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CCRN-Neonatal exam Format | CCRN-Neonatal Course Contents | CCRN-Neonatal Course Outline | CCRN-Neonatal exam Syllabus | CCRN-Neonatal exam Objectives

Exam Code: CCRN-Neonatal

Exam Name: Critical Care Register Nurse (Neonatal)

Total Questions: 150 multiple-choice questions.

Scored Questions: 125 scored, 25 unscored

Time Allotted: 3 hours

Passing Score: 84 correct answers out of the 125 scored questions.



Cardiovascular

- Acquired cardiac conditions

- Alteration in the transition to extrauterine life(e.g., PDA, PFO, PPHN)

- Cardiac tamponade

- Congenital heart defects

- Dysrhythmias

- Heart failure (e.g., high output, congestive,secondary)

- Hemodynamic instability

- Surgery

Respiratory

- Acute respiratory distress and/or failure

- Alteration in the transition to extrauterine life(e.g., surfactant deficiency, secondary apnea)

- Apnea of prematurity

- Aspiration (e.g., meconium, secretions, milk,gastric contents)

- Chronic conditions (e.g., CLD/BPD, PIE)

- Congenital anomalies (e.g., CDH, TEF-EA,choanal atresia, tracheal malacia/stenosis/atresia, CPAM, chylothorax)

- Infection (bacterial, viral, and fungal)

- Pleural space abnormalities (e.g.,pneumothorax, hemothorax, empyema,pleural effusions)

- Pulmonary hemorrhage

- Pulmonary hypertension (e.g., PPHN,structural failure)

- Respiratory distress syndrome (RDS)

- Surgery

- Transient tachypnea of the newborn (TTN)

Endocrine, Hematology/Immunology, GI, Renal/GU, Integumentary

- Endocrine

- Adrenal disorders

- Calcium homeostatis disorders

- Glucose homeostasis (hypo- andhyperglycemia)

- Metabolism disorders (e.g., glucose,protein, fat)

- Thyroid disorders

- Hematology and Immunology

- Blood cell disorders (e.g., anemias,polycythemia, sickle cell disease,leukopenia)

- Coagulopathies (e.g., DIC,thrombocytopenias, hemorrhagic diseaseof the newborn, factor deficiencies)

- Hemolytic disease of the newborn (e.g., Rhincompatibilities, ABO incompatibilities)

- Gastrointestinal

- Abnormalities - congenital or acquired (e.g.,omphalocele, gastroschisis, malrotation/volvulus, imperforate anus, Hirschsprungdisease, intussusception, pyloric stenosis,atresias)

- Gastroesophageal reflux

- Hepatic failure (e.g., portal hypertension,biliary atresia, cholestasis)

- Necrotizing enterocolitis (NEC)

- Nutritional conditions

- Intolerance (e.g., feeding, proteinabsorption, milk allergy)

- Malabsorption

- Surgery

- Renal and Genitourinary

- Conditions - congenital and acquired (e.g.,hypospadias, polycystic kidney disease,hydronephrosis, bladder exstrophy, posterior urethral valves, ambiguousgenitalia, AKI, CKD)

- Infections

- Surgery

- Integumentary

- Complications related to neonatal skin (e.g.,injury, transepidermal water loss, contactdermatitis)

- Congenital abnormalities(e.g., epidermolysis bullosa, skin tags,hemangiomas)

- Diaper dermatitis

- Infection (bacterial, viral, and fungal)

- IV infiltration/extravasation

- Skin conditions associated with gestationalage

- Wounds (non-surgical and surgical)

Psychosocial

- Musculoskeletal

- Acquired conditions (e.g., osteopenia,fractures, brachial plexus injury, infection)

- Congenital conditions (e.g., craniofacial,limb, muscle, spine, osteogenesisimperfecta)

- Neurological

- Congenital abnormalities (e.g., AVmalformation, myelomeningocele,encephalocele, hydrocephalus)

- Hemorrhage (e.g., extracranial, intracranial,intraventricular)

- Infection (bacterial, viral, and fungal)

- Ischemic insult (e.g., stroke, periventricularleukomalacia, HIE)

- Seizures

- State dysregulation (e.g., stress, pain,agitation)

- Surgery

- Behavioral and Psychosocial

- Alterations in family systems (e.g.,engagement, resource limitations, caregiverconfidence, PTSD, postpartum mooddisorder)

- Abuse/neglect/maltreatment

- Families in crisis (e.g., grief, lack of coping,violent behavioral escalation, obstructionof care)

- Culture/communication/language

Multisystem

- Acid-base and fluid/electrolyte imbalance

- Birth trauma

- Conditions requiring advanced therapy(e.g., ECMO, CRRT, dialysis, therapeutichypothermia)

- Delay in growth and/or developmentalmilestones

- Genetic conditions

- Metabolic

- Syndromes (e.g., Turner, Noonan, BeckwithWiedemann, Prader-Willi, Angelman,CHARGE)

- Trisomies (13, 18, 21)

- Healthcare-acquired conditions (e.g., CAUTI,CLABSI, VAE, HAPI, PIVIE, MDRO)

- Hydrops fetalis

- Hyperbilirubinemia

- Infant of a diabetic mother (IDM)

