NurseCompetency offers current, clinically relevant, valid, and reliable tests. Based on best practices for test development, NurseCompetency tests meet psychometric standards1 and the federal directives as outlined in the US Equal Employment Opportunity Commission’s Uniform Guidelines on Employee Selection Procedures.2 Not surprising, because we develop our evidence-based competency tests using a rigorous six-step process:

Step 1 - Conduct the Job Analysis

NurseCompetency’s six-step process begins with a careful analysis of the most recent nationwide studies of the critical tasks, skills, and abilities required for a given health care specialty. Known as a “role delineation study,” these studies—often initiated by professional organizations or associations (e.g., American Nurses Credentialing Center, American Association of Critical-Care Nurses)—identify the essential knowledge and skills of the health care specialty and serve as the blueprint for targeted test development.

1 To assist NurseCompetency in the statistical analysis and interpretation, we retained Gregory J. Zarow, PhD., who trained in measurement theory and test construction at the University of California at San Diego, has published in the Journal of Neurosurgery, Neurological Research, and Magnetic Resonance in Medicine, and has co-authored the Spacelab Life Sciences Final Report for NASA. We also retained Yuhua Su, PhD., who obtained her PhD in Statistics from North Carolina State University in 2010. Dr. Su is currently a faculty member of the Nutritional Assessment of Populations program under the Department of Human Nutrition, Food, and Animal Sciences in the University of Hawaii at Manoa. Dr. Su is a member of the American Statistical Association and an editorial board member of the International Journal of Statistics and Applications. 2 According to EEOC regulations, “the content of the selection procedure . . . represent[s] . . . important aspects of performance on the job for which the candidates are to be evaluated." 29 CFR §1607.5 (2012).

1. Conduct Job Analysis (role

delineation study)

2. Create Test Blueprint -determine the knowledge, skills, and abilities (KSAs)

for each role

3. Develop New items - to accurately measure KSAs

4. Review Items - to ensure editorial

integrity, technical accuracy, and fairness

5. Test New Items - in cooperation with

Validation Partners

6. Evaluate and Adjust Items - based on

detailed psychometric analysis

Continuum of Competency

Step 2 - Create the Test Blueprint

NurseCompetency convenes a team, consisting of a Subject Matter Expert (SME)—who has a minimum of three years’ current experience in his or her clinical area, a member of our Clinical Advisory Board, and our Director of Clinical Education. Using the role delineation study and data from the US Department of Labor, the team develops the test blueprint, which identifies the knowledge, skills, and abilities that are necessary for successful job performance in the clinical area that the test will assess.

Step 3 - Develop the Items

NurseCompetency’s SME uses the test blueprint to create multiple choice test items that address the topics identified as essential for successful job performance in that position.

Step 4 - Review the Items

To ensure editorial integrity, technical accuracy, and fairness, NurseCompetency’s Director of Clinical Education3 and a member of our Clinical Advisory Board scrutinize the items for content, clarity, grammar, and syntax, and validate that the correct answers are, in fact, supported in the current, generally accepted professional literature of the specialty. NurseCompetency’s critical review ensures that each item measures a critical element of successful job performance, and documents why the test taker’s knowledge of the correct answer is essential for successful job performance which ensures compliance with EEOC UGESP guidelines. Consider this item from our Labor and Delivery Competency Test:

Which of the following is a symptom of severe preeclampsia?

a. Edema of the feet and ankles b. Epigastric pain and/or impaired liver function c. Weight gain of one pound per week d. Early morning headache

Validation analysis:

a) The knowledge measured by this question is the recognition of symptoms of severe preeclampsia.

b) This knowledge is important, because the L&D nurse should recognize that epigastric pain in addition to hypertension and other specific symptoms indicate severe preeclampsia. This symptom indicates liver swelling and capsular stretch and may be considered as rationale for delivery of the baby. This symptom may also be accompanied by the elevation of serum liver enzymes.

3 Our Director of Clinical Education, Kathy Mercer, MA, MSN, RNC-OB, CNM, is an advanced practice nurse board certified in nurse-midwifery and inpatient obstetrics nursing. Ms. Mercer has worked as a clinical expert for Mosby/Elsevier, Inc., conducting literature review for and clinically editing updates on selected topics in maternal-infant care for Mosby’s Nursing Skills series in conjunction with the Association of Women’s Health, Obstetric, and Neonatal Nurses (AWHONN).

Step 5 - Test the Test Items

To gather statistics on each test item, NurseCompetency deploys newly created (or updated) tests on the platforms of our validation partners and collects data from test takers nationwide over a 30-60 day period. Each item is rigorously analyzed. We use item difficulty index, item discrimination index, and the item-total polyserial correlation to flag troublesome test questions.

Step 6 - Evaluate and Adjust

To ensure that each item meets or exceeds psychometric standards, NurseCompetency’s measurement experts employ statistical analysis (e.g., Cronbach’s alpha, KR21) to determine test reliability, and internal consistency. Based on the statistics and the item analysis, we update or retire the items as necessary, update the test statistics and benchmarking data, notify all current customers of any updates, and redeploy the test. Finally, to keep our tests current and relevant, we evaluate and make changes as needed our test content annually.

Our goal is to promote your continuum of competency.

"Working with a great partner like NurseCompetency, we were able to effectively and efficiently upgrade our testing platform for our clinical staff. The NurseCompetency System provided flexibility, more testing options, and an easy-to-use end user experience. The training for administrators allowed for a seamless transition and was easily adaptable to our current business model. The NurseCompetency team has been instrumental in the success of this endeavor by providing quick response to our individual needs, rapid implementation plan, and excellent customer service."

- Tony Mangola MSN, RN, Director of Education, Parallon Workforce Management Solutions

"The clinical exams from NurseCompetency play a key role in our talent management program—as they are used to measure and ensure that our clinical personnel are knowledgeable and competent to perform the tasks associated with their respective positions. The high level of authority among the subject matter experts consulted and the rigor in exam development both contribute to make NurseCompetency’s clinical exams among the best available anywhere for assessing competencies.”

- Kellie Hodge, Director of Nursing, Omega Hospital

“We are very pleased with NurseCompetency's online testing services. They have proven to be a good business partner, and are very responsive to meeting their client's needs. They have consistently demonstrated a commitment to keeping their clinical material relevant and current, while maintaining validity, reliability, and compliance with industry standards. The quality and efficacy of their methods and materials was the determining factor in our selection of NurseCompetency as our vendor of choice.”

- Susan O'Brien, Clinical Nurse Manager, RN Network

Statistical Analysis Overview

NurseCompetency uses the jMetrik statistical software for psychometric analysis of our exams. The statistical analysis and interpretation shown below are taken from a report created for NurseCompetency by Dr. Yuhua Su. 4

Item Analysis

For each item included on a test, jMetrik calculates the difficulty index, standard deviation, item discrimination index, and the item-total polyserial correlation. When evaluating each test item, we primarily focus on the difficulty index, and the discrimination index.

Figure 1

Figure 1 above is a screen shot taken from the analysis of our Cardiac Rhythm Interpretation Competency Test. For item 2769 the difficulty index is 0.7529, which means 75.29% of test takers answered this question correctly. An item with difficulty index above 0.9 is a very easy item, and an item with difficulty index below 0.2 is a very difficult item. NurseCompetency uses this index to gauge the level of difficulty for each item on a test, since it is our goal to measure basic competency, not necessarily mastery of a subject. The item discrimination index provided by jMetrik is a Pearson product-moment correlation coefficient between test taker responses to a particular item and total scores on all other items on the test. The possible range of the item discrimination index is -1.0 to 1.0. For item 2769 in Figure 1 above, the item discrimination index is 0.4776. Optimally, an item should have a positive discrimination index of at least 0.2, which indicates that high scorers have a high probability of answering correctly and low scorers have a low probability of answering correctly.

