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As healthcare becomes increasingly complex and challenging, certification has emerged as a mark ofexcellence showing patients, employers and the public that a nurse is qualified and competent and hasmet the rigorous requirements to achieve specialty or subspecialty certification.

AACN Certification Corporation certification programs were created to protect healthcare consumers byvalidating the knowledge of nurses who care for the acutely and critically ill. We are pleased to provideyou with this application handbook with information about our programs and how to apply for and takethe CCRN, PCCN, CMC and CSC certification exams.

Today, more than 58,000 practicing nurses have received one or more of these certifications fromAACN Certification Corporation:

• CCRN® specialty certification introduced in 1976 for nurses providing care to acutely and/orcritically ill adult, pediatric and neonatal patients.

• PCCN® specialty certification introduced in 2004 for progressive care nurses providing care toacutely ill adult patients.

• CCNS® entry-level advanced practice certification launched in 1999 for clinical nurse specialistsproviding care to acutely and critically ill adult, pediatric and neonatal patients. For details, refer tothe CCNS Exam Handbook, online at www.certcorp.org.

• CMC® subspecialty certification launched in 2005 for certified nurses providing care to acutelyand/or critically ill adult cardiac patients.

• CSC® subspecialty certification launched in 2005 for certified nurses providing care to acutelyand/or critically ill adult patients during the first 48 hours after cardiac surgery.

• ACNPC® entry-level advanced practice nursing certification launched in 2007 for registered nurseseducated at the graduate level to provide advanced nursing care across the continuum of healthservices to meet the specialized physiologic and psychologic needs of adult patients with complexacute, critical and/or chronic health conditions. For details, refer to the ACNPC Handbook, online atwww.certcorp.org.

• CNML certification for nurse managers launched in 2008 in partnership with the AmericanOrganization of Nurse Executives (AONE) – visit www.certcorp.org for details.

We continually seek to provide quality certification programs that meet the changing needs of nursesand patients. If you do not find information in this handbook about certification in your area of practice,please visit www.certcorp.org or call (800) 899-2226.

Thank you for your commitment to patients and their families and to becoming certified.

CONGRATULATIONS!

You have taken your first step toward becoming a certified nurse.

OCTOBER 2009

Certification Organization for the American Association of Critical-Care Nurses

CERTIFICATION EXAM HANDBOOK

CONTENTS

Application Instructions ...................................................................................................................................................3

Application Process Overview..........................................................................................................................................4

AACN Certification Programs ...........................................................................................................................................6

Name and Address Changes ...........................................................................................................................................6

Testing Site Information ...................................................................................................................................................7

Scheduling an Exam Appointment ..................................................................................................................................8

Exam Rescheduling and Cancellation.............................................................................................................................8

On the Day of Your Exam..................................................................................................................................................9

Duplicate Score Reports ................................................................................................................................................11

Recognition of Certification and Use of Credentials....................................................................................................12

Denial of Certification ....................................................................................................................................................12

Revocation of Certification ............................................................................................................................................13

Review and Appeal of Certification Eligibility ...............................................................................................................13

Exam Fees.......................................................................................................................................................................14

CCRN Certification Program.....................................................................................................................................15-34

AACN Products for CCRN Exam Preparation.................................................................................................................21

PCCN Certification Program.....................................................................................................................................37-49

AACN Products for PCCN Exam Preparation .................................................................................................................41

CMC Subspecialty Certification Program ................................................................................................................53-61

AACN Products for CMC/CSC Exam Preparation ......……………………………………………………………………………………….65

CSC Subspecialty Certification Program.................................................................................................................67-73

AACN Synergy Model for Patient Care .....................................................................................................................76-77

Forms:

CCRN Exam Honor Statement (3rd page of application).............................................................................................35

PCCN Exam Honor Statement (3rd page of application) .............................................................................................51

CMC Exam Honor Statement (3rd page of application) ..............................................................................................63

CSC Exam Honor Statement (3rd page of application) ...............................................................................................75

Certification Exam Application (1st and 2nd pages of 3-page application) .........................................................79-80

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APPLICATION INSTRUCTIONS

AACN Certification Corporation recommends that you be ready to take the exambefore submitting your exam application.

1. Complete 2-page exam application at back ofhandbook.

CCRN, PCCN, CMC and CSC applicants taking acomputer-based test may register online atwww.certcorp.org.

□ Fill in all requested information; print name and date.

2. Complete 1-page honor statement page found at end ofindividual exam section. □ List verifier information, RN or APRN license information,

sign and date.

3. CMC and CSC applicants: Attach proof of current NCCA-or ABNS-accredited clinical nursing specialty certification(applies to non-AACN certifications only).

CMC and CSC subspecialty certification will be tied to thiscertification and must be valid for 90 days beyond theapplication date.

□ Examples of proof include wallet card, wall certificate or verificationletter from certifying organization.

Proof is not required if you wish to tie your CMC or CSC subspecialtycertification to your CCRN, PCCN, CCNS or ACNPC certification.

4. Include application fee. □ Make check payable to AACN Certification Corporation. Make surethat total amount is correct and sign check. Staple check to the upperright front corner of application. When paying by credit card provideall requested information including expiration date.

5. When joining AACN or renewing membership at thetime of applying for the exam, write one check for thetotal amount payable to AACN Certification Corporation.Total amount should equal AACN membership fee plusmember fee for the exam.

□ AACN offers a special 3-year membership discount for certificantsand exam applicants.

AACN membership may be renewed at the discounted 3-yearcertification fee of $179.35 as long as the certification remainscurrent. This fee represents an additional 15% savings from thepublished 3-year AACN membership fee.

AACN membership includes nonrefundable $12 and $15 one-year subscriptions to Critical Care Nurse® and the American Journal ofCritical Care®, respectively. AACN dues are not deductible as charitable contributions for tax purposes, but may be deducted as a businessexpense in keeping with Internal Revenue Service regulations.

Please direct inquiries to:

AACN Certification Corporation, 101 Columbia, Aliso Viejo, CA 92656-4109(800) 899-2226 • Fax: (949) 362-2020 • [email protected]

Please include your AACN customer/member number with all correspondence to AACN Certification Corporation.

3

APPLICATION PROCESS OVERVIEW

AACN Certification Corporation recommends that you be ready to take the exam before submitting your application.

1. Complete exam application and honorstatement and pay exam fee

Register for your computer-based exam online at www.certcorp.org >Apply Online.

You may mail a paper application to:AACN Certification Corporation101 Columbia, Aliso Viejo, CA 92656Or fax to (949) 362-2020 (DO NOT fax and mail; choose 1 method only)

AACN cannot be responsible for materials lost in the mail or the timelyperformance of the post office. If you desire documentation of mailing orverification of receipt of application, send the application "return receiptrequested" or use certified mail. Include the confirmation postcard on theback cover of your handbook or include a self-addressed stamped postcard(write AACN in the "from" area) and it will be mailed to you when yourapplication is received. Return of the postcard by AACN indicates receipt ofyour application only, not approval.

2. Waiting period for application processing Allow 4 to 6 weeks from date received at AACN for your application to beprocessed. Once it is processed, AACN will notify the testing service, AMP, ofeligible exam candidates. Applying online shortens this process by severalweeks.

AACN will notify you in writing when your application is incomplete orrequires clarification, or if you are ineligible for an exam.

Your eligibility period begins upon successful processing of your application.Call the toll-free number shown on your confirmation postcard or go online promptly to select a preferred testing date.

3. Receive Approval-to-Test postcard and e-mail.See next page for sample AMP postcard.

If you do not receive an Approval-to-Test confirmationor e-mail within 8 weeks of successfully applying for anexam, please contact AACN Certification Corporationat (800) 899-2226.

Please ensure that AACN has your current e-mail addresson record. E-mail address updates may be made onlineat www.aacn.org > My Account or e-mailed [email protected].

AACN’s testing service (AMP) will mail a postcard and send an e-mail toeligible candidates. The postcard and e-mail include a toll-free number andonline instructions to schedule your testing appointment. The postcard ande-mail also include the 90-day period during which you must schedule andtake the exam.

The address label and e-mail will contain the letter “C” plus your uniqueAACN customer number (i.e., C00123456). Use this number foridentification in place of your social security number.

4. Schedule your exam Immediately upon receipt of postcard schedule a date and time of yourchoice that falls within your 90-day eligibility period. To locate one of morethan 170 testing centers within the U.S. visit www.goAMP.com.

You may be randomly selected for an audit of your exam eligibility, which could occur anytime after application.Those selected will be notified by mail and will have 60 days to respond.

5. Sit for the exam Exam results with a score breakdown will be presented on-site uponcompletion of computer-based exams. Paper and pencil exam results arereceived by mail within 6 to 8 weeks of testing.

6. Receive congratulations packet

Address changes may be made online at www.aacn.org >My Account or e-mailed to [email protected].

Successful candidates will receive their wallet card and wall certificatewithin 6 to 8 weeks of passing the exam.

Unsuccessful candidates are eligible for a discounted retest fee. Refer topage 11 for more information.

Confidentiality of Exam Application StatusInformation regarding the status of an exam application submitted to AACN Certification Corporation

will not be released to anyone without the exam candidate’s written authorization.

4

SAMPLE AMP POSTCARD

When you receive your postcard, make sure that your name and address are listed correctly and that you’ve been registered for the correct exam.If not, please call AACN Customer Care at (800) 899-2226.

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What is Certification?Certification is a process by which a nongovernmentalagency validates, based upon predeterminedstandards, an individual nurse’s qualification andknowledge for practice in a defined functional orclinical area of nursing.

Certification validates your knowledge of nursing inyour specialty area to hospitals, peers, patients and,most importantly, to yourself. Certification promotescontinuing excellence in the nursing profession.

Certification and Exam AdministrationThe certification programs are administered by AACNCertification Corporation. The certification exams areconducted in cooperation with Applied MeasurementProfessionals, Inc. (AMP).

Computer-based exams are administered five days aweek throughout the year at more than 170 locationsacross the United States. Computer experience is notnecessary as you will use only a few keystrokes or amouse and be able to take a tutorial and practice testbefore the exam begins. During the exam you will beable to move back and forth between items and markitems for later review. You will receive final resultsincluding a breakdown by question type at the end ofthe exam.

Cognitive Levels of QuestionsThe cognitive level of the test items is based on acondensed version of Bloom’s Taxonomy. Themajority of the items are written at the application andanalysis levels. Testing at higher cognitive levelsprovides a better indication of the candidate’s criticalthinking abilities when caring for acutely and criticallyill patients and their families.

Exam PreparationAACN Certification Corporation does not endorse orsponsor any review courses for the certificationexams. Study bibliographies and test plans areincluded in this handbook to provide candidates withresources for exam preparation. For informationabout locating a local AACN chapter, contact us at(800) 899-2226 or visit www.aacn.org.

AACN Membership Not RequiredMembership in the American Association of Critical-Care Nurses is not an eligibility requirement for AACNCertification Corporation programs.

Non-Discrimination PolicyIt is the policy of AACN Certification Corporation, itsBoard of Directors, committee members and staff tocomply with all applicable laws that prohibitdiscrimination in employment or service provisionbecause of a person’s race, color, religion, gender,age, disability, national origin or any other protectedcharacteristic.

You are responsible for notifying AACN CertificationCorporation should your name and/or address changeat any time before or after you become certified.Failure to do so may result in not receiving informationnecessary for certification renewal.

AACN CERTIFICATION PROGRAMS

NAME AND ADDRESS CHANGES

You are responsible for renewing your certificationeven if you do not receive a renewal notice. Pleasenotify us of any name, address or e-mail changes; youmay update your profile online at www.aacn.org > MyAccount, e-mail [email protected], or call AACN CustomerCare at (800) 899-2226.

6

TESTING SITE INFORMATION

Computer-Based Testing (CBT)AACN exams are offered at more than 170 CBTlocations throughout the United States. To locate thetesting site nearest you please visit www.goAMP.comor call Applied Measurement Professionals, Inc. (AMP)at (888) 519-9901. If you have more than a three-hour one-way drive to the nearest computer-basedtesting site please contact AACN via e-mail [email protected] to request alternate testingaccommodations. Discounted group pricing isavailable; for information visit our Web site atwww.certcorp.org.

Paper and Pencil Testing/DANTES SitesIndividuals residing outside the U.S. may apply to testat a DANTES (military) testing site. The same eligibilityrequirements apply, although fees for paper andpencil testing (with the exception of exams offered atNTI or TRENDS conferences) are higher than for CBTand are priced per person. Refer to pricinginformation on page 14. For DANTES (Defense Activityfor Non-Traditional Education Support) inquiries orrequests please contact AACN via e-mail [email protected].

Requests for paper and pencil testing must besubmitted in writing at least 3 months before the testdate, along with all completed applications andappropriate fees. An e-mail address for the grouppoint of contact must be provided.

For information about group paper and pencil exams(large groups testing together) within the U.S., pleasecontact AACN via e-mail at [email protected] of paper and pencil exams are sent tocandidates four to six weeks following paper andpencil testing.

Candidates WithDisabilities or ImpairmentsAACN Certification Corporation is committed toensuring that no individual is deprived of theopportunity to take the exam solely by reason of adisability or impairment. Every testing site is fullyaccessible and compliant with the Americans withDisabilities Act. Special testing arrangements will beconsidered for disabled individuals who submit arequest in advance. Documentation and verificationof the disability or impairment from a licensed

professional must be submitted with the examapplication and indicated by checking the appropriatebox on the exam application. Special testingaccommodations, such as additional testing time,reader signer or amanuenses, require advanceapproval. Only candidates approved by AACNCertification Corporation will receive specialaccommodations during testing. Scheduling for thehearing impaired is available online atwww.goAMP.com.

Candidate Evaluation or ComplaintsYou may provide comments for any test item during acomputerized exam by clicking on the buttondisplaying an exclamation point (!) to the left of theTIME button. This opens a dialog box to entercomments. Only comments submitted at the test sitewill be considered during the final scoring process.Because of test security considerations, you will notreceive individual replies about the content of testitems, nor will you be permitted to review test itemsafter completing the exam. At the conclusion of theexam, you may also complete a brief survey about testadministration conditions.

Please mail complaints or comments aboutassessment site facilities, test supervision or anyother matter related to the testing program to:

AACN Certification Corporation101 ColumbiaAliso Viejo, CA 92656-4109

Or e-mail: [email protected].

Provide your name and address in all correspondence.When questions or comments concern an examalready taken, the date and time of the exam alongwith the location of the testing site must also be noted.Each complaint will be investigated and replied to.

7

SCHEDULING AN EXAM APPOINTMENT

January 1January 19February 2-7February 16April 8-15

May 25July 4September 7October 12November 11

November 26November 27December 24December 25

Exams are administered by appointment only, Mondaythrough Saturday at 9:00 a.m. and 1:30 p.m.Individuals are scheduled on a first-come, first-servedbasis. You must make your appointment at least twobusiness days before the desired testing date.

You will receive a confirmation postcard and e-mailafter you have successfully applied for the exam. Youmay schedule an exam appointment online or bytelephone once you receive the postcard or e-mail.If you have not received your postcard or e-mailwithin eight weeks after applying for an exam,please contact AACN Certification Corporation.

Schedule online at www.goAMP.com or by phone at(888) 519-9901.

Be prepared to confirm a date and location for testingand provide your AACN Customer ID #, preceded by theletter “C,” in place of your social security number. Thisnumber will be on the label of your confirmationpostcard. AACN Certification Corporation does not

collect social security numbers from candidates. Whenthe appointment is made, you will be given a time toreport to the site.

Note the time and date since you will not be sent anadmission ticket.

You can only take the exam for which you made theappointment. Therefore, verify on your confirmationpostcard that you are registered for the correct examand notify AACN Certification Corporation immediatelyof any error.

The exam type cannot be changed at the testing site.Unscheduled walk-in candidates will not be admittedto the testing site.

During 2009, exams will not be offered:

EXAM RESCHEDULING AND CANCELLATION

Once you have scheduled your exam with AMP, you may reschedule once within your 90-day eligibility period bycalling AMP at (888) 519-9901. This request must be made at least two business days before your previouslyscheduled date according to this schedule:

There are no refunds or extensions for missedappointments. If you are unable to sit for the examwithin your 90-day eligibility period, you may call AACNCertification Corporation at (800) 899-2226 before thescheduled testing session to request a one-time 90-dayextension. A $100 change fee is required.

If you do not schedule an exam within your 90-dayeligibility period, contact AACN Certification Corporationto request a new 90-day period. A $100 fee is charged.If you contact AACN Certification Corporation to cancelyour exam after receiving confirmation of eligibility youwill receive a refund minus a $100 processing fee.

If you are unable to sit for a scheduled paper and pencilexam at an NTI® or TRENDS conference and notify AACNCertification Corporation prior to the exam date you mayreschedule for computer-based testing within your 90-dayeligibility period. You will be charged the differencebetween the paper and pencil exam fee and the computer-based testing fee and notified when payment is due.

Alternatively, if you are unable to sit for an NTI® orTRENDS paper and pencil exam or reschedule withinyour 90-day eligibility period, you may request a refund.The paper and pencil exam fee will be refunded minusa $100 processing fee.

When the exam is scheduled on: AMP must be called by 3:00 p.m. Central Time toreschedule the exam by the:

Monday previous WednesdayTuesday previous Thursday

Wednesday previous FridayThursday previous Monday

Friday/Saturday previous Tuesday

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ON THE DAY OF YOUR EXAM

Report to the designated testing site no later than yourscheduled time. The address is available when youschedule your exam. AMP sites are typically located inH&R Block offices. Look for signs indicating AMPAssessment Site Check-In. You will not be admitted ifyou arrive more than 15 minutes late.

No books, papers, dictionaries, other referencematerials or personal items—including purses,briefcases, coats, etc.—may be taken into the testingsite and must be left in a vehicle or at home. NeitherAMP, AACN nor H&R Block will be responsible for lossor damage to personal items. We also recommendlayering your clothing so that you can adjust to theroom’s temperature during the exam.

Security StandardsAACN Certification Corporation and AMP maintain testadministration and test security standards designed toensure that all candidates are provided the sameopportunity to demonstrate their abilities. The testingsite is continuously monitored by audio and videosurveillance equipment for security purposes.

Verifying Your IdentityYou must present two forms of identification to gainadmission to the testing site. Both forms ofidentification must be current and include your nameand signature, which must match the name on theconfirmation postcard. You will be required to sign aroster for verification of identity. You are prohibitedfrom misrepresenting your identity or falsifyinginformation to obtain admission.

One form of identification must include yourphotograph. The second form need not be a photo IDand can be a credit card as long as it bears a matchingname and signature. Employment, student and anytype of temporary identification cards are notacceptable. Acceptable forms of photo identificationinclude a current:

1. Driver’s license with photograph2. State identification card with photograph3. Passport with photograph4. Military identification card with photograph

Logging inAfter your identity has been confirmed, you will bedirected to a testing carrel where the computer screenwill instruct you to enter your social security number.

Instead, use your AACN customer identificationnumber preceded by the letter “C,” as printed on yourconfirmation postcard label. If you do not rememberthis number, you may ask the proctor. You will thencapture your own photograph, which will remain on-screen throughout your testing session. Thephotograph will also appear on your score report.

Taking the ExamEach exam consists of multiple-choice questions. Thenumber of questions answered correctly determinesyour score.

