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Medical CCRN : Critical Care Register Nurse Exam

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Exam Number : CCRN
Exam Name : Critical Care Register Nurse
Vendor Name : Medical
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CCRN test Format | CCRN Course Contents | CCRN Course Outline | CCRN test Syllabus | CCRN test Objectives


A criterion-referenced standard setting process, known as the modified Angoff, is used to establish the passing point/cut score for the exam. Each candidates performance on the test is measured against a predetermined standard.
The passing point/cut score for the test is established using a panel of subject matter experts, an test development committee (EDC), who carefully reviews each test question to determine the basic level of knowledge or skill that is expected. The passing point/cut score is based on the panels established difficulty ratings for each test question.
Under the guidance of a psychometrician, the panel develops and recommends the passing point/cut score, which is reviewed and approved by AACN Certification Corporation. The passing point/cut score for the test is established to identify individuals with an acceptable level of knowledge and skill. All individuals who pass the exam, regardless of their score, have demonstrated an acceptable level of knowledge.

I. CLINICAL JUDGMENT (80%)
A. Cardiovascular (17%)
1. Acute coronary syndrome:
a. NSTEMI
b. STEMI
c. Unstable angina
2. Acute peripheral vascular insufficiency:
a. Arterial/venous occlusion
b. Carotid artery stenosis
c. Endarterectomy
d. Fem-Pop bypass
3. Acute pulmonary edema
4. Aortic aneurysm
5. Aortic dissection
6. Aortic rupture
7. Cardiac surgery:
a. CABG
b. Valve replacement or repair
8. Cardiac tamponade
9. Cardiac trauma
10. Cardiac/vascular catheterization
11. Cardiogenic shock
12. Cardiomyopathies:
a. Dilated
b. Hypertrophic
c. Idiopathic
d. Restrictive
13. Dysrhythmias
14. Heart failure
15. Hypertensive crisis
16. Myocardial conduction system abnormalities
(e.g., prolonged QT interval, Wolff-ParkinsonWhite)
17. Papillary muscle rupture
18. Structural heart defects (acquired and congenital, including valvular disease)
19. TAVR

B. Respiratory (15%)
1. Acute pulmonary embolus
2. ARDS
3. Acute respiratory failure
4. Acute respiratory infection (e.g., pneumonia)
5. Aspiration
6. Chronic conditions (e.g., COPD, asthma, bronchitis, emphysema)
7. Failure to wean from mechanical ventilation
8. Pleural space abnormalities (e.g., pneumothorax, hemothorax, empyema, pleural effusions)
9. Pulmonary fibrosis
10. Pulmonary hypertension
11. Status asthmaticus
12. Thoracic surgery
13. Thoracic trauma (e.g., fractured rib, lung contusion, tracheal perforation)
14. Transfusion-related acute lung injury (TRALI)

C. Endocrine/Hematology/Gastrointestinal/Renal/Integumentary (20%)
1. Endocrine
a. Adrenal insufficiency
b. Diabetes insipidus (DI)
c. Diabetes mellitus, types 1 and 2
d. Diabetic ketoacidosis (DKA)
e. Hyperglycemia
f. Hyperosmolar hyperglycemic state (HHS)
g. Hyperthyroidism
h. Hypoglycemia (acute)
i. Hypothyroidism
j. SIADH
2. Hematology and Immunology
a. Anemia
b. Coagulopathies (e.g., ITP, DIC, HIT)
c. Immune deficiencies
d. Leukopenia
e. Oncologic complications (e.g., tumor lysis syndrome, pericardial effusion)
f. Thrombocytopenia
g. Transfusion reactions
3. Gastrointestinal
a. Abdominal compartment syndrome
b. Acute abdominal trauma
c. Acute GI hemorrhage
d. Bowel infarction, obstruction, perforation (e.g., mesenteric ischemia, adhesions)
e. GI surgeries (e.g., Whipple, esophagectomy, resections)
f. Hepatic failure/coma (e.g., portal hypertension, cirrhosis, esophageal varices, fulminant hepatitis, biliary atresia, drug-induced)
g. Malnutrition and malabsorption
h. Pancreatitis
4. Renal and Genitourinary
a. Acute genitourinary trauma
b. Acute kidney injury (AKI)
c. Chronic kidney disease (CKD)
d. Infections (e.g., kidney, urosepsis)
e. Life-threatening electrolyte imbalances
5. Integumentary
a. Cellulitis
b. IV infiltration
c. Necrotizing fasciitis
d. Pressure injury
e. Wounds:
i. infectious
ii. surgical
iii. trauma
D. Musculoskeletal/Neurological/