4 Dr. Yuhua Su obtained her PhD in Statistics from North Carolina State University in 2010, is currently a faculty member of the Nutritional Assessment of Populations program under the Department of Human Nutrition, Food, and Animal Sciences in the University of Hawaii at Manoa. Dr. Su is a member of the American Statistical Association and an editorial board member of the International Journal of Statistics and Applications.

Test Level Statistics For each test, jMetrik generates the number of items included, number of examinees, minimum score, maximum score, mean, median, standard deviation, interquartile range, skewness, kurtosis, and Kuder-Richardson 21 (KR21).

Figure 2

Figure 2 is a screen shot taken from the analysis of our Telemetry Competency Test, and most of these descriptive statistics are self-explanatory. Some of the lesser known items are described below.

Interquartile range is the difference between the upper and lower quartiles. The sample skewness measures the tendency of the deviations to be larger in one direction than in the

other. Skewness is a measure of symmetry. Observations that are normally distributed should have skewness near zero (as normal distribution is symmetric). A negative skew indicates that the tail on the left side of the probability density function is longer than the right side and the bulk of the values lie to the right of the mean (skewed to the left). A positive skew indicates that the tail on the right side is longer than the left side and the bulk of the values lie to the left of the mean (skewed to the right).

The sample kurtosis measures the peakedness of the distribution and the heaviness of its tail (relative to a normal distribution). Observations that are normally distributed should have a kurtosis near zero. A high kurtosis distribution has a sharper peak and longer, fatter tails, while a low kurtosis distribution has a more rounded peak and shorter, thinner tails.

Kuder-Richardson 21 (KR21) is a reliability coefficient and is a measure of internal consistency. Internal consistency focuses on the degree to which the individual items are correlated with each other and is thus often called homogeneity. Test reliability is an indication of the consistency of the test. Test reliability tells us how likely it is that an examinee would obtain the same score when the examinee takes the test again. This index can hold a value between 0 and 1. Higher test reliability indicates that the test measures whatever it measures in a consistent manner.

Reliability Analysis For each test, jMetrik also generates Guttman’s lambda, Cronbach’s alpha, Feldt-Gilmer, Feldt-Brennan, and Raju’s beta. NurseCompetency focuses on Cronbach’s alpha as its measure for statistical reliability.

Figure 3

Figure 3 is a screen shot taken from the analysis of our Medical-Surgical Competency Test. Cronbach’s alpha is a coefficient of internal consistency. It is commonly used as an estimate of the reliability of a psychometric test for a sample of examinees, and a value greater than 0.7 is considered good for a test.

Question Types

The NurseCompetency tests contain a combination of multiple-choice questions, and/or true-false questions. We use a two-tiered classification system to identify the level of thinking required to respond to a question. The two levels are knowledge (memory or recall) and skills (reasoning or application). Knowledge items test an examinee’s recognition or recollection of discrete information. These items usually test memory or recall of specific facts, generalizations, concepts, principles, processes, procedures, or theories. To simplify, such an item will ordinarily ask: “Which (or what) is X?” This question from our Endoscopy Competency Test as an example of a knowledge item: Which of the following is the most distal part of the small intestine?

a. Appendiceal orifice b. Cecum c. Jejunum d. Terminal ileum

Skills items test an examinee’s ability to assess data, interpret, or apply information. Requiring more than simple recall, these items include a problem-solving component and require an examinee to evaluate the effectiveness, appropriateness, or best course of action for a given situation. For example, the last sentence of the stem of a skills item may end with: “. . . what action should the healthcare provider take.” This question from our Cardiac Catheterization Competency Test as an example of a skill item: The patient has just developed a sustained ventricular tachycardia. His blood pressure is 120/82; he has no symptoms of pulmonary edema; and he is alert and talking with you. The most appropriate initial treatment for this patient is:

a. amiodarone (Cordarone®) 150 mg IV. b. atropine sulfate (Atropine®) 0.5 mg IV. c. defibrillation. d. synchronized cardioversion.

Frequently Asked Questions

How is NurseCompetency different from other web-based healthcare testing services? NurseCompetency has one of the most innovative software platforms in the industry. Our software platform benefits our nationwide customers by enabling them to perform the following tasks:

Link tests and checklists to roles to eliminate the tedious registration of individual candidates. Create their own tests, checklists, and educational materials with the option of using our extensive

libraries as a base. Create customized instructions and email messages to send out to clinical candidates. View real-time descriptive statistics for their company from our test statistics dashboard. Enable or disable the display of correct answers to a candidate upon test completion. Enable scoring based on our national benchmarks. Enable a fully integrated online application with our Plus package and staffing software with our

Premium package. Enable or disable open registration to save valuable administrative time spent manually entering

candidates into the database. What effect does displaying the correct answer have on test validity? NurseCompetency provides our customers with the option to either display or not display the correct answers to a candidate upon test completion. When this option is enabled, the correct answers are displayed one time at the end of the test. Because the questions are randomized, there is never an answer key that can be memorized, if the customer has chosen to enable additional test attempts. "Showing the correct answers after the test is over will not affect the item analysis results for the test as long as responses after the first attempt are not included in the analysis." - Yuhua Su, PhD (Psychometrician) All of our statistics are generated on first attempts only, and our content validation comes from linking our questions back to our test blueprints and our knowledge, skills, and abilities (KSA) assessment. This KSA assessment is completed by our subject matter experts (SMEs), Director of Clinical Education, and members of our clinical advisory board. For each question on our clinical competency tests, we have assessed and documented the knowledge, skill, or ability that is being tested by the question, and why this element is necessary for successful job performance. How are the NurseCompetency tests developed and validated? Our Continuum of Competency model used for our test development was refined by Kathleen Maguire, RN, JD, who has worked as a senior editor with the American Nurses Credentialing Center (ANCC). This Continuum of Competency model is similar to the model of test development used by the ANCC. In addition, NurseCompetency uses content-based validity, which ties each question back to a test blueprint and a full knowledge, skills, and abilities (KSA) assessment.

Does NurseCompetency have clinicians on staff? Yes, we have two full-time master’s-prepared nurses on staff that are dedicated to keeping our content current, and to answer any clinically related questions. Joseph Caracci, MBA, RN, co-founder of NurseCompetency, has served as the chief executive officer, president, and chairman of the board of directors since 2004. He brings more than 20 years of healthcare, technology, and business experience, and leads the company's software platform and content development. Joseph has worked for several healthcare organizations such as Banner Health, Dignity Health (formerly CHW), and Phoenix Children's Hospital. He has experience in Pediatrics, Pediatric Oncology, Telemetry, Critical Care, and Emergency Nursing. Kathy Mercer, MA, MSN, RNC-OB, CNM, our Director of Clinical Education, is dedicated full-time to our content development and validity. Kathy is an advanced practice nurse and seasoned clinical educator, who has served as a faculty member for nursing programs at Oral Roberts University, Tulsa Community College, and Duke University College of Nursing. Most recently, she has worked as a clinical expert for Mosby/Elsevier, Inc., where she conducted literature reviews and clinically edited updates on selected topics in maternal-infant care for the Mosby’s Nursing Skills series in conjunction with the Association of Women’s Health, Obstetric, and Neonatal Nurses (AWHONN). What type of statistical analysis does NurseCompetency perform? NurseCompetency carries out both descriptive statistical analysis and reliability statistical analysis using jMetriK statistical software. The descriptive statistics evaluated are minimum score, maximum score, mean, median, standard deviation, interquartile range, skewness, and kurtosis. The reliability statistics evaluated are Cronbach's alpha, and Kuder-Richardson 21 (KR21). In addition, we perform an item analysis by evaluating the item difficulty index, item discrimination index, and the item-total polyserial correlation. If challenged on test validity, what part will NurseCompetency play? If any of our customers are summoned to court, NurseCompetency will provide documentation of its content validation process as published on our website, along with test blueprints, test descriptions, and test statistics (both descriptive and reliability statistics). In addition, for each question being challenged, NurseCompetency will provide its documented answers to the following questions:

What knowledge, skill, or ability is being tested by the question? Why is this knowledge, skill, or ability important for successful job performance?

