Was ist das eigentlich? Cyberrisiken verständlich erklärt

Es wird viel über Cyberrisiken gesprochen. Oftmals fehlt aber das grundsätzliche Verständnis, was Cyberrisiken überhaupt sind. Ohne diese zu verstehen, lässt sich aber auch kein Versicherungsschutz gestalten.

Beinahe alle Aktivitäten des täglichen Lebens können heute über das Internet abgewickelt werden. Online-Shopping und Online-Banking sind im Alltag angekommen. Diese Entwicklung trifft längst nicht nur auf Privatleute, sondern auch auf Firmen zu. Das Schlagwort Industrie 4.0 verheißt bereits eine zunehmende Vernetzung diverser geschäftlicher Vorgänge über das Internet.

Anbieter von Cyberversicherungen für kleinere und mittelständische Unternehmen (KMU) haben Versicherungen die Erfahrung gemacht, dass trotz dieser eindeutigen Entwicklung Cyberrisiken immer noch unterschätzt werden, da sie als etwas Abstraktes wahrgenommen werden. Für KMU kann dies ein gefährlicher Trugschluss sein, da gerade hier Cyberattacken existenzbedrohende Ausmaße annehmen können. So wird noch häufig gefragt, was Cyberrisiken eigentlich sind. Diese Frage ist mehr als verständlich, denn ohne (Cyber-)Risiken bestünde auch kein Bedarf für eine (Cyber-)Versicherung.

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NCC NNP-BC : Neonatal Nurse Practitioner exam Questions, MCQs and Practice Test

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Exam Number : NNP-BC
Exam Name : Neonatal Nurse Practitioner
Vendor Name : NCC
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Total MCQs : Check Questions

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NNP-BC exam Format | NNP-BC Course Contents | NNP-BC Course Outline | NNP-BC exam Syllabus | NNP-BC exam Objectives


Exam Code: NNP-BC
Exam Name: NCC Neonatal Nurse Practitioner
Exam Type: Computer-based- multiple-choice questions.
Number of Questions: 175 questions (150 scored- 25 unscored pretest questions).
Time Allotted: 3 hours (180 minutes).
Passing Score: Scaled score of 700 (on a scale of 300–900).

- Maternal History affecting the Newborn Antepartum
- Neonatal complications: maternal risk factors & complications
- gestational hypertension
- cardiac/pulmonary disease
- diabetes
- common infectious diseases
- common hematologic diseases
- placental insufficiency
- substance abuse
- medication effects
- Fetal exam
- fetal fibronectin
- nonstress test
- biophysical profile
- ultrasound/doppler flow
- amniocentesis
- antenatal screening/quad screen
- Fetal procedures
- Intrapartum
- Fetal Heart Rate (FHR) Patterns
- Effects on the Fetus/Neonate
- tocolysis/induction
- analgesia
- anesthesia
- neuroprotective agents
- Intrapartum Complications
- amniotic fluid volume
- oligohydramnios
- polyhydramnios
- Rupture of Membranes
- premature
- prolonged
- Intrauterine Drug Exposure
- Nicotine
- Alcohol
- Prescription/nonprescription
- Illicit Drug

- Neonatal
- General appearance
- Head- eyes- nose- ears and mouth
- Neck and throat
- Chest
- Abdomen
- Spine/back
- Extremities
- Genitalia
- Musculoskeletal
- Skin
- Vital signs
- Gestational age exam physical Characteristics of
- preterm
- term
- post-term
- AGA
- SGA
- LGA

- Associated risks/Complications of variations in gestational age
- Abnormalities of intrauterine parameters
- Behavioral exam
- state
- Muscle movement/tone/reflexes
- Autonomic control/responses
- Neurosensory capabilities
- Neurological exam
- Clinical Laboratory Tests
- Microbiological
- Biochemical
- Hematological
- Endocrine
- Immunologic
- Genetic

- Diagnostic studies
- Ultrasound/Doppler
- CT scan
- MRI
- X-ray/fluoroscopy
- EKG
- EEG
- Echocardiogram
- Voiding Cystourethrogram

