KeyNote - RobsCPNE Study companion...“A goal without a plan is just a wish” Welcome pg. 2-3 Study Manual Book Overview pg. 8-10 Pre-Course Evaluation pg. 11 Day 1 pg. 14 Day 2

RobsCPNE

Study Companion Book

1

Hello!

I’m excited to have you here and I hope you find this companion book a great resource to your training. I do want to remind you that this book is just for YOU.

It is strictly for YOUR personal use. No part of this book can be legally or ethically shared in whole or in part either through digital or printed copy.

Thank you for respecting the hard work I put into this book for you and other students across the country.

Here’s to your future success;

-Rob

Robbie Wolff

Creator, RobsCPNE

“Progress, not perfection…”

2

WELCOME, FUTURE RN’s !

One thing that we can all agree on, is that keeping a record of your progress will multiply your chances of success and for that reason I put together this companion book just for you so you can see what progress you are making along the way. (You can’t know where you’re going, unless you know where you’ve been…)

Allow this book to help guide your training decisions as you progress through your RobsCPNE program training. I encourage you to embrace this resource fully. It will document your journey and your success will shine through in the process. If you add other training sessions during the day (which I encourage), just make a note of it as you progress.

I promise you that your knowledge of the CPNE process will grow exponentially by following the steps in this book and charting your progress.

Happy training!

-Rob


3

“A goal without a plan is just a wish”

Welcome pg. 2-3

Study Manual Book Overview pg. 8-10

Pre-Course Evaluation pg. 11

Day 1 pg. 14

Day 2 pg. 15

AOC Video Q&A pg. 17-20

Day 3 pg. 21

AOC Critical Elements Cards pg. 23-38

AOC Critical Elements Evaluation pg. 39

Test Statistics pg. 414

Table Of Contents


Grid Descriptions pg. 42-44

Grid Blank Sheets pg. 46-49

Grid Q&A pg. 50

Documentation Exercise pg. 51-55

Nursing Care Plans Q&A pg. 56-59

Video Updates Q&A pg. 62

Mental Strength Q&A pg. 64

20 Minute Checks Q&A pg. 66-67

Lab Sim Critical Elements Cards pg. 71-74

Lab Sim Critical Element Evaluation pg. 755

Table Of Contents


Lab Sim Chapter 3-5 Q&A pg. 77

Lab Sim Video Updates Q&A pg. 78

Lab Sim Med Math Q&A pg. 79

Dummy / Lab Sim Set-UP pg. 81-82

Study Schedule (weeks 1-2) pg. 83-89



Study Schedule (week 8) pg. 101-104

Final Thoughts pg. 105

Blank AOC Evaluation Sheet pg. 1066

Table Of Contents


Blank Lab Sim Evaluation Sheet pg. 107

Blank Days Of The Week Training Sheet PG. 108

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Table Of Contents

Of all of the ideas I try to encourage students to implement here in the RobsCPNE program, record keeping seems to be the toughest for me to “sell”. I can see why… it takes time! Time away from doing your critical elements, time away from doing your lab sims and time away from the other 1,001 things that you have to learn for this test (not to mention what’s going on outside in your life!)

However, record keeping is something that can create time for you. The truth is that human beings fall into patterns of behavior. We repeat things, regardless if they work or not. We may not repeat the same thing that end disastrously in back to back sessions but we will go back to what gave us a level of comfort. When you record keep (properly) you will be less likely to fall into habitual failing. Your constant review of records will prevent it!

Another bonus of keeping records is that you will help break up your training sessions. You will be more likely to work short sessions as you can’t keep all that information in your head. Short learning session work to your long term memories benefit. Another great thing about record keeping is that you’ll be able to see exactly what you’ve retained and how far you’ve come. By giving yourself a “CPNE check-up” it will give you positive affirmations that you ARE on the right track and that you WILL pass. Having these affirmations gives you momentum like a boulder rolling down a hill, and when you reach top speed - WATCH OUT! …Nothing can stop you!

But the bottom line is record keeping just works. Scientific studies have proven it. If you take a group of CPNE students who are doing the same thing over the course of a year, those with effective records alway end up as being the highest percentage of people who have PASSED this test. HANDS DOWN!

However, you must be careful to document only that which is pertinent. I have seen records that have been way too lengthy and detailed. Those are often done by students that are more focused on data than the overall goal, which is to make yourself ready for the CPNE (and crush it). Good records should not be excessively complicated to fill out and should capture only the details that are critical to your uncovering a source in a challenge or documenting improvement.


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In all education you will have 4 stages of learning and that is a good thing. As time goes on we want to go from the bottom (#1 - Unconscious Incompetence) to the top (#4 - Unconscious Competence).

Here is how your learning will go with the RobsCPNE program.

#1 on the pyramid - You will start off not knowing ALL the things you need to know. This is the scariest part because you don’t even know what you need to study!

#2 on the pyramid - Next you will start to discover ALL the things you need to learn. You’ll feel better but a little overwhelmed. Don’t worry…that’s totally normal!

#3 on the pyramid - Here is where things come together. You know how to do everything but you have to consciously think about the steps. This is a great place to be, but we need to go one step further…

#4 on the pyramid - You’re a test terminator! Basically, you can do all the critical elements and documentation without even thinking too much. This is where actions become ‘automatic’ and that is our goal.


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Be certain to document and focus on those things that you did well on! Plan your futures sessions based upon what you would like to change but do not dwell only on your weaknesses. When you are not PHYSICALLY doing the actions, be sure you rehearse scenarios and critical elements in your MIND.

That way your SUB-CONSCIENCE can work out any problems that you might have in the background. It is the same thing as when you think about a problem that you are having in your life before you go to bed and when you wake up *poof* there is the resolution!

Our minds are powerful, so if you aren’t doing the actions PHYSICALLY, make sure you are doing them MENTALLY throughout the day (and right before you go to sleep…)

One thing I do encourage every student to do is if you didn’t study/practice today - to write: “I did not study / practice today. My commitment to passing the CPNE was not that great.”

