Professional Documents
Culture Documents
CSEPrep Manifesto
CSEPrep Manifesto
2
Table of Contents
Introduction ……………………………………………………………..…………………………………...……..4
How to Pass the CSE ……………………………………………..…………………………………...……..5
About the CSE ……………………………………………………………..………………..……………...……..6
How to Prepare for the CSE ……………………………..…………………………………...……..15
Conclusion ………………………………………………………….…..…………………………………...……..28
References ……………………………………………………….……..…………………………………...……..29
3
Introduction
If you’re reading this right now then it most likely means that
you’ve already passed the TMC Exam. If so, congratulations! That is
an amazing accomplishment and it means that you’re one step
closer to becoming a Registered Respiratory Therapist.
I just want to say thank you for choosing Respiratory Therapy Zone
as a way to help prepare for the Clinical Simulations Exam. Our #1
goal is to help you pass the exam on your very first attempt. And
the contents of this book can set you on the right path to do just
that.
4
How to Pass the CSE?
Once you set your mind to the fact that you CAN pass the exam
through hard work and dedication, it makes everything else a
whole lot easier.
Our CSE Study Guide is, without question, the best resource on
the market today. But we’ll tell you more about it later on in this
book.
For now, just know that it’s crucial that you are studying
the right information if you want to increase your chances of
passing the exam on your next attempt.
5
About the Clinical Sims Exam
As I’m sure you already know, the CSE has a much different
structure than the TMC Exam. Yes, the CSE shares the same
topical content with the TMC. The difference is — if you only
master the topical content alone, you will not get you a passing
score because the CSE also tests your case-management abilities.
Our goal is to help you master both — the content and the
comprehensive abilities you need to pass the exam.
• You will not be able to bring a calculator to use for the exam.
• A pencil and a sheet of scratch paper will be provided for you.
No outside notes or books are allowed. You must return your
scratch paper after completing the exam.
• No personal belongings are allowed in the testing area. You
will need to leave them in your car.
• You may leave the testing area at any time to stretch or use
the restroom. Keep in mind, though, that your test timer will
not stop.
6
• Be on time. If you arrive more than fifteen minutes late, you
will not be admitted to take the exam.
• You will need to show two forms of identification, with at
least one showing a current photograph. Both forms must be
current and must include a signature.
This is the basic qualification for most students, although there are
others that can be found on the NBRC website.
7
You must pass the Clinical Simulations Exam within three years
after graduating for a CoARC accredited Respiratory Therapy
Program.
If you do not pass it within this time limit, you will be required to
retake (and pass) the TMC Exam again at the high-cut score to
regain eligibility.
The good news it, if you put in the work by studying and preparing
well, you can pass the exam on your first (or next) attempt, and
you’ll only have to pay the fee once.
8
What Content Will Be on the CSE?
As we’ve already discussed, the same content that was on the TMC
Exam will be on the CSE as well. They just ask it to you in a totally
different way.
Not to worry — we will cover it all inside of our CSE Study Guide. A
big focus of the CSE will be on Pathology.
9
How Are the Problems Structured on the CSE?
The CSE is designed to evaluate your patient management skills
and ability to evaluate ongoing treatment, recommend changes,
and adapt to circumstances and events.
As you can see, 3 windows will appear on the screen at all times
during the exam.
10
Each simulation begins with a brief paragraph in this window that
provides preliminary information about the patient. The following
sections will contain information about the changing patient
situation in this window as well.
You select an option by clicking the check box next to the option.
Basically, it helps you see the results that you selected already, in
case you forgot.
When you are finished with a particular section, you can hit the
“Go To Next Section” button at the bottom left of the screen to
continue to the next section.
11
A timer button is shown in the lower right portion of the screen
and displays the time remaining for the exam. You may hide the
time remaining button if you wish, simply by clicking it.
CSE Scoring
There will be a total of 22 problems on the exam that are selected
from 8 different categories.
Each version of the exam will be different which means that each
version will have a minimum passing score. Of course, this is
decided by the testing committee for each exam.
Exam Hint: More than half of the total possible points will come
from the selections you make in the Information Gathering
sections.
12
Now let’s talk about the actual physical points that you can get for
each selection you make.
13
• You lose two points (–2) for making a selection that is very
counterproductive.
• You lose three points (–3) for making a selection that is
detrimental to the patient.
• This includes any selection that could result in harming the
patient, or worse.
14
How to Prepare for the CSE
We’ve already touched on this earlier, but now, let’s dive a little bit
deeper.
You have to take what you know and apply it to a real-life situation
in order to make a decision to help the patient — just as if it were
in a real hospital.
By the way, these little “Exam Hint” boxes are included all
throughout our CSE Study Guide. They contain some of the most
important tips, tricks, and insights that all students must know in
order to pass the exam.
This is one of the many perks of using our CSE Study Guide.
15
What Diseases will be on the CSE?
Now let’s talk about all the different diseases that you must know
for the exam.
We cover each disease in detail in our CSE Study Guide, but for
now, let’s familiarize your brain with all the possible disease cases
that you need to know.
Here are the 8 disease categories that you should focus on when
preparing for the CSE:
Disease # of
Examples
Category Cases
COPD (Critical
Mechanical Ventilation and NIV
Care) 2
management.
16
Guillain-Barre Syndrome, Myasthenia
Neuromuscular
2 Gravis, Muscular Dystrophy, Stroke,
Diseases
and Drug overdose.