How does NurseCompetency’s prices compare to its competitors? For NurseCompetency, one unit is equal to a completed test or skills checklist. One of our competitors offers tests for one point and checklists for 1/4 of a test point. Their cost per test point, however, is about three times as much as the cost of one NurseCompetency unit - making our program a significant value by comparison. NurseCompetency works hard to maintain a low overhead, so that we can pass on the savings to our customers. One way to decrease our overhead is by using the “train the trainer” method of product support. This innovative concept, used by multiple software companies such as SAP and VMware, provides in-depth

training and unlimited access to the NurseCompetency helpdesk for your company super user. This onsite super user, who fully understands your company’s system configuration choices, as well as your company’s culture, can then assist your staff. This method of support provides greater confidence in the company super user, a more meaningful learning experience for your internal staff, and significant overall savings for your testing services. How does NurseCompetency assist its customers in meeting the Joint Commission and OSHA standards and regulations? NurseCompetency offers 25 core competency education topics. For each of these topics, there is a corresponding test to assure compliance with Joint Commission and OSHA regulations. We also offer comprehensive exams that cover all regulatory topics - Core Competency: Nursing, Core Competency: Non-Licensed, and Core Competency: Allied. These exams cover multiple topics such as Advance Directives, Age-Related Competency, Child Abuse and Neglect, Cultural Competency, Elder Abuse, Emergency Preparedness, Facility Safety, Fire Safety, HIPAA, Intimate Partner Violence, TJC NPSG, Latex Allergy, Medication Error Prevention, Musculoskeletal Injury Prevention, Pain Management, Patient Care Partnership, Restraints and Seclusion, Sexual Harassment, Tuberculosis Competency, Universal Precautions, Workplace Violence. What is the average number of skill items available on a NurseCompetency skills checklist? The average number of skill items on a NurseCompetency skills checklist is 152. As job complexity increases, so does the number of skill items evaluated. For example, our CNA skills checklist contains 18 skill items, our ER skills checklist contains 238 skill items and our CVICU skills checklist contains 330 items. Because they are completed annually in order to document a current assessment of clinical skills, our skills checklists are designed to measure both frequency and recency of experience. We also allow our customers to customize our checklists and create their own checklists, by providing them access to our skills library, consisting of 2,533 skill items in 87 categories. Can the NurseCompetency tests be manipulated? No, none of the NurseCompetency tests can be manipulated.

Test Descriptions Acute Rehabilitation Nurse Competency Test The Acute Rehabilitation Competency Test covers the application of the nursing process in the care of patients with spinal cord injuries, hip fractures, burn injuries, closed head injuries, cerebral vascular accidents, and chronic debilitating diseases, such as Parkinson’s disease. There are questions related to tracheostomy care, preventing skin breakdown, Glasgow Coma Scale, increased intracranial pressure, dysphagia, neurogenic shock, and additional knowledge, skills, and abilities needed for successful job performance by the acute rehabilitation nurse. Advance Directives Competency Test The Advance Directives Competency Test is part of the “Core Competency” test series. Topics covered in this test include durable power of attorney, patient rights related to advance directives, the Patient Self-Determination Act (PSDA), and living wills. The test also presents some situations where clinical staff would need to refer to a patient’s advance directives. Age-Related Competency Test The Age-Related Competency Test is part of the “Core Competency” test series. Topics covered in this test include the recognition of normal aging changes, the importance of age appropriate care, and identifying common stressors for different age groups. Blood Glucose Monitoring Test The Blood Glucose Monitoring Competency Test is a post-test for the education topic Blood Glucose Monitoring. Topics covered include acute hypoglycemia, hypoglycemia in the pediatric and neonatal populations, non-diabetic and diabetic hyperglycemia, diabetes mellitus (types 1 & 2), gestational diabetes, monitoring management and procedure, and preventing transmission of bloodborne pathogens. Cardiac Catheterization Lab Nurse Competency Test The Cardiac Catheterization Competency Test covers topics related to the care of patients undergoing a cardiac catheterization. Topics include cardiac anatomy, hemodynamic monitoring/measurements, patient safety, treatments for cardiac arrhythmias, use of contrast, cardiac emergencies, and additional knowledge, skills, and abilities needed for successful job performance by a cardiac catheterization nurse. Cardiac Rhythm Identification Competency Test The Cardiac Rhythm Identification Test presents test takers with the following rhythms for identification - Sinus Bradycardia , Second degree A-V Block (Wenkebach), Atrial Fibrillation, Atrial Flutter , Asystole , First degree A-V Block (Heart Block), Idioventricular Rhythm, Junctional Tachycardia, Second degree A-V Block (Mobitz II), Premature Atrial Contractions (PAC’s), Premature Atrial Tachycardia, Normal Sinus Rhythm with Premature Junctional Contraction, Premature Ventricular Contraction (Bigeminy), Third degree A-V Block (Heart Block), Sinoatrial Block, Sinus Tachycardia, Right Bundle Branch Block, Torsades de Pointes, Ventricular Tachycardia, and Ventricular Fibrillation. Cardiovascular Technologist Competency Test The Cardiovascular Technologist Competency Test covers topics related to the care of patients undergoing a cardiac catheterization. Topics include cardiac anatomy, hemodynamic monitoring/measurements, patient safety, treatments for cardiac arrhythmias, use of contrast, cardiac emergencies, and additional knowledge, skills, and abilities needed for successful job performance by a Cardiovascular Invasive Specialist.

Care of Clients with Dementia: Non-Licensed Test The Care of Clients with Dementia: Non-Licensed Competency Test is designed to be completed by non-licensed healthcare workers that work with patients with dementia. This test covers topics related to signs/symptoms, causes, stages of dementia, and differences between dementia and delirium. The test also covers topics related to client safety, essential skills, and psychological support of clients with dementia. Care of Clients with Dementia: Nursing Test The Care of Clients with Dementia: Nursing Competency Test is designed to be taken by RN’s and LPN’s working with patients with dementia. This test covers topics related to signs/symptoms, causes, stages of dementia, and differences between dementia and delirium. The test also covers topics related to client safety, essential skills, and psychological support of clients with dementia. Care of the Patient with Atrial Fibrillation Test The Care of Patient with Atrial Fibrillation Test presents the case of a resident of an assisted living center who is diagnosed with atrial fibrillation (AF). The nurse is presented with the history of this patient and is asked questions regarding diagnostic testing, types of AF, risk factors, pharmacologic and medical treatments, and prognosis of the patient with AF. The goal of this learning activity is to assess the knowledge of nurses who care for patients in a variety of settings who have AF. This learning activity meets applicable guidelines for treatment of the patient with AF set by the American Heart Association | American Stroke Association. Care of the Patient with Congestive Heart Failure Test The Care of the Patient with Congestive Heart Failure Test presents the case of a resident of an assisted living center who is diagnosed with congestive heart failure. The nurse is asked questions regarding physical exam findings, incidence, and etiology of heart failure, pathophysiological basis for heart failure, treatment and management of heart failure, and hospital discharge instructions and follow-up care for a patient with heart failure. The goal of this learning activity is to assess the knowledge of nurses who care for patients in a variety of settings who experience congestive heart failure. Guidance for this learning activity was obtained in part from current resources published by the American Heart Association | American Stroke Association, and the activity meets the treatment standards for the care of a patient with congestive heart failure set by The Joint Commission. Care of the Patient with COPD Test The Care of Patient with COPD Test presents the case of a resident of a nursing home who has developed chronic obstructive pulmonary disease (COPD). The nurse is given the resident's history and is asked questions regarding etiology, pathophysiology, signs/symptoms, diagnostic testing, pharmacologic treatment, and nursing care of a patient with COPD. The goal of this learning activity is to assess the knowledge of nurses who care for patients in a variety of settings who have been diagnosed with COPD. Care of the Patient with Diabetes Competency Test The Care of Patient with Diabetes Competency Test covers topics related to signs/symptoms, etiology, and care of a diabetic patient. The test also covers topics related to type I diabetes mellitus, type II diabetes mellitus, hemoglobin A1C interpretation, hypoglycemic agents, diabetic ketoacidosis, insulin administration, and foot care.