Answering Test Items: Only one question is presentedat a time. The item number appears in the lower right-hand corner of the screen. The entire test item willappear on the screen (i.e., a stem and four answeroptions labeled A, B, C and D). Use the mouse to clickon your answer or use the keyboard to enter the letterfor your answer. Your answer will appear in the lowerleft section of the screen.

Changing Your Answer: Click on a different answer oruse the keyboard to change your answer as manytimes as you wish during the exam.

Moving to the Next Item: Click on the forward arrow(>) in the lower right corner of the screen or select theNEXT key. Either action will move you forward throughthe exam item by item. Click the backward arrow (<) oruse the left arrow on the keyboard to return to previousitems.

Unanswered Items: You may leave an itemunanswered and return to it later. You should notspend too much time on difficult questions. Instead,proceed to other questions and return to the difficultones if time permits. You may bookmark an item forlater review by clicking the blank square to the right ofthe TIME button. Clicking on the hand icon or selectingthe NEXT key advances to the next unanswered orbookmarked item on the exam. To identify allunanswered and bookmarked items, repeatedly clickon the hand icon or press the NEXT key.

Answer Every Item: When you have completed theexam, the number of items you answered is reported.If you have not answered every item and have timeremaining, return to the exam and answer them.There is no penalty for guessing.

9

Practice Exam: The time of a practice exam is notcounted as part of the timed exam. Once you arecomfortable with the computer-based testing process, youmay end the practice session and start the timed exam.

Timed Exam: After your practice session, you will beginthe actual exam. Instructions for taking the exam areavailable on-screen once you begin the exam. The timelimit is intended to allow you to complete the entireexam by working quickly and efficiently. The computermonitors the time you spend on the exam, and theexam ends automatically if you exceed the time limit.You can display a digital clock showing the timeremaining by clicking the TIME button in the lower right-hand corner of the screen or selecting the TIME key. Ifyou find it distracting, you may turn off the digital clockusing either command anytime during the exam.

During the ExamQuestions About Content: You may not ask questionsabout the content of the exam at any time.

Making Notes: You will be provided with scratch paperto use during the exam. You may not remove anydocuments or notes from the exam room and theirreturn to the proctor is required in order to receive yourscore. All computer screens, questions, paper andwritten materials are the property of AACN CertificationCorporation and AMP and may not be reproduced inany form.

Commenting on Items: You may comment about anyitem by clicking on the exclamation point (!) to the leftof the TIME button. This opens a dialog box where youmay enter your comments.

Breaks, Food, Drink, Smoking: Breaks are consideredpart of your exam time. You may request a breakwhenever you wish, but will not be allowed additionalmake-up time. Leaving the testing site withoutauthorization automatically voids the exam. You maynot eat, drink or smoke in the testing site.

Ending the Exam: If you finish the exam early, you mayend the exam and receive your score by clicking theCOVER button on the screen.

Inclement Weather or Emergency24-Hour AMP Weather Hotline (800) 380-5416

In the event of inclement weather or unforeseenemergencies on the day of an exam, AMP willdetermine whether circumstances warrant thecancellation and subsequent rescheduling of an exam.

Contact the 24-hour weather hotline before the examto determine if AMP has been notified that any testingsites will be closed.

An exam will usually not be rescheduled if testing sitepersonnel can reach and operate the site. Every attemptis made to administer exams as scheduled. Should anexam be canceled at an assessment site, all scheduledcandidates will receive follow-up notification regarding arescheduled exam date or reapplication procedures.

Dismissal From the Testing SiteThe proctor may dismiss you from the exam for any ofthese reasons:

• Unauthorized admission to the exam

• Creating a disturbance, being abusive or otherwiseuncooperative

• Bringing unauthorized electronic devices includingpersonal digital assistants (PDAs), other hand-heldcomputers, calculators, telephones, pagers, alarmsand other signaling devices

• Bringing notes or other resources into the testing site

• Attempting to record test questions or make notes

• Attempting to take the exam for someone else

• Giving or receiving help or being suspected ofdoing so

• Leaving the premises without notifying the proctor

You will be dismissed for any of these violations. Yourexam score will be voided and your fees will not berefunded. Evidence of misconduct will be reviewed byAACN Certification Corporation to determine whetheryou will be allowed to reapply for the exam. If a re-examis granted, a complete application and fee are requiredto reapply.

Failure to Report for an ExamYou may reapply to take the exam in the future if youdid not appear for your scheduled testing session. Ifyour original application is less than one year old, itmay be reactivated by paying the initial exam fee. If theapplication is more than one year old, you must submita new application and the initial exam fee.

After the ExamAfter you finish the exam, you will be asked tocomplete a short evaluation of your testing experience.Then the proctor will provide you with your officialscore report. The report will also provide the percent of

10

correct answers for each major content category.Refer to the exam content area of each section of thishandbook for information about how the variousexams are scored. Successful candidates receive theircertification wallet card and wall certificate suitable forframing six to eight weeks after the exam.

Improper Behavior After the ExamAny individual who removes or attempts to removematerials from the test center, or who receives,discusses, discloses, reproduces, distributes, displaysor otherwise misuses a test question or any part of atest question from a certification exam by written,electronic, oral or other form of communication,including, but not limited to e-mailing, copying orprinting of electronic files and reconstruction throughmemorization and/or dictation, will be subject to legalaction and monetary damages. Any nurse whoengages in such improper behavior also may facedenial or revocation of eligibility for certification ordenial or revocation of certification.

Passing ScoresNo test measures performance with perfect accuracyand consistency. AACN Certification Corporation setspassing scores for certification exams using asystematic procedure developed collaboratively byexperts from the corporation’s Exam DevelopmentGroup and professional psychometricians from AMP.

If you take more than one version of an exam, for eachversion you would probably achieve a different scorethat clusters around a typical or average value. Thestatistical estimate of the difference between theaverage score and your actual score on a specificversion is called the standard error of measurement.The standard error of measurement reflects theaccuracy of exam scores, and AMP determines thestandard error of measurement for each exam. Thesestatistical data are reported to AACN CertificationCorporation as a measure of the consistency of examscores. For each content area, the percent ofquestions answered correctly is also reported to givecandidates an idea of how well they performed in eacharea and to identify areas of weakness.

The questions are designed to test both your ability toremember specific facts or points of knowledge andyour ability to apply that knowledge in performingspecific knowledge, skills and abilities required ofacute or critical care nurses. Since an exam measuresyour knowledge in all areas, you could achieve a highpercentage of correct responses in some areas, butnot pass the exam.

Confidentiality of Exam ScoresYour exam application submitted to AACN CertificationCorporation constitutes written authorization for AMPto release your exam scores to AACN CertificationCorporation. Scores are reported only to youimmediately after the exam or by U.S. mail. Scores arenot reported by telephone, electronic mail or facsimile.Neither AMP nor AACN Certification Corporation willrelease scores to any institution or employer withoutyour written consent. Or you may release a copy of yourscore report yourself.

If You Do Not Pass the ExamIf you do not pass the exam, you may reapply to AACNCertification Corporation for a retest. Candidates mayapply for retest by phone at (800) 899-2226 ifapplying within 12 months of the date that the examhonor statement was signed. After 12 months, signinga new honor statement is required. Candidates mayalso apply for a retest online (two weeks after theexam was taken) at www.certcorp.org or submit apaper application by mail or fax. Select the retestoption on the application to obtain the discountedretest fee, which is available to candidates who tookthe exam within their most recent 90-day window butdid not pass. Candidates may apply and sit for thesame certification exam up to four times in a 12-month period.

Canceled ScoresAACN Certification Corporation and AMP areresponsible for the integrity of the scores they report.On occasion, occurrences such as computermalfunction or misconduct by a candidate may causea score to be suspect. AACN Certification Corporationand AMP are committed to rectifying such occurrencesas quickly as possible. AACN Certification Corporationmay void exam results if investigation shows itsregulations have been violated.

Duplicate Score ReportsYou may request an additional copy of your scorereport at $25 per copy. Submit requests and paymentby check or money order within 12 months of sittingfor the exam to: Applied Measurement Professionals,Inc. (AMP), 18000 W. 105th Street, Olathe, KS66061. The request must include your name, AACNCustomer ID# preceded by the letter “C” (e.g.,C00123456), address, telephone number, and dateand type of exam taken. Sign and date your request.Duplicate score reports are mailed withinapproximately two weeks after receipt of your request.

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RECOGNITION OF CERTIFICATION AND USE OF CREDENTIALS

AACN Certification Corporation will deny certification toinitial exam candidates for any reason deemedappropriate including, but not limited to, the following:

•Violating any rules of the exam

• Falsification of the certification application

• Falsification of any information requested by AACNCertification Corporation

• Failure to pay fees

• Failure to meet deadlines

• Failure to respond to or pass an audit

• Conviction of a felony

• Cheating (or reasonable evidence of intent tocheat) on the exam

• Sharing exam contents

• Restrictions placed on RN or APRN licensure.(A current unencumbered license is required; anunencumbered license is not currently subject toformal discipline by any Board of Nursing and hasno provisions or conditions that limit the nurse’spractice in any way.)

• Misrepresentation of certification status

In the event of denial, you may be notified that you areprohibited from reapplying for the certification examfor a period of up to three years. AACN CertificationCorporation may take additional actions pendingfurther investigation, including sending notification toyour employer and/or state Board of Nursing, asappropriate.

DENIAL OF CERTIFICATION

AACN certifications are not punctuated with periods. Thespecific program of certification, i.e., CCRN, PCCN, CMC orCSC and neonatal, pediatric or adult, will be noted on yourwallet card and wall certificate. AACN CertificationCorporation maintains a list of nurses it has certified andmay report the list in its publications.

Specialty CertificationsCandidates who meet all eligibility requirements and passa specialty certification exam may use the correspondingcredential (“CCRN” or “PCCN”) after their licensing title.CCRN and PCCN are registered service marks. The properuse of CCRN is as follows:

Chris Smith, RN, CCRN; the proper use of PCCN is asfollows: Chris Smith, RN, PCCN.

Subspecialty CertificationsCandidates who meet all eligibility requirements andpass the CMC or CSC subspecialty certification examsmay use the corresponding credential(s) after theirlicensing title, linked to a nationally accredited clinicalnursing specialty certification. Candidates mustindicate to AACN to which certification they wish toattach their subspecialty certification. CMC and CSCare registered service marks. The proper use of CMC isas follows: Chris Smith, RN, CCRN-CMC. The properuse of CSC is: Chris Smith, RN, CCRN-CSC.

12

AACN Certification Corporation may revoke certificationfor any reason deemed appropriate including, but notlimited to, the following:

•Falsification of the certification application orrenewal application

• Falsification of any information requested by AACNCertification Corporation

• Failure to maintain eligibility requirements

• Failure to pay fees

• Failure to meet deadlines

• Failure to respond to or pass an audit

• Misrepresentation of certification status

• Conviction of a felony

• Cheating (or reasonable evidence of intent tocheat) on the exam

• Restrictions placed on RN or APRN licensure.(A current unencumbered license is required; anunencumbered license is not currently subject toformal discipline by any Board of Nursing and hasno provisions or conditions that limit the nurse’spractice in any way.)

In the event of revocation, notification may be sent toyour employer and state Board of Nursing, whereappropriate. You will be notified that you may beprohibited from reapplying for the exam for a period ofup to three years. Fees paid for certification renewalare not refunded.

REVOCATION OF CERTIFICATION

You may request a review of your certification eligibilityat any time. The review process is conducted by thestaff of AACN Certification Corporation. The appealprocess is conducted by the AACN CertificationCorporation Appeals Panel. The review and appealprocess is available if your certification status hasexpired, been denied or revoked. You may appeal if youdo not meet the AACN Certification Corporationexperience component of the clinical practice eligibilityrequirement but believe your practice conforms to theintent, if not the precise content and definition, of theexperience requirement.

Typing or printing legibly, describe your clinical practiceand how it conforms to the certification program.Submit a written request for review to:

Certification SpecialistAACN Certification Corporation101 ColumbiaAliso Viejo, CA 92656-4109

Or e-mail: [email protected]

Following review, if AACN Certification Corporation staffaffirms the decision to deny or revoke certification, aRequest for Appeal form with detailed informationabout the appeal process will be sent to you. Once youreturn the form and provide additional documentation,if needed, the Appeals Panel will review the case at itsnext scheduled review. You will be notified in writing ofthe Appeals Panel’s decision. The decision of theAppeals Panel is final.

For questions about this process, call AACNCertification Corporation at (800) 899-2226.

REVIEW AND APPEAL OF CERTIFICATION ELIGIBILITY

13

14

CCRN PCCN CMC CSC

AACNmember

Non-member

AACNmember

Non-member

AACNmember

Non-member

AACNmember

Non-member

$220 $325 $170 $250 $135 $180 $135 $180

Computer-Based Exams

EXAM FEES

Payable in U.S. funds. Fees are subject to change without notice. A $15 fee will be charged for a returned check.Computer-based testing discounts are available for groups of 10 or more exam candidates who apply together.Employers may pre-purchase exam vouchers at a further discounted rate. For details about the group and bulkdiscount programs visit www.certcorp.org or call (800) 899-2226.

Paper and Pencil Exams

Testing LocationNumber of candidatestesting simultaneously

at one siteCCRN PCCN CMC CSC

AACNmember

Non-member

AACNmember

Non-member

AACNmember

Non-member

AACNmember

Non-member

U.S. Pricing 4 $240 $345 $230 $310 $220 $265 $220 $265

5 $220 $325 $200 $280 $190 $235 $190 $235

6 or more $220 $325 $180 $260 $170 $215 $170 $215

AACNmember

Non-member

AACNmember

Non-member

AACNmember

Non-member

AACNmember

Non-member

DANTES(Military) Pricing

4 $265 $370 $240 $320 $250 $295 $250 $295

5 $230 $335 $200 $280 $210 $255 $210 $255

6 or more $220 $325 $175 $255 $185 $230 $185 $230

DANTES - Defense Activity for Non-Traditional Education Support

Payable in U.S. funds. Fees are subject to change without notice. A $15 fee will be charged for a returned check.

Paper and pencil exams are available to those located three hours or more from the nearest computer-basedtesting center. Requests must be submitted to AACN Certification Corporation three months in advance of testdate. For details see page 7 or contact AACN via e-mail at [email protected].

The above pricing does not apply for the paper and pencil exam sessions offered at the NTI® and TRENDSeducational conferences. Visit www.certcorp.org for more information.

CCRN CERTIFICATION

CCRN Certification Program ..........................................................................................................................................16

CCRN Exam Eligibility .....................................................................................................................................................16

CCRN Certification Renewal ..........................................................................................................................................17

CCRN Online Registration..............................................................................................................................................19

CCRN Application Fees ..................................................................................................................................................19

AACN Products for CCRN Exam Preparation.................................................................................................................21

CCRN Study Bibliography .........................................................................................................................................23-24

CCRN Test Plan–Adult Program ..............................................................................................................................25-26

CCRN Test Plan–Pediatric Program.........................................................................................................................27-28

CCRN Test Plan–Neonatal Program ........................................................................................................................29-30

CCRN Sample Exam Questions–Adult ..........................................................................................................................31

CCRN Sample Exam Questions–Pediatric ....................................................................................................................32

CCRN Sample Exam Questions–Neonatal..............................................................................................................33-34

CCRN Exam Honor Statement (use with application at end of handbook) ................................................................35



15

CCRN® certification is a specialty certification for nurses who provide care for acutely and/or critically ill patients,regardless of the geographic location of their nursing care. Specialty nurses interested in this certification maywork in such areas as: intensive care units; cardiac care units; combined ICU-CCUs; medical/surgical ICUs; traumaunits; or critical care transport/flight.

CCRN

CCRN® Registered Service MarkCCRN is a registered service mark of AACNCertification Corporation and denotes certification incritical care nursing as granted by AACN CertificationCorporation. Registered nurses who have not achievedCCRN certification status, whose CCRN status haslapsed or who have chosen Inactive status are notauthorized to use the CCRN credential.

Although a common misconception, CCRN is not anacronym for “critical care registered nurse.” Thiswould imply that nurses are registered as critical carenurses, which is not accurate.

Validated Knowledge and SpecializedSkillsEach CCRN certification exam is based on a jobanalysis. The most recent study, completed in 2003,defines the dimensions of critical care practice,identifying what is required of registered nursespracticing in acute and critical care settings.

In the study, acute and critical care nurses across theUnited States were surveyed to ascertain thefrequency and significance of the various elements oftheir practice. Through an extensive review andevaluation process, the knowledge, skills and abilitiescrucial to acute and critical care nursing were definedusing the AACN Synergy Model for Patient Care as anorganizing framework. The CCRN certification examsare based on these skills and abilities and theknowledge required to perform them.

CCRN certification is achieved by those acute andcritical care nurses who pass the CCRN exam inneonatal, pediatric and/or adult critical care nursing.CCRN certification denotes to the public thosepractitioners who possess a distinct and clearlydefined body of knowledge called critical care nursing.

CCRN Exam ContentThe CCRN exams are three-hour tests consisting of150 multiple-choice items. Of the 150 items, 125 arescored and 25 are used to gather statistical data onitem performance for future exams. The CCRN examsfocus on adult, pediatric and neonatal patientpopulations. 80% of each exam focuses on clinicaljudgment and is age specific for the adult, pediatricand neonatal populations. The remaining 20% coversprofessional caring and ethical practice. Professionalcaring and ethical practice questions may be askedabout any age across the life span while clinicaljudgment questions are restricted to adult, neonatal orpediatric populations.

CCRN Test PlansThe content of the CCRN exams is described in the testplans included in this handbook. Candidates aretested on a variety of patient care problems that areorganized under major categories. Please note thepercentage of the CCRN exam devoted to eachcategory.

CCRN CERTIFICATION PROGRAM

• Current unencumbered licensure as an RN or APRNin the United States is required.

An unencumbered license is not currently subject toformal discipline by any Board of Nursing and has noprovisions or conditions that limit the nurse’spractice in any way.

It is the responsibility of candidates and CCRN-certified nurses to notify AACN CertificationCorporation when any restriction is placed on theirRN or APRN license. If you are randomly selected foraudit, you will be asked to provide a copy of your RNor APRN license copy – please do not submit withyour application.

• Practice as an RN or APRN is required for 1,750hours in direct bedside care of acutely and/orcritically ill patients during the previous two years,with 875 of those hours accrued in the most recentyear preceding application. Eligible hours are thosespent caring for the patient population (adult,pediatric or neonatal) of the exam for which you areapplying.

Clinical practice hours for the CCRN exam or renewaleligibility must take place in a U.S.-based or Canada-based facility or in a facility determined to becomparable to the U.S. standard of acute/criticalcare nursing practice, as evidenced by ANCC MagnetStatus or Joint Commission Internationalaccreditation.

CCRN EXAM ELIGIBILITY

16

CCRN certification is conferred for a period of threeyears. Your certification period begins the first day ofthe month in which the CCRN certification exam ispassed and ends three years later; for example,October 1, 2009 through September 30, 2012. Thepurpose of certification renewal is to enhancecontinued competence.

A copy of the CCRN Renewal Handbook will be mailedto you approximately 90 days before your scheduledCCRN renewal date. You are responsible for renewingyour certification even if you do not receive renewalnotification.