Psychosocial (14%)
1. Musculoskeletal
a. Compartment syndrome
b. Fractures (e.g., femur, pelvic)
c. Functional issues (e.g., immobility, falls, gait disorders)
d. Osteomyelitis
e. Rhabdomyolysis
2. Neurological
a. Acute spinal cord injury
b. Brain death
c. Delirium (e.g., hyperactive, hypoactive, mixed)
d. Dementia
e. Encephalopathy
f. Hemorrhage:
i. intracranial (ICH)
ii. intraventricular (IVH)
iii. subarachnoid (traumatic or aneurysmal)
g. Increased intracranial pressure (e.g., hydrocephalus)
h. Neurologic infectious disease (e.g., viral, bacterial, fungal)
i. Neuromuscular disorders (e.g., muscular dystrophy, CP, Guillain-Barr, myasthenia)
j. Neurosurgery (e.g., craniotomy, Burr holes)
k. Seizure disorders
l. Space-occupying lesions (e.g., brain tumors)
m. Stroke:
i. hemorrhagic
ii. ischemic (embolic)
iii. TIA
n. Traumatic brain injury (TBI): epidural, subdural, concussion
3. Behavioral and Psychosocial
a. Abuse/neglect
b. Aggression
c. Agitation
d. Anxiety
e. Suicidal ideation and/or behaviors
f. Depression
g. Medical non-adherence
h. PTSD
i. Risk-taking behavior
j. Substance use disorders (e.g., withdrawal, chronic alcohol or drug dependence)
E. Multisystem (14%)
1. Acid-base imbalance
2. Bariatric complications
3. Comorbidity in patients with transplant history
4. End-of-life care
5. Healthcare-associated conditions (e.g., VAE, CAUTI, CLABSI)
6. Hypotension
7. Infectious diseases:
a. Influenza (e.g., pandemic or epidemic)
b. Multi-drug resistant organisms (e.g., MRSA, VRE, CRE)
8. Life-threatening maternal/fetal complications (e.g., eclampsia, HELLP syndrome, postpartum hemorrhage, amniotic embolism)
9. Multiple organ dysfunction syndrome (MODS)
10. Multisystem trauma
11. Pain: acute, chronic
12. Post-intensive care syndrome (PICS)
13. Sepsis
14. Septic shock
15. Shock states:
a. Distributive (e.g., anaphylactic, neurogenic)
b. Hypovolemic
16. Sleep disruption (including sensory overload)
17. Thermoregulation
18. Toxic ingestion/inhalations (e.g., drug/alcohol overdose)
19. Toxin/drug exposure (including allergies)

II. PROFESSIONAL CARING 7 ETHICAL PRACTICE (20%)
A. Advocacy/Moral Agency
B. Caring Practices
C. Response to Diversity
D. Facilitation of Learning
E. Collaboration
F. Systems Thinking
G. Clinical Inquiry

