outlined in the guide.
  12. by   Raggedy Ann
    Quote from NURSET2007
    I am just beginning Excelsior and from what I have read about the CPNE really has me wondering if they are this tough why are all these BONs questioning Excelsior? Texas being the latest. I find it ridiculous on some of the things that they can fail you for, but what can you do?!?
    Yes...I got my lovely "Texas Letter" I plan on writing senators, congressman...Whomever I have to. Put too much time into this now to throw it away...and I want others to be given this same opportunity to complete this program. If it happens will be grandfathered in? Have to do extra clinical hours? I know we will definitely have a dead line...Which I need to work on any way. Good Luck to all in Texas! Traci
  13. by   rnlately
    Quote from Raggedy Ann
    Yes...I got my lovely "Texas Letter" I plan on writing senators, congressman...Whomever I have to. Put too much time into this now to throw it away...and I want others to be given this same opportunity to complete this program. If it happens will be grandfathered in? Have to do extra clinical hours? I know we will definitely have a dead line...Which I need to work on any way. Good Luck to all in Texas! Traci
    Sounds like Georgia all over again.

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