CNRN Exam Blueprint

      Following are a detailed content outline of the exam, by categories of disorders, domains, and the exam matrix showing the relative weights of the exam by disorder and type of nursing intervention.  Although not all content or human responses are part of the CNRN Examination Matrix, the core of neuroscience nursing knowledge required for specialty practice is clearly represented.

Disorders Detailed

1.      Trauma

A.     Traumatic brain injury

1.      Blast   

2.      Blunt   

3.      Penetrating

B.     Hematoma

1.      Chronic Subdural

2.      Acute Subdural

3.      Epidural

C.     Diffuse Axonal Injury

D.     Contusions

E.      Fractures

1.      Spinal column

2.      Skull   

F.      Spinal cord injury

G.     Herniated nucleus pulposus

H.     Peripheral nerve injury                       

I.        Repetitive stress injury (e.g., carpal tunnel syndrome, lumbar/cervical strain)

2.      Cerebrovascular

A.     Transient Ischemic Attack      

B.     Aneurysm       

C.     Arterio-venous malformation 

D.     Arterio-venous Fistula

E.      Carotid Stenosis          

F.      Cavernous angiomas   

G.     Dural Arterial-venous fistula

H.     Carotid dissection

I.        Ischemic Stroke

1.      Thrombotic

2.      Embolic

3.      Lacunar

J.       Hemorrhagic Stroke

1.      Intracerebral hemorrhage

2.      Subarachnoid hemorrhage

3.      Intraventricular hemorrhage

K.     Headaches

1.      Acute

2.      Chronic

3.      Tumors

A.     Brain Tumors

1.      Neuroepithelial tissue (e.g., astrocytoma, oligodendroglioma, embryonal tumors)

2.      Cranial and spinal nerves (e.g., schwannoma, neurofibroma)

3.      Meningeal and related tissues

4.      Hematopoietic (e.g., lymphomas, hemangioblastomas)

5.      Pituitary

6.      Metastatic

7.      Other (e.g., craniopharyngioma, pineal)

B.     Spinal Cord Tumors

1.      Primary (e.g., astrocytoma, ependymoma, meningioma)

2.      Metastatic

3.      Neurofibroma

4.      Immune/Infection

A.     Abscesses

B.     Amyotrophic Lateral Sclerosis

C.     AIDS

D.     Bell’s Palsy

E.      Encephalitis

F.      Guillain-Barré

G.     Meningitis (viral, bacterial, fungal origin)

H.     Multiple Sclerosis

I.        Myasthenia Gravis

5.      Seizures

A.     Partial

B.     Generalized

C.     Status Epilepticus

D.     Pseudoseizures

6.      Developmental/Degenerative

A.     Arnold-Chiari malformation

B.     Cerebral Palsy

C.      Hydrocephalus

1.      Communicating

2.      Obstructive     

3.      Normal pressure

D.     Spina Bifida: Myelomeningocoele

E.      Down’s Syndrome

F.      Attention Deficit Hyperactivity Disorder

G.     Dementia

1.      Alzheimer’s Disease

2.      Vascular

H.     Dystonia

I.        Parkinson’s Disease

J.       Peripheral Neuropathy

K.     Benign Essential Tremor

L.      Degenerative spine disease

1.      Degenerative disk disease

2.      Vertebral compression fractures

3.      Lumbar spondylolisthesis

4.      Spinal stenosis

M.    Craniosynostosis

N.     Balance and dizziness disorders (e.g., Meniere’s disease, Friedrich’s Ataxia)

7.       Other Disorders

A.     Trigeminal neuralgia

B.     Sleep disorders

C.     Toxic encephalopathies

D.     Delirium

E.      Pain

1.      Acute

2.      Chronic

F.      Chemical dependency

 List of Interventions by Domain

Domain 1: Basic Physiological

Activity/Exercise Management

Elimination Management

Immobility Management

Nutritional Support

Physical Comfort Promotion 

Self-care Facilitation

Domain 2: Complex Physiological

Electrolyte & Acid-base Management

Drug Management

Neurological Management

Perioperative Care

Respiratory Management

Skin/Wound Management

Thermoregulation

Tissue Perfusion Management

Domain 3: Behavioral

Behavior Therapy

Cognitive Therapy

Communication Enhancement

Coping Assistance

Patient Education

Psychological Comfort Promotion

Domain 4: Family

Lifespan Care

Domain 5: Safety

Crisis Management

Risk Management

Domain 6: Health System

Health System Mediation

Health System Management

            Information Management


Examination Matrix

Neurological Disorder			Trauma	Cerebro - vascular	Tumors	Immune / Infection	Seizure	Develop/ Degen	Other Disorders
Intervention		% of Exam	12%	25%	15%	10%	8%	20%	10%
Domain 1	Activity/Exercise Mgmt	24%	The distribution of content and test construction procedures for the CNRN are based on this table and described below: Since the specification has two content dimensions: disorders and intervention, we need to independently consider both content domains while creating a test from. Before an item can be included on a test form, it must be assigned to a disorder domain and linked to an intervention domain. Disorder is the primary domain, and as such items are selected to fulfill the content specifications of seven neurological disorder domains. The percentage of total number of scored items in each domain is given below: Content Description                          Percentage of                                                          Items                            Items   Trauma:                                    12%                              25 Cerebrovascular:                       25%                              52 Tumors:                                    15%                              32 Immune/Infection:                      10%                              20 Seizure:                                    8%                               15 Developmental/Degenerative:     20%                              41 Other Disorders                         10%                              20 Total                                          100%                           205 In addition the final 200 scored items reflect a sampling of a content related to nursing interventions. The result of the 2009 Role Delineation Study established target percentages for intervention groupings for the test specifications. While the test form is being constructed a serious effort is made to match the target percentage and the number of items established for each intervention domain. Targeted percentage of total scored items and approximate number of items in each intervention is given below: Content Description              Percentage of         Approximate Number of                                                Items                              Items Domain 1                                  24%                              50 Domain 2                                  36%                              72 Domain 3                                  15%                              31 Domain 4                                  7%                               14 Domain 5                                  9%                              19 Domain 6                                 9%                               19 Total                                        100%                           205 A list of six nursing intervention domains is available after the disorder domains detailed content outline located on page 11 of the Candidate Handbook.
	Elimination Mgmt
	Immobility Mgmt
	Nutrition Support
	Physical Comfort Promotion
	Self-Care Facilitation
Domain 2	Electrolyte & Acid Base Mgmt	36%
	Drug Mgmt
	Neurological Mgmt
	Perioperative Care
	Respirator Mgmt
	Skin/Wound Mgmt
	Thermo- regulation
	Tissue Perfusion Mgmt
Domain 3	Behavior Therapy	15%
	Cognitive Therapy
	Communication Enhancement
	Coping Assistance
	Patient Education
	Psychological Comfort Promotion
Domain 4	Lifespan Care	7%
Domain 5	Crisis Mgmt	9%
	Risk Mgmt
Domain 6	Health System Mediation	9%
	Health System Mgmt.
	Information Mgmt