Care of the Patient with Myocardial Infarction Test The Care of the Patient with Myocardial Infarction Test presents the case of a resident of an assisted living center who experiences a myocardial infarction (MI). The nurse is asked questions regarding pre-hospital care of the patient having an MI, pathophysiology, signs/symptoms, diagnostic testing, thrombolytic therapy, pharmacologic and interventional treatment, and rehabilitation of the patient with an MI. The goal of this learning activity is to assess the knowledge of nurses who care for patients in a variety of settings who experience an MI. Guidance for this learning activity was obtained from the American College of Cardiology Foundation (ACCF)/American Heart Association (AHA) Task Force on Practice Guidelines and the activity meets the treatment standards for acute myocardial infarction (AMI) set by The Joint Commission. Care of the Patient with Pneumonia Exam The Care of Patient with Pneumonia Exam presents the case of a resident of a retirement home who is diagnosed with pneumonia. The nurse is presented with the patient's history and is asked questions regarding the etiology, signs/symptoms, assessment, diagnostic testing, complications, pharmacologic treatment, nursing care, and long-term monitoring of the patient with pneumonia. The goal of this learning activity is to assess the knowledge of nurses who care for patients in a variety of settings who are diagnosed with pneumonia. Care of the Patient with Stroke Competency Test The Care of the Patient with Stroke Test presents the case of a resident of an assisted living center who experiences a stroke. The nurse is asked questions regarding pre-hospital care of the patient having a stroke, thrombolytic therapy, rehabilitation, and follow-up care of the patient with a stroke. The goal of this learning activity is to assess the knowledge of nurses who care for patients in a variety of settings who experience a stroke. Guidance for this learning activity was obtained in part from current resources published by the American Heart Association, American Stroke Association, and National Institute of Neurological Disorders and Stroke (NINDS) and the activity meets the treatment standards for stroke care set by The Joint Commission. Case Manager Competency Test The Case Manager Competency Test covers topics related to the coordination and integration of healthcare services for patients with complex and/or costly medical issues. The test includes questions related to coordinating care for chronically ill patients, disease management, quality improvement, HEDIS, understanding clinical pathways, and additional knowledge, skills, and abilities needed for successful job performance by a case management nurse. Certified Medication Aide Competency Test The Certified Medication Aide Test covers topics related to the safe administration of oral medications. The test also covers proper medication documentation in a Medical Administration Record. Child Abuse and Neglect Competency Test The Child Abuse and Neglect Competency Test is part of the “Core Competency” test series. Topics covered in this test include recognizing abuse patterns, reporting abuse, and discerning between accidents and abuse in children. CNA Competency Test The Certified Nursing Assistant (CNA) Competency Test covers topics related to safely performing activities of daily living (ADL’s), measuring and documenting vital signs, finger stick blood glucose, and I&O. The test also includes topics on body mechanics, basic medical terminology, skin care, and additional knowledge, skills, and abilities needed for successful job performance by a CNA in the acute care setting.

CNA: LTC Competency Test The Certified Nursing Assistant (CNA) - LTC Competency Test covers topics related to safely performing activities of daily living (ADL’s), measuring and documenting vital signs, finger stick blood glucose, and I&O. The test also includes topics on body mechanics, basic medical terminology, skin care, and additional knowledge, skills, and abilities needed for successful job performance by a CNA in the long-term care setting. Conscious Sedation Competency Test The Conscious Sedation Competency Test is part of the “Core Competency” test series. Topics covered in this test include the safe administration of conscious sedation medications, patient safety, identifying adverse reactions, and legal considerations. Core Competency Test: Allied The Core Competency Test: Allied is designed to be completed by allied healthcare staff. The exam randomly pulls from a bank of over 210 questions on the following topics - Advance Directives, Age-Related Competency, Bloodborne Pathogens, Cultural Competency, Documentation and Risk Management, Drug-Impaired Healthcare Worker, Electrical Safety, Emergency Preparedness, End of Life Care, Fire Safety, HIPAA Standards, Joint Commission National Patient Safety Goals, Latex Sensitivity and Allergies, Medication Error Prevention, Musculoskeletal Injury Prevention, Organ and Tissue Donation, Pain Management, Patient Rights, Recognizing and Reporting Abuse (Child, Domestic, and Elder), Restraints and Seclusion, Security and Workplace Violence Prevention, Sexual Harassment, Tuberculosis Education, and Universal Precautions. Core Competency Test: Non-Licensed The Core Competency Test: Non-Licensed is designed to be completed by non-licensed healthcare staff (e.g. CNA, HHA). The exam randomly pulls from a bank of over 200 questions on the following topics - Advance Directives, Age-Related Competency, Bloodborne Pathogens, Cultural Competency, Documentation and Risk Management, Drug-Impaired Healthcare Worker, Electrical Safety, Emergency Preparedness, End of Life Care, Fire Safety, HIPAA Standards, Joint Commission National Patient Safety Goals, Latex Sensitivity and Allergies, Medication Error Prevention, Musculoskeletal Injury Prevention, Organ and Tissue Donation, Pain Management, Patient Rights, Recognizing and Reporting Abuse (Child, Domestic, and Elder), Restraints and Seclusion, Security and Workplace Violence Prevention, Sexual Harassment, Tuberculosis Education, and Universal Precautions. Core Competency Test: Nursing The Core Competency Test: Nursing is designed to be completed by licensed nursing staff. The exam randomly pulls from a bank of over 250 questions on the following topics - Advance Directives, Age-Related Competency, Bloodborne Pathogens, Cultural Competency, Documentation and Risk Management, Drug-Impaired Healthcare Worker, Electrical Safety, Emergency Preparedness, End of Life Care, Fire Safety, HIPAA Standards, Joint Commission National Patient Safety Goals, Latex Sensitivity and Allergies, Medication Error Prevention, Musculoskeletal Injury Prevention, Organ and Tissue Donation, Pain Management, Patient Rights, Recognizing and Reporting Abuse (Child, Domestic, and Elder), Restraints and Seclusion, Security and Workplace Violence Prevention, Sexual Harassment, Tuberculosis Education, and Universal Precautions. Corrections Nurse Competency Test The Corrections Nurse Competency Test covers topics related to application of the nursing process to patients in correctional facilities. Topics include intake screening, chronic care clinic, medication administration, nursing sick call, clinical management of inmates/detainees, oral/dental screening, emergency response, environmental safety, infection control, health promotion and maintenance, PREA, HIPAA, professional responsibilities/delegation, mental health screening, and additional knowledge, skills, and abilities necessary for successful job performance by a corrections nurse.

