Student Experiences
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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 - 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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