You may seek certification renewal via Renewal bySynergy CERPs or Renewal by Exam, or you maychoose Inactive, Retired or Alumnus status. Do notapply for more than one option. Renewal by Examcandidates must successfully apply for and scheduletheir exam in enough time to complete the CCRN exambefore their scheduled renewal date. You may nottake the exam early, then attempt to renew by CERPs ifyou do not pass.

To renew, you must hold a current unencumbered RNor APRN license in the United States, complete 432hours of direct bedside care of acutely and/or criticallyill patients within the three-year certification period,

with 144 of those hours in the 12-month period priorto the scheduled renewal date, and complete therequired Synergy CERPs or complete the CCRN exam.Eligible hours are those spent caring for the patientpopulation (adult, pediatric or neonatal) in whichcertification is held. For more details, refer to theCCRN Renewal Handbook, available atwww.certcorp.org.

Option 1 - Renewal by Synergy CERPsMeet eligibility requirements for CCRN renewal andcomplete the Continuing Education Recognition Point(CERP) Program, which requires 100 CERPs in variouscategories (A, B & C). For more details refer to Renewalby Synergy CERPs At-a-Glance and other Synergy CERPresources available online at www.certcorp.org.

Online Renewal by Synergy CERPs is available to allactive CCRNs as early as four months prior to theirscheduled renewal date. For more information visitwww.certcorp.org - click Renew Your Certification.

Option 2 - Renewal by ExamMeet the eligibility requirements for CCRN renewal andsuccessfully apply for and schedule your exam inenough time to complete the CCRN exam before yourscheduled renewal date.

CCRN CERTIFICATION RENEWAL

• Nurses serving as manager, educator (in-service oracademic), APRN or preceptor may apply their hoursspent supervising nursing students or nurses at thebedside. Nurses in these roles must be activelyinvolved in caring for patients at the bedside; forexample, demonstrating how to measure pulmonaryartery pressures or supervising a new employee orstudent nurse performing a procedure.

• The name and address of a professional associatemust be given for verification of eligibility related toclinical practice hours. If you are randomly selectedfor audit, this associate will need to verify that youhave met the clinical hour requirements. Aprofessional associate is defined as either a clinicalsupervisor (RN or physician), or RN colleague withwhom you work.

• AACN Certification Corporation may adopt additionaleligibility requirements at its sole discretion fromtime to time. Any such requirements will bedesigned to establish, for the purposes of CCRNcertification, the adequacy of a candidate'sknowledge and experience in caring for the acutelyand critically ill.

CCRN

17

OPTION 3 - Inactive StatusInactive status is available to CCRN-certified nurseswho do not meet the renewal eligibility requirementsbut do not wish to lose their CCRN certification status.Inactive status provides CCRN-certified nursesadditional time, up to three years from the scheduledrenewal date, to meet the eligibility requirements.During the time of Inactive status candidates may notuse the CCRN credential.

Alternate Designations

ALUMNUS STATUSAlumnus status is for nurses who have been CCRN-certified but no longer provide direct bedside care toacutely and/or critically ill patients for enough hours tomeet the clinical hour requirement for active CCRNcertification, but are still in the nursing profession insome other capacity and wish to remain connectedwith the credential. Renewable every three years, the“Alumnus CCRN” designation, written out, may be usedon your resume or below your name and credentials ona business card, but may not be used with yoursignature or on a name badge. To be eligible forAlumnus CCRN status, you must have held CCRNcertification and have no plans to renew CCRNcertification in the future. There are no CE or CERPrequirements to maintain Alumnus CCRN status.

RETIRED STATUSRetired status provides the CCRN-certified nurse orAlumnus CCRN who is retiring from the nursing

profession with a continued sense of career identityand professional connectedness. The Retired CCRNdesignation recognizes CCRN-certified nurses for theiryears of service at the bedside. It also acknowledgestheir pride and dedication in maintaining theircertification. To be eligible for Retired CCRN status, youmust have been a CCRN without plans of returning tonursing practice or renewing certification. The retiredRN must not be working in any type of position thatrequires the possession of an RN license. You are noteligible if you are changing from bedside practice toanother nursing role. The “Retired CCRN” designation,written out, may be used on your resume or below yourname and credentials on a business card, but may notbe used with your signature or on a name badge.There are no CE or CERP requirements to maintainRetired CCRN status.

For more details about Alumnus and Retired status,refer to the Alumnus CCRN and Retired CCRNapplications available online at www.certcorp.orgunder Documents and Handbooks.

CCRN-E STATUSIf you work primarily or exclusively in a remote ICUenvironment (such as a virtual or electronic ICU) anddo not meet the requirements for regular CCRNrenewal and would like to see if this renewal option isappropriate for you, refer to the CCRN-E RenewalHandbook online at www.certcorp.org underDocuments and Handbooks.

CCRN CERTIFICATION RENEWAL (CONTINUED)

18

Online registration is available for the CCRN exam. This paperless registration streamlines the exam applicationprocess by up to six weeks. Once you register online your 90-day window for testing will begin within one to twoweeks. Candidates should be prepared to sit for the exam before registering online. For more information andto register visit www.certcorp.org.

CCRN ONLINE REGISTRATION

CCRN Computer-Based Exam

AACN Members $220

Nonmembers $325

CCRN Retest Fee

AACN Members $170

Nonmembers $275

Current CCRN Renewal by Exam

AACN Members $170

Nonmembers $275


CCRN

CCRN APPLICATION FEES

19

OFCRHB

AACN PRODUCTS FOR CCRN EXAM PREPARATION

OCTOBER 2009 21

For more details and to place an order, visit our Web site at www.aacn.org and click on Marketplace,or call AACN Customer Care at (800) 899-2226, between 7:30 a.m. and 4:30 p.m., Pacific Time.

*Denotes products developed by AACN Certification Corporation.

**Adult CCRN Review Packages include Adult CCRN Review Course, Adult Practice CCRN Exam Questions and AACN CoreCurriculum for Critical Care Nursing.

***Pediatric CCRN Review Packages include Pediatric/Neonatal CCRN Review Course, Pediatric Practice CCRN Exam Questionsand AACN Core Curriculum for Pediatric Critical Care Nursing.

****Neonatal CCRN Review Packages include Pediatric/Neonatal CCRN Review Course, Neonatal Practice CCRN ExamQuestions and Certification Core Review for Neonatal Intensive Care Nursing.

Description Item #

* Online Adult CCRN Self-Assessment Exam (SAE) – mirrors content of CCRN exam; includes 60 questions with correctanswers and rationale; score report upon completion to assess strengths and areas for further study; access for 90 daysfrom purchase date.

Purchase online only atwww.certcorp.org.

* Adult Practice CCRN Exam Questions, 6th ed. (2009). 190 questions. 200305

AACN Core Curriculum for Critical Care Nursing, 6th ed. (2006). Grif Alspach, J. 992 pages. 128700

AACN Procedure Manual for Critical Care, 5th ed. (2005). Lynn-McHale, D & Carlson, K. 1,280 pages. 128150

AACN Certification and Core Review for High Acuity and Critical Care, 6th ed. (2007). Grif Alspach, J. 192 pages. 128800

Adult CCRN Review Course on DVD. (2007). 301965

Adult CCRN Review Course on CD-ROM. (2007). 301950

Adult CCRN Review Course on Audio CD . (2007). 301973

Adult CCRN Review Course Additional Syllabus, to accompany 2007 review courses. 199 pages. 301995

** Adult CCRN Review Package on DVD. 302000** Adult CCRN Review Package on Audio CD. 302005

** Adult CCRN Review Package on CD-ROM . 302010

Mosby’s Critical Care Drug Reference. (2007). 1,040 pages. 128163ACLS Pocket Reference Cards. (2006). AHA, AACN. Set of 2. 400862Emergency Psychiatry: Principles and Practice. (2008). Glick, R., et. al. 488 pages. 301650Synergy for Clinical Excellence: The AACN Synergy Model for Patient Care. (2004). Hardin, S. & Kaplow, R. 160 pages. 100149Critical Care Nursing: Synergy for Optimal Outcomes ( 2007). Kaplow, R. & Hardin, S. 778 pages. 100147* Pediatric Practice CCRN Exam Questions, 6th ed. (2009). 130 questions. 200205AACN Core Curriculum for Pediatric Critical Care Nursing, 2nd ed. (2006). Slota, M. 912 pages. 128870AACN Procedure Manual for Pediatric Acute & Critical Care. (2007). Verger, J. 1,520 pages. 131104

Emergency Management of the Pediatric Patient: Cases, Algorithms, Evidence. (2006). Prentiss, K., Cummings, B.,Mick, N. & Filbi, M. 176 pages. 131109

Resuscitation and Stabilization of the Critically Ill Child. (2009). Wheeler, D., Wong, H. & Stanley, T. 172 pages. 131106*** Pediatric CCRN Review Package on DVD. 302006*** Pediatric CCRN Review Package on Audio CD. 302008Perinatal and Pediatric Respiratory Care. (2010). Walsh, B., Czervinske, M. & DiBlasi, R. 840 pages. 128744

Pediatric /Neonatal CCRN Review Course on DVD. (2006). 301850Pediatric /Neonatal CCRN Review Course on Audio CD. (2006). 301990* Neonatal Practice CCRN Exam Questions, 6th ed. (2009). 125 questions. 200105Core Curriculum for Neonatal Intensive Care Nursing, 4th ed. (2009). Verklan, M. & Walden, M. 1,040 pages. 128710

Certification & Core Review for Neonatal Intensive Care Nursing, 3rd ed. (2007). Watson, R. 176 pages. 128720

Handbook of Neonatal Intensive Care, 6th ed. (2006). Merenstein, G. & Gardner, S. 928 pages. 128745Manual of Neonatal Care. (2007). Cloherty, J. Eichenwald, E. & Stark, A. 800 pages. 128749Perinatal Cardiology Handbook. (2008). Bader, R. & Hornberger, L. 544 pages. 128748

**** Neonatal CCRN Review Package on DVD. 302007

**** Neonatal CCRN Review Package on Audio CD.. 302009

CCRN

Clinical Judgment – Adult CCRNAmerican Heart Association. (2005). Guidelines 2005for Cardiopulmonary Resuscitation and EmergencyCardiovascular Care. Available at:www.americanheart.org/presenter.jhtml?identifier=3035517

Conover, M. B. (2003). UnderstandingElectrocardiography. 8th ed. St. Louis, Mo:Mosby/Elsevier.

Copstead, L. & Banasik, J. L. (2000). Pathophysiology:Biological and Behavioral Perspectives. 2nd ed.Philadelphia: W. B. Saunders/Elsevier.

Darovic, G. O. (2002). Hemodynamic Monitoring:Invasive and Noninvasive Clinical Application. 3rd ed.Philadelphia: W. B. Saunders/Elsevier.

Emergency Nurses Association & Newberry, L. (2005).Sheehy’s Manual of Emergency Care. 6th ed. St.Louis: Mosby/Elsevier.

Finkelmeier, B. A. (2000). Cardiothoracic SurgicalNursing, 2nd ed. Philadelphia: Lippincott Williams &Wilkins.

Hickey, J. V. (2008).The Clinical Practice ofNeurological and Neurosurgical Nursing. 6th ed.Philadelphia: Lippincott Williams & Wilkins.

McNally, P. (2001). GI/Liver Secrets. 2nd ed.Philadelphia: Hanley & Belfus/Elsevier.

McQuillan, K. A., Whalen, E. & Flynn Makic, M. B.(2008). Trauma Nursing: From Resuscitation ThroughRehabilitation. 4th ed. Philadelphia: Elsevier.

Pagana, K. D. & Pagana, T. J. (2008). Mosby’sDiagnostic and Laboratory Test Reference. 9th ed. St.Louis, Mo: Mosby/Elsevier.

Skidmore-Roth, L. (2008). Mosby’s 2009 Nursing DrugReference. 22nd ed. St. Louis, Mo: Mosby/Elsevier.

Smeltzer, S., Bare, B. G., Hinkle J. L. & Cheever, K. H.(2008). Brunner and Suddarth’s Textbook of Medical-Surgical Nursing. 11th ed. Philadelphia: LippincottWilliams & Wilkins.

Sole, M. L., Klein, D. G. & Moseley, M. (2008).Introduction to Critical Care Nursing. 5th ed.Philadelphia: W. B. Saunders.

Stillwell, S. (2006). Mosby’s Critical Care NursingReference. 4th ed. St. Louis, Mo: Mosby/Elsevier.

Urden, L., Lough, M. E., & Stacy, K. L. (2005). Thelan’sCritical Care Nursing: Diagnosis and Management. 5thed. St. Louis, Mo: Mosby/Elsevier.

Wiegand, D. J. L. & Carlson, K. K. (eds.) (2005). AACNProcedure Manual for Critical Care. 5th ed.Philadelphia: Elsevier.

Woods, S., Sivarajan Froelicher, E. S., & Motzer, S. U.(2004). Cardiac Nursing. 5th ed. Philadelphia:Lippincott Williams & Wilkins.

Clinical Judgment – Pediatric CCRNAmerican Heart Association. (2005). Guidelines 2005for Cardiopulmonary Resuscitation and EmergencyCardiovascular Care. Available at:www.americanheart.org/presenter.jhtml?identifier=3035517

Betz, C. L. & Sowden, L. A. (2004). Pediatric NursingReference. 5th ed. St. Louis, Mo: Mosby/Elsevier.

Boylston, M. & Beer, D. (2002). “Methemoglobinemia:A Case Study.” Critical Care Nurse. 22 (4): 50-55.

Copstead, L. & Banasik, J. L. (2000). Pathophysiology:Biological and Behavioral Perspectives, 2nd ed.Philadelphia: W. B. Saunders/Elsevier.

Curley, M. A. Q. & Moloney-Harmon, P. A. (2001).Critical Care Nursing of Infants and Children. 2nd ed.Philadelphia: W. B. Saunders/Elsevier.


Finkelmeier, B. A. (2000). Cardiothoracic SurgicalNursing, 2nd ed. Philadelphia: Lippincott Williams &Wilkins.

Hockenberry, M. J., Wilson, D., Winkelstein, M. L. &Kline, N. E. (2007). Wong’s Nursing Care of Infantsand Children. 8th ed. St. Louis, Mo: Mosby/Elsevier.

Moloney-Harmon, P. A. & Czerwinski, S. J. (2003).Nursing Care of the Pediatric Trauma Patient.Philadelphia: W. B. Saunders/Elsevier.

CCRN STUDY BIBLIOGRAPHYRECOMMENDED REFERENCES FOR THE CCRN EXAM

23

CCRN STUDY BIBLIOGRAPHY (CONTINUED)

Pagana, K. D. & Pagana, T. J. (2008). Mosby’sDiagnostic and Laboratory Test Reference. 9rd ed. St.Louis, Mo: Mosby/Elsevier.


Slota, M. C. (ed.). (2006). AACN Core Curriculum forPediatric Critical Care Nursing. 2nd ed. St. Louis: Elsevier.


Urden, L., Lough, M. E. & Stacy, K. L. (2005). Thelan’sCritical Care Nursing: Diagnosis and Management. 5thed. St. Louis, Mo: Mosby/Elsevier.

Clinical Judgment – Neonatal CCRNAmerican Heart Association. (2005). Guidelines 2005for Cardiopulmonary Resuscitation and EmergencyCardiovascular Care. Available at:www.americanheart.org/presenter.jhtml?identifier=3035517

Copstead, L. & Banasik, J. L. (2000). Pathophysiology:Biological and Behavioral Perspectives, 2nd ed.Philadelphia: W. B. Saunders/Elsevier.

Curley, M. A. Q. & Moloney-Harmon, P. A. (eds.)(2001). Critical Care Nursing of Infants and Children.2nd ed. Philadelphia: W. B. Saunders/Elsevier.

Finkelmeier, B. A. (2000). Cardiothoracic SurgicalNursing. 2nd ed. Philadelphia: Lippincott Williams &Wilkins.

Hockenberry, M. J., Wilson, D., Winkelstein, M. L. &Kline, N. E. (2007). Wong’s Nursing Care of Infantsand Children. 8th ed. St. Louis, Mo: Mosby/Elsevier.

Merenstein, G. B. & Gardner, S. L. (eds). (2006).Handbook of Neonatal Intensive Care. 6th ed. St.Louis, Mo: Mosby/Elsevier.


Polin, R. A., Yoder, M. C. & Burg, F. D. (2001).Workbook in Practical Neonatology. 3rd ed.Philadelphia: W. B. Saunders/Elsevier.


Verklan, M. T. & Walden M. (eds.) (2004). CoreCurriculum for Neonatal Intensive Care Nursing. 3rded. St. Louis. Mo: Elsevier/Saunders.

Young, T. E. & Mangum, B. (2005). Neofax: A Manualof Drugs Used in Neonatal Care. 18th ed. Raleigh, NC:Acorn Publishing.

Professional Caring and Ethical PracticeAmerican Association of Critical-Care Nurses. (2005).AACN Standards for Establishing and SustainingHealthy Work Environments: A Journey to Excellence.Available at: http://www.aacn.org/WD/HWE/Docs/HWEStandards.pdf.

Dossey, B. M., Keegan, L. & Guzzetta, C. (2003).Holistic Nursing: A Handbook for Practice. 3rd ed.Boston: Jones & Bartlett.

Hardin, S. R. & Kaplow, R. (eds.). (2005). Synergy forClinical Excellence: The AACN Synergy Model forPatient Care. Boston: Jones & Bartlett.

Lipson, J. G., Dibble, S. L. & Minarik, P. A. (eds.)(1996). Culture and Nursing Care: A Pocket Guide.San Francisco: UCSF Nursing Press.

Many references available through AACN; visitwww.aacn.org > Marketplace > Online Bookstore.

More current version may be available.

