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Test Number : CNN
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Exam ID : CNN
Exam Title : Certified Nephrology Nurse
Number of Questions : 150
Duration of exam : 3 hours
Passing Scores : 70%

The CNN exam consists of 150 questions and must be completed in three (3) hours. A correct response rate of no less than 70% is required to pass the exam.

Content Areas % of Test
Concepts of kidney disease 35%
Hemodialysis 30%
Peritoneal dialysis 20%
Transplant 10%
Acute therapies 5% (CRRT, SLEDD, apheresis, acute HD, acute PD)

1. Recognize pathologic processes and complications that occur with kidney disease and/or treatment modalities. (18%)
2. Select interventions appropriate to the pathologic processes and complications that occur with kidney disease and/or treatment modalities. (15%)
3. Apply physiologic and technical principles of renal replacement therapies. (10%)
4. Select appropriate teaching/learning strategies to educate client, family, other health professionals, and the public. (10%)
5. Select appropriate actions in administering medication(s) to the patient being treated for kidney disease. (12%)
6. Recognize the importance of an interdisciplinary approach to promote optimum functioning across the continuum of care. (7%)
7. Select interventions appropriate to the psychological and sociocultural effects of kidney disease. (6%)
8. Apply principles of infection control. (16%)
9. Recognize the importance of professional nursing practice in promoting patient outcomes (e.g., staff development, quality improvement, consultation, and research). (6%)

The applicant must hold a full and unrestricted license as a registered nurse in the United States, or its territories. The applicant must have completed a minimum of 3,000 hours of experience in multiple areas of nephrology nursing within the three (3) years prior to application. If the applicant is working in an outpatient hemodialysis facility, at least 750 hours (25%) of the 3,000 hours of experience must also include one or more of the following:
Home hemodialysis.
Home peritoneal dialysis.
Inpatient acute kidney injury on kidney replacement therapy.
Inpatient critical care on kidney replacement therapy.
CKD management NOT on kidney replacement therapy.
Kidney transplant.
Apheresis.
The applicant must possess a baccalaureate degree in nursing or a masters degree in nursing.
The applicant must have completed thirty (30) contact hours of approved continuing education credit in nephrology nursing within three (3) years prior to submitting the exam application.

Continuing education must be approved by one of the following:
Organizations accredited by the American Nurses Credentialing Center � Commission on Accreditation (ANCC-COA) the credentialing body of the American Nurses Association.
The American Association of Critical-Care Nurses (AACN).
The Council of Continuing Education.
California, Florida, Iowa, Kansas, or Ohio State Boards of Nursing.
Please be aware that although programs may meet requirements set forth by other state boards of nursing, they may not meet the Nephrology Nursing Certification Commission criteria.

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Medical Nephrology exam Questions

Ambulatory (health center) working towards | CNN boot camp and braindumps

each and every fellow participates in a continuity health center apply one-half day per week. These turn up in blocks of time which are 6 months long and coincide with the health center website that the primary yr fellow is rotating via. therefore, when the fellow is on the Montefiore hospital-Moses Campus for six months, the man will attend continuity hospital for six months on the Moses Campus. The identical will hang proper for fellows on the Montefiore health center-Einstein Campus.

each and every half-day block usually involves 4-6 affected person encounters; the fellow is responsible for each new patient work-usaand follow-up visits. each hospital is mentored by way of on-web page college attendings. additionally, all the way through the 6 months rotation at the Montefiore health center-Moses Campus, the first year fellow also attends Renal Transplant health center, hence obtaining 6 months of continuity in out-patient transplant care with the possibility to follow at least 20 patients all over this six month period.