CLINICAL JUDGMENT
General
Recognize normal and abnormal:
o developmental assessment findings and provide developmentally appropriate care
o physical assessment findings
o psychosocial assessment findings
Recognize signs and symptoms of emergencies, initiate interventions, and seek assistance as needed
Recognize indications for, and manage patients requiring:
o capnography (EtCO2)
o central venous access
o medication reversal agents
o palliative care
o SvO2 monitoring
Manage patients receiving:
o complementary/alternative medicine and/or nonpharmacologic interventions
o medications (e.g., safe administration, monitoring, polypharmacy)
Monitor patients and follow protocols for pre- and postoperative care
Assess pain
Evaluate patients response to interventions
Identify and monitor normal and abnormal diagnostic test results
Manage fluid and electrolyte balance
Manage monitor alarms based on protocols and changes in patient condition Cardiovascular
Apply leads for cardiac monitoring
Identify, interpret and monitor cardiac rhythms
Recognize indications for, and manage patients requiring:
o 12-lead ECG
o arterial catheter
o cardiac catheterization
o cardioversion central venous pressure monitoring
o defibrillation
o IABP
o invasive hemodynamic monitoring
o pacing: epicardial, transcutaneous, transvenous
o pericardiocentesis
o QT interval monitoring
o ST segment monitoring
Manage patients requiring:
o endovascular stenting
o PCI Respiratory
Interpret blood gas results
Recognize indications for, and manage patients requiring:
o modes of mechanical ventilation
o noninvasive positive pressure ventilation (e.g., BiPAP, CPAP, high-flow nasal cannula)
o oxygen therapy delivery devices
o prevention of complications related to mechanical ventilation (ventilator bundle)
o prone positioning
o pulmonary therapeutic interventions related to mechanical ventilation: airway clearance, extubation, intubation, weaning
o therapeutic gases (e.g., oxygen, nitric oxide, heliox, CO2 )
o thoracentesis
o tracheostomy Hematology and Immunology
Manage patients receiving transfusion of blood products
Monitor patients and follow protocols:
o pre-, intra-, post-intervention (e.g., plasmapheresis, exchange transfusion, leukocyte depletion)
o related to blood conservation Neurological
Recognize indications for, and manage patients requiring neurologic monitoring devices and drains (e.g., ICP, ventricular or lumbar drain)
Use a swallow evaluation tool to assess dysphagia
Manage patients requiring:
o neuroendovascular interventions (e.g., coiling, thrombectomy)
o neurosurgical procedures (e.g., pre-, intra-, post-procedure)
o spinal immobilization Integumentary
Recognize indications for, and manage patients requiring, therapeutic interventions (e.g. wound VACs, pressure reduction surfaces, fecal management devices, IV infiltrate treatment) Gastrointestinal
Monitor patients and follow protocols for procedures pre-, intra-, post-procedure (e.g., EGD, PEG placement)
Intervene to address barriers to nutritional/fluid adequacy (e.g., chewing/swallowing difficulties, alterations in hunger and thirst, inability to self-feed)
Recognize indications for, and manage patients requiring:
o abdominal pressure monitoring
o GI drains
o enteral and parenteral nutrition Renal and Genitourinary
Identify nephrotoxic agents
Monitor patients and follow protocols pre-, intra-, and post-procedure (e.g., renal biopsy, ultrasound)
Recognize indications for, and manage patients requiring, renal therapeutic intervention (e.g., hemodialysis, CRRT, peritoneal dialysis)
Musculoskeletal
Manage patients requiring progressive mobility
Recognize indications for, and manage patients requiring, compartment syndrome monitoring
Multisystem
Manage continuous temperature monitoring
Provide end-of-life and palliative care
Recognize risk factors and manage malignant hyperthermia
Recognize indications for, and manage patients undergoing:
o continuous sedation
o intermittent sedation
o neuromuscular blockade agents
o procedural sedation - minimal
o procedural sedation - moderate
o targeted temperature management (previously known as therapeutic hypothermia)
Behavioral and Psychosocial
Respond to behavioral emergencies (e.g., nonviolent crisis intervention, de-escalation techniques)
Use behavioral assessment tools (e.g., delirium, alcohol withdrawal, cognitive impairment)
Recognize indications for, and manage patients requiring:
o behavioral therapeutic interventions
o medication management for agitation
o physical restraints

I. CLINICAL JUDGMENT (80%)
A. Cardiovascular (14%)
1. Cardiac infection and inflammatory diseases
2. Cardiac malformations
3. Cardiac surgery
4. Cardiogenic shock
5. Cardiomyopathies
6. Cardiovascular catheterization
7. Dysrhythmias
8. Heart failure
9. Hypertensive crisis
10. Myocardial conduction system defects
11. Obstructive shock
12. Vascular occlusion
B. Respiratory (18%)
1. Acute pulmonary edema
2. Acute pulmonary embolus
3. Acute respiratory distress syndrome (ARDS)
4. Acute respiratory failure
5. Acute respiratory infection
6. Air-leak syndromes
7. Apnea of prematurity
8. Aspiration
9. Chronic pulmonary conditions
10. Congenital airway malformations
11. Failure to wean from mechanical ventilation
12. Pulmonary hypertension
13. Status asthmaticus
14. Thoracic and airway trauma
15. Thoracic surgery