PUBLISHER CONTACTS:AACN – (800) 899-2226Acorn Publishing – (919) 786-1155American Heart Association – (800) 242-8721Elsevier (including Mosby, W. B. Saunders, and Hanley & Belfus) – (800) 545-2522Jones & Bartlett – (800) 832-0034Lippincott Williams & Wilkins – (800) 638-3030UCSF Nursing Press – (415) 476-4992

24

CCRN TEST PLAN – ADULT

I. CLINICAL JUDGMENT (80%)

A. Cardiovascular (32%)

1. Acute coronary syndromes/unstable angina

2. Acute heart failure/pulmonary edema

3. Acute inflammatory disease (e.g., myocarditis,endocarditis, pericarditis)

4. Acute myocardial infarction/papillary musclerupture

5. Acute peripheral vascular insufficiency (e.g.,acute arterial occlusion, carotid artery stenosis,endartarectomy, peripheral stents)

6. Cardiac surgery (e.g., valve replacement, CABG)

7. Cardiac tamponade

8. Cardiac trauma (blunt and penetrating)

9. Cardiogenic shock

10. Cardiomyopathies (e.g., hypertrophic, dilated,restrictive, idiopathic)

11. Cardiovascular pharmacology

12. Conduction defects, blocks and pacemakers

13. Dysrhythmias/AICDs

14. Heart failure

15. Hemodynamic monitoring

16. Hypertensive crisis

17. Hypovolemic shock and volume deficit

18. Pulmonary hypertension (e.g., valvular defects,aortic stenosis, mitral stenosis)

19. Ruptured or dissecting aneurysm (e.g.,thoracic, abdominal)

B. Pulmonary (17%)

1. Acute pulmonary embolus, fat embolus

2. Acute respiratory distress syndrome (ARDS)

3. Acute respiratory failure, hypoxemia

4. Acute respiratory infections

5. Air leak syndromes (e.g., spontaneouspneumothorax, pneumopericardium,pneumomediastinum, PIE)

6. Aspirations (e.g., aspiration pneumonia,hospital acquired pneumonia, foreign bodyaspiration)

7. Chronic lung disease

8. Pulmonary pharmacology

9. Pulmonary trauma (e.g., pulmonaryhemorrhage, tracheal perforation)

10. Respiratory distress (e.g., emphysema,bronchitis)

11. Status asthmaticus, exacerbation of COPD,emphysema

12. Thoracic surgery (e.g., lung contusions,fractured ribs, hemothorax, pulmonaryhemorrhage, lung reduction, pneumonectomy,lobectomy, tracheal surgery)

13. Thoracic trauma (e.g., lung contusions,fractured ribs, hemothorax, pneumothoraxfrom trauma, pulmonary hemorrhage)

14. Ventilator management and ABG interpretation,mixed venous gases, CPAP, volutrauma andbarotraumas

C. Endocrine (4%)

1. Acute hypoglycemia

2. Diabetes insipidus

3. Diabetic ketoacidosis

4. Hormones and endocrine anatomy andphysiology

5. Hyperosmolar hyperglycemic state (HHS)

D. Hematology/Immunology (3%)

1. Hematology, anatomy and physiology, bloodproducts and plasma

2. Immunosuppression-acquired (e.g., HIV, AIDS,neoplasms)

3. Life-threatening coagulopathies (e.g., ITP, DIC,hemophilia, HITTS, ReoPro-induced) and nonlife-threatening coagulopathies

4. Organ transplantation (e.g., liver, bone marrow,kidney, heart, pancreas, lung)

5. Sickle cell crisis

E. Neurology (5%)

1. Aneurysm, AV malformation2. Encephalopathy (e.g., hypoxic-ischemic,

metabolic, edema, infectious)3. Head trauma (blunt, penetrating), skull

fractures

CCRN

25

Applies to CCRN exams taken through January 12, 2010.

If you are taking the CCRN exam on January 13, 2010 or later please refer to the revised CCRN Test Planavailable online at www.certcorp.org, under Certification News > New CCRN Test Plans Effective Mid-January 2010.

CCRN TEST PLAN – ADULT (CONTINUED)

4. Intracranial hemorrhage/intraventricularhemorrhage (e.g., subarachnoid, epidural,subdural)

5. Neurologic infectious diseases (e.g., meningitis,GBS, West Nile)

6. ICP monitoring7. Neurosurgery (e.g., evacuation of hematoma,

tumor resection)8. Seizure disorders 9. Stroke (e.g., embolic events, hemorrhagic)

F. Gastrointestinal (6%)

1. Acute abdominal trauma

2. Acute GI hemorrhage (e.g., esophageal, upperand lower)

3. Bowel infarction, bowel obstruction, bowelperforation

4. GI surgeries (e.g., Whipple, esophago-gastrectomy, gastric bypass)

5. Hepatic failure/coma (e.g., portal hypertension,cirrhosis, esophageal varicies, fulminanthepatitis)

6. Pancreatitis

7. Gastro-esophageal reflux

G. Renal (5%)

1. Acute renal failure (e.g., acute tubular necrosis,hypoxia, dialysis)

2. Chronic renal failure and dialysis

3. Life-threatening electrolyte imbalances (e.g.,potassium, sodium, phosphorus, magnesium,calcium)

4. Fluid balance concepts and renal anatomy &physiology

5. Renal trauma

H. Multisystem (8%)

1. Multisystem trauma

2. Septic shock/infectious diseases (e.g., viral,bacterial, line sepsis, nosocomial infections,immunosuppression)

3. Systemic inflammatory response syndrome (SIRS)/sepsis/MODS

4. Toxic exposure (e.g., chemicals, radiation,anaphylaxis)

5. Toxic ingestions and inhalations (e.g.,drug/alcohol overdose, poisoning)

II. PROFESSIONAL CARING AND ETHICAL PRACTICE(20%)

A. Advocacy/Moral Agency (2%)

B. Caring Practices (4%)

C. Collaboration (4%)

D. Systems Thinking (2%)

E. Response to Diversity (2%)

F. Clinical Inquiry (2%)

G. Facilitation of Learning (4%)

26

CCRN TEST PLAN – PEDIATRIC





3. Cardiac surgery

4. Cardiac trauma (blunt and penetrating)


6. Cardiomyopathies (e.g., hypertrophic, dilated, restrictive, idiopathic)


8. Conduction defects, blocks and pacemakers

9. Congenital heart defect/disease

10. Dysrhythmias

11. Hemodynamic monitoring


13. Hypovolemic shock and volume deficit

14. Pulmonary hypertension (e.g., aortic and mitralstenosis and regurgitation)

B. Pulmonary (22%)



3. Acute respiratory infections (e.g., pneumonia,croup, strep pneumonia, RSV, bronchiolitis)

4. Air-leak syndromes (e.g., spontaneouspneumothorax, bronch-fistula, emphysema,[PIE], pneumopericardium,pneumomediastinum)

5. Apnea of prematurity

6. Aspirations (e.g., aspiration pneumonia,hospital-acquired pneumonia, foreign bodyaspiration)

7. Chronic lung disease (e.g., bronchopulmonarydysplasia)

8. Congenital anomalies

9. Persistent pulmonary hypertension

10. Pulmonary trauma (e.g., pulmonaryhemorrhage, tracheal perforation)


12. Respiratory distress (e.g., epiglottitis,bronchitis)

13. Status asthmaticus


15. Thoracic trauma (e.g., lung contusions,fractured ribs, hemothorax, pulmonaryhemorrhage)


C. Endocrine (5%)


2. Diabetes insipidus


4. Hormones and anatomy & physiology

5. Inborn errors of metabolism

6. Syndrome of inappropriate secretion ofantidiuretic hormone (SIADH)


1. Hematology, anatomy & physiology, bloodproducts and plasma

2. Hyperbilirubinemia

3. Immunosuppression (e.g., congenital [SCID],acquired [HIV, AIDS, neoplasms])

4. Life-threatening coagulopathies (e.g., DIC, ITP,hemophilia)

5. Organ transplantation (e.g., liver, bone marrow,kidney, heart, pancreas, lung)

6. Sickle cell crisis

E. Neurology (10%)

1. Acute spinal cord injury2. Congenital neurological abnormalities (e.g.,

spina bifida, myelomeningocele, anencephaly,encephalocele)

3. Encephalopathy (e.g., hypoxic-ischemic,metabolic, edema, infectious)

4. Head trauma (blunt, penetrating) includingshaken baby

5. Hydrocephalus

CCRN

27



CCRN TEST PLAN – PEDIATRIC (CONTINUED)

6. ICP monitoring7. Intracranial hemorrhage/intraventricular

hemorrhage (e.g., subarachnoid, epidural,subdural) including stroke

8. Neurologic infectious diseases (e.g., meningitis,congenital infections, viral infections, WestNile)

9. Neuromuscular disorders (e.g., musculardystrophy, Werdnig-Hoffman)

10. Neurosurgery (e.g., evacuation of hematoma,tumor resection)

11. Seizure disorders12. Space-occupying lesions (e.g., brain tumors)13. Spinal fusion


1. Acute abdominal trauma

2. Acute GI hemorrhage

3. Bowel infarction/obstruction/perforation (e.g.,necrotizing enterocolitis)


5. GI abnormalities at birth (e.g., Hirschprung's)

6. GI surgeries

7. Hepatic failure/coma (e.g., portal hypertension,fulminant hepatitis, biliary atresia,hyperbilirubinemia)

G. Renal (4%)

1. Acute renal failure (e.g., acute tubular necrosis)

2. Chronic renal failure and dialysis

3. Congenital renal-genitourinary abnormalities(e.g., polycystic kidneys, exstrophy of bladder,hydronephrosis)



6. Renal trauma

H. Multisystem (9%)

1. Asphyxia (e.g., near-drowning, traumatic)

2. Burns

3. Hemolytic uremic syndrome

4. Multisystem trauma

5. Septic shock/infectious diseases (e.g.,congenital viral, bacterial, line sepsis,nosocomial infections)

6. Systemic inflammatory response syndrome(SIRS)/sepsis/MODS

7. Toxic exposure (e.g., fetal exposure todrug/alcohol, drug withdrawal, anaphylaxis)

8. Toxic ingestions and inhalations (e.g.,drug/alcohol overdose, poisoning)









28

CCRN

CCRN TEST PLAN – NEONATAL





3. Cardiac surgery


5. Congenital heart defect/disease

6. Hemodynamic concepts

7. Pulmonary hypertension

8. Shock states (e.g., cardiogenic,hypovolemic/volume deficit)

B. Pulmonary (36%)


2. Acute respiratory infections

3. Air-leak syndromes (e.g., spontaneouspneumothorax, bronch-fistula, emphysema,[PIE], pneumopericardium, pneumo-mediastinum)

4. Apnea of prematurity

5. Aspirations (e.g., aspiration pneumonia,meconium aspiration)

6. Chronic lung disease (e.g., bronchopulmonarydysplasia)

7. Congenital anomalies

8. Pulmonary hypertension in newborn

9. Respiratory distress syndrome

10. Respiratory pharmacology


12. Transient tachypnea of the newborn


C. Endocrine (4%)


2. Hormones and anatomy & physiology

3. Inborn errors of metabolism

4. Infant of diabetic mother


1. Anemia of prematurity

2. Hematology, blood products and plasma

3. Hyperbilirubinemia

4. Immunosuppression (e.g., Rh incompatibilities,ABO incompatibilities, hydrops fetalis)

5. Life-threatening coagulopathies (e.g., ITP, DIC)and non life-threatening coagulopathies

E. Neurology (6%)

1. Congenital neurological abnormalities (e.g.,spina bifida, myelomeningocele, anencephaly,encephalocele)

2. Encephalopathy (e.g., hypoxic-ischemic,metabolic, edema, infectious)

3. Hydrocephalus4. ICP monitoring 5. Intracranial hemorrhage/intraventricular

hemorrhage 6. Neurologic infectious diseases (e.g., meningitis,

congenital infections, viral infections, TORCH)7. Seizure disorders


1. Bowel infarction/obstruction/perforation (e.g.,necrotizing enterocolitis, adhesions, shortgut)


3. GI abnormalities at birth

4. Hepatic failure/coma

29



CCRN TEST PLAN – NEONATAL (CONTINUED)

G. Renal (2%)

1. Acute renal failure (e.g., acute tubular necrosis,hypoxia)

2. Congenital renal-genitourinary abnormalities(e.g., polycystic kidneys, exstrophy of bladder,hydronephrosis)



H. Multisystem (11%)

1. Asphyxia (e.g., neonatal-perinatal)

2. Life-threatening maternal-fetal complications(e.g., birth trauma and birth-related injuries,genetic disorders, maternal-fetal transfusion,placenta abruptio, placenta previa)

3. Low birth weight/prematurity

4. Septic shock/infectious diseases (e.g.,congenital viral, bacterial, line sepsis,nosocomial infections)

5. Toxic exposure (e.g., fetal exposure todrug/alcohol, drug withdrawal, anaphylaxis)









30

CCRN

SAMPLE CCRN EXAM QUESTIONS – ADULT

1. A patient with a recent myocardial infarctionsuddenly develops a loud systolic murmur. Themost likely cause is which of the following?

A. pulmonary embolism

B. congestive heart failure

C. ruptured papillary muscle

D. increased systemic vascular resistance

2. A patient with unstable angina has an IABPinserted. Hemodynamics are: HR = 148 (sinustachycardia); MAP = 40 mm Hg; PCWP = 25mm Hg; CI = 1.4 L/min/m2.

Which of the following should be included in thispatient’s plan of care?

A. checking timing of the IABP, decreasing balloonto 1:2 frequency

B. stat echocardiogram, furosemide (Lasix),checking timing of the IABP

C. dobutamine (Dobutrex), isoproterenol (Isuprel),12-lead ECG

D. adenosine, stat Hgb and HCT, dobutamine(Dobutrex)

3. The family of a critically ill patient wishes to spendthe night, which is contrary to visiting policy. Thenurse’s best action would be to

A. adhere to the visiting policy.

B. allow the family to stay in the room.

C. obtain a motel room near the hospital wherethe family may spend the night.

D. allow one or two family members to stay, thenevaluate the patient’s response.

4. A patient who is one day post-gastroplasty has asudden onset of restlessness, dyspnea, and chestpain. His heart rate is 122/min., and auscultationof heart sound reveals an increased intensity of apulmonary S2. The most likely cause is

A. aspiration pneumonia.

B. a spontaneous pneumothorax.

C. a pleural effusion.

D. a pulmonary embolus.

5. The nursing staff is resisting being assigned to adisruptive patient. An appropriate resolutionwould be to

A. request the physician to transfer the patient.

B. rotate the patient assignment among staff.

C. confront the family and demand an end to thedisruptive behavior.

D. hold a nursing team conference to discusspossible alternatives.

6. A patient who is 72 hours postoperative repair of aruptured abdominal aortic aneurysm suddenlybecomes dyspneic with an increased respiratoryrate from 24 to 40/min. An arterial blood gassample obtained while the patient is receivingoxygen via a nasal cannula at 6L/min reveals thefollowing results:

pH 7.50

pCO2 31

pO2 48

A chest x-ray is obtained and a “ground-glass-likeappearance” is reported. Auscultation of thelungs reveals basilar crackles that were notpreviously present. On the basis of thisinformation, the nurse should suspect that thepatient has developed

A. a pulmonary embolus.

B. bacterial pneumonia.

C. chronic obstructive pulmonary disease.

D. acute respiratory distress syndrome.

7. Members of the nursing staff are developingwritten patient education materials for a group ofpatients with diverse reading abilities. It would bemost effective for the staff to

A. design individual handouts for each patient.

B. develop a computer-based education series.

C. write the materials at a fourth-grade reading level.

D. limit text and provide color pictures.

Answers1. C 2. A 3. D 4. D

5. D6. D7. C

31

SAMPLE CCRN EXAM QUESTIONS – PEDIATRIC

1. In caring for a patient with salicylate intoxication,the critical care nurse would anticipate which ofthe following as a primary treatment measure?

A. administration of protamine sulfate

B. administration of glucose

C. transfusion of packed RBCs

D. replacement of fluid and electrolytes

2. An adolescent with the developmental age of a 4-year-old requires placement of a chest tube. Thebest way to prepare the patient for this procedureis to

A. use short simple sentences and limitdescriptions to concrete explanations.

B. show the patient a chest tube and explain howit will feel.

C. explain in detail why a chest tube is neededand how it works.

D. tell the parents what will be done so they canexplain it to their child.

3. A child is admitted with a gunshot wound to thehead, accidentally inflicted by an older sibling.The parents are overcome with grief, and appearto be ignoring the following statements made bythe older sibling: “It was an accident; I didn’tmean to do it; I’m sorry!” Which of the followingactions by the nurse would be most appropriate?

A. Discuss the importance of gun safety with theolder sibling while the parents are at the bedside.

B. Seek additional support for the parents forways they can assist the older sibling.

C. Tell the parents that they need to providesupport for the older sibling.

D. Tell the older sibling, “Accidents happen; I knowyou didn’t mean to do it.”

4. Which of the following laboratory findings isindicative of the syndrome of inappropriate ADHsecretion (SIADH)?

A. serum sodium = 148 mEq/L

B. decreased serum osmolality

C. blood urea nitrogen (BUN) = 28 mg/dl

D. serum potassium = 5.1 mEq/L

5. A 3-year-old is admitted to the ICU with a 10-hourhistory of an acute-onset asthma attack. Initialassessment reveals the following

HR 160pH 7.25RR 48pCO2 35BP 112/76pO2 40T 32°C (oral)HCO3- 22

In this situation, the critical care nurse wouldexpect initial treatment to include

A. administration of NaHCO3.

B. fluid resuscitation.

C. racemic epinephrine.

D. intubation.

6. A 2-year-old is experiencing manifestations ofdigoxin (Lanoxin) toxicity. BP is 94/60, capillaryrefill time is 2 seconds and the electrocardiogramreveals AV block with a heart rate of 60. Thecritical care nurse would anticipate which of thefollowing interventions?

A. performance of cardioversion

B. administration of Atropine

C. performance of vasovagal maneuvers

D. monitoring of HR and rhythm and perfusion status

7. An adolescent with asthma is readmitted just a weekafter discharge from the hospital. On questioning, thenurse learns that the patient refuses to use theinhalers at school. The nurse should

A. talk to the teen about long-term consequences ofthe disease if the treatment plan is not followed.

B. talk to the school nurse to find out why they arenot monitoring the medications at school.

C. help the parents set up a disciplinary contractwith the teen.

D. arrange for the teen to attend an asthmasupport group.

Answers1. D 2. A 3. B 4. B

5. D6. D7. D

32

CCRN

SAMPLE CCRN EXAM QUESTIONS – NEONATAL

1. After application of a warm saline-soaked gauzedressing to an infant’s abdominal wall defect, themost effective method for preventing evaporativeheat loss is to

A. place the infant in a warmed isolette.

B. place the infant under a radiant heat source.

C. moisten the gauze dressing every 30 minutes.

D. cover the gauze dressing with plastic.

2. An infant has just been intubated for respiratoryfailure due to respiratory distress syndrome (RDS).The infant’s breath sounds are heard on the rightside but not on the left. Which of the followinginterventions would be most appropriate?

A. leave the tube in position and increase bagpressure

B. advance the tube until breath sounds areheard bilaterally

C. withdraw the tube until breath sounds areheard bilaterally

D. remove the tube and re-intubate

3. A preterm infant with necrotizing enterocolitis andresultant bowel perforation has returned from theoperating room with an ileostomy. The first stepin management of the ostomy should include

A. contacting the dietitian for recommendations

regarding easily digested formula.

B. contacting the enterostomal nurse to provide a

pattern for the ostomy appliance.

C. applying a dry sterile dressing over the ostomy.

D. clini-testing stool to determine degree of

malabsorption.

4. An infant at 38-weeks-gestation is born viacesarean section. At 4 hours of age, heart rate is155 and respiratory rate is at 60. Physicalassessment reveals grunting, mild retractions,and nasal flaring. A chest x-ray reveals perihilarstreaking bilaterally. The following arterial bloodgas (ABG) results are obtained:

pH 7.40

pCO2 35

pO2 40

HCO3- 22

Appropriate management of this patient wouldconsist of

A. intubation and mechanical ventilation.

B. surfactant replacement therapy.

C. chest tube insertion.

D. oxygen administration via hood.

5. A meeting is planned to discuss the parents’ethical concerns regarding life supportinterventions for their neonate with Trisomy 18.The nurse’s role would be to

A. assist the parents in articulating theirquestions and concerns.

B. provide legal information regarding end-of-lifedecisions.

C. describe reasons for the infant’s poorprognosis.

D. inform the parents that the goal of the meetingis to obtain a DNR order.

6. An infant with documented hypoglycemia is beingstarted on a continuous dextrose infusionfollowing a bolus injection of glucose. Anappropriate rate of dextrose infusion would be

A. 1 - 3 mg/kg/min.

B. 4 - 8 mg/kg/min.

C. 9 - 12 mg/kg/min.

D. 13 - 16 mg/kg/min.

33

SAMPLE CCRN EXAM QUESTIONS – NEONATAL (CONTINUED)

7. An infant with isometric hydrops is delivered at 28-weeks-gestation by cesarean section.Which of the following interventions should beanticipated in the initial management of thisinfant?