COTA Competency Test The Certified Occupational Therapy Assistant (COTA) Competency Test covers topics related to interventions that support activities of daily living. The test includes questions related to the evaluation of range of motion and physical impairment, goal writing, and scope of practice, as well as the safe implementation of treatment interventions, and additional knowledge, skills, and abilities needed for successful job performance by a COTA. Critical Care (ICU) Nurse Competency Test The Critical Care (ICU) Competency Test covers topics related to application of the nursing process to patients in the critical care unit. Topics include cardiac anatomy, hemodynamic monitoring/measurements, patient safety, treatments for cardiac arrhythmias, arterial blood gas interpretation, respiratory disorders, and additional knowledge, skills, and abilities needed for successful job performance by a critical care nurse. CT Technologist Competency Test The CT Technologist Competency Test covers topics related to technical specifications of the CT scanner, anatomy, pathophysiology, lab values, calculation of contrast administration time, CT-specific terminology, and additional knowledge, skills, and abilities needed for successful job performance by a CT technologist. Cultural Competency Test The Cultural Competency Test is part of the “Core Competency” test series. Topics covered in this test include recognizing other’s belief systems, recognizing one’s own belief system, perceptions of illness, treatment, and death, and the use of an interpreter. CVICU Nurse Competency Test The Cardiovascular Intensive Care Unit (CVICU) Competency Test covers topics related to the application of the nursing process to patients in the CVICU. Topics include cardiac anatomy, hemodynamic monitoring/measurements, patient safety, treatments for cardiac arrhythmias, cardiac emergencies, and additional knowledge, skills, and abilities needed for successful job performance by a CVICU nurse. Dental Assistant Competency Test The Dental Assistant Competency Test includes topics related to anatomy, tooth numbering, medical emergencies in dental offices, office procedures, dental radiology, dental terminology, infection control, patient safety and education, and additional knowledge, skills, and abilities needed for successful job performance by a dental assistant. Dialysis Nurse Competency Test The Dialysis Competency Test covers topics related to the application of the nursing process to patients undergoing dialysis treatment. Topics include assessment of fistula or graft, administration of dialysis, heparin boluses, AAMI water standards, blood leaks, air embolisms, and additional knowledge, skills, and abilities needed for successful job performance by a dialysis nurse. Dialysis Technician Competency Test The Dialysis Technician Competency Test covers topics related to operating dialysis machinery, understanding patient needs, and caring for patients undergoing dialysis treatment. Topics include assessment of the fistula or graft, administration of dialysis, solution mixtures, pH levels, air embolism, and additional knowledge, skills, and abilities needed for successful job performance by a dialysis technician.

Discharge Planning Competency Test The Discharge Planning Competency Test is part of the “Core Competency” test series. Topics covered in this test include working with a multidisciplinary team, managing financial resources, timing, patient teaching, and follow-up. Documentation and Risk Management Competency Test The Documentation and Risk Management Competency Test is part of the “Core Competency” test series. Topics covered in this test include use of approved abbreviations, incident reports, and handling mistakes in charting. Drug-Impaired Healthcare Workers Competency Test The Drug-Impaired Healthcare Workers Competency Test is part of the "Core Competency" test series. Topics covered in this exam include physical and behavioral signs and symptoms displayed by drug-impaired healthcare workers, drugs that are frequently abused, the costs of drug abuse in the healthcare work setting, and help for the drug-impaired healthcare worker. EEG Technologist Competency Test The EEG Technologist Competency Test covers topics related to the International 10-20 System, proper head measurement and EEG electrode placement, skull landmarks, waveforms and waveform frequencies, normal and abnormal EEG patterns, sleep stages, activation procedures, localization of abnormalities using montages, description of EEG activity, seizures, artifact, and additional knowledge, skills, and abilities needed for successful job performance by an EEG technologist. Elder Abuse Competency Test The Elder Abuse Competency Test is part of the “Core Competency” test series. Topics covered in this test include recognizing and reporting elder abuse, types of abuse including neglect, and legal considerations. Emergency Preparedness Competency Test The Emergency Preparedness Competency Test is part of the “Core Competency” test series. Topics covered in this test include identifying facility hazards, identifying and following a facility’s emergency action plan, Material Safety Data Sheets (MSDS), Personal Protective Equipment (PPE), and dealing with emergencies that might be encountered in a healthcare facility. Emergency Nurse Competency Test The Emergency Nursing Competency Test covers topics related to the application of the nursing process to patients in the emergency room. Topics include blood transfusions, shock, cardiopulmonary emergencies, neurological emergencies, burns, and additional knowledge, skills, and abilities needed for successful job performance by an ER nurse. End-of-Life Care Competency Test The End-of-Life Care Competency Test is part of the “Core Competency” test series. This test examines the knowledge of healthcare workers in relation to provision of care to the dying patient and is a post-test for the education topic End-of-Life Care. Topics covered include palliative care, hospice care, advance directives, do-not-attempt resuscitation (DNAR) orders, artificial nutrition and hydration (ANH), pain relief, signs of imminent death, and postmortem care.

Endoscopy Nurse Competency Test The Endoscopy Competency Test covers topics related to the application of the nursing process to patients undergoing an endoscopic procedure. Topics include signs/symptoms of gastrointestinal disorders, GI anatomy/physiology, endoscopy procedure steps, safety, sedation, and additional knowledge, skills, and abilities needed for successful job performance by an endoscopy nurse. Facility Safety Competency Test The Facility Safety Competency Test is part of the “Core Competency” test series. Topics covered in this test include identifying electrical hazards, Material Safety Data Sheets (MSDS), radiation safety, and dealing with unsafe conditions that might be encountered in a healthcare facility. Fall Prevention Competency Test The Fall Prevention Competency Test serves as the post-test for the education topic Fall Prevention. Topics include general information about falls (e.g. incidence, etiology, statistical data, long-term sequelae), risk assessment, reduction/elimination of contributing factors for falls, nursing interventions following a fall, client teaching, and fall prevention at home. This topic should be reviewed by healthcare personnel who work with adult patients in any setting, particularly in those settings with a high population of older adults. Fetal Heart Monitoring Competency Test The Fetal Heart Monitoring (FHM) Competency Test presents test takers with images of fetal monitor strips along with different clinical scenarios (vital signs, weeks’ gestation, number of contractions, etc.). The questions focus on interpretation, etiology, appropriate interventions, and mother and infant safety, based on these scenarios. The examination items are congruent with standards set by the Association of Women's Health, Obstetric and Neonatal Nurses (AWHONN). Fire Safety Competency Test The Fire Safety Competency Test is part of the “Core Competency” test series. Topics covered in this test include fire prevention, Material Safety Data Sheets (MSDS), fire extinguisher use, P.A.S.S. method, and evacuation. Healthcare-Associated Infections Competency Test The Healthcare-Associated Infections (HAI) Competency Test serves as the post-test for the education topic Healthcare-Associated Infections (HAI). Topics covered in this exam include the definition and statistics related to the occurrence of HAI, risk factors and types of HAI, and CDC-recommended measures in addition to standard precautions that will prevent HAI. HIPAA Competency Test The Health Insurance Portability and Accountability Act (HIPAA) Competency Test is part of the “Core Competency” test series. Topics covered in this test include protected health information (PHI), HIPAA standards, and patient consent. The test also presents multiple scenarios where a worker might violate a HIPAA regulation. Histotechnologist Competency Test The Histotechnologist Competency Test covers topics related to cell morphology, fixative solutions, paraffin embedding, microtomy, staining techniques, immunohistochemical methods, general chemistry principles, and additional knowledge, skills, and abilities needed for successful job performance by a histotechnologist.