—The point is: people usually do not want to write that two days in a row!

“Success is the sum of small efforts, repeated”

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Pre-Course Evaluation This is an assignment that will help you to keep in touch with your starting point in your journey. On the left hand vertical column are each area you will have to completely understand to be successful at the CPNE.

On the top will be what level of understanding you believe you have for each subject. Place an “X” in the appropriate box. As you move through the training at RobsCPNE, your goal is to have all “X” in the 100% understanding column.


25% or greater understanding



100% understanding

1.What determines if you pass/fail the CPNE?2. How many adult PCS’s can I fail?3. How many pediatric PCS’s can I fail?4. What days will I be doing the Lab Sim stations?5. What days will I be doing the PCS’s?6. What is the difference between the Areas of Care (AOC’s) and the Critical Elements?7. What days will I be doing the Critical Elements?8. What does the PLANNING phase consist of and what will I be doing?9. What does the IMPLEMENTATION phase consist of and what will I be doing?10. What does the EVALUATION phase consist of and what will I be doing?11. What should I bring to the CPNE test?12. I know how to perform ALL of the critical elements for the AOC’s13. know how to perform ALL of the critical elements for the Lab Sim stations14. I can write up a PLANNING phase plan of nursing care (nursing care plan)15. I can write up a REVISED phase plan of nursing care (nursing care plan)16. I can write up a EVALUATION phase plan of nursing care (nursing care plan)17. I know what my study schedule is and how to follow it so I’m successful18. I know how to set myself up to become mentally stronger before I go to the CPNE19. I know what the 20 minute checks are20. I know what lab sim supplies I need to make my home set up 21. I know how to do the Med-Math for the Lab Sim stations22. I know how to set up my dummy so I can practice all the AOC’s

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Reminders on how to make learning effective

“Don’t wish for it, work for it”

• Focus on incremental progress, not perfection - Rome wasn’t built in a day you know.

• When you’re frustrated just remember WHY you are doing this. Chances are you’re not just doing it for yourself.

• You must learn something EVERY SINGLE DAY. Learning is like exercise - when you take a day off you get a little weaker, but if you do it every day, you get a little stronger.

• Studies have shown when you learn something new you only retain a fraction in 24 hours. However, when you keep reinforcing the new learning every day (see above), your retention of the new information skyrockets.

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“I may not be there yet, but I’m closer than I was yesterday”

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“Do something today your future self will thank you for”

Day 1 Congratulations! You made it to the exciting part… where we actively start learning. On this very first day, I want you to make SURE you watched the video when you logged into the members area at RobsCPNE. This quick 8 minute video gives you an overview of how to navigate the site so you know WHERE stuff is and HOW to access it. If you haven’t viewed the video go view it NOW and I’ll wait :)

Now that you’re all done, let’s jump into the Areas Of Care Module - Introduction and start reading this section NOW. As you go through it, make sure you can answer #s 1-11 at 100% understanding in your Pre-Course Evaluation on page 11

After you’re done reading, take time to reflect on the gravity of your situation. Really think about what this test is all about and how complex it is with all its’ moving parts (and ways to fail). Don’t worry too much, because as we progress we are going to break down this massive test into small learnable chunks. We can do this one BITE at a time… How do you eat an elephant? … One bite at a time.

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“What you do today can improve ALL your tomorrow’s”

1. Moving forward, we are going to take a look at the Areas Of Care Module - Chapter 1: Mnemonics and pictures of the mnemonics as well as all the critical elements. Now just like in the introduction, I don’t want you to really focus in on any of them, just casually look at them. What we are doing is casually understanding what this whole process will look like. This shouldn’t take you more than 10 minutes.

2. Now that we are done with glancing over Chapter 1: mnemonics, I want you to go take a look at Chapter 5: Video Updates. There have been some minor revisions over time so please look at that chapter now. Again, this shouldn't take you much time at all. You might be surprised with what you learn here (taking gloves off before touching the IV tubing or you fail? When to gel your hands?)

3. OK, we’ve done a lot today so far - we’ve seen a bit of the mnemonics and we’ve seen what revisions were done on the videos, now we get to sit back and watch a movie. This will be one of the most important movies you’ll ever see because it will set the tone for what happens in your professional nursing career for a LONG time. That’s the good news… the better news is that you get to see me explain everything to you in quite some detail about how you are going to pass this test. This movie won’t win any oscars, but you’re going to remember it for a long time.

QUICK NOTE: I will probably be re-recording these videos just to make them LOOK a little better. Truth be told, the videos are like that older, yet dependable car or truck you may have owned at some point in your life… that vehicle may not have looked or sounded like a Porsche, but it got you EXACTLY to where you needed to be. It’s the same thing with these videos. They could sound and look a little better, but they get you to where you want to be… which is passing the CPNE test and becoming an RN. These are the exact same videos that have helped THOUSANDS to pass , and that my friend is the only thing that counts… RESULTS.

Day 2

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“Success is simple - do it the right way at the right time”

Please go to the Areas Of Care Module - Chapter 8: AOC Video

and watch ALL videos now

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AOC Video Q&AQ. What is the walk UP the the arm / DOWN the arm technique? A. ___________________________________________________

Q. What do you need to do EVERY time you leave or enter a room? A. ___________________________________________________

Q. What is the mnemonic for FLUID MANAGEMENT? A. ___________________________________________________

Q. What are you supposed to do with a water pitcher at the beginning? A. ___________________________________________________

Q. What is the mnemonic for Musculoskeletal Management? A. ___________________________________________________

Q. What is the mnemonic for Mobility and how does it differ from Musculoskeletal Management? A. ___________________________________________________17


AOC Video Q&AQ. What is the mnemonic for Respiratory Assessment & Management? A. ___________________________________________________

Q. Can you listen to breath sounds over the patients gown? A. ___________________________________________________

Q. Why do so many students fail the Medication AOC? A. ___________________________________________________

Q. What is the mnemonic for Pain management? A. ___________________________________________________

Q. What do you have to do BEFORE you check the patients ABDOMEN for abdominal assessment? A. ___________________________________________________

Q. What does the “D” stand for in the mnemonic for Patient Teaching? A. ___________________________________________________18


AOC Video Q&A

Q. What is the mental image for the AOC of Oxygen Management? A. ___________________________________________________

Q. What does the “M” stand for in the mnemonic for the Skin Assessment AOC? A. ___________________________________________________

Q. Why do so many students fail the Peripheral NeuroVascular AOC? A. ___________________________________________________

Q. What is the mental image for the Neurological assessment AOC? A. ___________________________________________________

Q. Approximately how long did it take for me to do ALL the AOC in the last video? A. ___________________________________________________

Q. Who will be the FIRST person you call/text when you pass the CPNE? A. ___________________________________________________

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WOW!