C. Endocrine/Hematology/Gastrointestinal/Renal/Integumentary (20%)
1. Endocrine
a. Adrenal insufficiency
b. Diabetes insipidus (DI)
c. Diabetic ketoacidosis (DKA)
d. Diabetes mellitus, types 1 and 2
e. Hyperglycemia
f. Hypoglycemia
g. Inborn errors of metabolism
h. Syndrome of inappropriate secretion of antidiuretic hormone (SIADH)
2. Hematology and Immunology
a. Anemia
b. Coagulopathies (e.g., ITP, DIC)
c. Immune deficiencies
d. Myelosuppression (e.g., thrombocytopenia, neutropenia)
e. Oncologic complications
f. Sickle cell crisis
g. Transfusion reactions
3. Gastrointestinal
a. Abdominal compartment syndrome
b. Abdominal trauma
c. Bowel infarction, obstruction and perforation
d. Gastroesophageal reflux
e. GI hemorrhage
f. GI surgery
g. Liver disease and failure
h. Malnutrition and malabsorption
i. Necrotizing enterocolitis (NEC)
j. Peritonitis
4. Renal and Genitourinary
a. AKI
b. Chronic kidney disease (CKD)
c. Hemolytic uremic syndrome (HUS)
d. Kidney transplant
e. Life-threatening electrolyte imbalances
f. Renal and genitourinary infections
g. Renal and genitourinary surgery
5. Integumentary
a. IV infiltration
b. Pressure injury
c. Skin failure (e.g., hypoperfusion)
d. Wounds

D. Musculoskeletal/Neurological/Psychosocial (15%)
1. Musculoskeletal
a. Compartment syndrome
b. Musculoskeletal surgery
c. Musculoskeletal trauma
d. Rhabdomyolysis
2. Neurological
a. Acute spinal cord injury
b. Agitation
c. Brain death
d. Congenital neurological abnormalities
e. Delirium
f. Encephalopathy
g. Head trauma
h. Hydrocephalus
i. Intracranial hemorrhage
j. Neurogenic shock
k. Neurologic infectious disease
l. Neuromuscular disorders
m. Neurosurgery
n. Pain: acute, chronic
o. Seizure disorders
p. Space-occupying lesions
q. Spinal fusion
r. Stroke
s. Traumatic brain injury (TBI)
3. Behavioral and Psychosocial
a. Abuse and neglect
b. Post-traumatic stress disorder (PTSD)
c. Post-intensive care syndrome (PICS)
d. Self-harm
e. Suicidal ideation and behavior

E. Multisystem (13%)
1. Acid-base imbalance
2. Anaphylactic shock
3. Death and dying
4. Healthcare-associated conditions (e.g., VAE, CAUTI, CLABSI)
5. Hypovolemic shock
6. Post-transplant complications
7. Sepsis
8. Submersion injuries (i.e. near drowning)
9. Hyperthermia and hypothermia
10. Toxin and drug exposure

II. Professional Caring & Ethical Practice (20%)
A. Advocacy/Moral Agency
B. Caring Practices
C. Response to Diversity
D. Facilitation of Learning
E. Collaboration
F. Systems Thinking
G. Clinical Inquiry

