Student Experiences
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Name - Chava K.
Date of CPNE - June 11-13, 2010
Dear Robbie,
Just wanted to take the moment to tell you more about my individual CPNE. Firstly because mine was
midweek in Utica it seems that the hospital (Foxton's st. luke) had to temporarily reposses the rooms
the usually give excelsior (which i am told were nice big airy well lite rooms) instead we had
orientation confrence in the cafeteria (which was a little bit noisy and distracting) and labs were done
in a small utility room. My woundcare station was set up on a bed! Now for me this was no problem
because this was exactly what my makeshift lab at home looked like - but some of the ladies (It
happen to be an all female group) really freaked out! One said she took the workshop by excelsior
down in albany and there was big tables, good lighting etc. (She unfortunately did not pass - she
failed the IM/SubQ station twice) And our makeshift room in the hospital had a broken air conditioner
and half the room the lights were out and the IV piggy back station was on that side. They set up an
additional IM/SubQ station in a little closet - all in all I am trying to tell you to be aware that even in
makeshift conditions, excelsior excpects you to do the station perfectly. (I had asked the CE before
starting if I can hang my tape off the side of the bed rail since it wasn't a reg. table and she said
yes.) We had plenty of time to familiraze ourselves with the equipment i tried on the pair of gloves i
thought would fit best - and practice doing the wound on the bed to see if it effected me at all that the
station was lower than i'd practiced, it didn't. (the ca gave us a little over 20 min to orient ourselves to
the stations) The gloves were easy to slide on and the gauze was very cooperative and came apart
easy for fluffing.
Bec. of the smaller room for labs the group split into half and 1 did labs while the other oriented to
the floor. I oriented to the floor first. My pt had Spinal stenosis I did risk for injury and chronic pain
bec. he has consistanly beenrating it as a 9/10. Of corse when i went in the next day and asked how
he felt he scored it a 1/10. I kept chronic pain as my evaluation NCP diagnosis anyways bec. even
though it was controlled it was still the primary concern as the stenosis was not very advanced.
My second pt was for the books and completeky freaked me out. A 69 year old man on dialysis that
came in vomitting, naseous, was diagnosed with hypokalemia and was ready to discharge and send
home. everything was perfect with the pt. All his values were in line he moved around and did all his
care like a 20 year old. He was wonderfully nice but there was no diagnose to do. In the end I held
my breath did readiness for enhanced comfort r/t hospitalization and kept telling myself as long as i
do it well it will not fail me. other diagnosis was risk for injury. It took 20 min. for me to convice the
nice man to allow me to do comfort measures bec. he was perfectly comfortable and ready to go
home. He was discharged and left the hospital as i gave report to the primary nurse during
evaluation phase.
The third pt. was very difficuly 99 year old room with fractured shoulder -imoobilized, fracture to neck
of femur. how did she injure herself? She was fully active living by herself before the injury,
volentered with community works, soup kitchen, etc. she fell taking a leaf out of her dining room table
! she was sweet and a riot, but oh time consuming. Breakfast to 30 min! I tried to ask the CE if i can
get a CNA to help with breakfast while I did charting (there was plenty to chart but she very kindly told
me no. Anyways, took 15 min to do her mouthcare too bec. she wanted to try to do it with the non
dominante hand, etc. it took very long. than i had to do resp. management on her! I spent 15 min.
