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© Canadian Nurses Association, 2012

CNA Certification: Care to be the Best and be prepared for the Certification exams

CNA Webinar Series: Progress in Practice

Leslie Anne PatryManager, Certification and Credentialing

Professional Practice Division, Canadian Nurses Association

Brenda MorganClinical Nurse Specialist, Critical Care Trauma Centre

Victoria Hospital, London Health Sciences Centre

January 21, 2014 Yvette Laforêt-FliesserCommunity and Public Health Consultant

Vice-President, Edellys Training Corp.

Leslie Anne Patry, RN, MScNManager, Certification and Credentialing

Professional Practice DivisionCanadian Nurses Association

Yvette Laforêt-Fliesser, RN, BScN, MScN, CCHN(C)

Community and Public Health ConsultantVice-President, Edellys Training Corp.

Brenda Morgan, RN, MSc, CCHN(C)Clinical Nurse Specialist, Critical Care

Trauma CentreVictoria Hospital, London Health

Sciences Centre

• Certification exams• Exam development • Sample questions• How to prepare• What to expect on exam day

CNA Certification Program

• Exam Administration– Pre-assigned writing centre –

Admission letter – Check Certification website, few

days prior exam – bilingual exams offered– 2,000+ candidates– 70+ writing centres across Canada– Paper and pencil administration

• 3.5 hour exam: 9:30 a.m. to 1:00 p.m.• Between 160 and 165 multiple choice questions• Stem (question), then four possible answers• Question types:

– Cases– Independent questions

1. Knowledge/comprehension

2. Application

3. Critical thinking

• Tests your cognitive ability to recall learned material and to understand its meaning

• Select correct facts, concepts, principles or procedures

• 15–25% of questions

Mr. Blanchard tells the community health nurse that he has a "funny rash" in his groin area. He reports that it has been present for about 3 weeks and is getting bigger. Examination reveals flat, red, moist, circular lesions with normal-appearing skin in the centre. What is this most likely indicating?

a. Scabiesb. Ringwormc. Pubic liced. Yeast infection

Mr. Blanchard tells the community health nurse that he has a "funny rash" in his groin area. He reports that it has been present for about 3 weeks and is getting bigger. Examination reveals flat, red, moist, circular lesions with normal-appearing skin in the centre. What is this most likely indicating?

a. Scabiesb. Ringwormc. Pubic liced. Yeast infection

Rationale: Ring worm is frequently reported, usually occurs in males, can be transmitted from lesions on animals and is aggravated by friction and excessive perspiration.

References: Heymann (2008), pp. 174-175

Competency: 1.17f Identifies communicable diseases: parasitic (e.g., lice, scabies, bed bugs).

• Tests your ability to apply knowledge in providing patient care

• Applies rules, methods and theories

• Identifies consequences• 50–60% of questions

Joann, a 16-year-old high-achieving student, has greatly restricted her daily food intake. She exercises up to 6 hours/day and is presently at 70% of her ideal body weight. Joann has postural hypotension and has been amenorrheic for 4 months. She is admitted to the hospital.

What should the psychiatric and mental health nurse do first?

a. Place Joann on bed rest with close monitoring of cardiac status.b. Place emphasis on weight gain, rather than food intake. c. Educate Joann about the negative effects of her present

behaviour.d. Refer Joann to a dietitian for nutritional counselling.

Joann, a 16-year-old high-achieving student, has greatly restricted her daily food intake. She exercises up to 6 hours/day and is presently at 70% of her ideal body weight. Joann has postural hypotension and has been amenorrheic for 4 months. She is admitted to the hospital. What should the psychiatric and mental health nurse do first?

a. Place Joann on bed rest with close monitoring of cardiac status.b. Place emphasis on weight gain, rather than food intake. c. Educate Joann about the negative effects of her present behaviour.d. Refer Joann to a dietitian for nutritional counselling.

Rationale: Medical status is the priority at this time. References: Fortinash & Holoday Worret (2008), pp. 400-401.Competency: Selects appropriate nursing interventions for clients experiencing eating disturbances.

Mr. Murphy, 70 years old, has a temporary transvenous pacemaker in place, with the following settings: rate 80/min, output 4 mA and sensitivity 5 mV. The critical care nurse observes the following rhythm strip on Mr. Murphy's cardiac monitor:

What should the critical care nurse prepare to do?a.Increase output.b.Decrease output.c. Increase sensitivity.d. Decrease sensitivity.

Mr. Murphy, 70 years old, has a temporary transvenous pacemaker in place, with the following settings: rate 80/min, output 4 mA and sensitivity 5 mV. The critical care nurse observes the following rhythm strip on Mr. Murphy's cardiac monitor:

What should the critical care nurse prepare to do?a. Increase output.b. Decrease output.c. Increase sensitivity.d. Decrease sensitivity.

