the melted pot

I was on a forum for CRNE and this is one candidate had to say after taking the February 2012 CRNE.

I am so happy I have written this exam & am on the floor now! For all of you who have not- a few key suggestions on my end would be to focus on; heart, stroke, diabetes, mental health (how to react during an outburst/violent situation, common medications & side effects, especially for schizophrenia), a little Hepatitis (e.g. knowing how it’s spread), a little HIV, some renal system (e.g. dehydration & drug excretion), some GI stuff, critical aspects of labour & delivery (for mom & for baby), pH (acidosis/alkalosis & how to determine them based on ABG results), some calculations (drip rate, flow rate, med concentrations). This is all I can think of right now…

Also- use your critical thinking skills while reflecting on the BPGs. I’ve written this exam twice, & the first time I made the error of reflecting back to different clinical-based scenarios that I had been involved with, & not all nurses adhere to the BPGs in practice, especially when they’re being run off their feet and overtired. So I would sincerely suggest to think back to what you learned in school & what the textbooks imply because the CRNE is designed for us to use our best nursing judgment to provide the best client outcome; hence, BPGs.

Don’t forget; failing doesn’t mean you’re a failure. It just means that you gave it your best shot & you’ll do better the next time. The CNA gives not 1, not 2, but 3 chances to pass this exam & statistics have shown that it is uncommon to remain unsuccessful after the 2nd attempt.

Just be positive & you can do it! You know a lot more than you may think. Good luck everyone, & I’d be happy to answer any more CRNE/nursing related questions.

Ever since I came back from my trip, I was shot back to reality and forced into studying for my board licencing exam, and it’s been a marathon of information (my last tumblr posts were all medical crap). I feel like a dying hamster running on a wheel of misfortune because my scores haven’t change much since I first started studying back in the beginning of April. I’m tearing up in frustration.

Despite the initial feeling of panic and distraught, I have come to accept, like an ovarian cancer patient, that my prognosis is bleak and the possibility of death is high. That makes me sad, considering the lengths I had to endure to get my degree. It almost seems unfair. I think anyone who goes through nursing and survives it should be be privy to a licence without getting examined under a microscope and face scrutiny. 

At the same time, I understand the implications of the exam and why they would want to screen nursing candidates. I guess I’m just tired from studying so much, getting really frustrated with my scores, and impatiently waiting for exam day to come (not that I’m excited or ready for it).

I promise though, when I arrive in that place and I feel like I need to run away from it, I WILL run away—no joke. And if I happen to sit the exam, I’ll do what I can and answer each question and just walk away and let God decide my outcome. Let go, let God.

Pray for me. God bless to those writing this dreaded exam, I’ll see you there.

RHF

1. jugular vein distention
2. ascites
3. hepatomegaly
4. anorexia and GI bloating
5. ankle edema
6. R-sided pleural effusion

LHF

1. agitation
2. orthopnea
3. cough
4. wheezing
5. nocturia
6. lung crackles & rhonchi
7. tachycardia
8. frothy, blood-tinged sputum
9. PMI at 6th ICS

factors influencing CO:

• sodium sensitivy
• aldosterone
• beta-1 adrenergic receptors
• antidiuretic hormone

factors influencing SVR:

• angiotensin II
• beta-2 adrenergic receptors
• alpha-1 adrenergic receptors
• prostaglandins PGE2 and PGI2
• endothelin
• endothelium-derived relaxing factor (EDRF)

• allow the client to lie quietly for 5 mins before taking bp
• use the arm with the original highest reading for all subsequent measurements
• postural hypertension is determined by taking the blood pressure while standing 2 mins after taking it sitting or supine
• the arm should be be held at level of the heart