- Techniques & Equipment
- Procedures
- bag and mask ventilation and T-piece
- LMAs
- endotracheal intubation
- umbilical vessel and peripheral catheterization
- chest tube insertion/removal
- needle aspiration
- spinal/lumbar tap
- intraosseous access
- intravenous line placement (central/peripheral)
- blood sampling
- circumcisions - complications/contraindications

- Equipment
- cardiopulmonary monitors
- oxygenation equipment/end tidal CO2 monitoring
- invasive/non-invasive blood gas monitoring
- indwelling catheters
- incubators/radiant warmers
- ventilators
- phototherapy
- NIRS

- Family Integration
- Communication
- Family centered care
- Barriers to parent/infant interaction
- Grieving Process
- Stages of grieving and common behaviors
- Factors influencing enhancement or impediment of grief process
- Palliative care/End of life
- Parental depression
- Periviability
- Diversity- Equity and Inclusion
• Culturally supportive care

- Discharge Planning and Follow Up
- Anticipatory guidance
- Follow up screening
- Hearing
- Vision - ROP
- Developmental
- Health risks
- Discharge preparation
- Follow-up care

- Thermoregulation
- Mechanisms and management of heat transfer
- evaporation
- conduction
- convection
- radiation
- Rewarming techniques
- Mechanisms of heat production
- Temperature exam
- Neutral thermal environment

- Resuscitation and Stabilization
- Transition to extrauterine life
- Delivery room exam
- Techniques of resuscitation
- Indications for interventions
- Cord blood gas interpretation
- Neonatal transport

- Growth and Nutrition
- Physiology of Digestion and Absorption
- Nutritional Requirements
- Enteral Feeding
- Parenteral Nutrition
- Composition of Breast Milk/Formulas/Donor milk
- Dietary Supplementation

- Fluids and Electrolytes
- Common problems and conditions
- Fluid & Electrolyte requirements
- Insensible water loss/gain
- Central & peripheral infusion
- Acid base balance
- Fish oil emulsion (Omegaven) SMOF

- Pharmacokinetics & Pharmacodynamics
- Pharmacokinetics
- distribution
- excretion
- absorption
- metabolism
- withdrawal
- Principles of administration
- dosage/interval
- route
- tolerance/weaning
- Common Drug Therapies
- Analgesia/narcotics
- Anticoagulants
- Anticonvulsants
- Antihypertensive drugs
- Antimicrobials
- biologics/immunities
- vaccinations
- Cardiovascular drugs
- vasodilators/vasopressors
- antidysrhythmia drugs
- Diuretics
- GI drugs
- antacids
- prokinetic
- proton pump inhibitors
- Inhalants
- iNO
- Neurologic agents
- anesthetics agents
- sedatives
- hypnotics
- Respiratory drugs
- bronchodilators
- respiratory stimulants
- surfactant therapy
- Steroids
- Drugs and breastfeeding
- Drug transfer
- Drug safety

- Cardiac
- Congenital Cardiac Defects
- cyanotic
- Ebsteins Anomaly
- Tetralogy of Fallot
- truncus arteriosus
- transposition of great vessels
- total anomalous pulmonary venous return
- tricuspid atresia
- acyanotic
- ventricular septal defect
- coarctation of aorta (interrupted arch)
- atrial septal defect septal defect
- hypoplastic left heart syndrome
- endocardial cushion defect (AV canal)
- aortic stenosis
- Patent ductus arteriosus
- Congestive heart failure
- Hypertension/Hypotension
- Shock
- Dysrhythmias
- PGEs

- Respiratory
- Respiratory distress syndrome
- Transient tachypnea
- Pneumothorax and air leaks/chylothorax
- Congenital pulmonary airway malformation (CPAM)
- Cystic pulmonary
- Apnea of prematurity
- Meconium aspiration
- Diaphragmatic eventrations
- Persistent pulmonary hypertension
- Pneumonia
- Pulmonary hemorrhage
- Pulmonary hypoplasia
- Diaphragmatic hernia
- Chronic lung disease
- Laryngeal- tracheomalacia/stenosis
- Respiratory support
- principles and methods of oxygen
- administration/ventilation
- risk factors affecting oxygenation/ventilation
- oxyhemoglobin dissociation curve
- high frequency ventilation (HFV)
- extracorporeal membrane oxygenation (ECMO)
- nitric oxide
- neurally adjusted ventilatory assist (NAVA)
- nasal intermittent positive pressure ventilation (NIPPV)
- noninvasive ventilation (NIV)

