Racine Test Experience

Here is another student experience from my past files....


I took my CPNE in Racine, WI on Feb 8-10th and passed! Wow... what an
experience. First, let me say, that what Tina teaches is right on
the mark. Knowing your mnemonics is essential. Everything else is
keeping it simple and sticking to your timeline/grid. I took some
golden advice from a friend who tested a week before me and wrote my
lab mnemonics RIGHT ON THE WORKSHEET they provide at each of the
calculation labs. When they handed me my blank worksheet to calculate
my meds, I did the calculation then quickly wrote out notes to myself
(aka mnemonics) of the critical elements I didn't want to forget. I
practiced my labs HUNDREDS of times. I knew them well. I would time
myself and knew how long each lab should take me. But this
[confidence] paled in comparison to how outrageously nervous I was
when finally faced with taking them for real. It was a great comfort
to me to look down on my worksheet and see the step I was about to
take was the right one. It helped me keep my head during a time I
was sure it was going to fall off I was shaking so bad. The only lab
this doesn't work on is the wound station where you're not given a
work sheet. You just need to remember to breathe and say your
mnemonic over and over. I talked to myself A LOT. So, I was able to
get through all my labs on Friday night. Yeh!! One monkey off my
back! I found out that my first PCS was to be a 7 year old girl
admitted for pneumonia with a history of asthma. I went up to the
floor with my CE on Friday night where she oriented me to the rooms
and floor and pretty much everything I needed to know. She also let
me know that I'd be hanging a piggy-back med on the patient. When I
got back to the hotel, I called Tina and she helped me figure my
nursing dx as well as gave me some good support.
Saturday 7am: We met in the cafeteria, talked with our CA some (she
was great... very supportive and funny). Went to the room where we
had our labs the night before and dispersed to our CE's for our first
PCS. It is nervewracking -I don't think there's a way around that.
One thing our CA said quite a bit is to "Keep your feet under you;
stay grounded" She said don't get too far ahead of yourself or too
far behind.
PCS #1: 7y.o. female, admit dx: bilat pneumonia w/asthma hx.
Nursing Dx: Ineffective Airway Clearance
Outcome: Pt will maitain an O2 sat of 92% or higher and
not aspirate during PCS (latter from Carpenito's)
Intrvn 1: Perform respitory assessment
Intrvn 2: monitor oxygen saturation
I was assigned Oxygen Management,and Respitory Assessment and walk
patient x1 during PCS. -so... both interventions were pulled
directly from there. (thank you tina!!)

I did Risk for Injury on EVERY PATIENT.

PCS #2: 80yo male, R DVT
Nurs'g Dx: Impaired Comfort
Outcome: Pt will verbalize improved comfort during PCS.
Intrvn 1: Assess patient's comfort level/status
Intrvn 2: Provide warm, moist compress to Right leg
(assigned)
Areas of care assigned: Abdominal Assmt, Mus/Skel Mgmt with Active
ROM to both LE, Comfort Mgmt with Warm, Moist Compress to Right Leg,
Mobility: move pt OOB to chair x1 dur'g PCS.

PCS #3: 50yo male; Pnuemo... (can't remember...it's a dx I've never
heard of before). He had 2 chest tubes off his R chest wall. Hx of DM
(diabetes), HTN and questionable if patient "mentally slow".
Nurs'g Dx: Innective Airway Clearance
Outcome: (same as PCS 1)
Intrvn 1: Assess Respitory Status
Intrvn 2: Encourage pt to use incentive spirometer
(assigned)
Areas of care assigned: Mobility: Walk pt x1 dur'g PCS. PVA bilat LE,
Comfort Mgmt, and Resp Mgmt with DB/Cough and IS x10.

Fluid Mgmt on all -I&O's (which wasn't as hard as I absolutely
believed it would be).

For me, the biggest challenge was time management. I had quite a few
interruptions and stalls in each PCS. When this would happen, I'd do
my best to document (On PCS#2, 30 seconds into the pt's room,he told
me he didn't want to be disturbed while he ate his breakfast. -I
NEEDED to complete my 20 min check. I asked if it would be ok to
check a couple of things about his room w/o disturbing him and he
said yes. I checked off as much as I could on my HIPPICOWPTSD
without disturbing him and then told my CE that I was still within my
20 minutes and could I give him 5 mins or so to finish eating in
peace. She said "Yes, that's fine... let's come back in 5 or 10
minutes. I "SWIM" out of the room, and start immediately writing
stuff down... my 20min check, my eval page (dx, r/t, aeb, outcome,
interventions and rationale. I left blank the "outcme met"
and "intervention effective" boxes). When I came back into the room,
I re-intro'd myself and finished my 20min check. Almost half of my
documenting was already done). I kept my grid with me LIKE A
LIFELINE. I referred to it often and made my notes right on it (even
pt quotes). I told each pt in the beginning that I'd be referring
to "my notes" quite a bit to ensure I was giving them the best of
care. None of the pt's seem to mind I was looking at my notes a bunch
and writing stuff down. The CE's certainly didn't seem to mind. They
are what they are: Evaluators. They are the fly on the wall to make
sure you give safe patient care which includes the critical elements.
If you know Tina's mnemonics, this WON'T BE AN ISSUE.

-So... this post was long and I hope somewhat helpful. Please let me
know if you have any questions or if I need to clarify something.
BEST WISHES TO YOU ALL. Be Positive. Stay calm. Stay focused. STAY
WITHIN YOUR GRID! You will pass too.