Scenario
This will describe the physical setting for the patient and you as
the Respiratory Therapist. This could include the hospital or clinic
type, the home, Med-Surg unit, ICU, time or day, etc.
17
This is also where you will find out the general information about
the patient, including their: age, sex, general appearance, and
general presenting conditions.
You will also learn about the patient’s history and a brief history of
the patient’s active illness or event.
Exam Hint: While reading the Scenario, the first thing you want to
do is interpret if the situation is an emergency! If it is, you must
take immediate action to help the patient.
18
Information Gathering
This is the section that you will be directed to in order to find out
more about the patient.
They will list out 15-20 parameters for you to choose from.
For example, you will see vital signs, ABG, PFT, and various lab
studies.
You must select ONLY those that are important for this patient at
this particular time given what you know.
For example, if you select that the patient needs an ABG, as soon
as you click that option, it’s going to show you the patient’s ABG
results on the screen.
You can then act immediately, for example, if their results were to
show that they are in respiratory failure. If that were the case, what
would you do?
19
Of course, you know this — you would want to recommend
intubation and mechanical ventilation.
20
Visual
First and foremost, you should go through the list a select the
visual things first — meaning the thing you can see.
These are the things that you can literally see with your eyes.
Choose all of these first. Then ask yourself, “Is there an
emergency?” If not, then move on to the bedside choices.
Bedside
Now you can go through the list and select the choices that can
be performed at the bedside. These should all still be relatively
easy to obtain.
Now you can select any lab tests that are necessary for this
patient. Examples include ABG, CBC, 12-lead EKG, Electrolytes,
and/or Chest X-ray.
These are your basic tests that still aren’t difficult to perform but
are only necessary if indicated for some patients. Still no
emergency? Move along to the special tests.
21
Special Tests
Now you can select any special test that is indicated for the
patient. These are very specific and should only be selected if it’s
necessary for this patient’s case.
Exam Hint: There are a few options that you should Always select
when they are available. These are quick to obtain and usually
always helpful in identifying the patient’s problem.
We cover this stuff in more detail inside of our CSE Study Guide.
You should only make selections if they are appropriate for the
situation at hand.
For example, you probably don’t need the check any PFT results
for a patient with ARDS.
22
Not every test should be selected for every patient. Only those that
are pertinent to their situation. Are you following me here? If so,
good — let’s keep moving!
23
• Never select Urinalysis. Just skip it unless you really just want
to lose points.
I hope that these tips were helpful for you. These are just a few of
the many tips that we share inside of our CSE Study Guide, where
we go into much more detail.
Now let’s keep moving along and talk about Decision Making.
Decision Making
This is where you must take what you know from the information
given and make the best possible decision for the patient.
Keep in mind, sometimes you will have to make the Best Available
selection if the most desired option is not listed.
Once you make the selection, it will usually say: “Physician Agrees.
Done.”
24
Exam Hint: However, it could possibly say, “Physician Disagrees.
Make another selection.”
Don’t Panic!
Just because it says this does not necessarily mean you are wrong.
Proceed to pick the next best option using the information that
you have available.
After you’ve made your decision, you will be taken to the next
scenario. You must then evaluate how the patient responded to
the decisions you previously made.
25
You take what they give you, gather the necessary information,
then make the best decision possible for the patient.
I hope this simplifies things for you! It’s not as bad as people make
it out to be. You just have to take it one step at a time.
26
• Is the patient’s secretions yellow, green, or colored? This
means that the patient likely has an infection and you should
recommend antibiotics.
• Does the patient have frothy secretions? If so, you
automatically should know it’s pulmonary edema and you
should recommend BiPAP or NPPV for this patient.
• ABG interpretation is also important! You passed the TMC
Exam, so I know you already know how to do so. Here are
things to keep in mind when interpreting ABGs for the CSE:
• A really low pH with a high CO2 and normal HCO3 means
acute ventilatory failure. Recommend mechanical ventilation.
• A normal pH with high CO2 and high HCO3 means chronic
ventilatory failure. Recommend low-flow oxygen and avoid
intubation if possible.
• A high pH with a normal CO2 and a high HCO3 means acute
metabolic alkalosis. Recommend either potassium or
chloride, depending on what is needed.
• A low pH with a normal CO2 and a low HCO3 means acute
metabolic acidosis. You should increase the ventilation and
treat the underlying cause.
• If the patient has a PaO2 > 60 on an FiO2 < 60%, this is
moderate hypoxemia (V/Q imbalance). You should
recommend oxygen therapy and treat the underlying
problem.
• If the patient has a PaO2 < 60 on an FiO2 > 60%, this is severe
hypoxemia (shunting). You should recommend oxygen
therapy with PEEP/CPAP and treat the underlying cause.
Again, these are just a few of the basic things I want you to
remember to get the juices flowing in your brain.
For more tips and insights, check out our CSE Study Guide.
27
Conclusion
So there you have it! That wraps up this little eBook on how to
prepare for (and pass) the clinical simulations exam. I truly hope
that this information was helpful for you.
However, this information can definitely set you on the right path
to learning exactly what you need to know so that you can pass
the exam and earn your RRT credentials.
If you enjoyed what you just read, then you’ll definitely get even
more out of our CSE Study Guide. We created it to specifically help
students pass the CSE on their very next attempt.
Thanks again for reading and I wish you the best of luck. And as
always, breathe easy my friend.
28
References
29