Rationale: The pacemaker spikes fail to produce capture; increasing the MA might facilitate proper capture. References: Morton & Fontaine (2009), p. 395.Competency: Select appropriate evidence-informed nursing interventions to correct alterations in cardiac output, such as optimizing heart rate or rhythm: pacing and cardioversion.

• Test your ability to interpret data

• Deal with abstracts

• Evaluate options

• Problem solve

• 20–30% of questions

Mrs. Rodgers, 68 years old, presents with a right stroke (brain attack). Her risk factors include type 1 diabetes and smoking two packages of cigarettes per day. She is completely independent in all her ADLs and IADLs and is being discharged home. The client refuses to alter her smoking habits even though she will not be able to afford buying appropriate food.

What should the gerontological nurse do to promote healthy lifestyle changes?

a. Refer to pharmacist for nicotine patches.b. Refer to social services for counselling.c. Refer to a dietitian for meal planning.d. Refer to smoking cessation program.

Mrs. Rodgers, 68 years old, presents with a right stroke (brain attack). Her risk factors include type 1 diabetes and smoking two packages of cigarettes per day. She is completely independent in all her ADLs and IADLs and is being discharged home. The client refuses to alter her smoking habits even though she will not be able to afford buying appropriate food. What should the gerontological nurse do to promote healthy lifestyle changes?

a. Refer to pharmacist for nicotine patches.b. Refer to social services for counseling.c. Refer to a dietitian for meal planning. d. Refer to smoking cessation program.

Rationale: Most important given diabetes. References: Eliopoulos (2010), pp. 348-353.Competency: Selects the relevant interventions to support the following: lifestyle patterns (e.g., lifestyle counselling, determining priorities for action, support for lifestyle change, leisure, resources).

Online exam preparation resources and exam practice test

Specialty Competencies ListExam Blueprint

Bibliography-Textbooks

Mentors

Study Groups

NurseONE

National Nursing Specialty AssociationsNational Specialty Associations

Where do I start?

Determine your priorities

• Review competencies and perform a self-assessment

• Rate each competency according to your level of competence (e.g., strong, moderate or weak)

• Rating should reflect your knowledge of the theory and evidence, not just your clinical experience

Create a study plan

• List all of the topics you want to review• Create a realistic study schedule to

address each topic• Study your weakest subjects first, but

stick to a time limit• Make a commitment to stay with your

plan, revising as required to accommodate life events

• Plan to complete your overall study at least two weeks before exam date (to allow overall review)

Create a learning environment

Study Group

Customize your learning style

• Do you learn best with short, frequent study or longer sessions?

• Seek out experts in your area on specific topics

• Look for opportunities to practice infrequent skills or activities

Start studying!

• Complete the practice exam to test your baseline knowledge

• Review theory, best evidence and practice recommendations for each topic

• Focus on national standard vs. local expectations or experience

• Repeat practice exam at conclusion of study plan to assess overall preparedness

Use multiple learning strategies

• Texts, landmark studies, best practice guidelines, videos, interactive learning modules

• Look for opportunities to test your knowledge (quiz at end of book chapters, continuing learning modules, practice exams)

• Beware of references used, validate information in a second reference

• Know where you are going (CNA website for writing centre details)

• Eat breakfast (very important)• Bring photo ID, CNA admission letter• Bring supplies (snack, water, HB pencils,

highlighters, erasers, ruler)• Dress in layers

Be confident!

• Think positive • Listen carefully to announcements• Read instructions• Complete all forms accurately• Budget your time: 3.5 hrs(210 min) / 160–165 questions = 1.25/min per question

• Read each question carefully• Choose and record the correct answer on your

answer sheet• Cover up answers before you read the stem

• Anticipate the answer before looking at options

• Eliminate all obviously wrong response

• Erase all accidental marks on the answer sheet

Guess. There is no penalty for

incorrect answers.

• Missing important information in the question

• Not relating question to information in the case study

• Making assumptions (very important)• Focusing on insignificant details and

missed key issues• Selecting more than one answer• Filling in the wrong oval on answer

sheet

• Result letter: 5–6 weeks after exam date

• Results released as: Pass or unsuccessful result

Congratulations! Félicitations!CNA certified nurses can use designation after their name

Florence Nightingale, RN BScN ENC(C)

Jeanne Mance, Inf., B. Sc. Inf., CSU(C)

Employer Recognition AwardNomination

Princess Margaret Hospital 2013 ERA winner

© Canadian Nurses Association, 2012

For more information:

lpatry@cna-aiic.ca

http://getcertified.cna-aiic.ca

Photo credits: iStock

© Canadian Nurses Association, 2012

Thank you!