talking to myself outloud on how i am going to do this. I can't sit her up bec. the shoulder immobilizer
and her painscale rated at 7 and she hadnt been medicated yet and i only had 30 min remaining to
pcs. I couldnt very well turn her onto the imobilized arm, so i would have to turn her onto the good
arm. I ask the CE what would be acceptable in this case reguarding the fact the pt would be in pain -
and of corse she tells me i have to decide. so the CE helping me we roll her towards her good arm
while trying to keep the arm as immobilized as possible and than i see the immobilizer runs along the
whole back I stick the stethoscope under get 3 feilds but the pt is in a lot of pain and there is noway
to manuever her enough to get to the last feild I rool her back in place and reposition her while
thinking what am I gonna do now. It is then that the CE speaks up and says "you know chava,
excelsior has a very quiet policy that in extreme circumstances auscultation can be done on the
front." - I was ready to kill her. After me putting the pt. through 5 min. of torture (O would have failed
myself by the way for it but she told me to just try to do it and be as quick as possible with the first
sounds of pain from the pt.) so she tells me this policy. Which I had read as one blip in the CPNE
study guide. well, the rest went quickly, and she told me i passed. It was a harrowing experience. Not
to mention I didn't know weather to include the 5 ml of maple syrup on fluid intake but decided i
should especially cause you specify what the fluid was. And than I heard the pt ask for the CE to add
milk to my pt. coffee when I was in the bathroom washing the mouthcare equipment. I came out to do
it but was too late and when I asked her how much she looked at me like I was off the wall. I told her
for I and O and that i was gonna measure the milk before adding it to the coffee. She told me it was
probably one tsp. I thought that was mean - now I know 1 tsp is 5 ml in my sleep with 4 young
children and plenty of tylonel having been given in the last year alone. But if another student with not
too much pt care acess and poor meomory of conversion rates - well - If i told you I was going to
measure it I think at least she should have answered 5ml - she was waiting for me to tell her what the
1 tsp ratio was and I promptly did so. Anyways, I really didn't mind anything she'd done by the end
when she passed me (cuz i don't think i would have if situation was switched! But I still believe I am a
very cometant nurse)
So there you go - No repeat labs, No repeat PCS. hope I didn't bore you but figured I could give you
the info and you take from it what you will. (Also, the plungers on the insulin syringes I used stuck a
little bit and it had to be rocked back and forth to loosen it (It caused me a problem the first time I
drew up and than i quickly refilled another after loosening the plunger that time.)
Oh, and I wanted to tell you that for the first 30 sec of my labs I felt lost like i didn't know where to
begin and than i told myself, you memorized rob's mneumonics SO why don't you WRITE THEM
DOWN! I did that and than it was a breeze it kept my anxiety in check and allowed me to focus on the
task. So that is my extended story. Sorry again, I hope it didn't bore you. And thank you again - I
would not have passed this test without your help!
Sincerly,
Chava K. (Kurant)
Name - Heather Santa Cruz
Date of CPNE - Mar 19-21, 2010
Hi Rob,
I just wanted to let you know that I finished my last PCS this morning at Grady and I have officially
passed the CPNE. I also wanted to thank you, not only for your website, DVD's and Ebook, but for
answering my questions (even the little ones) when I really needed to know more or I was just
anxious.
I did great on my PCSs--one CE said my documentation was "excellent". I have you to thank for that.
The only mishap was I had to re-do the wound lab sim. According to the CE, I touched the side with
the gauze. That night I practiced on the wound I made (using a different method--I personally don't
recommend the parachute method). Then, after a good cleansing cry in the 6th floor Grady
bathroom, I passed the thing that could have sent me home. After I passed on the second try, I felt
like I'd already won. Today's peds PCS was cake.
Thank you for your recommended nursing diagnosis--they were all highlighted in the back of my
book and were very handy. In my experience, acute pain was used successfully for all 3 PCS. It was
my primary for two of the three.
I'll give a little info on my experience in the hope that it may help others. Grady is a very old and worn
looking hospital in a not-so-great area in Atlanta. However, I would recommend the location to
anyone looking for a Southern test site. The CA was very comforting and knowledgeable. The CE's
were also great. They don't seem to sweat the small stuff. When I had I &O's, they never expected
me to pour any liquids into a graduate--they either told me what to put down or allowed me to
estimate (half a juice was 60mLs). I only had to wash my hands at the sink initially before each PCS,
then the "foam in, foam out" (which is Grady's policy) was acceptable every other time. Grady has a
great hand hygiene and infection control policy--I was impressed.
In my experience, as well as some other student's, the CE's seemed to prompt us to remember
certain things even if it wasn't necessary. They just did it as a courtesy. I'm not certain, but it is
possible that the CE I had at the IV push station gave me a couple extra minutes. Another student
said the same thing. It's not that they aren't strict--you better know your stuff--it's just that they don't
seem to want to fail you for the stupid things that have nothing to do with being a good nurse in the
real world. They seemed very down to Earth and practical.
If anyone is planning to go to Grady, they can email me with questions if they want to. I'd be happy to
help--I certainly know how it feels to have anxiety about every aspect of this exam.
Everyone in my group of 7 passed. It really can be done. I had to see it for myself to believe it, but it's
true. I work part time, have a toddler, and I'm 21 weeks preggo with number 2. I did this with no Xanax
for anxiety, no Lunesta to help me sleep, and no beer or cigarettes to help me relax like most of my
group members did, and I still made it through with no problems (aside from the wound). If I can swing
it, I think anyone can as long as they're prepared. I had my husband and 2 year old with me for
support and comic relief at the hotel which, for me, was great. I also brought all of my study stuff with
me--even my IV bag. I know some others have said NOT to study during the CPNE, but just knowing
my resources were available if I needed them helped a lot. Reading or practicing something "just one
more time" before the real event made me feel more confident.