Continuity health facility Rotation Competency-based mostly goals & goals

each and every fellow rotates into the outpatient rotation with assigned nephrology college member for a complete of two years. each and every continuity health facility block of time is at the least six consecutive months in length. Fellows evaluate new nephrology talk to referrals and comply with patients continually for the whole block. apart from customary nephrology clinics, they additionally rotate in the transplant health facility whereas on the inpatient transplant rotation (2 month blocks during 2nd 12 months of fellowship evaluating pre/post transplant sufferers and donors), and for six months whereas a primary year fellow and primarily based on the Montefiore medical institution-Moses division. all the clinics have a Montefiore school mentor assigned for supervision. within the clinics, fellows are expected to make initial opinions and current the history, actual findings, evaluation and plans to the nephrology school member. the fellow is expected to support train and supervise medical residents and clinical college students who rotate into the clinics.

tutorial goals:

The outpatient rotation builds the foundations for a wide abilities base in outpatient nephrology, with the aid of presenting fellows publicity and alternatives to sufferers with an unlimited array of prevalent nephrology problems, patients with complicated forms of hypertension, and transplant patients (both comparison before and after renal transplant).

the guy is anticipated to strengthen competency in featuring compassionate and complete care to a medically and socially distinct group of outpatient conventional nephrology patients and transplant patients.

Fellows serve as leaders in the medical institution and have opportunities to enhance teaching, management, and administration capabilities with residents and students.

The goal of this rotation is to supply the fellows with the education and abilities imperative to develop into proficient in outpatient nephrology. As a part of outpatient practicing they engage and study radiology, vascular surgical procedure and pathology issues in sufferers from these functions. also, this rotation will provide the fellows with the training and capabilities quintessential to develop into proficient in outpatient care of accepted nephrology, hypertension and renal pathology.

goals:

affected person Care

each fellow will rate as constructive the magnitude of being a nephrologist to a medically and socially different group typical nephrology patients with numerous renal disorders

each and every fellow should be in a position to attain and doc an entire heritage and actual, formulate an intensive evaluation and plan, and when acceptable, communicate this evaluation to the other care providers (colleagues, nursing team of workers, dieticians)

each and every fellow will reveal the skill to make each day assessments of their regularly occurring nephrology patients. they will additionally display the capability to convey that information to the complete health care team through plenty of strategies, including each day written progress notes

certain educational desires are to provide scientific talents and alternatives to benefit event in:

well-known outpatient nephrology; and method to their care (differential diagnosis, radiologic evaluation, and medicine);

Outpatient nephrology with its associated co-morbid conditions reminiscent of anemia, malnutrition/acidosis, hypertension/hypotension, and renal osteodystrophy and its approach (radiologic evaluation, and medicine);

principles and practice of care for CKD and its complications;

cognizance of brief and long-term issues of AKI, CKD and different illnesses;

Fluid electrolyte and acid-base abnormalities in ESRD patients and their method (differential diagnosis and medication);

Hypertensive and hypotensive problems in sufferers;

CKD and its impact on gender considerations, together with being pregnant;

Dermatologic, rheumatologic and gastrointestinal disorders enjoyable to ESRD sufferers;

Cardiovascular and cerebrovascular disorder in AKI and CKD patients;

prognosis and management of anemia, together with iron deficiency, EPO resistant states, and applicable use of intravenous iron and erythropoietin stimulating agents in AKI and CKD sufferers;

analysis and management of renal osteodystrophy, together with secondary hyperparathyroidism, adynamic bone sickness, combined bone disorder, and low bone turnover (including interpretation of bone biopsy and different tests equivalent to intact PTH);

got cystic kidney sickness and its issues in CKD patients.

clinical advantage

the guy will show a knowledge and figuring out of the pathophysiology, diagnostic contrast, and therapeutic administration of a core community of sufferers with conventional nephrology as described above.

with the aid of the conclusion of the outpatient rotation, each and every fellow can have attended and took part within the tutorial actions listed within the educating methods section.