- Gastrointestinal
- Development of the GI tract
- Digestive and absorptive disorders
- diarrhea/short gut
- Disorders of suck/swallow/motility
- GERD
- cleft lip palate
- Duodenal atresia
- tracheoesophageal fistula -esophageal atresia
- small left colon syndrome
- Hirschsprung disease
- volvulus
- imperforate anus
- pyloric stenosis
- Malabsorption/maldigestion
- Diarrhea/short gut
- Anomalies/obstruction of upper and lower GI tract
- small left colon syndrome
- Hirschsprungs disease
- Abdominal wall defects
- gastroschisis -omphalocele
- Obstructions
- Perforations
- Meconium ileus
- Tracheoesophageal fistula
- Necrotizing enterocolitis
- Inguinal hernia
- Malrotaton

- Renal/Genitourinary
- Renal vein/artery thrombosis
- Acute renal failure/insufficiency
- Polycystic/multicystic dysplastic kidneys
- Urinary outflow tract obstruction
- Testicular torsion
- Exstrophy of the bladder
- Hypospadias/epispadias
- Hydronephrosis grading system/hydroureter

- Endocrine/Metabolic
- Adrenal disorders
- Ambiguous genitalia
- Calcium disorders
- Glucose disorders
- Magnesium disorders
- Phosphorus disorders
- Pituitary disorders
- Thyroid disorders
- Infants of diabetic mothers
- Osteopenia of prematurity

- Hematopoietic
- Hematological disorders
- anemia
- polycythemia
- platelet disorders
- coagulopathies
- vitamin K deficiency
- disseminated intravascular coagulation
- factor deficiencies
- neutropenia/neutrophilia
- Rh disease and ABO incompatibility
- Blood component therapy
- Jaundice and liver disease
- Hyperbilirubinemia (direct and indirect)
- Breastmilk jaundice
- Kernicterus
- Phototherapy
- Exchange transfusion
- Biliary atresia

- Infectious Diseases
- Normal immunologic function
- Common neonatal infections
- group B streptococcal
- e-coli
- staphylococcal
- klebsiella
- enterococcus
- candidiasis
- pseudomonas
- enterovirus
- respiratory syncytial virus (RSV)
- CMV
- hepatitis B
- toxoplasmosis
- herpes
- HIV/AIDS
- chlamydia
- gonorrhea
- syphilis
- varicella
- Neonatal sepsis
- SIRS
- Meningitis
- Septic shock
- Infection control and universal precautions
- MRSA/VRSE
- Osteomyelitis

- Musculoskeletal
- Abnormalities of the skeleton
- metatarsus adductus
- achondroplasia
- Clubfoot
- Developmental dysplasia of the hip
- Spinal abnormalities
- Musculoskeletal birth injuries
- fractures
- nerve damage
- torticollis
- Aperts- crouzon- etc.

- Integumentary
- General skin development and care
- Disorders
- ecchymosis -epidermolysis bullosa
- hemangiomas
- ichthyosis
- subcutaneous fat necrosis
- Milia/miliara
- Hyperpigmented macule
- Erythema toxicum
- Neonatal pustular melanosis
- Auricular tags
- Petechiae
- Port wine stain
- Hyper/hypopigmentation

- Genetics
- Genetic processes
- multifactorial inheritance
- nondisjunction
- translocation
- deletion/duplication
- sex linked inheritance
- Inborn errors of metabolism
- Hyperammonemia
- Newborn Screening
- galactosemia
- cystic fibrosis
- Chromosomal abnormalities/syndromes
- Trisomy 21
- Trisomy 13
- Trisomy 18
- Turner syndrome
- Beckwith-Wiedemann syndrome
- DiGeorge syndrome
- Osteogenesis imperfecta
- Potter sequence
- VATER/VACTERL
- CHARGE