Even though I did pass the wound station on the second try by practicing on the wound I made, I
really recommend buying the Excelsior wound model for anyone who is especially worried about that
station. The model is extremely shallow--almost flush with the surrounding "skin" in places. It is also
slippery. Unlike the wound I made with play doh, the gauze would not stick anywhere and could not
be tucked in nicely into corners. It behaves nothing like an actual wound, for sure.
I can't think of anything else at the moment, but please ask if you want any particular info. I would be
happy to help anyone if they have questions.
Thank you again for your great study materials. I would not have gone in so confident without them.
And I didn't get a one-time workshop for $400, I got your info, which was exceptional, that I could
watch or read as many times as needed. Plus, you were always there to answer questions. I can't
thank you enough. I (and many others out there) are very grateful for your dedication.
Heather
Name - Amy Bowers
Date of CPNE - Feb 26-28, 2010
CPNE date: Feb.26-28 I passed ONLY because of the organizational skills (mnemonics and both
DVDs) taught through Rob and a few other things I threw in, too... First, set up your lab equipment
the exact same way at home, then when you are at the CPNE, simply set the equipment up the same
way...Second, during my planning stage, I would place a number next to the AOC in the order of
which would be best (ie 1st 20 min check, 2nd Fluid Management, etc)...
Next, I ALWAYS had my grid out during the implementation and evaluation stages so I never forgot
anything...Last, for three weeks prior to my CPNE, I took a BID (twice a day) dose of Airborne to
prevent becoming sick and giving the CA a reason to fail me d/t illness. This product ROCKS!!! (I've
spoken to other students who have purchased Rob's product second hand...though you may feel as
though you are getting a price break, there are too many perks to purchase the product through
Rob: talking to Rob online, E-Books, and Study Partners.) I have been an LPN for over 5 years and
would have NEVER passed if it weren't for Rob preparing me!!!! :) Amy Bowers, GN Phoenix, AZ
Name - M. Clark-adams
Date of CPNE - UNKNOWN
Hey Rob!,
Not sure if this is the right way to email you but I wanted to thank-you cuz I passed the CPNE on the
first time and it was your videos that saved me!! The part that says " Don't forget to check the cap
refill", cuz I almost did forget. A couple of other things to, and the CPNE was in Racine WI:
It's one 4x4 for the wound center **, don't contaminate the edges or your sterile gloves, should
pass.
** Please see the FAQ tab, Q# 25 on how many gauze pieces to use **
Need to know that for the dummy buttocks, the landmarks are very,very poor. If using Vastus
Lateralis, find the middle part, where you think the knee is, and lower than you think the femur
landmark is, there isnt' really anyway to truly see/feel where the landmarks are as they are not really
there, but kinda look for the middle third.
IV push is fine, IV flow rate pretty good.
I failed two PCS on silly stuff, for some reason, it wasn't immediately clear to me that Apical pulse is
[taken under] the gown, failed. (Rob's NOTE: ALL auscultation should be done directly on the
skin or they will fail you - respiratory, abdominal, apical, etc.,) I couldn't get the manual B/P,
failed on another PCS for that. Don't have a comment to help anyone pass but maybe practice
manual B/P on a real person for a lot of practice time to make sure one doesn't fail for something
silly like that, worth a comment.
Third, YOUR video and coaching is what made me go the distance. It is so very important to not talk
yourself out of passing and trying no matter how many times you fail. As of Sat of the CPNE, I had
managed to only pass the four labs, and had to re-do two of those labs. I failed both the pediatric
and the adult PCS on Saturday. When I came back in on Sunday, I had to face three PCS's, and I
did it. I almost talked myself out of passing, and even thought of throwing the repeat labs just to "end
it" on Sat night, but all the coaching and studying that I did and comments about just getting through
it made me stand up and do my very best.
Again, Thank-you!!!
Michaele Clark-Adams
Name - R.W.
Date of CPNE - 1/29 - 1/31, 2010
I hope this information can help others out there and alleviate a little bit of their stress.
First, this exam is very regimented. The associate and examiners are there to test us and to
maintain as much neutrality as possible. Therefore, do not expect them to be overly personable and
friendly. They are always polite and cordial (or at least my experience has shown that to be the
case). I am sure this professional type atmosphere exists primarily so no one testing could ever say
there were incidents of favoritism.