CLINICAL JUDGMENT
General
Manage patients receiving:
o continuous sedation
o extracorporeal membrane oxygenation (ECMO)
o nonpharmacologic interventions
o pharmacologic interventions
o intra-procedural and post-procedural care
o post-operative care
o vascular access
Conduct physical assessment of critically ill or injured patients
Conduct psychosocial assessment of critically ill or injured patients
Evaluate diagnostic test results and laboratory values
Manage patients during intrahospital transport
Manage patients undergoing procedural sedation
Manage patients with temperature monitoring and regulation devices
Provide family-centered care Cardiovascular
Manage patients requiring:
o arterial catheterization (e.g., arterial line)
o cardiac catheterization
o cardioversion
o CVP monitoring
o defibrillation
o epicardial pacing
o near-infrared spectroscopy (NIRS)
o umbilical catheterization (e.g., UVC, UAC)
Manage patients with:
cardiac dysrhythmias
hemodynamic instability Respiratory
Manage patients requiring:
o artificial airways (e.g., endotracheal tubes, tracheotomy)
o assistance with airway clearance chest tubes
o high-frequency oscillatory ventilation (HFOV)
o mechanical ventilation
o noninvasive positive-pressure ventilation (e.g., CPAP, nasal IMV, high-flow nasal cannula)
o prone positioning
o respiratory monitoring devices (e.g., SpO2, SVO2, EtCO2)
o therapeutic gases (e.g., oxygen, nitric oxide, heliox, CO2)
o thoracentesis
Hematology and Immunology
Manage patients receiving:
o plasmapheresis, exchange transfusion or leukocyte depletion
o transfusion
Neurological
Conduct pain assessment of critically ill or injured patients
Manage patients with seizure activity
Provide end-of-life and palliative care
Manage patients requiring:
o neurologic monitoring devices and drains (e.g., ICP, ventricular drains, grids)
o spinal immobilization Integumentary
Manage patients requiring wound prevention and/or treatment (e.g., wound VACs, pressure reduction surfaces, fecal management devices, IV infiltrate treatment)
Gastrointestinal
Manage patients with inadequate nutrition and fluid intake (e.g., chewing and swallowing difficulties, alterations in hunger and thirst, inability to self-feed)
Manage patients receiving:
o enteral and parenteral nutrition
o GI drains
o intra-abdominal pressure monitoring Renal and Genitourinary
Manage patients requiring:
o electrolyte replacement
o renal replacement therapies (e.g., hemodialysis, CRRT, peritoneal dialysis)
Multisystem
Manage patients requiring progressive mobility
Behavioral and Psychosocial
Conduct behavioral assessment of critically ill or injured patients (e.g., delirium, withdrawal)
Manage patients requiring behavioral and mental health interventions
Respond to behavioral emergencies (e.g., nonviolent crisis intervention, de-escalation techniques)

I. CLINICAL JUDGMENT (80%)
A. Cardiovascular (5%)
1. Acute pulmonary edema
2. Cardiac surgery (e.g., congenital defects, patent ductus arteriosus)
3. Dysrhythmias
4. Heart failure
5. Hypovolemic shock
6. Structural heart defects (acquired and congenital, including valvular disease)

B. Respiratory (21%)
1. Acute respiratory distress syndrome (ARDS)
2. Acute respiratory failure
3. Acute respiratory infection (e.g., pneumonia)
4. Air-leak syndromes
5. Apnea of prematurity
6. Aspiration
7. Chronic conditions (e.g., chronic lung disease/bronchopulmonary dysplasia)
8. Congenital anomalies (e.g., diaphragmatic hernia, tracheoesophageal fistula, choanal atresia, tracheomalacia, tracheal stenosis)
9. Failure to wean from mechanical ventilation
10. Meconium aspiration syndrome
11. Persistent pulmonary hypertension of the newborn (PPHN)
12. Pulmonary hemorrhage
13. Pulmonary hypertension
14. Respiratory distress (RDS)
15. Thoracic surgery
16. Transient tachypnea of the newborn