That was a lot to take in! After watching all those videos, what do you think? Are you excited to continue on or do you feel overwhelmed?

Either way, you have to be proud of yourself for getting a SOLID start in a very difficult process.

I’ll let you in on a secret… there are people who buy this product and then don’t do ANYTHING with it!

It’s only used as a quick way to feel relief after they’ve bought a program I suppose. Remember how you felt when you signed up.? Maybe you felt a little bit of joy; a bit of relief; or maybe it was happiness. Whatever the case is, that is just a little rush of dopamine because you invested in something that will solve a problem. However, if you don’t take the time to really LEARN what I’m teaching then it’s truly money wasted.

BUT YOU’RE NOT THAT PERSON.

I know you’re not because your reading these words right now and you’ve come further than most. Champions do what others won’t so when the time comes they’ll be able to do what others can’t.

YOU’RE A CHAMPION… AND YOU’RE GOING TO PASS.

Excited to keep going? Me to… so let’s move forward to day 3 when you’re ready.


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Let’s go back to the Areas Of Care Module - Chapter 1: Mnemonics

What I want you to do today is to REALLY start to understand what these mnemonics are and how they are set up as well as HOW the mnemonics relate to the pictures and vice-versa.

I have an assignment for you (and you’re probably not going to like it, but it’s for you own good…I swear !)

Day 3

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I want you to RE-WRITE ALL of the mnemonics and I’m going to tell you why…

Actually, I’m going to have you read this article about WHY writing things down makes us remember (up to 70% more!). And I mean WRITING and not TYPING in the information. http://www.lifehack.org/articles/productivity/you-will-remember-information-longer-you-hand-write-notes.html

http://www.lifehack.org/articles/featured/writing-and-remembering-why-we-remember-what-we-write.html

NOTE: You must hand write ALL of these mnemonics AT LEAST one time. If you want to do it more, then great…It’s all up to you.

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http://www.lifehack.org/articles/productivity/you-will-remember-information-longer-you-hand-write-notes.html

http://www.lifehack.org/articles/featured/writing-and-remembering-why-we-remember-what-we-write.html

“DECIDE. COMMIT. SUCCEED”

Fluid Management

H_____________________________________ I ______________________________________ D______________________________________ S______________________________________

NOTES: _______________________________ ____________________________ ____________________________ ____________________________ ____________________________ ____________________________

Describe Mnemonic Picture Here:

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“Success doesn’t come to you, you work for it.”

Musculoskeletal Management

M_____________________________________ A _____________________________________ P______________________________________

H _____________________________________ A______________________________________ T______________________________________ R______________________________________

NOTES: _______________________________ _______________________________________ _______________________________________ _______________________________________ _______________________________________ _______________________________________


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Mobility

M_____________________________________ A _____________________________________ D_____________________________________

A _____________________________________ T______________________________________ O______________________________________ P______________________________________

NOTES: _______________________________ _______________________________________ _______________________________________ _______________________________________ _______________________________________ _______________________________________


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Respiratory Assessment

P_____________________________________ A______________________________________ I______________________________________ R______________________________________

NOTES: _______________________________ ____________________________ ____________________________ ____________________________ ____________________________ ____________________________


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Respiratory Management

H_____________________________________ A______________________________________ I______________________________________ R______________________________________

NOTES: _______________________________ ____________________________ ____________________________ ____________________________ ____________________________ ____________________________


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Medications

M_____________________________________ A______________________________________ R______________________________________ S______________________________________

NOTES: _______________________________ ____________________________ ____________________________ ____________________________ ____________________________ ____________________________


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Pain Management

ASSESS THE: L_____________________________________ D_____________________________________ D_____________________________________

P_____________________________________ R______________________________________ N______________________________________

NOTES: _______________________________ _______________________________________ _______________________________________ _______________________________________ _______________________________________ _______________________________________


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Abdominal Assessment

3 P’s are: _______, __________, __________ L_____________________________________ L_____________________________________ F_____________________________________

D_____________________________________ A______________________________________ R______________________________________ T______________________________________

NOTES: _______________________________ _______________________________________ _______________________________________ _______________________________________ _______________________________________ _______________________________________


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Patient Teaching

R_____________________________________ I ______________________________________ D______________________________________

NOTES: _______________________________ ____________________________ ____________________________ ____________________________ ____________________________ ____________________________


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Oxygen Management

S______________________________________ O______________________________________ A______________________________________ P______________________________________

NOTES: _______________________________ ____________________________ ____________________________ ____________________________ ____________________________ ____________________________


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Dreams + Work = SUCCESS

Skin Assessment

T_____________________________________ I______________________________________ M_____________________________________ E______________________________________ C______________________________________

NOTES: _______________________________ ____________________________ ____________________________ ____________________________ ____________________________ ____________________________


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Peripheral Neurovascular Assessment

P______________________________________ M_____________________________________ S______________________________________ T______________________________________ C______________________________________ C______________________________________

NOTES: _______________________________ ____________________________ ____________________________ ____________________________ ____________________________ ____________________________


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Neurological Assessment

L_____________________________________ A______________________________________ M______________________________________ P______________________________________

NOTES: _______________________________ ____________________________ ____________________________ ____________________________ ____________________________ ____________________________