Secondly, do not hesitate to ask the examiners questions!! If they cannot answer them, they will let
you know that. Always ask if an area in the patient's room is a clean area to put down a papers, if
needed. I even double checked as I found most examiners pointed this out, just to be sure. Another
question to ask is about liquid measurements while on the unit. My experience was this: I had a
patient who only drank sips of water to take medications. Nothing more for input, nothing for output.
On the area of the form where we document intake, I asked the examiner if we should measure it
and calculate, or put down "sips of water". In this instance, "sips of water" was appropriate. Be sure
to designate what it was that the patient drank. Just noting "sips" wouldn't be approved. But, check
first with your examiner about this!!!!
However, I did have an instance where an examiner wanted the urinary output to be measure in the
graduated container, and not use the measurement in the "nun's hat" in the bathroom. She told me
technically, they were instructed to use a graduated container for this. So, as you can see, not all
examiners handle things exactly the same way. I believe they follow guidelines and rules, but they
are all different people and not robots.
Also, the Clinical Associate also emphasized to us to always, always, take two sets of vital signs even
though you believe you are 100% correct! I had to retake a PCS because the examiner and I had
two different apical pulse readings. The patient had a very irregular heartbeat and I thought I heard
correctly, but, according to the examiner, I must have not. Do yourselves a favor by taking two sets.
Also, if needed, during respirations, ask the examiner if you can use the stethoscope to obtain
accurate respirations. Now, most times you will not need to do this and can just use the method of
putting your hand on their shoulder/chest to count respirations as Rob instructs. I had to because
the patient whose respirations I had to take required me to do this 4 times to get an accurate count
as he was very sleepy and experiencing apneic episodes while I took the respirations. That will
knock you out of the accuracy area quickly!! So, don't think you cannot perform something more
than once to obtain accuracy; they want those measurements correct and so do you so you can
pass the PCS.
I also had a PCS where the patient had CHF along with other issues and was not really very steady
on their feet. For the careplan, I used "risk for injury related to generalized weakness." Then, I
used safety measures I was already implementing for the interventions. I used this particular nursing
diagnosis on almost all of my patients. (as you had suggested :). On this same patient, the primary
diagnosis I used "ineffective airway clearance". (there were other reasons this was more appropriate
for this patient, and not something related to activity intolerance, I just can't recall) Yet, I was not
assigned respiratory assessment or respiratory management or oxygen management! My point here
to everyone is to do as Rob states, look over the kardex very well and you should easily be able to
come up with an appropriate care plan for your patient. In addition, even though I didn't do a
respiratory assessment or management, this is where you need to really look over the interventions
in the Mosby's book and do what is appropriate. I was able to encourage an appropriate level of
activity for this patient and to position the patient upright to facilitate ease of respiration. I believe the
goal I used was to maintain a patent airway during the course of my pcs. Don't let it throw you off
track if you are not doing a particular assessment or management area. If the symptoms fit and are
overall appropriate to a diagnosis, use it. But, think it through first. I know it seems weird to do this
and not listen to the lung sounds, but, it was correct. Don't add more work to what you are given.
Only perform the areas of care that you are assigned (just as Rob says!)
Lastly, I was assigned an abdominal assessment on a patient who had a major abdominal surgery
about 7-10 days prior (a major incision that was healing well, 2 JP drains and a biliary drain). I
verbalized to the examiner everything I was doing. I wondered about palpation given all that was
done. I verbalized that I was going to lightly palpate, which I did, and the patient slept through it! He
had not been experiencing any pain and rated it at "0", so I was safe, in this instance. Had the
surgery been within a very close time frame and the patient was experiencing pain, I would have
invoked CDM and possibly made another decision. Proceed through your areas of care thoughtfully
and methodically and you will perform better. Be mindful of the timeframe you are working in, but
don't rush as you don't want to miss anything. Follow your grid to a "T" and do not only rely on your
memory. Always refer back to your grid. Lastly, be sure to follow your grid completely while
documenting. Be sure you document on every critical element. Also, it is best to write down more
detail than not enough. Our CA had told us "if it isn't documented, it wasn't done." Also, as a last
reminder (really, this is last :) All patient rooms may not be set up the same. Be mindful of this
during your PCS and don't take room setup for granted. Always be aware of your surroundings and
where the gloves and hand gel are located. I had one patient where it was all located in the entryway
of the room. Nothing was near the bed. In another room, it was next to the patient! Be confident, in
control and aware!