A. administration of sodium polystyrene sulfonate(Kayexalate)

B. placement of an umbilical venous catheter andslow push of O-positive whole blood

C. thoracentesis and/or paracentesis

D. a difficult intubation

8. The following results were obtained from acerebro spinal fluid (CSF) sample obtained bylumbar puncture:

40 WBC/mm

65% polymorphonuclear cells

Glucose 50 mg/dl

Protein 165 mg/dl

Bacteria shown by Gram-staining

On the basis of these results, the mostappropriate additional study would include

A. drawing blood for sedimentation rate.

B. obtaining surface cultures.

C. continuing monitoring without intervention.

D. obtaining blood and urine cultures.

9. The mother of an infant with severe PPHN wouldlike to hold her infant. The infant’s oxygensaturation is 88% to 92% at rest and mean bloodpressure is 28. The nurse’s best response wouldbe to

A. explain signs and symptoms that demonstrateinstability of the infant.

B. assist the mother in holding the infant skin-to-skin.

C. encourage the mother to talk to the infant.

D. show the mother how to provide gentle infantmassage.

Answers1. D 2. C 3. B 4. D 5. A6. B7. C8. D9. A

34

CCRN CERTIFICATION APPLICATION HONOR STATEMENTOnline exam registration is available at www.certcorp.org; click Apply Online.

Complete and submit with 2-page application at back of handbook.

Name: _____________________________________________________ AACN #: ___________________LAST FIRST MIDDLE

Verification Information - List contact information for a professional associate (colleague or supervisor) whocan verify that you have met the clinical hour eligibility requirements:

ASSOCIATE’S NAME:

FACILITY ADDRESS:

City State ZIP

ASSOCIATE’S PHONE NUMBER: and/or E-MAIL ADDRESS:

Honor StatementI have fulfilled the clinical practice hour requirements of 1,750 hours of direct bedside care of acutely and/or critically ill (check one) � Adult

� Pediatric � Neonatal

patients within the previous 2-year period, with 875 hours accrued in the most recent year preceding this application. Or if renewing by exam I have completed 432 hours of direct bedside care of acutely and/or critically ill (check one) � Adult

�Pediatric �Neonatal

patients within the 3-year certification period, with 144 hours accrued in the most recent year preceding my scheduled renewal date.

I possess a current unencumbered U.S. license to practice as an RN or APRN. An unencumbered license is not currently subject toformal discipline by any Board of Nursing and has no provisions or conditions that limit the nurse’s practice in any way. I agree tonotify AACN Certification Corporation if any disciplinary action is taken against my RN or APRN license in the future.

I hereby apply for CCRN certification offered by AACN Certification Corporation. I understand that certification depends upon thesuccessful completion of the specified requirements. I further understand that the information acquired in the certification process maybe used for statistical purposes and for evaluation of the certification program.

To the best of my knowledge, the information contained in the application is true, complete, correct and is made in good faith. Iunderstand that information supplied is subject to audit and failure to respond to a request for further information may be sufficientcause for AACN Certification Corporation to bar me from the exam, to invalidate the results of my exam, to withhold certification, torevoke certification or to take other appropriate action.

My signature on this form indicates my agreement to keep the contents of the exam confidential and not discuss the specific examcontent with anyone except AACN Certification Corporation. By complying with and enforcing this obligation, I help maintain the integrityof the AACN Certification Program and the value of its certification credentials.

Applicant’s Signature: Printed Name: Date:

OCTOBER 2009This form may be photocopied and is also available online at www.certcorp.org. 35

3 of 3

PCCN CERTIFICATION

PCCN Certification Program ..........................................................................................................................................38

PCCN Exam Eligibility .....................................................................................................................................................38

PCCN Certification Renewal ..........................................................................................................................................39

PCCN Online Registration ..............................................................................................................................................40

PCCN Application Fees...................................................................................................................................................40

AACN Products for PCCN Exam Preparation .................................................................................................................41

PCCN Study Bibliography .........................................................................................................................................43-44

PCCN Test Plan .........................................................................................................................................................45-48

PCCN Sample Exam Questions .....................................................................................................................................49

PCCN Exam Honor Statement (3rd page of 3-page application) ................................................................................51



PCCN® certification is a specialty certification for nurses who provide care for acutely ill adult patients, regardlessof the geographic location of their nursing care. Specialty nurses interested in this certification may work in suchareas as: intermediate care units; direct observation units; stepdown units; telemetry units; transitional care units;or emergency departments.

PCCN

37

DefinitionProgressive Care Certified Nurse (PCCN) certificationvalidates your knowledge of nursing of acutely ill adultpatients in your specialty area to hospitals, peers,patients and, most importantly, to yourself. PCCNcertification promotes continuing excellence in theprogressive care nursing profession. Progressive careis the term the American Association of Critical-CareNurses (AACN) uses to collectively describe areas thatare also referred to as intermediate care units, directobservation units, stepdown units, telemetry units,transitional care units or emergency departments, aswell as to define a specific level of patient care. AACNrecognizes progressive care as part of the continuumof critical care.

PCCN® Registered Service MarkPCCN is a registered service mark of AACNCertification Corporation and denotes certification inprogressive care nursing as granted by AACNCertification Corporation. Registered nurses who havenot achieved PCCN certification status, whose PCCNstatus has lapsed, or who have chosen Inactive statusare not authorized to use the PCCN credential.

Validated Knowledge and SpecializedSkillsEach PCCN certification exam is based on a jobanalysis. The most recent study, completed in 2008,defines the dimensions of progressive care practice,identifying what is required of registered nursespracticing in acute care settings.

In the study, progressive care nurses across the UnitedStates were surveyed to ascertain the frequency andsignificance of the various elements of their practice.Through an extensive review and evaluation process,the knowledge, skills and abilities crucial toprogressive care nursing were defined using the AACNSynergy Model for Patient Care as an organizingframework. The PCCN certification exam is based onthese skills and abilities and the knowledge requiredto perform them.

PCCN certification is achieved by those progressivecare nurses who pass the PCCN exam in adultprogressive care nursing. PCCN certification denotes tothe public those practitioners who possess a distinctand clearly defined body of knowledge calledprogressive care nursing.

Exam ContentsThe PCCN exam is a 2 and ½ -hour test consisting of125 multiple-choice items. Of the 125 items, 100 arescored and 25 are used to gather statistical data onitem performance for future exams. Please refer to thePCCN test plan for detailed content information. ThePCCN exam focuses on adult patient populations only.

Test PlanThe content of the PCCN exam is described in the testplan included in this handbook. Candidates are testedon a variety of patient care problems that areorganized under major categories. Please note thepercentage of the PCCN exam devoted to eachcategory.

PCCN CERTIFICATION PROGRAM

• Current unencumbered licensure as an RN or APRNin the United States is required.


It is the responsibility of candidates and PCCN-certified nurses to notify AACN CertificationCorporation when any restriction is placed on theirRN or APRN license. If you are randomly selected foraudit, you will be asked to provide a copy of your RNor APRN license - please do not submit with yourapplication.

• Practice as an RN or APRN is required for 1,750hours in direct bedside care of acutely ill adultpatients during the previous two years, with 875 ofthose hours accrued in the most recent yearpreceding application.

Clinical practice hours for PCCN exam or renewaleligibility must take place in a U.S.-based or Canada-based facility or in a facility determined to becomparable to the U.S. standard of acute/criticalcare nursing practice, as evidenced by ANCC MagnetStatus or Joint Commission Internationalaccreditation.

PCCN EXAM ELIGIBILITY

38

PCCN certification is conferred for a period of threeyears. Your certification period begins the first day ofthe month in which the PCCN certification exam ispassed and ends three years later; for example,October 1, 2009 through September 30, 2012. Thepurpose of certification renewal is to enhancecontinued competence.

A copy of the PCCN Renewal Handbook will be mailedto you approximately 90 days before your scheduledPCCN renewal date. You are responsible for renewingyour certification even if you do not receive renewalnotification.

You may seek certification renewal via Renewal bySynergy CERPs or Renewal by Exam, or you maychoose Inactive status. Do not apply for more than oneoption. Renewal by Exam candidates must successfullyapply for and schedule their exam in enough time tocomplete the PCCN exam before their scheduledrenewal date. You may not take the exam early, thenattempt to renew by Synergy CERPs if you do not pass.

To renew, you must hold a current unencumbered RNor APRN license in the United States, complete 432hours of direct bedside care of acutely ill adult patientswithin the three-year certification period, with 144 ofthose hours in the 12-month period prior to thescheduled renewal date, and complete the requiredSynergy CERPs or complete the PCCN exam. For moredetails, refer to the PCCN Renewal Handbook,available at www.certcorp.org.

OPTION 1 - Renewal by Synergy CERPsMeet eligibility requirements for PCCN renewal andcomplete the Continuing Education Recognition Point(CERP) Program, which requires 100 CERPs in variouscategories (A, B & C). For more details refer to Renewalby Synergy CERPs At-a-Glance and other Synergy CERPresources available online at www.certcorp.org.

Online Renewal by Synergy CERPs is available to allactive PCCNs as early as four months prior to theirscheduled renewal date. For more information visitwww.certcorp.org - click Renew Your Certification.

OPTION 2 - Renewal by ExamMeet the eligibility requirements for PCCN renewal andsuccessfully apply for and schedule your exam inenough time to complete the PCCN exam before yourscheduled renewal date.

OPTION 3 - Inactive StatusInactive status is available to PCCN-certified nurseswho do not meet the renewal eligibility requirementsbut do not wish to lose their PCCN certification status.Inactive status provides PCCN-certified nursesadditional time, up to three years from the scheduledrenewal date, to meet the eligibility requirements.During the time of Inactive status candidates may notuse the PCCN credential.

PCCN CERTIFICATION RENEWAL

• Nurses serving as manager, educator (in-service oracademic), APRN or preceptor may apply their hoursspent supervising nursing students or nurses at thebedside. Nurses in these roles must be activelyinvolved in caring for patients at the bedside; forexample, performing a procedure or supervising anew employee or student nurse performing aprocedure at the bedside.

• The name and address of a professional associatemust be given for verification of eligibility related toclinical practice hours. If you are randomly selectedfor audit, this associate will be asked to verify in

writing that you have met the clinical hourrequirements. A professional associate is defined asa clinical supervisor (RN or physician), or RNcolleague with whom you work.

• AACN Certification Corporation may adopt additionaleligibility requirements at its sole discretion fromtime to time. Any such requirements will bedesigned to establish, for the purposes of PCCNcertification, the adequacy of a candidate'sknowledge and experience in caring for the acutelyill.

PCCN

39

Online registration is available for the PCCN exam. This paperless registration streamlines the exam applicationprocess by up to six weeks. Once you register online your 90-day window for testing will begin within one to twoweeks. Candidates should be prepared to sit for the exam before registering online. For more information and toregister visit www.certcorp.org.

PCCN ONLINE REGISTRATION

Computer-Based PCCN Exam

AACN Members $170

Nonmembers $250

PCCN Retest Fee

AACN Members $135

Nonmembers $215

Current PCCN Renewal by Exam

AACN Members $135

Nonmembers $215


PCCN APPLICATION FEES

40

OFCRHB

AACN PRODUCTS FOR PCCN EXAM PREPARATION

Description Item #

*Online PCCN Self-Assessment Exam (SAE) – mirrors content of PCCN exam; includes 50 questions with correct answersand rationale; score report upon completion to assess strengths and areas for further study; access for 90 days frompurchase date.

Purchase online only atwww.certcorp.org.

*Practice PCCN Exam Questions. (2008). 120 questions. 200405

Synergy for Clinical Excellence: The AACN Synergy Model for Patient Care. (2005). Hardin, S. & Kaplow, R. 160 pages. 100149

Critical Care Nursing: Synergy for Optimal Outcomes. (2007). Kaplow, R. & Hardin, S. 778 pages. 100147

AACN Certification and Core Review for High Acuity and Critical Care, 6th ed. (2007). Grif Alspach, J. 192 pages. 128800

Hemodynamic Monitoring: Invasive and Noninvasive Clinical Application, 3rd ed. (2002). Darovic, G. O. 676 pages. 128639

Handbook of Hemodynamic Monitoring, 2nd ed. (2004). Darovic, G. O. 400 pages. 128640

AACN Procedure Manual for Critical Care, 5th ed. (2005). Lynn-McHale, D. & Carlson, K. 1,280 pages. 128150

Mosby’s Manual of Diagnostic and Laboratory Tests, 3rd ed. (2005). Pagana, K. & Pagana, T. 1,280 pages. 128160

** PCCN Review Course on DVD (2009) – includes study guide and 12 hours of CE credit. 300900

** PCCN Review Course on Audio CD (2009) – includes study guide and 12 hours of CE credit. 300901

** PCCN Review Course on CD-ROM (2009) – includes study guide and 12 hours of CE credit. 300902

PCCN Review Course Additional Syllabus. (2009). 190 pages. 300903

PCCN Certification Review. (2009). CD-ROM & book. Brorsen, A. & Rogelet, K. 402 pages. 128820

AACN Essentials of Progressive Care Nursing (2006). Chulay, M. & Burns, S. 608 pages. 128765

AACN Protocols for Practice: Non-Invasive Monitoring, 2nd ed. (2005). Burns, S. 113 pages. 170680

AACN Protocols for Practice: Palliative and End-of-Life Issues in Critical Care (2006). Medina, J. & Puntillo, K. 59 pages. 170900

The Johns Hopkins Manual of Cardiac Surgical Care, 2nd ed. (2007). Conte, J., Owens, S., Dorman, T. 512 pages. 100255

Emergency Psychiatry: Principles and Practice. (2008). Glick, R., et. al., 488 pages. 301650

Hemodynamic Monitoring Made Incredibly Visual! (2006). 160 pages. 128642

ACLS Pocket Reference Cards. (2006). AHA, AACN. Set of 2. 400862

OCTOBER 2009 41

For more details and to place an order, visit our Web site at www.aacn.org and click on Marketplace, or call AACN Customer Care at (800) 899-2226, between 7:30 a.m. and 4:30 p.m., Pacific Time.

*Denotes products developed by AACN Certification Corporation.

**PCCN Review Course Packages also available; packages include PCCN Review Course, Practice PCCN ExamQuestions, and AACN Essentials of Progressive Care Nursing. Item numbers are 302015 (DVD), 302016 (CD-ROM) and302017 (Audio CD).

PCCN

Clinical Judgment – PCCNAmerican Association of Critical-Care Nurses. (2008).AACN Practice Alert. ST Segment Monitoring. Availableat: http://www.aacn.org/WD/Practice/Docs/ST_Segment_Monitoring_04-2008.pdf

American Heart Association. (2005). Guidelines 2005for Cardiopulmonary Resuscitation and EmergencyCardiovascular Care. Available at: www.americanheart.org/presenter.jhtml?identifier=3035517

Chulay, M. & Burns, S. (2006). AACN Essentials ofProgressive Care Nursing. Dubuque, IA: McGraw-Hill.

Conover, M. B. (2003). UnderstandingElectrocardiography. 8th ed. St. Louis, Mo:Mosby/Elsevier.


Darovic, G. O. (2004). Handbook of HemodynamicMonitoring. 2nd ed. St. Louis, Mo: W. B.Saunders/Elsevier.


Emergency Nurses Association & Newberry, L. (2005).Sheehy’s Manual of Emergency Care. 6th ed. St.Louis: Mosby/Elsevier.


Lemmer, J. H., Richenbacher, W. E. & Vlahakes, G. J.(2003). Handbook of Patient Care in Cardiac Surgery. Philadelphia: Lippincott Williams & Wilkins.

McQuillan, K. A., Whalen, E. & Flynn Makic, M. B.(2008). Trauma Nursing: From Resuscitation ThroughRehabilitation. 4th ed. Philadelphia: Elsevier.

Pagana, K. D. & Pagana, T. J. (2008). Mosby’sDiagnostic and Laboratory Test Reference. 9th ed.St. Louis, Mo: Mosby/Elsevier.

Skidmore-Roth, L. (2008). Mosby’s 2009 NursingDrug Reference. 22nd ed. St. Louis, Mo:Mosby/Elsevier.

Smeltzer, S., Bare, B.G., Hinkle, J.L. & Cheever, K.H.(2008). Brunner and Suddarth’s Textbook of Medical- Surgical Nursing. 11th ed. Philadelphia: LippincottWilliams & Wilkins.


Stillwell, S. (2006). Mosby’s Critical Care NursingReference. 4th ed. St. Louis, Mo: Mosby/Elsevier.

Urden, L., Lough, M. E. & Stacy, K. L. (2005). Thelan’sCritical Care Nursing: Diagnosis and Management.5th ed. St. Louis, Mo: Mosby/Elsevier.

Wiegand, D. J. L. & Carlson, K. K. (eds.) (2005).AACN Procedure Manual for Critical Care. 5th ed.Philadelphia: Elsevier.

Woods, S., Sivarajan Froelicher, E. S. & Motzer, S. U.(2004). Cardiac Nursing. 5th ed. Philadelphia:Lippincott Williams & Wilkins.

Professional Caring and Ethical PracticeAmerican Association of Critical-Care Nurses. (2005).AACN Standards for Establishing and SustainingHealthy Work Environments: A Journey to Excellence.Available at: http://www.aacn.org/WD/HWE/Docs/HWEStandards.pdf.

PCCN STUDY BIBLIOGRAPHYRECOMMENDED REFERENCES FOR THE PCCN EXAM

43

continued

PCCN STUDY BIBLIOGRAPHY (CONTINUED)

Dossey, B. M., Keegan, L. & Guzzetta, C. (2003).Holistic Nursing: A Handbook for Practice. 3rd ed.Boston: Jones & Bartlett.

Hardin, S. R. & Kaplow, R. (eds.). (2005). Synergy forClinical Excellence: The AACN Synergy Model forPatient Care. Boston: Jones & Bartlett.

Lipson, J. G., Dibble, S. L. & Minarik, P. A. (eds.)(1996). Culture and Nursing Care: A Pocket Guide.San Francisco: UCSF Nursing Press.

Purnell, L. D. & Paulanka, B. J. (2005). Guide toCulturally Competent Health Care. Philadelphia, PA:F.A. Davis.