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Enteral Feeding

R_____________________________________ A_____________________________________ T_____________________________________

F_____________________________________ E______________________________________ V______________________________________ E______________________________________ R______________________________________

NOTES: _______________________________ _______________________________________ _______________________________________ _______________________________________ _______________________________________ _______________________________________


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Wound Management

T_____________________________________ S_____________________________________ G_____________________________________ A_____________________________________ R_____________________________________ L_____________________________________

A_____________________________________ O_____________________________________ D_____________________________________ G_____________________________________

S______________________________________

C______________________________________ G______________________________________

P______________________________________ A______________________________________ T______________________________________

NOTES: ____________________________________________________________ ____________________________________________________________________ ____________________________________________________________________ ____________________________________________________________________ ____________________________________________________________________ ____________________________________________________________________


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“SUCCESS IS A SERIES OF small WINS”

Irrigation Maintenance of Intermittent Venous Access Device

P_____________________________________ F____________________________________ R_____________________________________ I_____________________________________ I_____________________________________ G____________________________________ I_____________________________________ R_____________________________________ W____________________________________ A_____________________________________ A____________________________________ T_____________________________________

NOTES____________________________________________________ ___________________________________________________________ ___________________________________________________________ ___________________________________________________________ ___________________________________________________________ ___________________________________________________________


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“Success is how HIGH you bounce when you hit bottom”

I’m sure your hand is tired after all that writing, but soon it will all be worth it! Now, I have a new task for you to do:

Evaluate the critical elements from LEAST understood to MOST understood. 25% or greater understanding



100% understanding

Fluid Management

Musculoskeletal Mangement

Mobility



Medications

Pain Management


Patient Teaching

Oxygen Management

Skin Assessment



Enteral Feeding

Wound Mangement

Irrigation

Maintenance of Intermittent Venous Access Device

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“SUCCESS IS A SERIES OF small WINS”

Now that you know which areas are difficult for you to understand, you will know which areas to focus on. Keep studying the mnemonics until you have 100% understanding for ALL of them.

These mnemonics will be the basis for everything that you do and it is IMPERATIVE that you have FULL mastery of every single on.

When things come up in the CPNE (and they will), you’ll be thankful that there is one area that you won’t have to struggle with…and that area will be the mnemonics for the critical elements.

YOU ARE DOING GREAT WORK!! Believe me when I say, that by doing all this training you are setting yourself apart from most everyone else who is taking the CPNE.

I want to break down some numbers for you on the next page…

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“You get what you give.”

You see, the reason the first time pass rate is at 64% is because that factors in ALL people who are taking the test (people who have prepped for the CPNE test like YOU, and people who just go and blindly take it like I did the first time)

Statistically speaking, everything you learn is slowly increasing your chances of passing.

So, with very little prep your chances of passing are: 64%

Now, let’s take a look at your chances with this system:

Learning the lab sims and AOC: 70-75%

Being able to do the lab sim and AOC automatically: 80-85%

Doing the LAB SIM’s and AOC automatically AND using the care plan checklist/perfection direction tools for your care plans: 90% and up

If someone told me that there is a team that had 90% or more chance of winning, you better believe I would put my money on that team. Likewise, I would definitely put my money on you because I know you will be successful… Don’t you see know that it isn’t a POSSIBILITY that you will pass, but a PROBABLITY!

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“Strength and growth only come through sustained effort.”

“WHAT ARE GRIDS?”

I remember asking this question to myself when I first heard this thing about a “grid”.

- what is it? - why do I need it? - what is the best way to use them? - Do I really need them to pass this test? -WHEN do I use them?

The answers may surprise you…42


Q: what is it? A: Grids are just a way to write your mnemonics so that you can remember HOW to do them and WHAT to chart on them.

To make things easy, you check off the critical element on the LEFT side when you DO it, and then check off the critical element to the right when you CHART on it. Here’s an example:

Skin Assessment

Done? Charted? __ T temperature ___ __ I integrity ___ __ M oisture ___ __ E dema ___ __ COLOR changes of the skin ___

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“There is no substitution for hard work”

So, at the END of your EVALUATION phase you should have everything checked off. NOTE: If you’re not 100% sure what the EVALUATION phase consists of, then please go back to the Areas Of Care Module - INTRODUCTION chapter.

Your “grid” should look like the following example when you are ready to turn in your paperwork to the examiner at the end of each PCS

Skin Assessment

Done? Charted? _x_ T temperature _x_ _x_ I integrity _x_ _x_ M oisture _x_ _x_ E dema _x_ _x_ COLOR changes of the skin _x_

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“Success comes down to 2 things: Focus & Effort - And you control both”

Now, it’s your turn… I need you to do 2 things: 1. Read AOC Chapter 2: Grid in the members section at RobsCPNE.com 2. Complete a “grid” for EVERY single Areas Of Care (remember, we LOVE to write things down, because then they “stick” into our long term memories!

MAKING IT SIMPLE: You can print out the next 4 pages as a guide to make your grid, but just be aware that when you are at your CPNE test, there will be NO assistance and you’ll just have to write the mnemonics from memory

Don’t worry, you’ll have done these mnemonics so many times that they will be cemented in your head so you literally CANNOT forget them. I know this seems crazy now, but trust me… I have students who email me after a year and say that they still haven’t forgotten the mnemonics because they actually use them at work on their patients…

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http://robscpne.com


Fluid Management Done Charted

Musculoskeletal Management Done Charted

Mobility Done Charted

Respiratory Assessment Done Charted

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Respiratory Management Done Charted

Medications Done Charted

Pain Management Done Charted

Abdominal Assessment Done Charted

47


Patient Teaching Done Charted

Oxygen Management Done Charted

Skin Assessment Done Charted

Peripheral Neurovascular Assessment Done Charted

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Neurological Assessment Done Charted

Enteral Feeding Done Charted

Wound Management Done Charted

Irrigation Done Charted

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You’re doing fantastic work! By doing these exercises you are setting yourself up for MASSIVE success so keep at it!