Date of CPNE - June 11-13, 2010
Dear Robbie,
Just wanted to take the moment to tell you more about my individual CPNE. Firstly because mine was
midweek in Utica it seems that the hospital (Foxton's st. luke) had to temporarily reposses the rooms
the usually give excelsior (which i am told were nice big airy well lite rooms) instead we had
orientation confrence in the cafeteria (which was a little bit noisy and distracting) and labs were done
in a small utility room. My woundcare station was set up on a bed! Now for me this was no problem
because this was exactly what my makeshift lab at home looked like - but some of the ladies (It
happen to be an all female group) really freaked out! One said she took the workshop by excelsior
down in albany and there was big tables, good lighting etc. (She unfortunately did not pass - she
failed the IM/SubQ station twice) And our makeshift room in the hospital had a broken air conditioner
and half the room the lights were out and the IV piggy back station was on that side. They set up an
additional IM/SubQ station in a little closet - all in all I am trying to tell you to be aware that even in
makeshift conditions, excelsior excpects you to do the station perfectly. (I had asked the CE before
starting if I can hang my tape off the side of the bed rail since it wasn't a reg. table and she said
yes.) We had plenty of time to familiraze ourselves with the equipment i tried on the pair of gloves i
thought would fit best - and practice doing the wound on the bed to see if it effected me at all that the
station was lower than i'd practiced, it didn't. (the ca gave us a little over 20 min to orient ourselves to
the stations) The gloves were easy to slide on and the gauze was very cooperative and came apart
easy for fluffing.
Bec. of the smaller room for labs the group split into half and 1 did labs while the other oriented to
the floor. I oriented to the floor first. My pt had Spinal stenosis I did risk for injury and chronic pain
bec. he has consistanly beenrating it as a 9/10. Of corse when i went in the next day and asked how
he felt he scored it a 1/10. I kept chronic pain as my evaluation NCP diagnosis anyways bec. even
though it was controlled it was still the primary concern as the stenosis was not very advanced.
My second pt was for the books and completeky freaked me out. A 69 year old man on dialysis that
came in vomitting, naseous, was diagnosed with hypokalemia and was ready to discharge and send
home. everything was perfect with the pt. All his values were in line he moved around and did all his
care like a 20 year old. He was wonderfully nice but there was no diagnose to do. In the end I held
my breath did readiness for enhanced comfort r/t hospitalization and kept telling myself as long as i
do it well it will not fail me. other diagnosis was risk for injury. It took 20 min. for me to convice the
nice man to allow me to do comfort measures bec. he was perfectly comfortable and ready to go
home. He was discharged and left the hospital as i gave report to the primary nurse during
evaluation phase.
The third pt. was very difficuly 99 year old room with fractured shoulder -imoobilized, fracture to neck
of femur. how did she injure herself? She was fully active living by herself before the injury,
volentered with community works, soup kitchen, etc. she fell taking a leaf out of her dining room table
! she was sweet and a riot, but oh time consuming. Breakfast to 30 min! I tried to ask the CE if i can
get a CNA to help with breakfast while I did charting (there was plenty to chart but she very kindly told
me no. Anyways, took 15 min to do her mouthcare too bec. she wanted to try to do it with the non
dominante hand, etc. it took very long. than i had to do resp. management on her! I spent 15 min.