PUBLISHER CONTACTS:AACN – (800) 899-2226 American Heart Association – (800) 242-8721Elsevier (including Mosby, W. B. Saunders, and Hanley & Belfus) – (800) 545-2522Jones & Bartlett – (800) 832-0034Lippincott Williams & Wilkins – (800) 638-3030UCSF Nursing Press – (415) 476-4992

44

PCCN

PCCN TEST PLAN


A.Cardiovascular (36%)

1. Acute coronary syndromes

2. Acute inflammatory disease

3. Cardiac surgery



6. Cardiomyopathies

7. Conduction defects

8. Dysrhythmias

9. Heart failure


11. Peripheral vascular disease

12. Peripheral vascular surgery

13. Pulmonary edema

14. Ruptured or dissecting aneurysm

15. Structural heart defects

B.Pulmonary (14%)

1. Acute lung injury (ALI)

2. Aspirations

3. Chronic ventilatory failure

4. Exacerbation of COPD

5. Pneumothorax

6. Pulmonary embolism


8. Respiratory infections

9. Severe asthma

10. Sleep disordered breathing

11. Thoracic surgery

C.Endocrine (4%)


2. Hypoglycemia

D.Hematology/Immunology (2%)

1. Anemia

2. Life-threatening coagulopathies

E. Neurology (5%)

1. Intracranial hemorrhage2. Seizure disorders3. Stroke


1. GI hemorrhage

2. GI infections

3. GI motility disorders

4. Hepatic failure

5. Malnutrition

6. Pancreatitis

G. Renal (5%)

1. Acute renal failure

2. Electrolyte imbalances

3. End-stage renal disease (ESRD)

H. Multisystem (5%)

1. Infectious diseases

2. Shock states

3. Systemic inflammatory response syndrome(SIRS)/sepsis/severe sepsis/septic shock/MODS

I. Behavioral (4%)

1. Delirium and dementia

2. Mood disorders and depression

3. Substance abuse









45

PCCN EXAM TESTABLE NURSING ACTIONS

CARDIOVASCULAR

1. Perform a comprehensive cardiovascularassessment

2. Identify, interpret and monitor:

• dysrhythmias

• ST segments

• QTc intervals

3. Select leads for cardiac monitoring for theindicated disease process

4. Recognize indications for and manage patientsrequiring hemodynamic monitoring using:

• an arterial line

• non-invasive hemodynamic monitoring

5. Monitor hemodynamic status and recognizesigns and symptoms of hemodynamicinstability

6. Recognize indications for and monitor/managepatients requiring cardiovascular therapeutic intervention using:

• cardioversion

• transcutaneous pacing

• defibrillation

7. Monitor normal and abnormal diagnostic testresults

8. Calculate dosages, administer cardiovascularmedications

9. Titrate vasoactive medications

10. Recognize signs and symptoms ofcardiovascular emergencies, initiatestandardized interventions and seekassistance as needed

11. Monitor patient and follow standardizedprotocols pre-, intra- and post-procedure

12. Monitor and manage patients followingcoronary intervention

PULMONARY

1. Perform a comprehensive pulmonaryassessment


3. Interpret ABGs and report findings

4. Monitor patient for response to pulmonarymedications

5. Manage patients requiring the following non-invasive 02 or ventilation delivery systems:

• nasal cannula

• face masks

• non-rebreather mask

• BiPAP

• CPAP

6. Manage patients requiring mechanicalventilation via tracheostomy tube

7. Manage patients requiring the followingrespiratory monitoring devices:

• continuous SPO2

• intermittent SPO2

8. Recognize signs and symptoms of respiratorycomplications and seek assistance as needed

9. Maintain patient airway

10. Manage patients with chest tubes

11. Assist with the following procedures:

• thoracentesis

• chest tube insertion

12. Administer medications for procedural(conscious) sedation and monitor patient’sresponse

13. Monitor patient and follow standardizedprotocols pre-, intra- and post-procedure

46

continued

ENDOCRINE

1. Perform a comprehensive endocrineassessment


3. Administer medications, treatments orinterventions and monitor patient response

4. Manage and titrate insulin infusions

HEMATOLOGY/IMMUNOLOGY

1. Perform a comprehensivehematology/immunology assessment



NEUROLOGY

1. Perform a comprehensive neurologicalassessment

2. Monitor normal and abnormal neurologicaldiagnostic test results


GASTROINTESTINAL

1. Perform a comprehensive gastrointestinalassessment

2. Monitor normal and abnormal gastrointestinaldiagnostic test results

3. Recognize indications for and complications ofenteral and parenteral nutrition

RENAL

1. Identify normal and abnormal renal assessmentfindings


MULTISYSTEM


2. Recognize signs and symptoms of emergencies,initiate standardized interventions and seek assistance as needed

3. Manage patients with complex wounds withfistulas, drains and vacuum-assisted closuredevices

BEHAVIORAL

1. Perform a psychosocial assessment


3. Recognize signs and symptoms of behavioralemergencies and initiate interventions

PCCN

47

PCCN EXAM TESTABLE NURSING ACTIONS (CONTINUED)

NURSING ACTIONS EXCLUDED FROM PCCN EXAM

CARDIOVASCULAR

1. Recognize indications for and manage patientsrequiring hemodynamic monitoring using:

• an arterial line

• CVP monitoring

2. Recognize indications for and manage patientsrequiring hemodynamic monitoring using CVPmonitoring

3. Recognize indications for and monitor/managepatients requiring cardiovascular therapeuticintervention using:

• transvenous pacing

• epicardial pacing

• arterial sheath removal

• venous sheath removal

• ventricular assist devices

4. Manage continuous veno-venoushemofiltration for heart failure

PULMONARY

1. Manage patients requiring mechanicalventilation via endotracheal tube

2. Manage patients requiring an ETCO2

respiratory monitoring device

3. Removal of:

• pleural chest tubes

• mediastinal tubes

4. Manage patients requiring:

• ventilator weaning

• extubation or decannulation

5. Assist with the following procedures:

• bronchoscopy

• intubation

ENDOCRINE

Manage patients using insulin pumps

NEUROLOGY

1. Manage patients requiring:

• lumbar drains

• ventriculostomy

• neurological monitoring devices and drains for intracranial pressure

2. Recognize signs and symptoms of increasedintracranial pressure

GASTROINTESTINAL

Perform intra-abdominal hypertension monitoring

RENAL

Assist with:

• hemodialysis

• peritoneal dialysis

• continuous renal replacement therapy (CRRT)

MULTISYSTEM

Manage patients with intraosseous devices

48

PCCN

SAMPLE PCCN EXAM QUESTIONS

1. A patient who is 1 week post MI suddenlybecomes agitated, restless and diaphoretic.Pulse pressure drops to 20 mm Hg. Assessmentalso reveals faint radial and apical pulses thatweaken significantly on inspiration. This patientis most likely experiencing

A. mitral valve rupture.

B. pulmonary embolus.

C. pulmonary edema.

D. cardiac tamponade.

2. Which of the following may predispose anindividual to ventricular fibrillation?

A. hypernatremia and hypomagnesemia

B. hypophosphatemia and hyperchloremia

C. hypermagnesemia and hyponatremia

D. hyperkalemia and hypocalcemia

3. Chest auscultation of a patient in statusasthmaticus commonly reveals

A. expiratory wheezes.

B. inspiratory crackles.

C. diminished bilateral breath sounds.

D. a pleural friction rub.

4. The family of a critically ill patient wishes to spendthe night, which is contrary to visiting policy. Thenurse’s best action would be to

A. adhere to the visiting policy.

B. allow the family to stay in the room.

C. obtain a motel room near the hospital wherethe family may spend the night.

D. allow one or two family members to stay, thenevaluate the patient’s response.

5. Members of the nursing staff are developingwritten patient education materials for a group ofpatients with diverse reading abilities. It would bemost effective for the staff to

A. design individual handouts for each patient.

B. develop a computer-based education series.

C. write the materials at a fourth-grade readinglevel.

D. limit text and provide color pictures.

6. Two days post admission for rapid atrialfibrillation, a patient has been weaned from IVdiltiazem (Cardizem) to PO administration. Thepatient develops new onset of hallucinations,agitation and disorientation. The most appropriateinitial nursing action is to

A. obtain an order for lorazepam (Ativan) every sixhours.

B. assess the patient’s SpO2 and neurologicalstatus

C. obtain an order for haloperidol (Haldol) andmonitor QT intervals.

D. consult with the pharmacy regarding possibledrug interaction.

7. Which of the following electrolyte abnormalitiesshould the nurse anticipate in a patient withchronic alcoholism?

A. hypomagnesemia

B. hyperphosphatemia

C. hyponatremia

D. hyperkalemia

Answers1. D 2. D 3. A 4. D 5. C6. B7. A

49

PCCN CERTIFICATION APPLICATION HONOR STATEMENTOnline exam registration is available at www.certcorp.org; click Apply Online.




ASSOCIATE’S NAME:

FACILITY ADDRESS:

City State ZIP


Honor StatementI have fulfilled the clinical practice hour requirements of 1,750 hours of direct bedside care of acutely ill Adult patients within theprevious 2-year period, with 875 hours accrued in the most recent year preceding this application. Or if renewing by exam, I havecompleted 432 hours of direct bedside care of acutely ill Adult patients within the 3-year certification period, with 144 hours accrued inthe most recent year preceding my scheduled renewal date.

I possess a current unencumbered U.S. license to practice as an RN or APRN. An unencumbered license is not currently subject toformal discipline by any Board of Nursing and has no provisions or conditions that limit the nurse’s practice in any way. I agree tonotify AACN Certification Corporation if any disciplinary action is taken against my RN or APRN license in the future.

I hereby apply for PCCN certification offered by AACN Certification Corporation. I understand that certification depends upon thesuccessful completion of the specified requirements. I further understand that the information acquired in the certification process maybe used for statistical purposes and for evaluation of the certification program.

To the best of my knowledge, the information contained in the application is true, complete, correct and is made in good faith. Iunderstand that information supplied is subject to audit and failure to respond to a request for further information may be sufficientcause for AACN Certification Corporation to bar me from the exam, to invalidate the results of my exam, to withhold certification, torevoke certification or to take other appropriate action.




3 of 3

CMC CERTIFICATION

CMC Certification Program ............................................................................................................................................54

CMC Exam Eligibility.......................................................................................................................................................54

CMC Online Registration................................................................................................................................................55

CMC Application Fees ....................................................................................................................................................55

CMC Certification Renewal ............................................................................................................................................56

CMC Test Plan ...........................................................................................................................................................57-58

CMC Study Bibliography.................................................................................................................................................59

CMC Sample Exam Questions .......................................................................................................................................61

CMC Exam Honor Statement (3rd page of 3-page application)..................................................................................63

AACN Products for CMC Exam Preparation ..................................................................................................................65


CMC® (Cardiac Medicine Certification) is a nursing subspecialty designed for specialty certified nurses who providecare for acutely and/or critically ill cardiac patients, regardless of the geographic location of their nursing care.Specialty nurses interested in this subspecialty certification may work in such areas as: cardiac care units;combined ICU/CCUs; medical ICUs; telemetry units; progressive care units; heart failure clinics; home care;interventional cardiology; cardiac catheterization laboratories; or electrophysiology units.

CMC

53

CMC® Registered Service MarkCMC is a registered service mark of AACN CertificationCorporation and denotes certification in cardiacmedicine nursing as granted by AACN CertificationCorporation. Registered nurses who have not achievedCMC certification status, whose CMC status haslapsed, or whose clinical nursing specialty certificationhas lapsed or is inactive are not authorized to use theCMC credential.

Validated Knowledge and SpecializedSkillsEach CMC certification exam is based on a jobanalysis. The most recent study, completed in 2003,defines the dimensions of acute and critical carepractice, identifying what is required of registerednurses practicing in acute and critical care settingsand caring for cardiac patients.

In the study, acute and critical care nurses across theUnited States were surveyed to ascertain thefrequency and significance of the various elements oftheir practice. Through an extensive review andevaluation process, the knowledge, skills and abilitiescrucial to cardiac nursing were defined using theSynergy Model for Patient Care as an organizingframework focusing on the clinical judgment

component exclusively. The CMC certification exam isbased on these skills and abilities and the knowledgerequired to perform them.

CMC certification is achieved by those acute andcritical care nurses who pass the CMC exam in cardiacmedicine. CMC certification denotes to the publicthose practitioners who possess a distinct and clearlydefined body of knowledge called cardiac medicinenursing.

CMC Exam ContentThe CMC exam is a two-hour test consisting of 90multiple-choice items. Of the 90 items, 75 are scoredand 15 are used to gather statistical data on itemperformance for future exams. Please see the testplan for more information. The CMC exam focuses onadult patient populations. One hundred percent(100%) of the exam focuses on clinical judgment.

CMC Test PlanThe content of the CMC exam is described in the testplan. Candidates are tested on a variety of patient careproblems that are organized under major categories.Please note the percentage of the CMC exam devotedto each category.

CMC CERTIFICATION PROGRAM

• Current unencumbered RN or APRN licensure in theUnited States is required.


It is the responsibility of candidates and certifiednurses to notify AACN Certification Corporation whenany restriction is placed on their RN or APRN license.If you are randomly selected for audit, you will beasked to provide a copy of your RN or APRN license– please do not submit with your application.

• Practice as an RN or APRN is required with 1,750hours in direct bedside care of acutely and/orcritically ill patients during the previous two years,with 875 of those hours accrued in the most recent

year preceding application. Of those 1,750 hours,875 need to be in the care of acutely/critically illcardiac patients.

Clinical practice hours for the CMC exam or renewaleligibility must take place in a U.S.-based or Canada-based facility or in a facility determined to becomparable to the U.S. standard of acute/criticalcare nursing practice, as evidenced by ANCC MagnetStatus or Joint Commission Internationalaccreditation.

• A current, nationally accredited NCCA (NationalCommission for Certifying Agencies) or ABNS(American Board of Nursing Specialties) clinicalnursing specialty certification, to which yoursubspecialty certification will be attached, isrequired. A clinical nursing specialty certificationrefers to a specialty certification that involves direct

CMC EXAM ELIGIBILITY

54

care of the patient, such as CCRN, PCCN, CCNS,ACNPC, FNP, CEN, CRNFA, APRN,BC, etc.


• The name and address of a professional associatemust be given for verification of eligibility related to

clinical practice hours. If you are randomly selectedfor audit, this associate will be asked to verify inwriting that you have met the clinical hourrequirements. A professional associate is defined asa clinical supervisor (RN or physician), or RNcolleague with whom you work.

• AACN Certification Corporation may adopt additionaleligibility requirements at its sole discretion fromtime to time. Any such requirements will bedesigned to establish, for the purposes of CMCcertification, the adequacy of a candidate'sknowledge and experience in caring for the acutelyand/or critically ill.

CMC

Online registration is available for the CMC exam. This paperless registration streamlines the exam applicationprocess by up to six weeks. Once you register online your 90-day window for testing will begin within one to twoweeks. Candidates should be prepared to sit for the exam before registering online. For more information andto register visit www.certcorp.org.

CMC ONLINE REGISTRATION

Computer-Based CMC Exam

AACN Members $135

Nonmembers $180

CMC Retest Fee

AACN Members $110

Nonmembers $155

Current CMC Renewal by Exam

AACN Members $110

Nonmembers $155


CMC APPLICATION FEES

55

CMC certification is conferred for a period of threeyears. Your certification period begins the first day ofthe month in which the CMC certification exam ispassed and ends three years later; for example,October 1, 2009 through September 30, 2012. Thepurpose of certification renewal is to enhancecontinued competence.

You may seek CMC certification renewal via Renewalby CERPs or Renewal by Exam. Do not apply for morethan one option. For Renewal by Exam, you mustsuccessfully apply for, schedule, and complete theCMC exam before your scheduled renewal date. Youmay not take the exam early and then attempt torenew by CERPs if you do not pass.

A renewal notification will be mailed to youapproximately 90 days before your CMC expirationdate. You are responsible for renewing yourcertification even if you do not receive a renewalnotification. Visit www.certcorp.org to download acopy of the CMC/CSC Renewal Handbook. OnlineRenewal by CERPs is available to all active CMCs asearly as four months prior to their renewal date. Visitwww.certcorp.org - click Renew Your Certification.

Candidates for CMC renewal must meet the followingrequirements:

• Current unencumbered RN or APRN license in theUnited States

An unencumbered license has not been subjectedto formal discipline by any Board of Nursing andhas no provisions or conditions that limit thenurse’s practice in any way.

• Current clinical nursing specialty certificationaccredited by the NCCA (National Commission forCertifying Agencies) or the ABNS (American Boardof Nursing Specialties)

• Completion of 432 clinical practice hours caring foracutely/critically ill cardiac patients within thethree-year period preceding the scheduled renewaldate, with 144 of those hours accrued in the mostrecent year preceding renewal date

• Completion of twenty-five (25) Category A ClinicalJudgment CERPs pertaining to cardiology (includesall items on the CMC test plan) during the three-year certification renewal period OR successfulcompletion of the CMC exam

CMC CERTIFICATION RENEWAL

56

CMC

CARDIAC MEDICINE CERTIFICATION (CMC) TEST PLAN

I. CARDIOLOGY PATIENT PROBLEMS (43%)

A. Acute Coronary Syndrome (8%)

1. Unstable angina

2. ST segment elevation myocardial infarction

3. Non-ST segment elevation myocardialinfarction

B. Dysrhythmias (11%)

1. Malignant ventricular dysrhythmias

2. Dysrhythmias

a. bradydysrhythmias

b. tachydysrhythmias

c. conduction defects and blocks

C. Other Cardiology Issues (24%)

1. Papillary muscle rupture

2. Ventricular septal rupture

3. Ventricular aneurysm

4. Heart failure

a. acute exacerbation

b. chronic

5. Pulmonary edema

6. Cardiomyopathy (e.g., hypertrophic, dilated,restrictive)

7. Valvular heart disease


9. Blunt cardiac trauma



12. Acute peripheral vascular insufficiency

a. acute arterial occlusion

b. carotid artery stenosis

c. venous thrombosis

13. Sudden cardiac death

14. Hypertension


a. primary

b. secondary (e.g., valvular disease, COPD, acutehypoxemia defects, congenital defects)

16. Congenital heart disease in adults

II. OTHER PATIENT PROBLEMS (16%)

A. Pulmonary (7%)

1. Acute pulmonary embolus


3. Acute respiratory failure

4. Cor pulmonale

5. Inatrogenic problems related to line insertionand ventilator management (e.g., air-leaksyndromes including pneumothorax,pneumopericardium, pneumomediastinum,ventilator-associated pneumonia, volutrauma,and barotraumas)

B. Endocrine (3%)

Diabetes mellitus

C. Hematology (1%)

Life-threatening coagulopathies (e.g., heparin-induced thrombocytopenia, platelet inhibitors,anticoagulants)

D. Neurology (1%)

Stroke (e.g., ischemic, hemorrhagic)

E. Renal (4%)

1. Acute renal failure (may be related to cardiacfailure)

2. Electrolyte imbalances (e.g., potassium,sodium, phosphorus, magnesium, calcium;may include imbalances not caused by renalproblems)

III. NURSING INTERVENTIONS (21%)

A. Cardiology Interventions (16%)

1. Percutaneous coronary interventions (e.g.,PTCA, stents, lasers)

2. Cardiac surgery, except immediatepostoperative care (e.g., valve repair, valvereplacement, CABG, aneurysm)


4. Assist devices - intraaortic balloon pump

57

Continued

CARDIAC MEDICINE CERTIFICATION (CMC) TEST PLAN (CONTINUED)

5. Dysrhythmia interventions

a. pacemakers

b. ICDs (e.g., defibrillation)

c. ablation

6. CPAP/BiPAP (e.g., heart failure, sleep apnea)

B. Pulmonary Interventions (5%)


2. Ventilators

IV. MONITORING (20%)

A. Cardiology Monitoring (15%)

1. Invasive hemodynamic monitoring (e.g.,pulmonary artery catheter)

2. ECG monitoring

a. dysrhythmia

b. ischemia

3. Blood studies (e.g., BNP, cardiac biomarkers,coagulation studies, chemistries)

B. Pulmonary Monitoring (5%)

1. ABGs

2. Mixed venous gases

3. Oxygen saturation

58

CMC

American Heart Association. (2005). Guidelines 2005for Cardiopulmonary Resuscitation and EmergencyCardiovascular Care. Available at: www.americanheart.org/presenter.jhtml?identifier=3035517

Apple, S. & Lindsay, J. (2000). Principles and Practice ofInterventional Cardiology. Baltimore: LippincottWilliams & Wilkins.