Home Health Nurse Competency Test The Home Health Competency Test covers topics related to the application of the nursing process to patients receiving care in the home setting. Topics include range of motion (ROM) exercises, oxygen therapy, insulin administration, nutrition, skin care, bowel care, patient education, and additional knowledge, skills, and abilities needed for successful job performance by a home health nurse. Home Health Aide (HHA) Competency Test The Home Health Aide (HHA) Competency Test covers topics related to safely performing activities of daily living (ADLs), measuring vital signs, weight, and I&O. The test also includes topics on body mechanics, basic medical terminology, skin care, and additional knowledge, skills, and abilities needed for successful job performance by an HHA. Infant/Child Abduction Competency Test The Infant/Child Abduction Competency Test serves as the post-test for the education topic Infant/Child Abduction. Topics include the definition and scope of the problem of abduction, statistical data collected by the National Center for Missing and Exploited Children (NCMEC), characteristics of the typical offender/modes of operation, proactive measures to prevent infant abduction, physical security safeguards, critical incident response guidelines, special guidelines for children admitted to special care units, pediatric units, outpatient settings, ways to prevent infant/child abduction in the community, and parent teaching. Infusion Nurse Competency Test The Infusion Competency Test covers topics related to the application of the nursing process to patients receiving intravenous infusion therapy. Topics include patient consent, patient education, venous access devices, acceptable tourniquet use, central line access, infiltration, and additional knowledge, skills, and abilities needed for successful job performance by an Infusion nurse. Intensive Care Nursery Level II Pharmacology Test The Intensive Care Nursery (ICN) (Level II) Pharmacology Test includes questions on topics such as weight-based dosage calculations, drip calculations, IV infusion pump rates, blood administration, surfactant administration, emergency drugs, side effects/adverse reactions of drugs, and patient safety. Intimate Partner Violence Competency Test The Intimate Partner Violence Competency Test is part of the “Core Competency” test series. Topics covered in this test include recognizing and reporting domestic violence, violence statistics, and legal considerations. Joint Commission NPSG Competency Test The Joint Commission National Patient Safety Goals (NPSG) Competency Test is part of the “Core Competency” test series. Topics covered in this test include reasons for the NPSG, sentinel events, reporting, compliance, approved abbreviations, and patient education. Labor and Delivery Nurse Competency Test The Labor and Delivery Competency Test covers topics related to the application of the nursing process to patients in labor and delivery. Topics include assessing labor status, FHR, stages of labor, pregnancy complications, patient safety, and additional knowledge, skills, and abilities needed for successful job performance by a labor and delivery nurse. The examination items are congruent with standards set by the Association of Women's Health, Obstetric and Neonatal Nurses (AWHONN).

Latex Sensitivity Competency Test The Latex Safety Competency Test is part of the “Core Competency” test series. Topics covered in this test include identifying signs and symptoms of latex allergy, and risk factors related to latex allergies, as well as ways to reduce the risk of developing a latex allergy. LPN Competency Test The LPN Competency Test covers topics related to the application of the nursing process by an LPN to patients in a medical-surgical department or long-term care facility. Topics include patient safety, medication safety, disease management, care of patients with chronic disease, and additional knowledge, skills, and abilities needed for successful job performance by an LPN. LTC Nurse Competency Test The Long-Term Care (LTC) Competency Test covers topics related to the application of the nursing process to patients in long-term care settings. Topics include patient assessment, elder care, falls, Alzheimer’s disease, Braden scale, pressure ulcers, enteral feeding, bowel and bladder care, and additional knowledge, skills, and abilities needed for successful job performance by a nurse working in a long-term care setting. Malignant Hyperthermia Competency Test The Malignant Hyperthermia (MH) Competency Test serves as the post-test for the education topic Malignant Hyperthermia. Topics include general information about MH (e.g. definition, etiology, incidence), at-risk patients, signs and symptoms of the disorder, diagnosis, treatment, prognosis, complications, and prevention. This topic should be reviewed by healthcare personnel who work with patients in any surgical setting in which volatile inhalational anesthetics and/or succinylcholine (Anectine®) may be used. Mammography Technologist Competency Test The Mammography Technologist Competency Test covers topics related to breast anatomy, screening and diagnostic mammography, patient positioning for standard mammographic views, breast cancer statistical and prevalence data, standards surrounding the performance of mammography, and additional knowledge, skills, and abilities needed for successful job performance by a mammography technologist. Mechanical Ventilation: Adult Competency Test The Adult Mechanical Ventilation Competency Test covers topics related to the care of adult patients receiving mechanical ventilation. Topics include respiratory anatomy and physiology, indications for mechanical ventilation, ventilator settings, blood gas interpretation, intubation, standard of care interventions, complications of mechanical ventilation, and additional knowledge, skills, and abilities needed for successful job performance by a nurse or respiratory therapist working with adult patients receiving mechanical ventilation. Mechanical Ventilation: NICU Competency Test The NICU Mechanical Ventilation Competency Test covers topics related to the care of neonatal patients receiving mechanical ventilation. Topics include respiratory anatomy and physiology, indications for mechanical ventilation, ventilator settings, blood gas interpretation, intubation, standard of care interventions, complications of mechanical ventilation, HFOV, CPAP, and additional knowledge, skills, and abilities needed for successful job performance by a nurse or respiratory therapist working with neonatal patients receiving mechanical ventilation.

Mechanical Ventilation: PICU Competency Test The PICU Mechanical Ventilation Competency Test covers topics related to the care of patients receiving mechanical ventilation in the pediatric intensive care unit (PICU). Topics include respiratory anatomy and physiology, indications for mechanical ventilation, ventilator settings, ventilator modes, blood gas interpretation, intubation, standard of care interventions, complications of mechanical ventilation, Heliox therapy, and additional knowledge, skills, and abilities needed for successful job performance by a nurse or respiratory therapist working with patients receiving mechanical ventilation in the PICU. Medical Assistant Competency Test The Medical Assistant Competency Test includes topics related to anatomy, administration of injections, medication dosage calculation, office procedures, medical terminology, patient safety and education, and legal considerations related to working under a provider’s license. Medical Biller: Inpatient Competency Test The Medical Billing: Inpatient Competency Test covers billing topics such as common terms and acronyms, insurance claims processing, Medicare laws, common patient situations, CPT coding and guidelines, claims adjustment, and additional knowledge, skills, and abilities needed for successful job performance by an inpatient medical biller. Medical Biller: Outpatient Competency Test The Medical Billing: Outpatient Competency Test covers billing topics such as common terms and acronyms, insurance claims processing, Medicare/Medicaid laws, common patient situations, CPT/HCPCS coding and guidelines, capitation, bankruptcy, and additional knowledge, skills, and abilities needed for successful job performance by an outpatient medical biller. Medical Coder: Inpatient Competency Test The Medical Coder: Inpatient Competency Test is composed of samples of medical documentation from a variety of inpatient encounters. The medical coder is expected to review the documentation and use appropriate resources to accurately select the appropriate set of codes to indicate principal and secondary diagnoses (including E-codes and V-codes) and principal and secondary ICD-9-CM procedure codes. Medical Coder: Outpatient Competency Test The Medical Coder: Outpatient Competency Test is composed of samples of medical documentation from a variety of outpatient encounters. The medical coder is expected to review the documentation and use appropriate resources to accurately select the appropriate set of ICD-9-CM principal and secondary diagnosis codes (including E-codes and V-codes) and CPT-4 procedure codes with modifiers. Medical Terminology for Allied Health Competency Test The Medical Terminology for Allied Health Competency Test is designed to be taken by trained allied health professionals who have completed a medical terminology class or have medical terminology experience. This test consists of items about the specialized language utilized across health disciplines that allow healthcare professionals to communicate information about body structures and functions, pathology, diagnostic and treatment procedures, Examination positions, pharmacology, and other information about health and illness. This terminology consists of words having interchangeable parts called prefixes, word roots, and suffixes, some of which are derived from languages such as Greek and Latin; they are connected by a variety of combining forms. This language also includes medical abbreviations which must be understood and communicated clearly among health workers. Learning this language provides necessary foundational knowledge upon which health workers build a strong knowledge base, and it contributes to public safety by helping healthcare professionals communicate clearly.