talking to myself outloud on how i am going to do this. I can't sit her up bec. the shoulder immobilizer
and her painscale rated at 7 and she hadnt been medicated yet and i only had 30 min remaining to
pcs. I couldnt very well turn her onto the imobilized arm, so i would have to turn her onto the good
arm. I ask the CE what would be acceptable in this case reguarding the fact the pt would be in pain -
and of corse she tells me i have to decide. so the CE helping me we roll her towards her good arm
while trying to keep the arm as immobilized as possible and than i see the immobilizer runs along the
whole back I stick the stethoscope under get 3 feilds but the pt is in a lot of pain and there is noway
to manuever her enough to get to the last feild I rool her back in place and reposition her while
thinking what am I gonna do now. It is then that the CE speaks up and says "you know chava,
excelsior has a very quiet policy that in extreme circumstances auscultation can be done on the
front." - I was ready to kill her. After me putting the pt. through 5 min. of torture (O would have failed
myself by the way for it but she told me to just try to do it and be as quick as possible with the first
sounds of pain from the pt.) so she tells me this policy. Which I had read as one blip in the CPNE
study guide. well, the rest went quickly, and she told me i passed. It was a harrowing experience. Not
to mention I didn't know weather to include the 5 ml of maple syrup on fluid intake but decided i
should especially cause you specify what the fluid was. And than I heard the pt ask for the CE to add
milk to my pt. coffee when I was in the bathroom washing the mouthcare equipment. I came out to do
it but was too late and when I asked her how much she looked at me like I was off the wall. I told her
for I and O and that i was gonna measure the milk before adding it to the coffee. She told me it was
probably one tsp. I thought that was mean - now I know 1 tsp is 5 ml in my sleep with 4 young
children and plenty of tylonel having been given in the last year alone. But if another student with not
too much pt care acess and poor meomory of conversion rates - well - If i told you I was going to
measure it I think at least she should have answered 5ml - she was waiting for me to tell her what the
1 tsp ratio was and I promptly did so. Anyways, I really didn't mind anything she'd done by the end
when she passed me (cuz i don't think i would have if situation was switched! But I still believe I am a
very cometant nurse)
So there you go - No repeat labs, No repeat PCS. hope I didn't bore you but figured I could give you
the info and you take from it what you will. (Also, the plungers on the insulin syringes I used stuck a
little bit and it had to be rocked back and forth to loosen it (It caused me a problem the first time I
drew up and than i quickly refilled another after loosening the plunger that time.)
Oh, and I wanted to tell you that for the first 30 sec of my labs I felt lost like i didn't know where to
begin and than i told myself, you memorized rob's mneumonics SO why don't you WRITE THEM
DOWN! I did that and than it was a breeze it kept my anxiety in check and allowed me to focus on the
task. So that is my extended story. Sorry again, I hope it didn't bore you. And thank you again - I
would not have passed this test without your help!
Sincerly,
Chava K. (Kurant)
Name - Heather Santa Cruz
Date of CPNE - Mar 19-21, 2010
Hi Rob,
I just wanted to let you know that I finished my last PCS this morning at Grady and I have officially
passed the CPNE. I also wanted to thank you, not only for your website, DVD's and Ebook, but for
answering my questions (even the little ones) when I really needed to know more or I was just
anxious.
I did great on my PCSs--one CE said my documentation was "excellent". I have you to thank for that.
The only mishap was I had to re-do the wound lab sim. According to the CE, I touched the side with
the gauze. That night I practiced on the wound I made (using a different method--I personally don't
recommend the parachute method). Then, after a good cleansing cry in the 6th floor Grady
bathroom, I passed the thing that could have sent me home. After I passed on the second try, I felt
like I'd already won. Today's peds PCS was cake.
Thank you for your recommended nursing diagnosis--they were all highlighted in the back of my
book and were very handy. In my experience, acute pain was used successfully for all 3 PCS. It was
my primary for two of the three.
I'll give a little info on my experience in the hope that it may help others. Grady is a very old and worn
looking hospital in a not-so-great area in Atlanta. However, I would recommend the location to
anyone looking for a Southern test site. The CA was very comforting and knowledgeable. The CE's
were also great. They don't seem to sweat the small stuff. When I had I &O's, they never expected
me to pour any liquids into a graduate--they either told me what to put down or allowed me to
estimate (half a juice was 60mLs). I only had to wash my hands at the sink initially before each PCS,
then the "foam in, foam out" (which is Grady's policy) was acceptable every other time. Grady has a
great hand hygiene and infection control policy--I was impressed.
In my experience, as well as some other student's, the CE's seemed to prompt us to remember
certain things even if it wasn't necessary. They just did it as a courtesy. I'm not certain, but it is
possible that the CE I had at the IV push station gave me a couple extra minutes. Another student
said the same thing. It's not that they aren't strict--you better know your stuff--it's just that they don't
seem to want to fail you for the stupid things that have nothing to do with being a good nurse in the
real world. They seemed very down to Earth and practical.
If anyone is planning to go to Grady, they can email me with questions if they want to. I'd be happy to
help--I certainly know how it feels to have anxiety about every aspect of this exam.
Everyone in my group of 7 passed. It really can be done. I had to see it for myself to believe it, but it's
true. I work part time, have a toddler, and I'm 21 weeks preggo with number 2. I did this with no Xanax
for anxiety, no Lunesta to help me sleep, and no beer or cigarettes to help me relax like most of my
group members did, and I still made it through with no problems (aside from the wound). If I can swing
it, I think anyone can as long as they're prepared. I had my husband and 2 year old with me for
support and comic relief at the hotel which, for me, was great. I also brought all of my study stuff with
me--even my IV bag. I know some others have said NOT to study during the CPNE, but just knowing
my resources were available if I needed them helped a lot. Reading or practicing something "just one
more time" before the real event made me feel more confident.