Aschenbrenner, D. S., Cleveland, L. W. & Venable, S. J.(2002). Drug Therapy in Nursing. Philadelphia:Lippincott Williams & Wilkins.

Aschenbrenner, D. S., Cleveland, L. W. & Venable, S. J.(2002). Study Guide to Accompany Drug Therapy inNursing. Philadelphia: Lippincott Williams & Wilkins.

Conover, M. B. (2003). Understanding Electrocardiography.8th ed. St. Louis, Mo: Mosby/Elsevier.


Critical Care Challenges: Disorders, Treatments, andProcedures. (2003). Philadelphia: Lippincott Williams &Wilkins.


Darovic, G. O. (2002). Hemodynamic Monitoring:Invasive and Noninvasive Clinical Application, 3rd ed.Philadelphia: W. B. Saunders/Elsevier.

Davis, L. (2004). Cardiovascular Nursing Secrets. St.Louis, Mo: Mosby/Elsevier.

Diepenbrock, N. H. (2004). Quick Reference to CriticalCare, 2nd ed. Philadelphia: Lippincott Williams & Wilkins.

Finkelmeier, B. A. (2000). Cardiothoracic Surgical Nursing.2nd ed. Philadelphia: Lippincott Williams & Wilkins.

Hickey, J. V. (2008).The Clinical Practice of Neurologicaland Neurosurgical Nursing. 6th ed. Philadelphia:Lippincott Williams & Wilkins.

Morton, P. G., Fontaine, D., Hudak C. M. & Gallo, B. M.(2005). Critical Care Nursing: A Holistic Approach. 8thed. Philadelphia: Lippincott Williams & Wilkins.

Moser, D. K. & Riegel, B. (2001). Improving Outcomesin Heart Failure: An Interdisciplinary Approach.Gaithersburg, MD: Aspen Publishers.


Schell, H. M. & Puntillo, K. A. (2006). Critical CareNursing Secrets, 2nd ed. Hanley & Belfus.


Smeltzer, S., Bare, B.G., Hinkle J.L. & Cheever, K.H.(2008). Brunner and Suddarth’s Textbook of Medical-Surgical Nursing. 11th ed. Philadelphia: LippincottWilliams & Wilkins.



Wiegand, D. J. L. & Carlson, K. K. (eds.) (2005). AACNProcedure Manual for Critical Care. 5th ed.Philadelphia: Elsevier.

Woods, S., Sivarajan Froelicher, E. S. & Motzer, S. U.(2004). Cardiac Nursing. 5th ed. Philadelphia:Lippincott Williams & Wilkins.

Many references available through AACN; visitwww.aacn.org > Marketplace > Online Bookstore.More current version may be available.

CARDIAC MEDICINE CERTIFICATION (CMC) STUDY BIBLIOGRAPHYRECOMMENDED REFERENCES FOR THE CMC EXAM

PUBLISHER CONTACTS:AACN – (800) 899-2226American Heart Association – (800) 242-8721Aspen Publishers – (800) 638-8437Blackwell Publishing – (800) 216-2522Elsevier (including Mosby, W. B. Saunders, and Hanley & Belfus) – (800) 545-2522Lippincott Williams & Wilkins – (800) 638-3030

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CMC

CARDIAC MEDICINE CERTIFICATION (CMC) SAMPLE QUESTIONS

1. In a patient admitted with an acute MI withpercutaneous coronary intervention 2 days ago,which of the following should the nurse expect tobe ordered at discharge?

A. clopidogrel (Plavix), metoprolol (Lopressor), andASA

B. enalapril (Vasotec), NTG SL, and metoprolol(Lopressor)

C. low-molecular-weight heparin, ASA, and statin

D. calcium channel-blocker, ASA, and NTG SL

2. One week after an ST segment elevation MI, apatient develops a holosystolic murmur and thrill.BP is 80/50, PAP 70/40, CVP 30, PCWP 35, andCO 1.2. The most likely cause of these symptomsis

A. pulmonary embolus.

B. ventricular septal defect.

C. cardiac wall rupture.

D. ventricular aneurysm.

3. Administration of furosemide (Lasix) in a patientwith acute tubular necrosis (ATN) caused byaminoglycosides will

A. improve the patient's renal status.

B. increase drug toxicity.

C. increase blood flow to kidneys and reversetubular damage.

D. improve therapeutic drug levels.

Answers1. A 2. B 3. B

61

CMC CERTIFICATION APPLICATION HONOR STATEMENTOnline exam registration is available at www.certcorp.org; click Apply Online.




ASSOCIATE’S NAME:

FACILITY ADDRESS:

City State ZIP


Clinical Nursing Specialty Certification To what nationally accredited clinical nursing specialty certification would you like to tie your CMC certification? (check ONE box only) � CCRN � PCCN � CCNS � ACNPC � Other ___________________________(Attach proof of non-AACN certification, such as copy of wallet card or wall certificate, or verification letter from certifyingorganization; must be valid for 90 days beyond CMC application date.)

Honor StatementI have fulfilled the clinical practice hour requirements of 1,750 hours of direct bedside care of acutely and/or critically ill Adult patientswithin the previous 2-year period, with 875 hours accrued in the most recent year preceding this application; of those 1,750 hours, 875were in the care of acutely and/or critically ill adult cardiac patients. Or if renewing by exam I have completed 432 hours of directbedside care of acutely and/or critically ill Adult cardiac patients during the 3-year certification period, with 144 of those hours accruedin the 12-month period prior to my scheduled renewal date.

I hold a current nationally accredited (NCCA and/or ABNS) clinical nursing specialty certification; and possess a current unencumberedU.S. license to practice as an RN or APRN. An unencumbered license is not currently subject to formal discipline by any Board ofNursing and has no provisions or conditions that limit the nurse’s practice in any way. I agree to notify AACN Certification Corporation ifany disciplinary action is taken against my RN or APRN license in the future. If my clinical nursing specialty certification is conferredby an organization other than AACN Certification Corporation, I agree to submit proof of my certification with this application. Iagree to notify AACN Certification Corporation if my clinical nursing specialty certification lapses.

I hereby apply for CMC subspecialty certification offered by AACN Certification Corporation. I understand that certification depends uponthe successful completion of the specified requirements. I further understand that the information acquired in the certification processmay be used for statistical purposes and for evaluation of the certification program.

To the best of my knowledge, the information contained in the application is true, complete, correct and is made in good faith. Iunderstand that information supplied is subject to audit and failure to respond to a request for further information may be sufficientcause for AACN Certification Corporation to bar me from the exam, to invalidate the results of my exam, to withhold certification, torevoke certification or to take other appropriate action, including revocation of or disciplinary action related to my clinical nursingspecialty certification.




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OFCRHB

AACN PRODUCTS FOR CMC AND CSC EXAM PREPARATION

CMC Item #

AACN Procedure Manual for Critical Care, 5th ed. (2005). Lynn-McHale, D. & Carlson, K. 1,280 pages. 128150

Critical Care Nursing Secrets. 2nd ed. (2006). Schell H.M. & Puntillo K.. A. 838 pages. 128636

Cardiac Nursing, 5th ed. (2004). Woods, S., Sivarajan Froelicher E. S. & Motzer S. U. 1,056 pages. 100151

Cardiac Nursing: A Companion to Braunwald’s Heart Disease. (2007). Moser D. & Reigel, B. 1,440 pages. 100253

CMC Review Course on CD-ROM. (2007). Includes CD-ROM, booklet & 12 hours of CE credit. 300917

CMC Review Course on DVD. (2007). Includes DVD, booklet & 12 hours of CE credit. 300916

CMC Review Course Package on CD-ROM. Includes CMC Review Course on CD-ROM, Cardiovascular Nursing Practice:A Comprehensive Resource Guide and Study Guide for Clinical Nurses and Cardiovascular Review Questions on CD-ROM. 300922

CMC Review Course Package on DVD. Includes CMC Review Course on DVD, Cardiovascular Nursing Practice: A Comprehensive Resource Guide and Study Guide for Clinical Nurses and Cardiovascular Review Questions on CD-ROM. 300923

CSC Item #

Cardiac Surgery Essentials for Critical Care Nursing. (2009). Hardin, S. & Kaplow R. Jones & Bartlett. 462 pages. 100257

The Johns Hopkins Manual of Cardiac Surgical Care, 2nd ed. (2007). Conte J., Owens S. & Dorman T. 512 pages. 100255

CSC Review Course on CD-ROM. (2008). Includes 7 CDs, syllabus & 12 hours of CE credit. 300910

CSC Review Course on DVD. (2008). Includes 3 DVDs, syllabus & 12 hours of CE credit. 300911

CSC Review Course on Audio CD. (2008). Includes 8 CDs, syllabus & 12 hours of CE credit. 300912

CSC Review Course Package on CD-ROM. Includes CSC Review Course on CD-ROM and Cardiac Surgery Essentials forCritical Care Nursing. 300924

CSC Review Course Package on DVD. Includes CSC Review Course on DVD and Cardiac Surgery Essentials for CriticalCare Nursing. 300925

Applicable for both CMC and CSC Item #

Cardiovascular Nursing Practice: A Comprehensive Resource Guide and Study Guide for Clinical Nurses. (2007).Jacobson C., Marlin, K. & Werner, C. 916 pages. 100256

Cardiovascular Nursing Secrets. (2004). Davis, L. 544 pages. 100152

Hemodynamic Monitoring: Invasive and Noninvasive Clinical Application, 3rd ed. (2002). Darovic, G. O. 676 pages. 128639

Mosby’s Diagnostic and Laboratory Tests, 3rd ed. (2005). Pagana K. & Pagana T. 1,280 pages. 128160

Combined CMC/CSC Review Course on CD-ROM . Includes CD-ROMs and 24 contact hours of CE credit. 300920

Combined CMC/CSC Review Course on DVD . Includes DVDs and 24 contact hours of CE credit. 300921

OCTOBER 2009 65

For more details and to place an order, visit our Web site at www.aacn.org and click on Marketplace, or call AACN Customer Care at (800) 899-2226, between 7:30 a.m. and 4:30 p.m., Pacific Time.

OCTOBER 200966

CSC CERTIFICATION

CSC Certification Program.............................................................................................................................................68

CSC Exam Eligibility........................................................................................................................................................68

CSC Online Registration.................................................................................................................................................69

CSC Application Fees .....................................................................................................................................................69

CSC Certification Renewal .............................................................................................................................................70

CSC Test Plan..................................................................................................................................................................71

CSC Study Bibliography..................................................................................................................................................72

CSC Sample Exam Questions........................................................................................................................................73

AACN Products for CSC Exam Preparation ...................................................................................................................65

CSC Exam Honor Statement (3rd page of 3-page application)...................................................................................75


CSC® (Cardiac Surgery Certification) is a nursing subspecialty designed for specialty certified nurses who providecare for acutely and/or critically ill cardiac surgery patients within the first 48 hours postoperatively. Specialtynurses interested in this subspecialty certification may work in areas such as: cardiothoracic surgery;cardiovascular surgery; or post-anesthesia care units.

CSC

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CSC® Registered Service MarkCSC is a trademark of AACN Certification Corporationand denotes certification in cardiac surgery as grantedby AACN Certification Corporation. Registered nurseswho have not achieved CSC certification status, whoseCSC status has lapsed, or whose clinical nursingspecialty certification has lapsed or is inactive are notauthorized to use the CSC credential.

Validated Knowledge and SpecializedSkillsThe CSC certification exam is based on a job analysis.The most recent study, completed in 2003, defines thedimensions of acute and critical care practice,identifying what is required of registered nursespracticing in acute and critical care settings and caringfor cardiac surgery patients.

In the study, acute and critical care nurses across theUnited States were surveyed to ascertain thefrequency and significance of the various elements oftheir practice. Through an extensive review andevaluation process, the knowledge, skills and abilitiescrucial to cardiac nursing were defined using theSynergy Model for Patient Care as an organizingframework focusing on the clinical judgment component exclusively. The CSC certification exam is

based on these skills and abilities and the knowledgerequired to perform them.

CSC certification is achieved by those acute andcritical care nurses who pass the CSC exam in cardiacsurgery. CSC certification denotes to the public thosepractitioners who possess a distinct and clearlydefined body of knowledge called cardiac surgerynursing.

CSC Exam ContentThe CSC exam is a 2-hour test consisting of 90multiple-choice items. Of the 90 items, 75 are scoredand 15 are used to gather statistical data on itemperformance for future exams. Please see the testplan for more information. The CSC exam focuses onadult populations. One hundred percent (100%) of theexam focuses on clinical judgment.

CSC Test PlanThe content of the CSC exam is described in the testplan. Candidates are tested on a variety of patient careproblems that are organized under major categories.Please note the percentage of the CSC exam devotedto each category.

CSC CERTIFICATION PROGRAM

• Current unencumbered RN or APRN licensure in theUnited States is required.


It is the responsibility of candidates and certifiednurses to notify AACN Certification Corporation whenany restriction is placed on their RN or APRN license.If you are randomly selected for audit, you will beasked to provide a copy of your RN or APRN license– please do not submit with your application.

• Practice as an RN or APRN is required for 1,750hours in direct bedside care of acutely and/orcritically ill patients during the previous two years,with 875 of those hours accrued in the most recentyear preceding application. Of those 1,750 hours

875 need to be in the care of cardiac surgerypatients within the first 48 hours postoperatively.

Clinical practice hours for the CSC exam or renewaleligibility must take place in a U.S.-based orCanada-based facility or in a facility determined tobe comparable to the U.S. standard of acute/criticalcare nursing practice, as evidenced by ANCCMagnet Status or Joint Commission Internationalaccreditation.


CSC EXAM ELIGIBILITY

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• A current, nationally accredited NCCA (NationalCommission for Certifying Agencies) or ABNS(American Board of Nursing Specialties) clinicalnursing specialty certification, to which yoursubspecialty certification will be attached, isrequired. A clinical nursing specialty certificationrefers to a specialty certification that involves directcare of the patient, such as CCRN, PCCN, CCNS,ACNPC, FNP, CNOR, CRNFA, APRN,BC, etc.

• The name and address of a professional associatemust be given for verification of eligibility related toclinical practice hours. If you are randomly selected

for audit, this associate will be asked to verify inwriting that you have met the clinical hourrequirements. A professional associate is defined asa clinical supervisor (RN or physician) or RNcolleague with whom you work.

• AACN Certification Corporation may adopt additionaleligibility requirements at its sole discretion fromtime to time. Any such requirements will bedesigned to establish, for the purposes of CSCcertification, the adequacy of a candidate'sknowledge and experience in caring for the acutelyand/or critically ill.

CSC

Online registration is available for the CSC exam. This paperless registration streamlines the exam applicationprocess by up to six weeks. Once you register online your 90-day window for testing will begin within one to twoweeks. Candidates should be prepared to sit for the exam before registering online. For more information andto register visit www.certcorp.org.

CSC ONLINE REGISTRATION

Computer-Based CSC Exam

AACN Members $135

Nonmembers $180

CSC Retest Fee

AACN Members $110

Nonmembers $155

Current CSC Renewal by Exam

AACN Members $110

Nonmembers $155


CSC APPLICATION FEES

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CSC certification is conferred for a period of threeyears. Your certification period begins the first day ofthe month in which the CSC certification exam ispassed and ends three years later; for example,October 1, 2009 through September 30, 2012. Thepurpose of certification renewal is to enhancecontinued competence.

You may seek CSC certification renewal via Renewal byCERPs or Renewal by Exam. Do not apply for morethan one option. For Renewal by Exam, you mustsuccessfully apply for, schedule and complete the CSCexam before your scheduled renewal date. You maynot take the exam early and then attempt to renew byCERPs if you do not pass.

A renewal notification will be mailed to youapproximately 90 days before your CSC expirationdate. You are responsible for renewing yourcertification even if you do not receive a renewalnotification. Visit www.certcorp.org to download acopy of the CMC/CSC Renewal Handbook. OnlineRenewal by CERPs is available to all active CSCs asearly as four months prior to their renewal date. Visitwww.certcorp.org - click Renew Your Certification.

Candidates for CSC renewal must meet the followingrequirements:

• Current unencumbered RN or APRN license in theUnited States

An unencumbered license has not been subjectedto formal discipline by any Board of Nursing andhas no provisions or conditions that limit thenurse’s practice in any way.

• Current clinical nursing specialty certificationaccredited by the NCCA (National Commission forCertifying Agencies) or the ABNS (American Boardof Nursing Specialties)

• Completion of 432 clinical practice hours withpostoperative cardiac patients within the three-year period preceding scheduled renewal date,with 144 of those hours accrued in the 12-monthperiod preceding scheduled renewal date; all 432clinical hours for renewal must be in the care ofcardiac surgery patients within the first 48 hourspostoperatively

• Completion of twenty-five (25) Category A ClinicalJudgment CERPs pertaining to cardiac surgery(includes all items on the CSC test plan) during thethree-year certification renewal period ORsuccessful completion of the CSC exam

CSC CERTIFICATION RENEWAL

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CSC

CARDIAC SURGERY CERTIFICATION (CSC) TEST PLAN

I. PATIENT PROBLEMS (52%)

A. Cardiothoracic Surgery (32%)

1. Cardiac arrhythmias (e.g., postoperative atrial fibrillation)

2. Patients who have had cardiopulmonary bypass

3. Complications of cardiac surgery

a. tamponade

b. postoperative bleeding

c. coagulopathy (e.g., DIC, HITTS, ReoPro-induced, heparin rebound)

d. open chest wound from the operating room

4. Abnormal pulsus paradoxus

5. Myocardial stunning/hibernation

6. Patients who have had surgery of the thoracic aorta

7. Patients who have had surgical treatment of

a. cardiac rhythm disorders (e.g., MAZE procedure/modified MAZE)

b. coronary artery disease

8. Patients with off-pump coronary artery bypass (OPCAB)

9. Patients who have had minimally invasive cardiac surgery

10. Patients who have had heart valve surgeryinvolving

a. surgical repair

b. surgical replacement

11. Radial artery as an alternate arterial conduit

B. Pulmonary (5%)

1. Acute respiratory failure related to phrenicnerve damage

2. Air-leak syndromes (e.g., pneumopericardium,pneumomediastinum)

3. Pleural effusions

4. Atelectasis (e.g., left lower lobe)

C. Hematology (3%)

1. Inflammatory response (e.g., hyperdynamicstate without documented infection)

2. Anaphylaxis (e.g., protamine reaction)

D. Neurology/Gastrointestinal (7%)

1. Encephalopathy (e.g., hypoxic-ischemic,metabolic)

2. Postoperative impaired cognition

3. Stroke (e.g., embolic, hemorrhagic)

4. Post-pump hepatic failure

E. Renal (5%)

1. Acute renal failure/insufficiency/azotemia

2. Life-threatening electrolyte imbalances (e.g.,potassium, sodium, phosphorus, magnesium,calcium; may include imbalances not causedby renal problems; many imbalances caused bypump)

II. NURSING INTERVENTIONS (48%)

A. Antidysrhythmics

B. Vasodilators

C. Vasopressors

D. Fluid volume management specific to cardiac surgery

E. Hemodynamic monitoring (e.g., standard pulmonary artery catheter, SvO2 catheter, intermittent mixed-venous sample interpretation)

F. Incision assessment and management

G. Pain management

H. Epicardial pacing

I. Intraaortic balloon pump

J. Mediastinal drainage (characteristics of drainage and normal amounts)

K. Emergent reopening of the chest

L. Assist with internal defibrillation

M. Ventilator management/weaning/ABG interpretation

N. Management of hyperglycemia and hypoglycemia

O. Management of recovery from anesthesia

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American Heart Association. (2005). Guidelines 2005for Cardiopulmonary Resuscitation and EmergencyCardiovascular Care. Available at:www.americanheart.org/presenter.jhtml?identifier=3035517

Aschenbrenner, D. S., Cleveland, L. W. & Venable, S. J.(2002). Drug Therapy in Nursing. Philadelphia:Lippincott Williams & Wilkins.