I have some questions for you. Please write in your answers on the “A” line… Q. Did you review AOC Chapter 2: Grid ? A: ____________________________________________

Q. What did I say about NUMBERING the grids? A: ____________________________________________

Q. What is the “to-do” list? A: ____________________________________________

Q. Which one will you be using at YOUR CPNE test? A: ____________________________________________

Q. Where will you be writing in your NURSING INTERVENTIONS from your Plan Of Nursing Care? A: ____________________________________________50


Q. Do you want to chart on ALL the AOC mnemonics you just wrote up in your grid? A: ____________________________________________

…Sorry, that was a trick question. Of course you want to chart on everything that you just wrote up because what happens when we write things down?… We remember them.

For this exercise I want you to:

1. Review AOC chapter 3: charting 2. Once you are done with that, please take the information from your grid and write up what actions you performed (critical elements and nursing interventions) as well as the patients responses. You can print out the following pages if you need to…

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Abdominal Assessment: Ex. Prior to assessment, patient asked if she needed to urinate or had any pain. Patient stated, she did not need to urinate or had any pain to abdomen. Patient positioned flat in bed. Assessment reveals abdomen soft and non-rigid, non-distended, bowel sounds present in all 4 quadrants No pain on light palpation.

Comfort Management ______________________________________________________________________________________ ______________________________________________________________________________________ ______________________________________________________________________________________

Drainage & Specimen Collection ______________________________________________________________________________________ ______________________________________________________________________________________ ______________________________________________________________________________________

Irrigation / Instillation ______________________________________________________________________________________ ______________________________________________________________________________________ ______________________________________________________________________________________

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“Winners are not people who never FAIL, they are people who never QUIT”

Musculoskeletal Management ______________________________________________________________________________________ ______________________________________________________________________________________

______________________________________________________________________________________

Neurological Assessment ______________________________________________________________________________________ ______________________________________________________________________________________ ______________________________________________________________________________________ Oxygen Management ______________________________________________________________________________________ ______________________________________________________________________________________ ______________________________________________________________________________________

Pain Management ______________________________________________________________________________________

______________________________________________________________________________________ ______________________________________________________________________________________53


Patient Teaching ______________________________________________________________________________________ ______________________________________________________________________________________

______________________________________________________________________________________

Peripheral Neurovascular Assessment ______________________________________________________________________________________ ______________________________________________________________________________________ ______________________________________________________________________________________ Respiratory Assessment ______________________________________________________________________________________ ______________________________________________________________________________________ ______________________________________________________________________________________

Respiratory Management ______________________________________________________________________________________

______________________________________________________________________________________ ______________________________________________________________________________________54


Skin Assessment ______________________________________________________________________________________ ______________________________________________________________________________________

______________________________________________________________________________________

Wound Management ______________________________________________________________________________________ ______________________________________________________________________________________ ______________________________________________________________________________________

NOTE: Fluid Management is documented on the FIRST page of the PCS recording form. You can see an example of this on pg. 391 in your CPNE guidebook.

NOTE: Medications is documented in the MAR. You can see an example of this on pg. 264 in your CPNE guidebook

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“Success is a state of mind - If you want success, start thinking of yourself as a success”

Now that we are done with the boring stuff (I never liked charting), now we can get onto one of THE BIGGEST causes of failure - Nursing Care Plans (or plan of nursing care as Excelsior calls it).

So, I need you to do some things: 1. Go to Chapter 4: Nursing Care Plans and watch the following videos-

a. BASIC Nursing Care Plan Class b. ADVANCED Nursing Care Plan Class c. SUPER ADVANCED Nursing Care Plan Class

Each video is about an hour so I would HIGHLY recommend that you break them up into 20-30 minute chunks when you sit down and watch them. Cramming in a bunch of information is great for COMPLETING the lesson but HORRIBLE for RETAINING the information learned.

Once you have finished those videos, we can move on to the next part…(next page)

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You can read the text part of Chapter 4, but MOST of that information is contained within the videos. I do have some questions for you after you review everything. Ready? Then lets get started.

Q. Do you need to write up a complete nursing diagnosis in the PLANNING phase? (i.e. activity intolerance R/T bed rest AEB verbal reports of weakness) or can it just be “activity intolerance” A. ___________________________________________________

Q. What would you assess if you chose “Deficient Fluid Volume” as a Nursing Diagnosis? A. ___________________________________________________

Q. Why do I tell you to write the Care Plan from Left to Right and then read it back Right to Left? A. ___________________________________________________

Q. Can the term “assess patients gait” be used as an INTERVENTION? A. ___________________________________________________

Q. Interventions move the patient ____________ the EXPECTED OUTCOME? A. ___________________________________________________

Q. Can you start the wording of your interventions with the words, “Weigh / Monitor Observe”? A. ___________________________________________________

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“Name the Nursing Diagnosis” Name 1-2 Nursing Diagnosis

If you are given this AOC: that you MIGHT use:

Patient Teaching ex. Deficient KnowledgeNeurological AssessmentEnteral FeedingOxygen ManagementMusculoskeletal ManagementSkin Assessment or Wound Management

Respiratory ManagementMobilityComfort ManagementPain ManagementPeripheral Neurovascular Assessment

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You can read the text part of Chapter 4, but MOST of that information is contained within the videos. I do have some questions for you after you review everything. Ready? Then lets get started.