with the aid of the conclusion of the outpatient rotation, every fellow is inspired to finished one of the counseled readings (see below)

every fellow will take the In-training examination, which will consist of questions which will cowl most of the universal nephrology considerations coated all through the rotation

conversation abilities

every fellow will demonstrate advantageous conversation knowledge with the attending healthcare professional by using discussing the comparison of widespread nephrology patients in a timely fashion

each fellow will focus on the continuing care of each widely wide-spread nephrology affected person with the appropriate attending on an everyday foundation

each fellow will reveal valuable instructing and comments capabilities with interns, residents and scientific college students as they relate to the care of generic nephrology sufferers

each and every fellow will model useful interpersonal verbal exchange expertise with sufferers, families, and allied fitness professionals, an quintessential element of popular nephrology outpatient care that need to be learned through all working towards nephrologists

Professionalism

each fellow will display compassion and figuring out to a gaggle of socially, economically and racially diverse community of typical nephrology patients

each and every fellow will expense as comfy his/her capacity to count on the leadership position on the healthcare group, together with medical residents, clinical college students, nurses, and social people

each fellow will model acceptable team feature with the aid of together with allied fitness professionals in management discussions, in particular at the aspect of health facility admission, which is vital for patients who need to be safely admitted from the health center to the medical institution

practice-primarily based discovering and growth

the guy will incorporate simple capabilities of proof-based medication in comparison and management of frequent nephrology sufferers with assorted clinical issues

each and every fellow will make the most of practicing within the care of anemia, renal osteodystrophy, hypertension, and cardiovascular disease in patients with CKD

every fellow will mannequin apply based mostly discovering and useful tips looking for in the day by day care of prevalent nephrology sufferers

methods-primarily based practice

the fellow will exhibit competence in the integration of outpatient care, and a methods approach to care, through demonstrating applicable follow-up plans for all general nephrology sufferers he/she has evaluated

the guy communicates key customary nephrology affected person suggestions upon admission to the accepting medical institution healthcare professional (together with trade in dialysis prescription, new drugs, and so forth)

the guy will demonstrate an attention of issues low in cost drugs in universal nephrology affected person care, via discussing the cost implications of a case/month with the attending physician

each and every fellow will price as beneficial the contributions of other participants of the fitness care team into administration plans for well-known nephrology patients

each and every fellow will automatically consider the socioeconomic wants of his/her universal nephrology patients, including medical insurance and access to care imperative to provide care

through the conclusion of outpatient rotation, each fellow could have assumed take care of prevalent nephrology patients of affiliates who transferred care of his/her own sufferers from the hospital to the outpatient hospital

academic strategies and teaching tools

instructing strategies include direct affected person contact with the nephrology school member. All usual nephrology patient issues are reviewed with the school member, and findings are validated by the faculty member. furthermore, radiological reports obtained are reviewed and if mandatory direct consultation is acquired from radiology faculty member (renal ultrasound, CT scan and MRI/MRA of kidneys, nuclear drugs scans. There are didactic classes referring to the certain tutorial desires in the Core curriculum series (see the list beneath).The nephrology school member can provide didactic sessions to members of the outpatient clinic fellow. advised practicing might also include papers dispensed at the beginning of fellowship covering key established nephrology and CKD topics, and papers provided with the aid of the nephrology faculty member right through the outpatient rotation. there's entry to PUBMED, Cochrane, AECOM library on line and updated as well as other digital medical literature databases in the fellows’ office and at all computer stations within the clinics.

types of diseases:

illnesses encountered on this rotation encompass common nephrology from varied causes (diabetes, hypertension, chronic glomerulonephritis, persistent tubulointerstitial disease, genetic kidney illnesses [polycystic kidney disease and others], HIVAN, SLE) as well as different assorted different diseases. Co-morbidities of CKD are encountered including anemia, iron deficiency, cardiovascular illnesses, renal osteodystrophy, hypertension/hypotension, dermatologic issues (NSF, CUA, uremic pruritis, and so forth), rheumatologic issues (B2-microglobulin amyloidosis, gout, chondrocalcinosis, OA, and many others), infectious problems (bacteremia/endovascular, joint, bone), peripheral vascular sickness, uremic pericarditis/pleuritis.