Aschenbrenner, D. S., Cleveland, L. W. & Venable, S. J.(2002). Study Guide to Accompany Drug Therapy inNursing. Philadelphia: Lippincott Williams & Wilkins.

Bojar, R. (2004). Manual of Perioperative Care in AdultCardiac Surgery. 4th ed. Maulden: Blackwell Publishing.




Davis, L. (2004). Cardiovascular Nursing Secrets.St. Louis, Mo: Mosby/Elsevier.

Diepenbrock, N. H. (2004). Quick Reference to CriticalCare. 2nd ed. Philadelphia: Lippincott Williams &Wilkins.

Finkelmeier, B. A. (2000). Cardiothoracic SurgicalNursing. 2nd ed. Philadelphia: Lippincott Williams &Wilkins.


Lemmer, J. H., Richenbacher, W. E. & Vlahakes, G. J.(2003). Handbook of Patient Care in Cardiac Surgery.Philadelphia: Lippincott Williams & Wilkins.

Pagana, K. D. & Pagana, T. J. (2008). Mosby’sDiagnostic and Laboratory Test Reference. 9th ed.St. Louis, Mo: Mosby/Elsevier.

Seifert, P. C. (2002). Cardiac Surgery: PerioperativePatient Care. St. Louis, Mo: Mosby/Elsevier.

Skidmore-Roth, L. (2008). Mosby’s 2009 NursingDrug Reference. 22nd ed. St. Louis, Mo:Mosby/Elsevier.

Smeltzer, S., Bare, B. G., Hinkle J. L. & Cheever, K. H.(2008). Brunner and Suddarth’s Textbook of Medical-Surgical Nursing. 11th ed. Philadelphia: LippincottWilliams & Wilkins.

Soltoski, P., Karamanoukian, H. & Salerno, T. (2003).Cardiac Surgery Secrets. 2nd ed. St. Louis, Mo:Mosby/Elsevier.



CARDIAC SURGERY CERTIFICATION (CSC) STUDY BIBLIOGRAPHYRECOMMENDED REFERENCES FOR THE CSC EXAM

PUBLISHER CONTACTS:AACN – (800) 899-2226American Heart Association – (800) 242-8721Aspen Publishers – (800) 638-8437Blackwell Publishing – (800) 216-2522– (800) 545-2522Lippincott Williams & Wilkins – (800) 638-3030

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CSC

CARDIAC SURGERY CERTIFICATION (CSC) SAMPLE QUESTIONS

1. A postoperative CABG patient is taken to the ICU.Four hours postoperatively, the patient is noted tobe restless, short of breath and has developedjugular vein distention. Vital signs are as follows:

BP 80/45

HR 125

RR 30

CVP 16

The patient’s chest tube output has been minimalduring the last hour. These symptoms would mostlikely be indicative of which of the following?

A. cardiac tamponade

B. pulmonary contusion

C. cardiogenic shock

D. fluid volume overload

2. The most important therapy ordered for apostoperative CABG patient who has received anarterial graft as an alternative conduit is the useof

A. beta-blockers to prevent tachycardia.

B. calcium channel-blockers to prevent arteryspasm.

C. anticoagulants to prevent thrombus formation.

D. phenylephrine to maintain MAP > 75.

Answers1. A 2. B

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CSC CERTIFICATION APPLICATION HONOR STATEMENTOnline exam registration is available at www.certcorp.org; click Apply Online.




ASSOCIATE’S NAME:

FACILITY ADDRESS:

City State ZIP


Clinical Nursing Specialty Certification To what nationally accredited clinical nursing specialty certification would you like to tie your CSC certification? (check ONE box only) � CCRN � PCCN � CCNS � ACNPC � Other ___________________________(Attach proof of non-AACN certification, such as copy of wallet card or wall certificate, or verification letter from certifyingorganization; must be valid for 90 days beyond CSC application date.)

Honor StatementI have fulfilled the clinical practice hour requirements of 1,750 hours of direct bedside care of acutely and/or critically ill Adultpatients within the previous 2-year period, with 875 hours accrued in the most recent year preceding this application; of those 1,750hours, 875 were in the care of cardiac surgery patients within the first 48 hours postoperatively. Or if renewing by exam I havecompleted 432 hours of direct bedside care of acutely and/or critically ill Adult cardiac surgery patients within the first 48 hourspostoperatively during the 3-year certification period, with 144 of those hours accrued in the 12-month period prior to my scheduledrenewal date.

I hold a current nationally accredited (NCCA and/or ABNS) clinical nursing specialty certification; and possess a current unencumberedU.S. license to practice as an RN or APRN. I agree to notify AACN Certification Corporation if any disciplinary action is taken against myRN or APRN license in the future.

If my clinical nursing specialty certification is conferred by an organization other than AACN Certification Corporation, I agree tosubmit proof of my certification with this application. I agree to notify AACN Certification Corporation if my clinical nursing specialtycertification lapses.

I hereby apply for CSC subspecialty certification offered by AACN Certification Corporation. I understand that certification dependsupon the successful completion of the specified requirements. I further understand that the information acquired in the certificationprocess may be used for statistical purposes and for evaluation of the certification program.

To the best of my knowledge, the information contained in the application is true, complete, correct and is made in good faith. Iunderstand that information supplied is subject to audit and failure to respond to a request for further information may be sufficientcause for AACN Certification Corporation to bar me from the exam, to invalidate the results of my exam, to revoke certification, towithhold certification, or to take other appropriate action, including revocation of or disciplinary action related to my clinical nursingspecialty certification.




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Synergy is an evolving phenomenon that occurs whenindividuals work together in mutually enhancing waystoward a common goal. AACN CertificationCorporation is committed to ensuring that certifiednursing practice is based on the needs of patients.Integration of the AACN Synergy Model for PatientCare into AACN Certification Corporation’s certificationprograms puts emphasis on the patient, and says tothe world that patients come first.

The Synergy Model creates a comprehensive look atthe patient. It puts the patient in the center of nursingpractice. The Synergy Model identifies nursing’sunique contributions to patient care and useslanguage to describe the professional nurse’s role. Itprovides nursing with a venue that clearly states whatwe do for patients and allows us to start linkingourselves to, and defining ourselves within, thecontext of the patient and patient outcomes.

NOTE: AACN certification exams do not test for knowledgeof the Synergy Model or its terminology; this is thetheoretical model within which the tests have beendesigned.

Patient CharacteristicsThe Synergy Model encourages nurses to viewpatients in a holistic manner rather than the “bodysystems” medical model. Each patient and family isunique, with a varying capacity for health andvulnerability to illness. Each patient, regardless of theclinical setting, brings a set of unique characteristicsto the care situation. Depending on where they are onthe healthcare continuum, patients may displayvarying levels of the following characteristics:

AACN SYNERGY MODEL FOR PATIENT CARE™

Resiliency the capacity to return to a restorative level offunctioning using compensatory/copingmechanisms; the ability to bounce back quicklyafter an insult.

Vulnerability susceptibility to actual or potential stressorsthat may adversely affect patient outcomes.

Stability the ability to maintain a steady-stateequilibrium.

Complexity the intricate entanglement of two or moresystems (e.g., body, family, therapies).

Resource Availability

extent of resources (e.g., technical, fiscal,personal, psychological, and social) thepatient/family/community bring to the situation.

Participation in Care

extent to which patient/family engages inaspects of care.

Participation in DecisionMaking

extent to which patient/family engages indecision making.

Predictability a characteristic that allows one to expect acertain course of events or course of illness.

FOR EXAMPLE: A healthy, uninsured, 40-year-old woman undergoing a pre-employment physical could be described as an individualwho is (a) stable (b) not complex (c) very predictable (d)resilient (e) not vulnerable (f) able to participate in decisionmaking and care, but (g) has inadequate resourceavailability.

On the other hand: a critically ill, insured infant with multi-system organ failure can be described as an individual whois (a) unstable (b) highly complex (c) unpredictable (d) highlyresilient (e) vulnerable (f) unable to become involved indecision making and care, but (g) has adequate resourceavailability.

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Nurse CharacteristicsNursing care reflects an integration of knowledge,skills, abilities and experience necessary to meet theneeds of patients and families. Thus, nursecharacteristics are derived from patient needs andinclude:

AACN SYNERGY MODEL FOR PATIENT CARE™ (CONTINUED)

ClinicalJudgment

Clinical reasoning, which includes clinicaldecision making, critical thinking and a globalgrasp of the situation, coupled with nursing skillsacquired through a process of integratingeducation, experiential knowledge and evidence-based guidelines.

Advocacy/MoralAgency

Working on another's behalf and representing theconcerns of the patient/family and nursing staff;serving as a moral agent in identifying andhelping to resolve ethical and clinical concernswithin and outside the clinical setting.

CaringPractices

Nursing activities that create a compassionate,supportive and therapeutic environment forpatients and staff, with the aim of promotingcomfort and healing and preventing unnecessarysuffering. These caring behaviors include but arenot limited to vigilance, engagement andresponsiveness of caregivers. Caregivers includefamily and healthcare personnel.

Collaboration

Working with others (e.g., patients, families,healthcare providers) in a way thatpromotes/encourages each person's contributionstoward achieving optimal/realistic patient/familygoals. Collaboration involves intra- and inter-disciplinary work with colleagues and community.

SystemsThinking

Body of knowledge and tools that allow the nurse tomanage whatever environmental and systemresources that exist for the patient/family and staff,within or across healthcare systems and non-healthcare systems.

Response toDiversity

The sensitivity to recognize, appreciate andincorporate differences into the provision of care.Differences may include, but are not limited to,individuality, cultural, spiritual, gender, race,ethnicity, lifestyle, socioeconomic, age andvalues.

Facilitationof Learning(or Patient/FamilyEducator

The ability to facilitate learning forpatients/families, nursing staff, other members ofthe healthcare team and community. Includesboth formal and informal facilitation of learning.

ClinicalInquiry (orInnovator/Evaluator)

The ongoing process of questioning and evaluatingpractice and providing informed practice. Creatingchanges through evidence-based practice,research utilization and experiential knowledge.

Nurses become competent within each continuum ata level that best meets the fluctuating needs of theirpopulation of patients. More compromised patientshave more severe or complex needs, requiring nursesto have advanced knowledge and skills in anassociated continuum.

FOR EXAMPLE:If the gestalt of a patient were stable butunpredictable, minimally resilient and vulnerable,primary competencies of the nurse would be centeredon clinical judgment and caring practices (whichincludes vigilance). If the gestalt of a patient werevulnerable, unable to participate in decision makingand care, and inadequate resource availability, theprimary competencies of the nurse would focus onadvocacy and moral agency, collaboration andsystems thinking.

Although all eight competencies are essential forcontemporary nursing practice, each assumes moreor less importance depending on a patient’scharacteristics. Synergy results when a patient’sneeds and characteristics are matched with thenurse’s competencies.

Results of a 1997 large-scale survey of subacute,acute and critical care nurses across the UnitedStates supported the applicability of the SynergyModel to nursing practice (Greenberg, Muenzen, andSmith, 1998). A second study, including adult,pediatric and neonatal CCRNs, identified the overallcontribution of each of the eight nurse characteristicsto optimal patient outcomes.

Based on these studies, as well as the 2003 jobanalysis completed by AACN Certification Corporation,the test plans for AACN certification exams have beencreated to reflect the Synergy Model, as well ascurrent acute and critical care nursing practice.

For more information about the AACN Synergy Modelfor Patient Care visit www.certcorp.org; click on theGeneral Information button on the left side of thepage.

77OCTOBER 2009

1. REGISTRATION INFORMATION PLEASE PRINT CLEARLY. PROCESSING WILL BE DELAYED IF INCOMPLETE OR NOT LEGIBLE.

AACN MEMBER NUMBER: RN/APRN LICENSE NUMBER: Exp. Date State Exp. Date

NAME: Last First MI Maiden

HOME ADDRESS: City State ZIP

INSTITUTION NAME: BUSINESS PHONE:

INSTITUTION ADDRESS: City State ZIP

PREFERRED EMAIL: HOME PHONE:

2. AACN MEMBERSHIP I would also like to join/renew my AACN membership at this time and select member pricing for my exam fees:(check only one box)

� 1-year AACN membership……………………………………..............................$78 � 2-year AACN membership……………………………………..............................$148� 3-year AACN membership………………………….………….............................$179.35 (special certification rate)

3. EXAM FOR WHICH YOU ARE APPLYING: (check only one box)Note: SPECIAL applications for NTI and TRENDS paper and pencil exams available at www.certcorp.org

� Check this box if you’ve attached a request and supporting documentation for special testing accommodations.

4. PAYMENT INFORMATION – application must be accompanied by payment� Check or money order attached – payable to AACN Certification Corporation. U.S. funds only. Bill my credit card � Visa � MasterCard � American Express � Discover Card

Name on Card _____________________________________________ Signature___________________________________________

Amount Billed $______________ Address of Payor (if different than applicant)_______________________________________________

5. IF JOINING AACN NOW, WERE YOU REFERRED BY A CURRENT MEMBER OR CHAPTER? � No � Yes

� Please do not include my name on lists sold to other organizations.

CERTIFICATION EXAM APPLICATION Online exam registration is available at www.certcorp.org; click Apply Online.

Exp. Date(mm/yy)Credit Card #

Member Name / AACN # or* Chapter Name (*include only one for referral incentives)

Please complete page 2 of application.

OCTOBER 2009APCCHW

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This application form may be photocopied and is also available online at www.certcorp.org.

Membership Fee:

$__________

+

Exam Fee:

$__________

=

Total Payment:

$__________

79

Exam Type

Initial ExamFee

Initial ExamFee

Retest orRenewal byExam Fee

Retest orRenewal byExam Fee

AACN Member Nonmember AACN Member Nonmember

CCRN Adult � $220 � $325 � $170 � $275

Neonatal � $220 � $325 � $170 � $275

Pediatric � $220 � $325 � $170 � $275

PCCN Adult Only � $170 � $250 � $135 � $215

CMC Adult Only � $135 � $180 � $110 � $155

CSC Adult Only � $135 � $180 � $110 � $155

CERTIFICATION EXAM APPLICATION

PRINTED NAME AACN#

6. DEMOGRAPHIC INFORMATION (check one box in each category) Information is used for statistical purposes.

Primary Area Employed� Acute Hemodialysis Unit (21)� Burn Unit (13)� Cardiac Rehabilitation (26)� Cardiac Surgery/OR (36)� Cardiovascular/Surg. ICU (09)� Catheterization Lab. (22)� CCU (03) � Combo Adult/Ped ICU (23)� Combined ICU/CCU (01)� Corporate Industry (24)� CC Transport/Flight (17)� eICU or Virtual ICU (37)� Emergency Dept.(12)� General Med./Surg Floor (18)� Home Care (25)� ICU (02)� Interventional Cardiology (31)� Long-Term Care (27)� Medical Cardiology (34)� Medical ICU (04)� Med. Surg. ICU (35)� Neonatal ICU (06)� Neuro/Neurosurgical ICU (10)� Oncology Unit (19)� Operating Room (15)� Outpatient Clinic (29)� Pediatric ICU (05)� Private Practice (32)� Progressive Care Unit (16)� Recovery Room/PACU (14)� Respiratory ICU (08)� Stepdown Unit (30)� Subacute Care (28)� Surgical ICU (07)� Telemetry (20)� Trauma Unit (11)� Other – specify below

___________________________ (99)

Primary Position Held� Academic Faculty (07)� Acute Care Nurse Practitioner (09)� Administrator/V.P. (43) � Clinical Director (04)� Clinical Nurse Specialist (08)� Corporate Executive (11)� Elected Official (12)� Inservice/Staff Dev. Instructor (06)� Legal Nurse Consultant (39)� Manager (03)� Nurse Anesthetist (02)� Nurse Educator (46)� Nurse Midwife (13)� Nurse Practitioner (05)� Pharmacist (14)� Physician (16)� Physician Assistant (17)� Researcher (18)� Respiratory Therapist (19)� Social Worker (20)� Staff Nurse (01)� Unit Coordinator (22)� Other - specify below

___________________________ (99)

Highest Nursing Degree� Associate’s Degree� Bachelor’s Degree� Diploma� Doctorate� Master’s Degree

Is English your first language?� Yes � No

Did you graduate from nursing school ina country other than the U.S.? � Yes � No

If yes, which country?

______________________________

What year did you startpracticing nursing in the U.S.?

______________________________

Ethnicity� African-American (02)� Asian (05)� White/Non-Hispanic (01)� Hispanic/Latino (03)� Native American (04)� Pacific Islander (06)� Other – specify below

___________________________ (99)

Gender� Female � Male

Have you completed Red Cross DisasterRecovery training?� Yes (01) � No (02)

Primary Type of Facility in Which

Employed� College/University (08)� Community Hospital (Nonprofit) (01)� Community Hospital (Profit) (02)� County Hospital (07)� HMO/Managed Care (12)� Home Health (13)� Military/Government Hospital (04)� Private Industry (11)� Registry (10)� Self-Employed (09)� Travel Nurse (15)� University Med. Center (03)� Other – specify below

__________________________ (99)

Number of beds in Institution

_________________________________

Years experience in Nursing

_________________________________

Years experience in Acute Care Nursing

________________________________

Date of Birth (Month/Day/Year)

_________________________________

7. HONOR STATEMENT - 3rd page of application that must be submitted with this formComplete the Honor Statement, found at the end of the exam section, for your selected exam:

CCRN (p. 35), PCCN (p. 51), CMC (p. 63) or CSC (p. 75).

8. SUBMIT APPLICATIONAttach Honor Statement to this application and submit with payment to:

AACN Certification Corporation, 101 Columbia, Aliso Viejo, CA 92656-4109 or fax to: (949) 362-2020.

DO NOT mail AND fax your application - please choose only ONE method.

NOTE: Allow 4 to 6 weeks from date received by AACN Certification Corporation for application processing.

Questions? Please call us at (800) 899-2226, e-mail [email protected] or visit www.certcorp.org.

OCTOBER 2009

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80 Did you include your signed honor statement and fee payment?