- Life-threatening maternal/fetal complications(e.g., eclampsia, HELLP syndrome, maternalfetal transfusion, placental abruption, placenta previa)

- 1Multi-organ failure

- Sensory impairment (e.g., retinopathy ofprematurity, glaucoma, congenital hearingimpairment)

- Sepsis (early and late onset)

- Sequences (e.g., VACTERL, Pierre Robin)

- Shock states (e.g., hypovolemic, septic,cardiogenic, obstructive)

- Terminal conditions (e.g., end-of-life, palliativecare, death and dying)

- Thermoregulation

- Toxin/drug exposure (e.g., withdrawal frommaternal or iatrogenic substances, fetal alcoholspectrum syndrome)

General

- Anticipate and recognize signs and systems ofevolving patient condition

- Assess and monitor based on patient's gestationalage

- Identify and monitor normal and abnormaldiagnostic test results (e.g., labs, radiology,pathology)

- Implement interventions to keep the neonatessafe (e.g., transport, security, safe sleep, safe infanthandling, infection prevention)

- Manage equipment and/or devices relevant topatient care

- Manage patients receiving enteral/oral andparenteral medications based on gestational age andweight

- Provide age-appropriate developmental care

- Provide care for families considering equity, diversity,and inclusion

- Provide pre- intra- and post-operative/proceduralcare

- Recognize indications for advanced therapies andfollow protocols

- Recognize signs and systems of emergencies, initiateinterventions, and seek assistance as needed

- Recognize the impact of genetics on postnatal care

- Cardiovascular

- Identify, interpret and monitor cardiac rhythms

- Recognize normal fetal circulation and transition toextrauterine life

- Recognize signs and symptoms of hemodynamicinstability

- Recognize indications for and manage patients with/requiring:

- congenital cardiovascular abnormalities

- hemodynamic monitoring (non-invasive andinvasive)

- patent ductus arteriosus (PDA)

- pharmacologic and mechanic cardioversion

- vascular access (e.g., PIVS, UVC, UAC, Midline,PICC, tunneled, non-tunneled)

- Respiratory

- Interpret blood gas results

- Manage medications and monitor patients requiringrapid sequence intubation (RSI)

- Prevent complications related to respiratory support

- Recognize indications for and manage patients with/requiring:

- alternative airways (e.g., endotracheal tube,laryngeal mask airway (LMA))

- assisted ventilation (traditional and highfreqency)

- chest tubes

- congenital respiratory/pulmonaryabnormalities

- non-invasive positive pressure ventilation(e.g., CPAP, NIPPV, high-flow nasal cannula)

- respiratory monitoring devices (e.g., SP02,SV02, ETC02)

- therapeutic gases (e.g., oxygen, nitric oxide,heliox, CO2)

- thoracentesis

- tracheostomy

- Hematology and Immunology

- Recognize indications for and manage patients with/requiring:

- bleeding disorders and other bloodpathophysiology

- blood conservation techniques

- congenital hematology/immunologyabnormalities

- transfusion of blood products

- Neurological

- Implement strategies for neurologic protection/promotion

- Recognize indications for and manage patients with/requiring:

- congenital neurological abnormailities

- neurologic monitoring devices and drains (e.g.,ICP, ventricular drain)

- pain (non-pharmacologic and pharmacologic)

- sedation (e.g., procedural, intermittent,continuous)

- therapeutic hypothermia

- Integumentary

- Recognize indications for, and manage patients with/requiring:

- altered skin integrity based on gestational age

- congenital integumentary abnormalities

- infiltration/extravasation

- preventative and therapeutic intervention(e.g., neonatal skin care, humidity, bathing,adhesives)

- therapeutic devices (e.g., wound VACs, pressurereduction surfaces, ostomy device)

- Gastrointestinal

- Recognize indications for and manage patients with/requiring:

- congenital GI abnormalities

- enteral and parenteral nutrition

- enteral tubes (gastic and post-pyloric)

- feeding diffulties and disorders

- lactation support

- necrotizing enterocolities (NEC)

- peritoneal drains

- transition to oral feedings

- Renal and Genitourinary

- Recognize indications for and manage patients with/requiring:

- congenital renal and genitourinaryabnormalities

- fluid/electrolyte management

- diagnostic procedures (e.g., renal biopsy,ultrasound)

- Multisystem

- Follow protocol for newborn screening (e.g., car seattesting, metabolic, hearing and congenital heartdisease)

- Recognize the impact of developmental physiologyon postnatal care

- Promote thermoregulation based on gestational age

- Recognize indications for and manage patients with/requiring:

- birth trauma

- early and late onset sepsis

- acid-base and fluid/electrolyte management

- palliative and end of life care

- toxin/drug exposure (e.g., withdrawal frommaternal or iatrogenic substances, fetal alcoholspectrum syndrome)

- Behavioral and Psychosocial

- Faciliate progressive family involvement in care

- Recognize indications of stress and provide supportto family

- Respond to behavioral emergencies (e.g., nonviolentcrisis intervention, de-escalation techniques)

- Provide care for diverse families (e.g., cultural,spiritual, LGBTQ+ community)

- Recognize the impacts of social determinants ofhealth

- Facilitate trauma informed care for families

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