Q. In the Evaluation Phase Nursing Care Plan, can you use a medical diagnosis for the R/T? ex. Impaired Physical Mobility R/T right fractured ankle AEB patient having limited ability to perform gross motor skills to right lower extremity A. ___________________________________________________

Q. In the Evaluation Phase Nursing Care Plan, can you use a medical order for the AEB? ex. Impaired gas exchange Related To (R/T) COPD and pneumonia As Evidenced By (AEB) oxygen @ 2 liters/minute via nasal cannula A. ___________________________________________________

Q.What is the IF / THEN way to write a Evaluation Phase Rationale? A. ___________________________________________________

Q. In the Evaluation Phase Nursing Care Plan section, under “Patients Progress toward achievement of outcome” what is the criteria for MET / PARTIALLY MET / UNMET? A. MET - ________________________________________________________________ B. PARTIALLY MET - _____________________________________________________ C. UNMET - _____________________________________________________________

59

60

“Some people only dream of success, others work for it”

Isn’t it amazing how much you’ve learned in a relatively short amount of time? Don’t be modest about this… you are really setting yourself up for success if you got this far. I want you to remember ONE phrase if I ever ask you for when we communicate. say the phrase:

“VIVA LAS VEGAS”

This isn’t because I like to hear Viva Las Vegas but it will tell me IMMEDIATELY that you have gotten this far in the book which means you are truly one of the ELITE students out there that takes this job seriously… and I’ll tell you right now - that’s impressive to me.

OK, let’s keep going on to the next section…

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This will be the shortest chapter you have to look at. Go to AOC Chapter 5: Video updates. Give it a quick read and answer the following questions:

Q. Can you use the same arm to take a blood pressure reading if it has an IV in it? A. ___________________________________________________

Q. Name 2 of the 3 criteria to ID a patient? A. ___________________________________________________

Q. Will you fail if you leave the bed at a high level and then walk out of the room, if done quickly enough? A. ___________________________________________________

Q. Can we listen to lung sounds over the gown because the material of the patients gown is so thin? A. ___________________________________________________

Q. If the patients nares are dry, what kind of lubricant can we use if they have oxygen on? A. ___________________________________________________

Q. Is it important to support the joints when doing passive ROM exercises? A. ___________________________________________________

62


SUPER easy right? OK, now it’s time to get serious…

Everyone thinks that the Mnemonics and the Care Plans are the most important chapters, but I firmly believe it is actually the chapter you are going to look at now. Please go to:

AOC - Chapter 6: Mental Strength

Once you’re done, turn to the next page to answer some very important questions…

63


Name the 5 things I did to get me through the test

1. Accept _____________________________________________________

2. Change ____________________________________________________

3. Get _______________________________________________________

4. In Between _________________________________________________

5. Change ____________________________________________________

BONUS: What does the basketball player Jason Kidd do before EVERY free throw and WHY can this can help you at the CPNE?

LAST Q: Should you treat the examiners as nursing students or as the ultimate authority figures?

64

65


20 minute checks… This is the last chapter we have to look at before we start drilling in the AOC critical elements. I want you to READ this chapter and then ANSWER these questions…

Within 20 Minutes YOU will: 1. Introduce _________________________________________________________ 2. Identify the patient with _____________________________________________

If the patient has an IV 3. Assess ____ site noting _____________ or ______________________________ 4. Verifying ________________________________________________________ 5. Adjust rate of _______ (if needed)____________________________________ 6. Verifies the TYPE of __________________________ is the same as _________ 7. Documenting on __________________________________________________

If the patient has any kind of enteral feeding 4. Verifying ________________________________________________________ 5. Adjust rate of _______ (if needed)____________________________________ 6. Verifies the TYPE of __________________________ is the same as _________ 7. Documenting on __________________________________________________66

“Do it today or regret it tomorrow”

20 minute checks…

Q. Which part of the Assignment Kardex (2 pages) should you be highlighting so that you won’t forget to assess the items of the 20 minute checks? A. ___________________________________________________

Q. Which part of the Student Recording Form (1st page) should you be highlighting so that you won’t forget to document the items of the 20 minute checks? A. ___________________________________________________

Q. If you have a GRAVITY FLOW IV (rare), where would you document the rate? A. ___________________________________________________

BONUS: I highly recommend you to PRINT out both pages of the Assignment Kardex and the first page of the Student Response Form so that you can get used to highlighting these areas when you are practicing at home.

REMEMBER: What we do in practice, we do in real life 67

68


Lab Sim Stations

Before we can get going on the AOC critical elements, we can’t forget that there are

2 PARTS TO THIS TEST…

1. Areas Of Care part

2. Lab Sim Stations part

… Let’s go over the Lab Sim section and then we will start drilling down on all the MNEMONICS for the CRITICAL ELEMENTS so you’ll be ready for your CPNE test.

Ready? let’s go…

69

“The more work you put in when you train, the easier the event that you train for becomes”

I want you to RE-WRITE ALL of the Lab Sim Station mnemonics just like you did for the AOC mnemonics…

I know it’s a pain, but what’s worse? Here are your options…

1. Re-writing these mnemonics so they can stick in your memory

OR

2. Failing the CPNE

REMEMBER: “The more work you put in when you train, the easier the event that you train for becomes”

70


Wound Management

T_____________________________________ I _____________________________________ G_____________________________________ R_____________________________________

O_____________________________________

G_____________________________________ S______________________________________

C______________________________________ G______________________________________

P______________________________________ A______________________________________ T______________________________________

NOTES: ____________________________________________________________ ____________________________________________________________________ ____________________________________________________________________ ____________________________________________________________________ ____________________________________________________________________ ____________________________________________________________________


71


IM/SQ Injection

R_____________________________________ C _____________________________________ A_____________________________________ D_____________________________________

R_____________________________________ I_____________________________________ C______________________________________

C______________________________________ A______________________________________ P______________________________________

NOTES: _________________________________________________________________ _________________________________________________________________ _________________________________________________________________ _________________________________________________________________ _________________________________________________________________ _________________________________________________________________


72


IV Med Station Mini-Bag (Piggy-back)

I _____________________________________ G _____________________________________ I _____________________________________ G _____________________________________

C _____________________________________ D _____________________________________ S ______________________________________

A ______________________________________ O ______________________________________

NOTES: _______________________________________________________________ _______________________________________________________________ _______________________________________________________________ _______________________________________________________________ _______________________________________________________________ _______________________________________________________________


73


IV Push

C _____________________________________ L _____________________________________ C _____________________________________

F _____________________________________ I _____________________________________ G ______________________________________ I ______________________________________ W ______________________________________ A ______________________________________

F ______________________________________ G ______________________________________ F ______________________________________

NOTES: _______________________________________________________________ _______________________________________________________________ _______________________________________________________________ _______________________________________________________________ _______________________________________________________________ _______________________________________________________________


74

“Doubts are what kills momentum, not failures”

I’m sure your hand is tired after all that writing, but soon it will all be worth it! Now, I have a new task for you to do:

Evaluate the critical elements from LEAST understood to MOST understood.