- Neurological
- Perinatal – depression/asphyxia
- Hypoxic ischemic encephalopathy
- therapeutic hypothermia
- Cranial hemorrhages
- Hydrocephalus
- Neural tube defects
- Seizures
- Jitteriness
- Periventricular leukomalacia
- Auto regulation
- Cerebral palsy
- aEEG
- Near-infrared spectroscopy (NIRS)
- Congenital neuromuscular disorders
- Craniosynostosis
- Neurodevelopmental care

- Ears- Eyes- Nose and Throat
- Eyes
- eye prophylaxis
- cataracts
- coloboma
- glaucoma
- retinopathy of prematurity
- strabismus
- conjunctivitis
- Nose
- nasolacrimal duct obstruction
- choanal atresia
- deviated septum
- Ears
- malformations
- Mouth/throat
- cleft lip and palate
- micrognathia/retrognathia
- macroglossia
- airway obstruction
- Ethical Principles
- Autonomy
- Beneficence
- Non-maleficence
- Justice
- Professional/Legal Issues
- Professional
- Regulation
- Practice
- HIPPA
- Staffing issues
- Legal liability
- Consent
- Documentation/medical records
- Negligence/malpractice
- Evidence-based practice
- Terminology
- Reliability
- Validity
- Significance
- Levels of Evidence
- Quality Improvement
- Research utilization
- Neonatal Safety
- Communication
- Interprofessional practice



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Warum sind Cyberrisiken so schwer greifbar?

Als mehr oder weniger neuartiges Phänomen stellen Cyberrisiken Unternehmen und Versicherer vor besondere Herausforderungen. Nicht nur die neuen Schadenszenarien sind abstrakter oder noch nicht bekannt. Häufig sind immaterielle Werte durch Cyberrisiken in Gefahr. Diese wertvollen Vermögensgegenstände sind schwer bewertbar.

Obwohl die Gefahr durchaus wahrgenommen wird, unterschätzen viele Firmen ihr eigenes Risiko. Dies liegt unter anderem auch an den Veröffentlichungen zu Cyberrisiken. In der Presse finden sich unzählige Berichte von Cyberattacken auf namhafte und große Unternehmen. Den Weg in die Presse finden eben nur die spektakulären Fälle. Die dort genannten Schadenszenarien werden dann für das eigene Unternehmen als unrealistisch eingestuft. Die für die KMU nicht minder gefährlichen Cyber­attacken werden nur selten publiziert.

Aufgrund der fehlenden öffentlichen Meldungen von Sicherheitsvorfällen an Sicherheitsbehörden und wegen der fehlenden Presseberichte fällt es schwer, Fakten und Zahlen zur Risikolage zu erheben. Aber ohne diese Grundlage fällt es schwer, in entsprechende Sicherheitsmaßnahmen zu investieren.

Erklärungsleitfaden anhand eines Ursache-Wirkungs-Modells

Häufig nähert man sich dem Thema Cyberrisiko anlass- oder eventbezogen, also wenn sich neue Schaden­szenarien wie die weltweite WannaCry-Attacke entwickeln. Häufig wird auch akteursgebunden beleuchtet, wer Angreifer oder Opfer sein kann. Dadurch begrenzt man sich bei dem Thema häufig zu sehr nur auf die Cyberkriminalität. Um dem Thema Cyberrisiko jedoch gerecht zu werden, müssen auch weitere Ursachen hinzugezogen werden.

Mit einer Kategorisierung kann das Thema ganzheitlich und nachvollziehbar strukturiert werden. Ebenso hilft eine solche Kategorisierung dabei, eine Abgrenzung vorzunehmen, für welche Gefahren Versicherungsschutz über eine etwaige Cyberversicherung besteht und für welche nicht.

Die Ursachen sind dabei die Risiken, während finanzielle bzw. nicht finanzielle Verluste die Wirkungen sind. Cyberrisiken werden demnach in zwei Hauptursachen eingeteilt. Auf der einen Seite sind die nicht kriminellen Ursachen und auf der anderen Seite die kriminellen Ursachen zu nennen. Beide Ursachen können dabei in drei Untergruppen unterteilt werden.