C. Endocrine/Hematology/Gastrointestinal/Renal/Integumentary (27%)
1. Endocrine
a. Adrenal insufficiency
b. Hyperbilirubinemia
c. Hyperglycemia
d. Hypoglycemia
e. Inborn errors of metabolism
2. Hematology and Immunology
a. Anemia
b. Coagulopathies (e.g., ITP, DIC)
c. Immune deficiencies
d. Leukopenia
e. Polycythemia
f. Rh incompatibilities, ABO incompatibilities, hydrops fetalis
g. Thrombocytopenia
3. Gastrointestinal
a. Bowel infarction/obstruction/perforation (e.g., mesenteric ischemia, adhesions)
b. Feeding intolerance
c. Gastroesophageal reflux
d. GI abnormalities (e.g., omphalocele, gastroschisis, volvulus, imperforate anus, Hirshsprung disease, malrotation, intussusception, hernias)
e. GI surgeries
f. Hepatic failure (e.g., biliary atresia, portal hypertension, esophageal varices)
g. Malnutrition and malabsorption
h. Necrotizing enterocolitis (NEC)
i. Pyloric stenosis
4. Renal and Genitourinary
a. Acute kidney injury (AKI)
b. Chronic kidney disease
c. Congenital genitourinary conditions (e.g., hypospadias, polycystic kidney disease, hydronephrosis, bladder exstrophy)
d. Genitourinary surgery
e. Infections
f. Life-threatening electrolyte imbalances
5. Integumentary
a. Congenital abnormalities (e.g., epidermolysis bullosa, skin tags)
b. IV infiltration
c. Pressure injury/ulcer (e.g., device, incontinence, immobility)
d. Wounds:
i. non-surgical
ii. surgical

D. Musculoskeletal/Neurological/Psychosocial (13%)
1. Musculoskeletal
a. Congenital or acquired musculoskeletal conditions
b. Osteopenia
2. Neurological
a. Agitation
b. Congenital neurological abnormalities (e.g., AV malformation, myelomeningocele, encephalocele)
c. Encephalopathy
d. Head trauma (e.g., forceps and/or vacuum injury)
e. Hemorrhage:
i. intracranial (ICH)
ii. intraventricular (IVH)
f. Hydrocephalus
g. Ischemic insult (e.g., stroke, periventricular leukomalacia)
h. Neurologic infectious disease (e.g., viral, bacterial, fungal)
i. Neuromuscular disorders (e.g., spinal muscular atrophy)
j. Neurosurgery
k. Pain (acute, chronic)
l. Seizure disorders
m. Sensory impairment (e.g., retinopathy of prematurity, hearing impairment, visual impairment)
n. Stress (e.g., noise, overstimulation, sleep disturbances)
o. Traumatic brain injury (e.g., epidural, subdural, concussion, physical abuse)
3. Behavioral and Psychosocial
a. Abuse and neglect
b. Families in crisis (e.g., stress, grief, lack of coping)

E. Multisystem (14%)
1. Birth injuries (e.g., hypoxic-ischemic encephalopathy, brachial plexus injury, lacerations)
2. Developmental delays
3. Failure to thrive
4. Healthcare-associated conditions (e.g., VAE, CAUTI, CLABSI)
5. Hypotension
6. Infectious diseases (e.g., influenza, respiratory syncytial virus, multidrugresistant organisms)
7. Life-threatening maternal/fetal complications (e.g., eclampsia, HELLP syndrome, maternal-fetal transfusion, placental
abruption, placenta previa) 8. Low birth weight/prematurity
9. Sepsis
10. Terminal conditions (e.g., end-of-life, palliative care)
11. Thermoregulation
12. Toxin/drug exposure (e.g., neonatal abstinence syndrome, fetal alcohol syndrome, maternal or iatrogenic).

II. Professional Caring & Ethical Practice (20%)
A. Advocacy/Moral Agency
B. Caring Practices
C. Response to Diversity
D. Facilitation of Learning
E. Collaboration
F. Systems Thinking
G. Clinical Inquiry