Medical Terminology for Medical Coders Competency Test The Medical Terminology for Medical Coders Competency Test is designed to be taken by professional medical coders. This 35-question test consists of items about the specialized language utilized across health disciplines that allow healthcare professionals to communicate information about body structures and functions, pathology, diagnostic and treatment procedures, examination positions, pharmacology, and other information about health and illness. This terminology consists of words having interchangeable parts called prefixes, word roots, and suffixes, some of which are derived from languages such as Greek and Latin; they are connected by a variety of combining forms. This language also includes medical abbreviations which must be understood and communicated clearly among health workers. Learning this language provides necessary foundational knowledge upon which health workers build a strong knowledge base, and it contributes to public safety by helping healthcare professionals communicate clearly. Medical-Surgical Nurse Competency Test The Medical-Surgical Competency Test covers topics related to the application of the nursing process to patients in the medical-surgical department. Topics include patient assessment, blood administration, post-operative care and complications, enteral feeding, and additional knowledge, skills, and abilities needed for successful job performance by a medical-surgical nurse. Medication Reconciliation Competency Test The Medication Reconciliation Competency Test serves as the post-test for the education topic Medication Reconciliation. Topics include the definition of medication reconciliation, collection of an admission medication history, adverse drug events (ADEs), admission/discharge medication reconciliation processes, and improvement of patient outcomes when healthcare information is relayed to patients. Mother-Baby Nurse Competency Test The Mother-Baby Competency Test covers topics related to the application of the nursing process to couplets in the mother-baby unit. Topics include postpartum and neonatal assessment, postpartum complications, neonatal complications, patient teaching, uterine involution, APGAR scoring, and additional knowledge, skills, and abilities needed for successful job performance by a mother-baby nurse. The examination items are congruent with standards set by the Association of Women's Health, Obstetric and Neonatal Nurses (AWHONN). MRI Technologist Competency Test The Magnetic Resonance Imaging (MRI) Competency Test covers topics related to clinical requirements, technical specifications, recommended dosage of gadolinium, and additional knowledge, skills, and abilities needed for successful job performance by a MRI technician. NICU Nurse Competency Test The Neonatal Intensive Care Unit (NICU) Competency Test covers topics related to the application of the nursing process to neonates in the NICU department. Topics include neonatal assessment, administration of Factor VIII, parent education, care of neonates with increased intracranial pressure, Tetralogy of Fallot, pulmonary atresia, bronchopulmonary dysplasia, cyanosis, bacterial sepsis, polycystic kidney disease, and additional knowledge, skills, and abilities needed for successful job performance by a NICU nurse. The examination items are congruent with standards set by the Association of Women's Health, Obstetric and Neonatal Nurses (AWHONN).

Nuclear Medicine Technologist Competency Test The Nuclear Medicine Technology Competency Test covers topics related to radiopharmaceuticals, scintigraphy, SPECT imaging, radiation exposure, patient safety and education, clinical guidelines, and additional knowledge, skills, and abilities needed for successful job performance by a nuclear medicine technologist. Nursery Competency Test The Nursery Competency Test covers topics related to the application of the nursing process to infants in the newborn nursery. Topics include infant assessment, resuscitation, administration of medications, parent teaching, APGAR scoring, and additional knowledge, skills, and abilities needed for successful job performance by a nursery nurse. The examination items are congruent with standards set by the Association of Women's Health, Obstetric and Neonatal Nurses (AWHONN). Occupational Therapist (OT) Competency Test The Occupational Therapy (OT) Competency Test covers topics related to the assessment and treatment of patients requiring occupational therapy. Topics include range of motion, workplace ergonomics modifications, thermal agents and cryotherapy, ADL training, the Mini-Mental State Examination (MMSE), stress reduction, and additional knowledge, skills, and abilities needed for successful job performance by an occupational therapist. Oncology Nurse Competency Test The Oncology Competency Test covers topics related to the application of the nursing process to patients in the oncology nursing unit. Topics include patient assessment, education, central line and port access, pain management, survival rates, care of the patient undergoing chemotherapy, and additional knowledge, skills, and abilities needed for successful job performance by an oncology nurse. Organ and Tissue Donation Competency Test The Organ and Tissue Competency Test is part of the “Core Competency” test series. Topics covered in this test include identifying potential organ donors, and the legal and ethical issues surrounding organ donation. PACU Nurse Competency Test The PACU Competency Test covers topics related to the application of the nursing process to patients in the post-anesthesia care unit. Topics include patient assessment, airway management, anesthesia phases, hypothermia, PCA pump, hemodynamic monitoring, discharge planning, and additional knowledge, skills, and abilities needed for successful job performance by a PACU nurse. Pain Management Competency Test The Pain Management Competency Test is part of the “Core Competency” test series. Topics covered in this test include assessment and treatment options for nociceptive, neuropathic, and chronic pain, discharge planning, and opioids. Palliative Care Nurse Competency Test The Palliative Care Competency Test covers topics related to the application of the nursing process to patients in the hospice setting. Topics include end-of-life care and support, bereavement, sedation, family support, and other knowledge, skills, and abilities needed for successful job performance by a palliative care nurse.

Patient Care Partnership Competency Test The Patient Care Partnership Competency Test is part of the “Core Competency” test series. Topics covered in this test include patient bill of rights, designating a proxy, refusing medical care, experimental research and treatments, and disclosing past medical history. Patient Care Technician Test The Patient Care Technician (PCT) Test covers topics related to safely performing activities of daily living (ADLs), measuring and documenting vital signs and finger stick blood glucose. The test also includes topics on body mechanics, basic medical terminology, skin care, proper collection tube identification, patient safety and education, and additional knowledge, skills, and abilities needed for successful job performance by a PCT in the acute care or office setting. Pediatric Pharmacology Competency Test The Pediatric Pharmacology Competency Test includes questions on topics such as weight-based dosage calculations, PCA calculations, intravenous pump rates, medication classes, and patient safety. Pediatrics Nurse Competency Test The Pediatrics Competency Test covers topics related to the application of the nursing process to patients in the pediatric setting. Topics include patient assessment, parent education, nutrition, APGAR scoring, clinical situations, and additional knowledge, skills, and abilities needed for successful job performance by a pediatric nurse. Perioperative (OR) Nurse Competency Test The Perioperative (OR) Competency Test covers topics related to the application of the nursing process to the care of patients in surgery. Topics include patient assessment and monitoring, electrocautery, laser safety, aseptic technique, counts, legal considerations, and additional knowledge, skills, and abilities needed for successful job performance by a perioperative nurse. Pharmacology: LPN Competency Test The LPN Pharmacology Competency Test includes dosage calculations for po and IM medications, and metric units. There are also items testing the LPN's knowledge about routes of administration, characteristics of medications, abbreviations, drug/food interactions, patient teaching, and additional knowledge, skills, and abilities necessary for LPNs who administer medications as part of their job responsibilities. Pharmacology: RN Competency Test The RN Pharmacology Competency Test includes dosage calculations for po, IM, IV medications, Intravenous boluses, insulin and heparin drips, metric units, and infusion rates. There are also items testing the RN's knowledge about routes of administration, characteristics of medications, abbreviations, drug/food interactions, patient teaching, and additional knowledge, skills, and abilities necessary for RNs who administer medications as part of their job responsibilities. Pharmacology: LTC LPN/LVN Competency Test The Pharmacology: LTC LPN/LVN Competency Test includes dosage calculations for oral and parenteral medications, as well as metric units. There are also items testing the knowledge of LPNs/LVNs about routes of administration, characteristics of medications, abbreviations, drug/food interactions, patient teaching, and additional knowledge, skills, and abilities necessary for LPNs/LVNs who administer medications as part of their job responsibilities in the long-term care setting.