100% understanding

Wound Management

IM/SQ Injection

IV Med Station Mini-Bag (Piggy-Back)

IV Push75


Lab Sim Chapter 2: Supplies You Will Need

WOW, that was a lot of work you did! I know it seems like I’m a slave driver (and I can be), but in reality I just want the best for you. When you hear these words:

“OK, that is your last patient and you passed. Congratulations. Let’s go to the break room and have you fill out the paperwork for Excelsior so you can go

home.”

…You’ll know it was all worth it.

OK, so the next chapter - Lab Sim chapter 2: Supplies You Will need is just the basic run down of the stuff you will need to put together mock Lab Sim stations. If you don’t have access to some of the items, NO WORRIES! Simply call Excelsior and they have a company that can sell you a LAB SIM kit that has everything you need. It’s not too expensive and it will be SOOO worth it while you are practicing.

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Lab Sim Chapter 3-5

Some chapters need to be explained, but some of my chapters are self-explanatory. Lab Sim Chapters 3-5 are pretty much self explanatory, BUT you must answer these questions to move on to the next section.

Q. On what pages can you find the Lab Sim Station Documents?

Intro: page _____ Wound Station: page _____ IV Meds (Piggy-Back): page _____ Injectable Meds - IV Push: page _____ Injectable Meds - IM/SubQ: page _____

Q. What angle can you give a Subcutaneous Injection? A. ___________________________________________________

Q. Where is the RobsCPNE PREFERRED area of injection for the IM injection? A. ___________________________________________________

Q. What makes the LAST wound picture a failure in Lab Sim Chapter 5? A. ___________________________________________________

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Lab Sim Chapter 6: Video updates

The video updates in Chapter 6…After you have ready these, I need you to test yourself by answering these questions:

Q. Can you pre-tear the tape in the WOUND MANAGEMENT Lab Sim station and place it on the table for later use? A. ___________________________________________________

Q. When should we tear the tape to use it? A. ___________________________________________________

Q. How many pieces of gauze can we use to pack the wound? A. ___________________________________________________

Q. When do we need STERILE gloves and when do we need NON-STERILE gloves in the WOUND MANAGEMENT Lab Sim station? A. ___________________________________________________

Q. Is it OK to flip over the bottles when you are pushing in air for 2 different types of insulins? A. ___________________________________________________

78

“It’s not a mistake - It’s learning how NOT to do things”

Lab Sim Chapter 8: Med Math

Chapter 8 is one of my favorites and the reason is because it is something that is a UNIVERSAL TRUTH which is math. It’s not subjective or objective…it’s just math. I don’t like it when things are left up to interpretation so here is THE section where you simply will not make an error because it’s so straight forward. I just need you to test yourself again and answer these 3 questions:ter you have ready these, I need you to test yourself by answering these questions:

Q. What is the answer for Example 1? A. ___ ml

Q. What is the answer for Example 2? A. ___ gtts/min

Q. What is the answer for Example 3? A. ___ gtts/min

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80


Dummy Set-Up / Lab Sim Station Set Up

So, now we are ready to start becoming great… This is where the rubber meets the road as they say. We are going to start drilling in the AOC and Lab Sim Station critical elements, but first we need to

1. Set Up our Dummy so we can do mock PCS’s (patient care situations) 2. Set Up our Lab Sim Stations.

Q: How do we set up a dummy exactly? A: Go to AOC Chapter 8: AOC Video and re-watch Video 2: Dummy Set UP

Q: how do we set up the Lab Sim Stations? A: If you don’t have access to all the supplies for the Lab Sim stations, you can talk with Excelsior and they have a company that will sell you everything you need to set it up. To learn how to set up each station go to LAB SIM Chapter 9: Lab Sim Video and I explain how each station will look and what you will need… easy peasy81


Please set up your DUMMY and Lab Sim Stations

82


Study Schedule

This may have taken you weeks to get here OR it may have taken you days. Either way, it is fine as everyone learns different things at different speeds. What I would like to tell you now that you are here, is that

THIS DAY IS ACTUALLY YOUR STARTING POINT IN THE RobsCPNE PROCESS.

You see, everything we have done up until now has really been just MENTALLY learning these things. Now we are going to put this into PHYSICAL ACTION which will turn you into someone who UNDERSTANDS how to do it, and someone who can actually DO IT.

Have you ever taken dance lessons? I have… and I can tell you that when the instructor showed me how to dance salsa it seemed so easy and so simple that I thought, “Man, this is going to be super easy. I’ll probably need like 3 total lessons and then I won’t have to keep paying for all these lessons!”

As you can probably guess, it didn’t go that way because when you actually DO IT, you quickly realize that you have a LONG, LONG, LONG way to go to actually be good at IT.

The same holds true for the CPNE process. You were probably thinking, “Why are people failing this test?… It seems so easy!”

You’re going to find out the answer very quickly my friend… Just remember this, “the devil is in the details.” Let’s get started…

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Study Schedule

As this is our FIRST week really, we will follow the Study Schedule I used (and thousands of others have used) to be successful. The schedule is found in Chapter 6: Mental Strength/Study Schedule

Weeks 1-2 __PCS ______ (with all the __________) and ALL the _______ Weeks 3-4 ___________________________________________________ Weeks 5-7 ___________________________________________________ Week 8 ___________________________________________________

You should have your dummy set up and your lab sim stations ready. Remember to treat the dummy as a real patient AND pretend that there is someone watching you. You can go so far as to set up a SECOND dummy up sitting in a chair in the corner to pretend that is the examiner who is watching you (hey, that sounds odd, but it works).