Even though I did pass the wound station on the second try by practicing on the wound I made, I
really recommend buying the Excelsior wound model for anyone who is especially worried about that
station. The model is extremely shallow--almost flush with the surrounding "skin" in places. It is also
slippery. Unlike the wound I made with play doh, the gauze would not stick anywhere and could not
be tucked in nicely into corners. It behaves nothing like an actual wound, for sure.
I can't think of anything else at the moment, but please ask if you want any particular info. I would be
happy to help anyone if they have questions.
Thank you again for your great study materials. I would not have gone in so confident without them.
And I didn't get a one-time workshop for $400, I got your info, which was exceptional, that I could
watch or read as many times as needed. Plus, you were always there to answer questions. I can't
thank you enough. I (and many others out there) are very grateful for your dedication.
Heather
Name - Amy Bowers
Date of CPNE - Feb 26-28, 2010
CPNE date: Feb.26-28 I passed ONLY because of the organizational skills (mnemonics and both
DVDs) taught through Rob and a few other things I threw in, too... First, set up your lab equipment
the exact same way at home, then when you are at the CPNE, simply set the equipment up the same
way...Second, during my planning stage, I would place a number next to the AOC in the order of
which would be best (ie 1st 20 min check, 2nd Fluid Management, etc)...
Next, I ALWAYS had my grid out during the implementation and evaluation stages so I never forgot
anything...Last, for three weeks prior to my CPNE, I took a BID (twice a day) dose of Airborne to
prevent becoming sick and giving the CA a reason to fail me d/t illness. This product ROCKS!!! (I've
spoken to other students who have purchased Rob's product second hand...though you may feel as
though you are getting a price break, there are too many perks to purchase the product through
Rob: talking to Rob online, E-Books, and Study Partners.) I have been an LPN for over 5 years and
would have NEVER passed if it weren't for Rob preparing me!!!! :) Amy Bowers, GN Phoenix, AZ
Name - M. Clark-adams
Date of CPNE - UNKNOWN
Hey Rob!,
Not sure if this is the right way to email you but I wanted to thank-you cuz I passed the CPNE on the
first time and it was your videos that saved me!! The part that says " Don't forget to check the cap
refill", cuz I almost did forget. A couple of other things to, and the CPNE was in Racine WI:
It's one 4x4 for the wound center **, don't contaminate the edges or your sterile gloves, should
pass.
** Please see the FAQ tab, Q# 25 on how many gauze pieces to use **
Need to know that for the dummy buttocks, the landmarks are very,very poor. If using Vastus
Lateralis, find the middle part, where you think the knee is, and lower than you think the femur
landmark is, there isnt' really anyway to truly see/feel where the landmarks are as they are not really
there, but kinda look for the middle third.
IV push is fine, IV flow rate pretty good.
I failed two PCS on silly stuff, for some reason, it wasn't immediately clear to me that Apical pulse is
[taken under] the gown, failed. (Rob's NOTE: ALL auscultation should be done directly on the
skin or they will fail you - respiratory, abdominal, apical, etc.,) I couldn't get the manual B/P,
failed on another PCS for that. Don't have a comment to help anyone pass but maybe practice
manual B/P on a real person for a lot of practice time to make sure one doesn't fail for something
silly like that, worth a comment.
Third, YOUR video and coaching is what made me go the distance. It is so very important to not talk
yourself out of passing and trying no matter how many times you fail. As of Sat of the CPNE, I had
managed to only pass the four labs, and had to re-do two of those labs. I failed both the pediatric
and the adult PCS on Saturday. When I came back in on Sunday, I had to face three PCS's, and I
did it. I almost talked myself out of passing, and even thought of throwing the repeat labs just to "end
it" on Sat night, but all the coaching and studying that I did and comments about just getting through
it made me stand up and do my very best.
Again, Thank-you!!!
Michaele Clark-Adams
Name - R.W.
Date of CPNE - 1/29 - 1/31, 2010
I hope this information can help others out there and alleviate a little bit of their stress.
First, this exam is very regimented. The associate and examiners are there to test us and to
maintain as much neutrality as possible. Therefore, do not expect them to be overly personable and
friendly. They are always polite and cordial (or at least my experience has shown that to be the
case). I am sure this professional type atmosphere exists primarily so no one testing could ever say
there were incidents of favoritism.
