How to Survive the CNRN Exam 3/9/2012

How to Survive the
Adapted By:
Daphne Stannard, RN, PhD, CCRN, CCNS, FCCM
Associate Chief Nurse Researcher & Perianesthesia Clinical Nurse Specialist
UCSF Medical Center
Adapted From:
Dorrie Fontaine RN, DNSc & Noraliza Salazar, RN, MSN, CCRN, CCNS
Test Tip #1
Know the Exam
• The CNRN exam is a generalist exam and is
not intended to emphasize any particular
developmental level
• The exam consists of approximately 220
multiple-choice items
 20 are pre-test items; not scored
• 3 levels of knowledge are tested:
 Knowledge
 Interpretation
 Problem Solving & Evaluation
Test Tip #2
Haste makes waste! Read each word in the stem carefully
before looking at the options. Look for key words.
Know the parts of the question and how to read them.
After a head injury, a patient has persistent recent
memory loss.
Which of the following strategies would be MOST
beneficial as the patient reintegrates into the
a. Keep a calendar of daily activities
b. Memorize the next day’s schedule every night
c. Hire a personal care assistant
d. Ask others for daily instructions
Test Tip #3
Answer difficult questions by eliminating the obviously
incorrect responses first. Then select the best from the
remaining options.
Following a CVA involving the middle cerebral artery, a patient developed
homonymous hemianopia. Which of the following interventions is MOST
suitable as part of the rehabilitation?
a. Gather assessment data for a likely ophthalmology consult
b. Patch the affected eye
c. Discourage ambulation
d. Teach visual scanning techniques
Test Tip #4
Identify theme and base it on information provided in the
stem. Do not assume information that is not given.
When planning care of a patient with increased ICP, the nurse includes appropriate
interventions to prevent worsening of the patient’s condition. The nurse realizes that
the patient’s condition may worsen with the development of:
a. Hypoxemia, hypercapnia, and respiratory alkalosis
b. Hypoxemia, hypercapnia, and respiratory acidosis
c. Hypoxemia, hypocapnia, and respiratory alkalosis
d. Hypoxemia, hypocapnia, and respiratory acidosis
What is the pattern?
Test Tip #5
Set priority. What action takes priority? What should the
nurse do first? What should the nurse do initially?
With these types of questions, remember... the first step is
Logical—first things first!
1. When caring for a postictal patient, the highest priority is
a. obtain a complete family history
b. begin saline IV infusion
c. suction patient
d. ensure adequate airway
Test Tip #6
When the stem of the question asks what is ESSENTIAL to
do, think safety.
Which nursing measure is ESSENTIAL to do on
a patient with a basal skull fracture?
a. Instructing patient to blow nose gently
b. Instructing patient to avoid the valsalva
c. Encouraging patient to cough and deep
d. Carefully inserting an NGT
Test Tip #7
Use your resources!
• See references at the end of this slide show
If possible, seek out patient assignments focused
on the largest sections of the test (if not your
strongest area). This will help in application and
analysis questions
Review content areas that you don’t see in your
practice (e.g. trauma)
Study, study, study. This test is to protect the
public so an easy test would defeat that purpose
Test Tip #8
The test is a national certification. There may be
some questions with which you don't have firsthand clinical experience. Try to reason through
the question, utilizing lateral thinking skills.
CNRN is always trialing new questions. Trial
questions are not used to add up your final score.
The review questions you see in review materials
are either retired or rejected questions.
• The good news: If they are bad questions, you
won’t see them on the actual exam
• The bad news: You can’t just memorize the
review materials!
Test Tip #9
Read the question--don't read INTO
the question. The test is for
general knowledge, not the once in
a lifetime case that came through
your unit that will be written up in
the archives.
Test Tip #10
Don’t change your answer unless you
have a compelling reason
•You initially misread the question
The Beat Poets were right!
•First Thought, Best Thought
Before the Exam Day
Plan your study time on your calendar now
Set up a schedule for yourself
Schedule some routine reviews
Don’t do marathon sessions
Reward yourself when you complete a study session
Familiarize yourself with the test format
Designate a “study” space
Make a dry run to the testing center. Don’t wait until the
exam day to find it!
If You Have Test Anxiety
Practice, practice, practice
 Make a dry run to the testing center
and visualize yourself successfully
taking the exam
 Utilize motivational reminders
 Rx
 Mastering the content helps to
master your anxiety!
The Night Before the Exam
Get everything organized for the
next morning
 Do your regular evening routine, but
add in some extra relaxation
•Bubble bath—no ETOH!
Get a good night’s rest
The Morning of the Exam
Stick to your usual morning routine, but
allow plenty of time
 Provide good fuel for your brain
• Avoid too much sugar and caffeine
Arrive early to give yourself time to sit for
a moment and relax
 Maintain your distance from “stress
 Focus and think positive
During the Exam
Read the instructions carefully
Pay attention to details
Monitor your time and set your pace
Read each question carefully
Mark items of which you’re not sure. Pace yourself so you
can go back to them.
Use all of the time provided. Do not rush to finish!!!
Change answer only when certain!
Anxiety can confuse the mind! Take a moment to
relax…even if you lose a minute or two, it’s worth it!
Relaxation Strategies
After the Exam
Take a deep breath and relax!
 Congratulate yourself on a job well
 Celebrate!!!
Good Luck!
AANN. (2004). Core curriculum for neuroscience
nursing (4th ed.). Philadelphia: Saunders.
Barker, E. (2007). Neuroscience nursing: A
spectrum of care (3rd ed.). St. Louis: Mosby.
Hickey, J. V. (2009). The clinical practice of
neurological and neurosurgical nursing (6th ed.).
Phildelphia: LWW.
Sides, M. & Korchek, N. (1998). Successful
test–taking: Learning strategies for nurses.
Philadelphia: LWW.