Pharmacology: LTC RN Competency Test The Pharmacology: LTC RN Competency Test includes dosage calculations for oral and parenteral medications, intravenous boluses, metric units, and infusion rates. There are also items testing the RN's knowledge about routes of administration, characteristics of medications, abbreviations, drug/food interactions, patient teaching, and additional knowledge, skills, and abilities necessary for RNs who administer medications as part of their job responsibilities in the long-term care setting. Pharmacy Technician Competency Test - Hospital The Pharmacy Technician - Hospital Competency Test includes dosage calculations, drug classifications, treatment indications, dosage forms, scheduled medications, administration routes, aseptic technique, pharmaceutical abbreviations, prescription labeling, regulatory agencies, pharmacy law, and additional knowledge, skills, and abilities necessary for pharmacy technicians working in the hospital setting. Pharmacy Technician Competency Test - Retail The Pharmacy Technician - Retail Competency Test includes dosage calculations, drug classifications, treatment indications, dosage forms, scheduled medications, administration routes, DEA numbers, NDC numbers, pharmaceutical abbreviations, prescription labeling, regulatory agencies, pharmacy law, and additional knowledge, skills, and abilities necessary for pharmacy technicians working in the retail setting. Phlebotomist Competency Test The Phlebotomy Competency Test covers topics related to venipuncture technique, proper collection tube identification, OSHA regulations, patient safety, and additional knowledge, skills, and abilities needed for successful job performance by a phlebotomist. Physical Therapist (PT) Competency Test The Physical Therapy (PT) Competency Test covers topics related to the assessment and treatment of patients requiring physical therapy. Topics include cryotherapy, anatomy, nerve conduction, musculoskeletal conditions, and additional knowledge, skills, and abilities needed for successful job performance by a physical therapist. Physical Therapy Assistant (PTA) Competency Test The Physical Therapy Assistant (PTA) Competency Test covers topics related to the treatment of patients requiring physical therapy. Topics include patient safety and education, strength training, heat/cold application, therapeutic exercises, and additional knowledge, skills, and abilities needed for successful job performance by a physical therapy assistant. PICU Nurse Competency Test The Pediatric Intensive Care Unit (PICU) Competency Test covers topics related to the application of the nursing process to patients in the PICU department. Topics include pediatric assessment, PALS protocol, care of patients with increased intracranial pressure, cardiac anomalies, status epilepticus, burns, cystic fibrosis, bacterial meningitis, trauma, and other knowledge, skills, and abilities necessary for successful job performance by a PICU nurse. Postpartum Nurse Competency Test The Postpartum Competency Test covers topics related to the application of the nursing process to patients in the postpartum unit. Topics include patient assessment, postpartum complications, patient teaching, uterine involution, and additional knowledge, skills, and abilities needed for successful job performance by a postpartum nurse. The examination items are congruent with standards set by the Association of Women's Health, Obstetric and Neonatal Nurses (AWHONN).

Preventing Medication Errors Competency Test The Preventing Medication Errors Competency Test is part of the “Core Competency” test series. Topics covered in this test include the, “five rights” of medication administration, root cause analysis, reviewing patient vital signs and allergies, and proper reporting of medication errors. Preventing Musculoskeletal Disorders Competency Test The Preventing Musculoskeletal Injuries Competency Test is part of the “Core Competency” test series. Topics covered in this test include ergonomics, use of proper lifting techniques, proper body mechanics, and importance of stretching. Psychiatric Nurse Competency Test The Psychiatric Nurse Competency Test covers topics related to the application of the nursing process to patients in a psychiatric setting. Topics include patient assessment, coping techniques, psychotropic medications; psychiatric disorders such as depression, anorexia nervosa, bulimia nervosa, schizophrenia, suicidal ideation, bipolar disorder, and dissociative identity disorder; and additional knowledge, skills, and abilities needed for successful job performance by a psychiatric nurse. Psychiatric Technician Competency Test The Psychiatric Technician (a.k.a. Behavioral Health Technician) Competency Test covers topics related to the care of patients in psychiatric settings. Topics include common psychiatric illnesses, patient safety, universal precautions, patient rights, and additional knowledge, skills, and abilities needed for successful job performance by a psychiatric/behavioral health technician. Radiology Technician (RT) Competency Test The Radiology Technician (RT) Competency Test covers topics related to x-ray types, wavelengths, patient positioning, safety and education, reducing scatter radiation, and additional knowledge, skills, and abilities needed for successful job performance by a radiology technician. Respiratory Therapist Competency Test The Respiratory Therapist Competency Test covers topics related to cardiopulmonary assessment, nebulizer treatments, respiratory medications, ventilator settings, and additional knowledge, skills, and abilities needed for successful job performance by a respiratory therapist. Restraints and Seclusion Competency Test The Restraints and Seclusion Competency Test is part of the “Core Competency” test series. Topics covered in this test include patient rights and safety, types of restraints, comfort considerations, clinical justification and proper documentation. RN First Assist (RNFA) Competency Test The RN First Assist (RNFA) Competency Test covers topics related to the Nurse Practice Act, RNFA role and practice privileges, types of anesthesia, types of suture and suturing techniques, positioning, operating room safety, patient safety, preoperative and postoperative teaching, and additional knowledge, skills, and abilities needed for successful job performance by an RNFA.

School Nurse Competency Test The School Nurse Test covers topics related to the application of the nursing process to students in elementary, middle, and high schools. Topics include autism, substance abuse, childhood obesity, bullying, eating disorders, child abuse, environmental contamination, head lice, "pink eye", diabetes, anaphylaxis, asthma, food allergies, teen pregnancy, seizures, concussion, disaster drills, lockdowns, legal aspects of school nursing (FERPA, IDEA), and additional knowledge, skills, and abilities needed for successful job performance by a school nurse. Sexual Harassment Competency Test The Sexual Harassment Competency Test is part of the “Core Competency” test series. Topics covered in this test include discrimination, recognition and reporting of sexual harassment, identifying different types of sexual harassment such as “quid pro quo," and other legal considerations. Sonography Technologist Competency Test The Sonography Technician Competency Test covers topics related to the scanning of various anatomical features, anatomy, waveforms, and additional knowledge, skills, and abilities needed for successful job performance by a sonography technician. Specimen Collector Test The Specimen Collector Test is based upon the Department of Transportation (DOT) rule, 49 CFR Part 40 and the current DOT Urine Specimen Collection Guidelines. The test covers topics such as the drugs/drug classes detected by urine testing, collection procedures, adulteration of urine specimens, shy bladder protocol, refusal to test, availability of test results, and additional knowledge, skills, and abilities needed for successful job performance by a specimen collector. Speech Language Pathologist (SLP) Competency Test The Speech Language Pathologist (SLP) Competency Test covers topics related to patient assessment, dysphagia, articulation, swallowing disorders, patient education, and additional knowledge, skills, and abilities needed for successful job performance by a speech therapist. Sterilization Technician Competency Test The Sterilization Technician Competency Test covers topics related to sterilization techniques and equipment, OSHA standards, steam sterilization, chemical safety, and additional knowledge, skills, and abilities needed for successful job performance by a central sterilization/supply processing and distribution (CS/SPD) technician. Surgical Technologist Competency Test The Surgical Technologist Competency Test covers topics related to the care of surgical patients. Topics include patient safety, electrocautery, laser safety, aseptic technique, counts, instruments, operative techniques, legal considerations, and additional knowledge, skills, and abilities needed for successful job performance by a surgical technologist. Telemetry Nurse Competency Test The Telemetry Competency Test covers topics related to the application of the nursing process to patients in the telemetry department. Topics include cardiac anatomy, ACLS protocols, patient safety, treatments for dysrhythmias, cardiac emergencies, and additional knowledge, skills, and abilities needed for successful job performance by a telemetry nurse. Tuberculosis Competency Test The Tuberculosis Competency Test is part of the “Core Competency” test series. Topics covered in this test include TB prevention; mask fit test, and annual screenings.

Universal Precautions Competency Test The Universal Precautions Competency Test is part of the “Core Competency” test series. Topics covered in this test include blood-borne pathogens, hand hygiene, body fluids, use of personal protective equipment (PPE), Standard versus Universal Precautions, and preventing needle stick injuries. Vascular Sonographer Competency Test The Vascular Technologist Competency Test covers topics related to the scanning of vascular structures, anatomy, waveforms, measurements, calculations, flow patterns, pressure gradients, and additional knowledge, skills, and abilities needed for successful job performance by a vascular technologist. Workplace Violence Competency Test The Workplace Violence Competency Test is part of the “Core Competency” test series. Topics covered in this test include recognizing, avoiding and diffusing potentially violent situations, recognizing behavior that can lead to a loss of control, reporting incidents, theft, and legal considerations.