Secondly, do not hesitate to ask the examiners questions!! If they cannot answer them, they will let
you know that. Always ask if an area in the patient's room is a clean area to put down a papers, if
needed. I even double checked as I found most examiners pointed this out, just to be sure. Another
question to ask is about liquid measurements while on the unit. My experience was this: I had a
patient who only drank sips of water to take medications. Nothing more for input, nothing for output.
On the area of the form where we document intake, I asked the examiner if we should measure it
and calculate, or put down "sips of water". In this instance, "sips of water" was appropriate. Be sure
to designate what it was that the patient drank. Just noting "sips" wouldn't be approved. But, check
first with your examiner about this!!!!
However, I did have an instance where an examiner wanted the urinary output to be measure in the
graduated container, and not use the measurement in the "nun's hat" in the bathroom. She told me
technically, they were instructed to use a graduated container for this. So, as you can see, not all
examiners handle things exactly the same way. I believe they follow guidelines and rules, but they
are all different people and not robots.
Also, the Clinical Associate also emphasized to us to always, always, take two sets of vital signs even
though you believe you are 100% correct! I had to retake a PCS because the examiner and I had
two different apical pulse readings. The patient had a very irregular heartbeat and I thought I heard
correctly, but, according to the examiner, I must have not. Do yourselves a favor by taking two sets.
Also, if needed, during respirations, ask the examiner if you can use the stethoscope to obtain
accurate respirations. Now, most times you will not need to do this and can just use the method of
putting your hand on their shoulder/chest to count respirations as Rob instructs. I had to because
the patient whose respirations I had to take required me to do this 4 times to get an accurate count
as he was very sleepy and experiencing apneic episodes while I took the respirations. That will
knock you out of the accuracy area quickly!! So, don't think you cannot perform something more
than once to obtain accuracy; they want those measurements correct and so do you so you can
pass the PCS.
I also had a PCS where the patient had CHF along with other issues and was not really very steady
on their feet. For the careplan, I used "risk for injury related to generalized weakness." Then, I
used safety measures I was already implementing for the interventions. I used this particular nursing
diagnosis on almost all of my patients. (as you had suggested :). On this same patient, the primary
diagnosis I used "ineffective airway clearance". (there were other reasons this was more appropriate
for this patient, and not something related to activity intolerance, I just can't recall) Yet, I was not
assigned respiratory assessment or respiratory management or oxygen management! My point here
to everyone is to do as Rob states, look over the kardex very well and you should easily be able to
come up with an appropriate care plan for your patient. In addition, even though I didn't do a
respiratory assessment or management, this is where you need to really look over the interventions
in the Mosby's book and do what is appropriate. I was able to encourage an appropriate level of
activity for this patient and to position the patient upright to facilitate ease of respiration. I believe the
goal I used was to maintain a patent airway during the course of my pcs. Don't let it throw you off
track if you are not doing a particular assessment or management area. If the symptoms fit and are
overall appropriate to a diagnosis, use it. But, think it through first. I know it seems weird to do this
and not listen to the lung sounds, but, it was correct. Don't add more work to what you are given.
Only perform the areas of care that you are assigned (just as Rob says!)
Lastly, I was assigned an abdominal assessment on a patient who had a major abdominal surgery
about 7-10 days prior (a major incision that was healing well, 2 JP drains and a biliary drain). I
verbalized to the examiner everything I was doing. I wondered about palpation given all that was
done. I verbalized that I was going to lightly palpate, which I did, and the patient slept through it! He
had not been experiencing any pain and rated it at "0", so I was safe, in this instance. Had the
surgery been within a very close time frame and the patient was experiencing pain, I would have
invoked CDM and possibly made another decision. Proceed through your areas of care thoughtfully
and methodically and you will perform better. Be mindful of the timeframe you are working in, but
don't rush as you don't want to miss anything. Follow your grid to a "T" and do not only rely on your
memory. Always refer back to your grid. Lastly, be sure to follow your grid completely while
documenting. Be sure you document on every critical element. Also, it is best to write down more
detail than not enough. Our CA had told us "if it isn't documented, it wasn't done." Also, as a last
reminder (really, this is last :) All patient rooms may not be set up the same. Be mindful of this
during your PCS and don't take room setup for granted. Always be aware of your surroundings and
where the gloves and hand gel are located. I had one patient where it was all located in the entryway
of the room. Nothing was near the bed. In another room, it was next to the patient! Be confident, in
control and aware!
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