medical Encounters:

patients are viewed in the Montefiore clinics in the CFCC (Einstein division) and MAP building (Moses division).

patients' qualities:

patients followed are these admitted Montefiore scientific middle outpatient clinics and the Renal Transplant medical institution. These sufferers might also consist of:

commonplace nephrology sufferers in the outpatient clinics previously stated.

established nephrology patients with electrolyte, acid base and divalent disorders.

typical nephrology sufferers with the anemia, renal osteodystrophy, and other co-morbidities

Hypertensive usual nephrology sufferers (including hypertensive emergency/urgency) and other disorders.

Out-patient transplant sufferers for follow-up and comparison.

The number of sufferers seen in ordinary nephrology hospital typical eight-10 sufferers per sanatorium (2 new sufferers). For Transplant hospital every fellow is afforded the opportunity to observe at least 20 sufferers longitudinally over the 6-8 months that they attend clinic. Many patients over the age of 70 are covered in this rotation and fellows journey points of geriatric nephrology.

features:

Fellows on this rotation can be asked to focus on patients by way of offering a very good general of care as stated by way of the six core medical talents. strategies concerned are for affected person care purposes. Fellows may additionally facilitate care with the aid of cellphone requires scheduling purposes; although, other health care gurus will perform the almost all these calls.

tactics:

processes may also encompass efficiency of urinalysis and urine microscopy as well as interpretation of quite a few laboratory, pathologic, and radiologic stories. proper use and interpretation of renal ultrasound, CT scan and MRI/MRA assessment of sufferers are taught to the fellows. Fellows are taught the acceptable out-affected person work up in certain settings. The nephrology college member evaluates the procedures performed through the man.

goals and objectives

(reviewed with fellow at starting of each and every rotation)

be taught the advantage of a renal consultant together with here:

affected person evaluation within the outpatient health center atmosphere

Case presentation to the attending

Write consultative stories with conclusions and suggestions; forward written reviews to referring docs as indicated.

communicate techniques/care-plan with referring physicians, nurses, and social employees

comply with the affected person longitudinally with ongoing development notations and communications in subsequent continuity health facility visits

strengthen an appropriate advantage base in the following areas:

diagnosis, assessment and medicine of renal parenchymal disorder including diabetic nephropathy, tubulointerstitial ailments, glomerular diseases, genetic renal diseases

assessment, prognosis and treatment of acid-base disturbances together with anion gap and non-anion gap acidoses

contrast, diagnosis and medicine of electrolyte disorders

assessment, diagnosis and medication of hematuria and proteinuria

contrast, prognosis and medicine of divalent disorders including hypo- and hypercalcemia, hypo- and hyperphosphatemia, hypo- and hypermagnesemia

assessment, prognosis and remedy of disorders of water metabolism including hypo- and hypernatremia

assessment, diagnosis and treatment of acute kidney injury together with factors of pre-renal, intra-renal and submit-renal renal dysfunction

evaluation, prognosis and treatment of cystic diseases of the kidney

assessment, analysis and medication of persistent kidney ailment including the problems associated with this disorder (progression of kidney disease, anemia, renal osteodystrophy, acidosis, malnutrition) and instruction for renal alternative remedy (vascular entry, peritoneal dialysis catheter)

comparison, prognosis and remedy of hypertension including assessment and management of simple and secondary types of hypertension

evaluation, prognosis and medicine of urologic considerations together with obstructive uropathy, renal hundreds, and renal malignancy

evaluation, diagnosis and remedy of mineral metabolism issues

contrast, analysis and remedy of nephrolithiasis

comparison, prognosis and medicine of glomerulonephritis and nephritic/nephrotic syndrome together with renal histopathology

Ordering and comparison of diagnostic imaging modalities employed in consultative nephrology including ultrasound, nuclear medication imaging, CT scan and MRA of the kidney; and renal angiography within the contrast of renal artery Stenosis

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