Elsevier Health Sciences - AACN Certification and Core Review for High Acuity and Critical Care

AACN Certification and Core Review for High Acuity and Critical Care

Sixth Edition

JoAnn Grif Alspach, RN, MSN, EdD, FAAN

Consultant, Nursing Staff Development, Preceptor Development and Competency-Based Perfomance Appraisal Systems

Editor, Critical Care Nurse, Annapolis, Maryland

SAUNDERS

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SAUNDERS ELSEVIER

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AACN Certification and Core Review for High Acuity and Critical Care, Sixth Edition

ISBN-13: 978-1-4160-3592-3

ISBN-10: 1-4160-3592-3

Copyright 2008 by Saunders, an imprint of Elsevier, Inc.

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Notice

Knowledge and best practice in this field are constantly changing. As new research and experience broaden our knowledge, changes in practice, treatment and drug therapy may become necessary or appropriate. Readers are advised to check the most current information provided (i) on procedures featured or (ii) by the manufacturer of each product to be administered, to verify the recommended dose or formula, the method and duration of administration, and contraindications. It is the responsibility of the practitioner, relying on their own experience and knowledge of the patient, to make diagnoses, to determine dosages and the best treatment for each individual patient, and to take all appropriate safety precautions. To the fullest extent of the law, neither the Publisher nor the Authors assumes any liability for any injury and/or damage to persons or property arising out or related to any use of the material contained in this book.

The Publisher

Previous editions copyrighted 1998, 1991, 1985

ISBN-13: 978-1-4160-3592-3

ISBN-10: 1-4160-3592-3

Executive Publisher: Barbara Nelson Cullen

Senior Developmental Editor: Jennifer Ehlers

Publishing Services Manager: John Rogers

Designer: Margaret Reid

Printed in the United States of America

Last digit is the print number: 9 8 7 6 5 4 3 2 1

Contributors

CARING AND ETHICAL PRACTICE

Sonya R. Hardin, RN, PhD, CCRN

Associate Professor, School of Nursing, University of North Carolina, Charlotte, North Carolina

Roberta Kaplow, RN, PhD, AOCNS, CCNS, CCRN

Clinical Nurse Specialist, DeKalb Medical Center, Decatur, Georgia

CARDIOVASCULAR

Karen L. Cooper, RN, MSN, CCRN, CNS, WOCN

Clinical Nurse Specialist, ICU, Telemetry, Medical-Surgical, Kaiser Permanente, Sacramento, California

PULMONARY

Karen L. Cooper, RN, MSN, CCRN, CNS, WOCN

Clinical Nurse Specialist, ICU, Telemetry, Medical-Surgical, Kaiser Permanente, Sacramento, California

Christine A. Cottingham, RN, MS, CCRN

Clinical Nurse Specialist, Critical Care and Trauma, Harborview Medical Center

Clinical Faculty, University of Washington School of Nursing, Seattle, Washington

Patricia A. Radovich, RN, MSN, CNS, FCCM

Clinical Nurse Specialist, Hepatology, Liver Transplant, Loma Linda University Medical Center, Loma Linda, California

Kyla F. Snyder, RN, MN, CCRN

Staff Nurse, Trauma Intensive Care Unit Harborview Medical Center

Adjunct Faculty, Seattle Pacific University

Clinical Faculty, University of Washington School of Nursing, Seattle, Washington

NEUROLOGIC

Lori K. Madden, MS, RN, ACNP, CCRN, CNRN

Nurse Practitioner III, Department of Neurological Surgery, University of CaliforniaDavis, Sacramento, California

Assistant Clinical Professor, Department of Physiological Nursing, University of California, San Francisco, California

RENAL

Ann E. Keane, RN, MSN, MA, CCRN

Director of Nursing, Acute Care, Sound Shore Medical Center, New Rochelle, New York

ENDOCRINE

Shelba D. Durston, RN, MSN, CCRN

Staff Nurse, Intensive Care Unit, San Joaquin General Hospital, French Camp, California

Nursing Instructor, San Joaquin Delta College, Stockton, California

HEMATOLOGY/IMMUNOLOGY

Shelba D. Durston, RN, MSN, CCRN

Staff Nurse, Intensive Care Unit, San Joaquin General Hospital, French Camp, California

Nursing Instructor, San Joaquin Delta College, Stockton, California

GASTROINTESTINAL

Patricia A. Radovich, RN, MSN, CNS, FCCM

Clinical Nurse Specialist, Hepatology, Liver Transplant, Loma Linda University Medical Center, Loma Linda, California

MULTISYSTEM

Leslie A. Collins, RN, APN-CNS, CCRN-CSC, CCNS

Clinical Nurse Specialist, Cardiothoracic Surgery, Northwest Community Hospital, Arlington Heights, Illinois

Preface

As a dynamic specialty nursing organization, the American Association of Critical-Care Nurses (AACN) continually evolves to better meet the needs of its members and the patients they serve. As the healthcare industry, healthcare services, and the traditional boundaries of healthcare institutions have been altered so rapidly and pervasively over recent years, AACN has continued its vital growth and development in order to remain at the forefront of these changes.

Quality care of the critically ill patient requires that the nurse be competent in critical care nursing practice. AACN denotes competency in critical care nursing by means of its CCRN certification program. Certification in critical care nursing demands both a clinical practice requirement as well as the successful completion of the CCRN examination, a written test on the cognitive elements that underlie critical care nursing practice. AACNs Core Curriculum for Critical Care Nursing defines the knowledge base for critical care nursing, and AACN Certification and Core Review for High Acuity and Critical Care provides a means to verify acquisition of that knowledge base.

In addition to its usefulness as a study guide for critical care nursing practice, the Core Review is also designed to assist nurses who are preparing to take the Adult CCRN certification examination administered by the AACN Certification Corporation. Each CCRN certification examination is based on a job analysis study that defines the dimensions of acute and critical care nursing practice. Using the AACN Synergy Model for Patient Care as an organizing framework, those dimensions of care are then reviewed in order to define the knowledge, skills, and abilities required for critical care nursing practice. CCRN certification examinations are based on these skills and abilities and the knowledge necessary to perform them. The Core Review provides three complete practice CCRN examinations based on the latest edition of the AACN Core Curriculum. The test items in this book evaluate the knowledge, skills, and abilities identified as crucial for nursing care of patients with acute and life-threatening health problems. Achievement of these dual purposes necessitates retention of many aspects of the prior edition of this work as well as inauguration of some new features.

Similarities with the fifth edition include comprehensive coverage of topics contained in the most recent version of the Core Curriculum. This edition of the Core Review is based on the sixth edition of the Core Curriculum. As with prior versions of the Core Review, test items cover revised, continued, expanded, additional, and updated content from the most recent Core Curriculum and integrate psychosocial aspects of care. The test items still consist of four-option multiple-choice questions with explanations for both correct and incorrect answers, and the test items are again segregated into three separate practice CCRN examinations. Content areas and their distributions precisely match those detailed in the adult version of the CCRN examination blueprintadult version (available at www.aacn.org/certcorp/). Feedback on answers is again located at the end of each examination so that test completion and timing are not disrupted and item responses may more closely resemble completion of the actual CCRN examination. References for each correct answer and annotated bibliographies are again provided to assist readers in identifying relevant references for each content area in the CCRN examination blueprint.