You should also remember to mimic sanitizing your hands EVERY time you go IN and OUT of the room that you are doing the PCS’s with the dummy.

NOTE: Everything we do in practice we will do when the actual event happens so treat every PRACTICE like you are AT THE CPNE TEST !!!

84


Run through a complete set of AOC’s (yes…ALL of them)

Also, do ALL 4 lab sim stations now

After you are finished with ALL of them, please fill out the evaluation forms

on the next pages…

85

“People lie….Numbers don’t”

Now that you had a chance to PHYSICALLY perform ALL the AOC’s, how do you feel your level of understanding is now?




100% understanding

Fluid Management


Mobility



Medications

Pain Management


Patient Teaching

Oxygen Management

Skin Assessment



Enteral Feeding

Wound Mangement

Irrigation


86


What about the Lab Sim Stations? Do you feel you have MORE or LESS total understanding after physically

performing each one?




100% understanding

Wound Management

IM/SQ Injection


IV Push87


Evaluation for each days training - Week 1

What Went Well What Challenged Me Questions I Have

Day 1

Day 2

Day 3

Day 4

Day 5

Day 6

Day 7 88




Day 1

Day 2

Day 3

Day 4

Day 5

Day 6

Day 7 89


Study Schedule

Great work on sticking with the schedule! Here is our 3rd & 4th week schedule….

Weeks 1-2 __ PCS ______ (with all the __________) and ALL the _________

Weeks 3-4 __ PCS _____ (with all the _________) and ALL the ______

Weeks 5-7 ___________________________________________________ Week 8 ___________________________________________________

REMEMBER: Everything we do in practice we will do when the actual event happens so treat every PRACTICE like you are AT THE CPNE TEST !!!

90


How are you feeling about your level of understanding now?




100% understanding

Fluid Management


Mobility



Medications

Pain Management


Patient Teaching

Oxygen Management

Skin Assessment



Enteral Feeding

Wound Mangement

Irrigation


91

“You have to push yourself, because no one else is going to do it for you”

Lab Sim Level of Understanding this week?




100% understanding

Wound Management

IM/SQ Injection


IV Push92




Day 1

Day 2

Day 3

Day 4

Day 5

Day 6

Day 7 93




Day 1

Day 2

Day 3

Day 4

Day 5

Day 6

Day 7 94

“Do things now… sometimes later becomes never”

Study Schedule

Here is where we kick it into high gear and really drill in the information into your long term memory. Here is our 5th, 6th & 7th week schedule….

Weeks 1-2 __ PCS _____ (with all the _____________) and ALL the _______ Weeks 3-4 __ PCS _____ (with all the _____________) and ALL the _______

Weeks 5-7 __ PCS _____ (with all the _____________) and ALL the _______

Week 8 ___________________________________________________

REMEMBER: Everything we do in practice we will do when the actual event happens so treat every PRACTICE like you are AT THE CPNE TEST !!!

95






100% understanding

Fluid Management


Mobility



Medications

Pain Management


Patient Teaching

Oxygen Management

Skin Assessment



Enteral Feeding

Wound Mangement

Irrigation


96






100% understanding

Wound Management

IM/SQ Injection


IV Push97

“If we did all the things we are capable of, we wound ASTOUND ourselves”



Day 1

Day 2

Day 3

Day 4

Day 5

Day 6

Day 7 98




Day 1

Day 2

Day 3

Day 4

Day 5

Day 6

Day 7 99




Day 1

Day 2

Day 3

Day 4

Day 5

Day 6

Day 7 100

“Hard work beats talent and intelligence EVERY time”

Study Schedule

Can you imagine in the beginning that you would have made it this far? I’m impressed, but what’s truly important is that you’re setting yourself up to absolutely crush this test.

Here is your week 8 schedule and did you notice that you’re actually doing less? It’s because ALL areas should be pretty much locked in to that long term memory so to keep going hard will only burn you out. Now it’s time for maintenance from week 8 on out.

Weeks 1-2 __ PCS _____ (with all the _____________) and ALL the _______ Weeks 3-4 __ PCS _____ (with all the _____________) and ALL the _______ Weeks 5-7 __ PCS _____ (with all the _____________) and ALL the _______

Week 8 __ PCS _____ (with all the _____________) and ALL the _______

REMEMBER: Everything we do in practice we will do when the actual event happens so treat every PRACTICE like you are AT THE CPNE TEST !!! 101






100% understanding

Fluid Management


Mobility



Medications

Pain Management


Patient Teaching

Oxygen Management

Skin Assessment



Enteral Feeding

Wound Mangement

Irrigation


102






100% understanding

Wound Management

IM/SQ Injection


IV Push103

“Either you run the day, or the day runs you”



Day 1

Day 2

Day 3

Day 4

Day 5

Day 6

Day 7 104

“Nothing is impossible. The word itself says, I’M Possible”

Final Thoughts

That is all for the training but keep in mind that EVERY MONTH there will be a LIVE training for members. These trainings are conducted via a webinar that anyone with a computer can access. As these training are based on the needs of the members, I highly encourage you to get in contact with me and tell me what YOU want to continue to learn about. This could be anything from:

Documentation study techniques AOC critical elements Nursing Care Plans How to make the grids work better How to be mentally strong for the test …any subject you can think of we can go over.

Also, I am attaching some additional evaluation sheets after this page so that you can copy and use if your study time needs to be more than 8 weeks.

I’m looking forward to hear from you telling me that you passed. If you’re reading these words then you have put in considerable time and I feel you will be successful at the test.

Best of luck,

-Rob

Robbie Wolff

Creator, RobsCPNE105






100% understanding

Fluid Management


Mobility



Medications

Pain Management


Patient Teaching

Oxygen Management

Skin Assessment



Enteral Feeding

Wound Mangement

Irrigation


106






100% understanding

Wound Management

IM/SQ Injection


IV Push107


Evaluation for each days training - Week ]


Day 1

Day 2

Day 3

Day 4

Day 5

Day 6

Day 7 108