CLINICAL JUDGMENT
General
Assess pain considering patients gestational age
Follow protocol for newborn car seat testing, hearing and congenital heart disease screening
Follow protocol for feeding and supplementation
Identify and monitor normal and abnormal diagnostic test results
Implement interventions to keep neonates safe (e.g., transponder use, safe sleep)
Manage monitor alarms based on protocol and change in patient condition
Manage patients receiving complementary alternative medicine and/or nonpharmacologic interventions
Manage patients receiving medications (e.g., safe administration, monitoring, polypharmacy)
Monitor patients and follow protocols for pre- and postoperative care
Recognize indications for, and manage patients requiring, central venous access
Recognize normal and abnormal:
o developmental assessment findings and provide developmentally appropriate care
o family psychosocial assessment findings
o physical assessment findings
Recognize signs and symptoms of emergencies, initiate interventions, and seek assistance as needed
Cardiovascular
Apply leads for cardiac monitoring
Identify, interpret and monitor cardiac rhythms
Monitor hemodynamic status and recognize signs and symptoms of hemodynamic instability
Recognize early signs of decreased cardiac output
Recognize normal fetal circulation and transition to extra-uterine life
Recognize indications for, and manage patients requiring:
o 12-lead ECG
o arterial catheter
o cardioversion
o invasive hemodynamic monitoring Respiratory
Interpret blood gas results
Manage medications and monitor patients requiring rapid sequence intubation (RSI)
Recognize indications for, and manage patients with, tracheostomy
Recognize indications for, and manage patients requiring:
o assisted ventilation
o bronchoscopy
o chest tubes
o endotracheal tubes
o non-invasive positive pressure ventilation (e.g., bilevel positive airway pressure, CPAP, high-flow nasal cannula)
o oxygen therapy delivery device
o prone positioning (lateral rotation therapy)
o rescue airways (e.g., laryngeal mask airway [LMA])
o respiratory monitoring devices (e.g., SpO2, EtCO2) and report values
o therapeutic gases (e.g., oxygen, nitric oxide, heliox, CO2)
o thoracentesis
Hematology and Immunology
Manage patients receiving transfusion of blood products
Monitor and manage patients with bleeding disorders
Monitor patients and follow protocols:
o pre-, intra-, post-intervention (e.g., exchange transfusion)
o related to blood conservation
Neurological
Manage patients with congenital neurological abnormalities



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Medical Register Question Bank

essential resources for the Boards: USMLE Step 1 | CCRN actual Questions and test dumps

Editor's note:

The aim of this column is to come up with the supplies you deserve to excel in medical school. For more scientific supplies, talk over with Emily Cooper's weblog, Med-source, which she keeps as a "one-cease ebook" for med students.

i used to be planning to expound upon pathology this month, but having simply achieved Step 1 of the boards (formally ordinary because the US clinical Licensing test or USMLE), it seemed appropriate that I share the pearls that I gleaned whereas the fabric became nevertheless a bit sparkling in my intellect. I studied for simply over 5 weeks, which felt like simply the correct period of time. Any shorter and that i shouldn't have been totally prepared, to any extent further and that i would have started to forget what I discovered at the beginning.

From the outset, i might highly recommend making a examine schedule during which you cover all the fabric in First support all through the first 3 1/2 to 4 weeks, doing at the least 50 questions each and every night after which simplest reviewing questions all through the closing week.

The optimum-yield online websites for the Boards are the query banks. despite the fact costly, the questions provide the most excellent way to assess your growth and, subsequent to First help, had been my most effective look at resource.

  • Kaplan Qbank still serves because the business standard. Your subscription provides access to greater than 2000 questions that can also be sorted by each discipline and organ equipment. A 1-month subscription costs $199, a three-month subscription costs $279, and a 6-month subscription fees $499 (coupon codes can be attainable via your scientific college). This software permits you to customise assessments together with your unused and/or fallacious questions, so so you might center of attention for your weaker areas. youngsters the interface is not similar to the actual examination, it is close satisfactory that the real examination will now not feel foreign. Kaplan's different robust aspects are their explanations for the answers. After completing a look at various, make certain to read the complete answers, as loads of advice is packed into explaining why definite choices are fallacious.

  • USMLE World is the regularly growing to be upstart rival to Kaplan. they've now accrued more than 2000 questions as well, making this q-financial institution able to standing by itself as a review supply. The structure is similar to the FRED structure that you'll see on the real issue. As with Kaplan, that you can music your efficiency. I found the inquiries to be a little bit more representative of the real examination than the Kaplan questions, however the explanations have been now not as thorough.

  • practice checks offered by using the countrywide Board of clinical Examiners additionally come enormously suggested and can be found for $forty five every. different college students who've used these assessments say that they're the most representative of the true examination, with form 1 being the simplest and form three probably the most elaborate.

