CPNE,....Anyone have any neg. experiences

Spazzy Nurse, RN · Aug 14, 2004

I'm so sorry you went through all of that.....and twice! That is rough. :kiss Sounds to me like you know what you need to do. I'm sure you know your stuff and could rattle off your CEs in your sleep. Now you just need to find a way that you can keep your head on straight during that hellish weekend. Having gone through it myself, I can really see how nerves can fail people. Since you did better controlling things your 2nd time around, do you think that maybe you'll be even better your 3rd? I bet you will.

And a little tip for you....... if you have an IV pump or some other machine that you're not familiar with, tell your CE that you are not familiar with it. They're all so different! I also had very little experience with pumps, so I was lost when I looked at my pt's IV pump. I just told my CE that I was not at all familiar with that pump (she didn't have to know that I wasn't familiar with any pump) and it turned out that she wasn't either. We walked through the whole thing together, start to finish.

And as far as sites go---- Madison ruled. I've heard wonderful, fabulous things about Racine too.

Best of luck to you!!!!! Please keep us posted, ok? :)

yvonnemuse, BSN, RN · Nov 27, 2005

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!

DutchgirlRN, ASN, RN · Nov 27, 2005

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......

mentalhealthman · Jun 9, 2006

Great advice.

Jo Dirt · Jun 10, 2006

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.

hsieh · Jun 10, 2006

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.

yvonnemuse, BSN, RN · Jun 10, 2006

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.

traumahawk99 · Jun 10, 2006

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.

anticoagulationurse · Jun 12, 2006

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.

samba urban · Mar 7, 2009

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

NURSET2007 · Mar 26, 2009

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?!?

pedinurse05 · Mar 26, 2009

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.