Nicht kriminelle Ursachen

Höhere Gewalt

Häufig hat man bei dem Thema Cyberrisiko nur die kriminellen Ursachen vor Augen. Aber auch höhere Gewalt kann zu einem empfindlichen Datenverlust führen oder zumindest die Verfügbarkeit von Daten einschränken, indem Rechenzentren durch Naturkatastrophen wie beispielsweise Überschwemmungen oder Erdbeben zerstört werden. Ebenso sind Stromausfälle denkbar.

Menschliches Versagen/Fehlverhalten

Als Cyberrisiken sind auch unbeabsichtigtes und menschliches Fehlverhalten denkbar. Hierunter könnte das versehentliche Veröffentlichen von sensiblen Informationen fallen. Möglich sind eine falsche Adressierung, Wahl einer falschen Faxnummer oder das Hochladen sensibler Daten auf einen öffentlichen Bereich der Homepage.

Technisches Versagen

Auch Hardwaredefekte können zu einem herben Datenverlust führen. Neben einem Überhitzen von Rechnern sind Kurzschlüsse in Systemtechnik oder sogenannte Headcrashes von Festplatten denkbare Szenarien.

Kriminelle Ursachen

Hackerangriffe

Hackerangriffe oder Cyberattacken sind in der Regel die Szenarien, die die Presse dominieren. Häufig wird von spektakulären Datendiebstählen auf große Firmen oder von weltweiten Angriffen mit sogenannten Kryptotrojanern berichtet. Opfer kann am Ende aber jeder werden. Ziele, Methoden und auch das Interesse sind vielfältig. Neben dem finanziellen Interesse können Hackerangriffe auch zur Spionage oder Sabotage eingesetzt werden. Mögliche Hackermethoden sind unter anderem: Social Engineering, Trojaner, DoS-Attacken oder Viren.

Physischer Angriff

Die Zielsetzung eines physischen Angriffs ist ähnlich dem eines Hacker­angriffs. Dabei wird nicht auf die Tools eines Hackerangriffs zurückgegriffen, sondern durch das physische Eindringen in Unternehmensgebäude das Ziel erreicht. Häufig sind es Mitarbeiter, die vertrauliche Informationen stehlen, da sie bereits den notwendigen Zugang zu den Daten besitzen.

Erpressung

Obwohl die Erpressung aufgrund der eingesetzten Methoden auch als Hacker­angriff gewertet werden könnte, ergibt eine Differenzierung Sinn. Erpressungsfälle durch Kryptotrojaner sind eines der häufigsten Schadenszenarien für kleinere und mittelständische Unternehmen. Außerdem sind auch Erpressungsfälle denkbar, bei denen sensible Daten gestohlen wurden und ein Lösegeld gefordert wird, damit sie nicht veröffentlicht oder weiterverkauft werden.

Ihre Cyberversicherung sollte zumindet folgende Schäden abdecken:

Cyber-Kosten:

  • Soforthilfe und Forensik-Kosten (Kosten der Ursachenermittlung, Benachrichtigungskosten und Callcenter-Leistung)
  • Krisenkommunikation / PR-Maßnahmen
  • Systemverbesserungen nach einer Cyber-Attacke
  • Aufwendungen vor Eintritt des Versicherungsfalls

Cyber-Drittschäden (Haftpflicht):

  • Befriedigung oder Abwehr von Ansprüchen Dritter
  • Rechtswidrige elektronische Kommunikation
  • Ansprüche der E-Payment-Serviceprovider
  • Vertragsstrafe wegen der Verletzung von Geheimhaltungspflichten und Datenschutzvereinbarungen
  • Vertragliche Schadenersatzansprüche
  • Vertragliche Haftpflicht bei Datenverarbeitung durch Dritte
  • Rechtsverteidigungskosten

Cyber-Eigenschäden:

  • Betriebsunterbrechung
  • Betriebsunterbrechung durch Ausfall von Dienstleister (optional)
  • Mehrkosten
  • Wiederherstellung von Daten (auch Entfernen der Schadsoftware)
  • Cyber-Diebstahl: elektronischer Zahlungsverkehr, fehlerhafter Versand von Waren, Telefon-Mehrkosten/erhöhte Nutzungsentgelte
  • Cyber-Erpressung
  • Entschädigung mit Strafcharakter/Bußgeld
  • Ersatz-IT-Hardware
  • Cyber-Betrug