  • in the event you register for Step 1, you get access to observe content material. The 3 blocks of content material are easier than the true examination, however they are an excellent self belief booster and are worth running via if simplest to grasp that you have coated the "official" material. The Kaplan Qbank subscription additionally comes with a .pdf file of explanations (a solution key devoid of explanations comes with the content).

  • also, be certain to take a look at materials provided by your college. at the school of Pennsylvania, they have entry to USMLEasy, which offers online question banks for the entire step assessments. if you should not have free access, which you can try sample quizzes on Medscape and learn more in regards to the Step 1 q-financial institution.

  • The quantity of print fabric attainable to prep for the boards is virtually limitless. fortunately, First support -- along with upperclassmen -- may still support you plow through and choose the most positive selections. beneath, I listed the properly 1 or 2 choices that my colleagues and i selected for each subject. It may be helpful to go to your medical bookstore and appear during the foremost collection (high Yield, BRS, and rapid overview) to make a decision which vogue works most suitable for you. additionally, First support has extensive studies of the subject-based evaluate books in the closing part.

  • First help for the USMLE Step 1 2008 (Le T, Bhushan V, Rao DA): deal with this e-book as your Boards bible. gain knowledge of it, find it irresistible, understand it. Take your whole notes during this ebook in order that for those who review on the end, you most effective should go back to 1 e-book.

  • Biochemistry: focus on the key enzymes and scientific consequences. any one of here will suffice:

  • Lippincott's Illustrated stories: Biochemistry (Champe pc, Harvey RA, Ferrier DR);

  • BRS Biochemistry and Molecular Biology (Swanson TA, Kim SI, Glucksman MJ);

  • excessive-Yield Biochemistry (Wilcox B).

  • Pharmacology: center of attention handiest on these medicine outlined in First assist and master the generic pharmacology chapter. I used handiest the flashcards and felt that they had been more than sufficient.

  • Pharmacology Flashcards (Barron) -- One aspect has a clinical vignette and the different has all the key guidance on the drug;

  • Lippincott's Illustrated reviews: Pharmacology (Howland RD, Mycek MJ, Harvey RA, et al);

  • Appleton & Lange overview of Pharmacology (Krzanowski JJ).

  • Microbiology: scientific Microbiology Made Ridiculously essential (Gladwin M, Trattler B)

  • Immunology: high-Yield Immunology (Johnson AG) or scientific Microbiology and Immunology (Immunology area only) (Levinson WE)

  • Pathology: BRS Pathology (Schneider AS, Szanto PA, Kim SI, et al)

  • Physiology: BRS Physiology (Costanzo LS)

  • Anatomy: excessive-Yield Gross Anatomy (Dudek RW, Louis TM)

  • Embryology: high-Yield Embryology (Dudek RW) or BRS Embryology (Dudek RW)

  • Neuroanatomy: excessive-Yield Neuroanatomy (repair JD) or medical Neuroanatomy Made Ridiculously essential (Goldberg S)

  • Behavioral Science: high-Yield Behavioral Science (Fadem B)

  • Histology: high-Yield Histology (Dudek RW)

  • As indicated above, First help is the quintessential supply for Boards overview. Take all your notes in this publication, writing in it as you go over your q-bank answers.

  • throughout your review days at the conclusion, go returned and reread your annotated reproduction.

  • Do questions! each evening after researching, answer at least 50 questions on what you studied that day. in opposition t the conclusion of your researching, finished blocks of fifty random questions to stronger simulate the true examination.

  • comprehend the fundamental pharmacology chapter. The theory of epinephrine reversal may be in your Boards.

  • examine with a friend. You may additionally or can also now not wish to definitely study out loud, but at the very least make sure to have someone you meet familiar and sit down with to help get you via. five weeks is a long time to sit in a room by means of your self.

  • Sleep, consume, endeavor, exit. Your lifestyles doesn't need to stop because you are studying. if you get going before 10 am, make sure you be completed by using eight pm with time to relax.

  • One remaining notion: you may be first-rate. in case you think overwhelmed, channel that power into doing an extra block of questions in place of freaking out concerning the examination. everybody panics a little at some point, but panicking is not productive. Doing questions is. decent luck!




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