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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RNC LRN : Low Risk Neonatal Nursing (LRN) test MCQs and Practice Test

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Exam Number : RNC-LRN
Exam Name : Low Risk Neonatal Nursing (LRN)
Vendor Name : NCC
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RNC-LRN test Format | RNC-LRN Course Contents | RNC-LRN Course Outline | RNC-LRN test Syllabus | RNC-LRN test Objectives

Certification: Low Risk Neonatal Nursing (RNC-LRN)
Issuing Organization: National Certification Corporation (NCC)
Eligibility: Requires an active RN license and latest experience in low-risk neonatal nursing
Exam Format: Computer-based, multiple-choice questions
Exam Length: 3 hours (180 minutes)
Number of Questions: 175 (150 scored + 25 pretest/un-scored)
Passing Score: Determined by a criterion-referenced standard (exact percentage not disclosed)

- Maternal risk factors and birth history
- Fetal Anatomy and Physiology
- Fetal Assessment
- GBS screening
- Nonstress testing
- Biophysical profile
- Antepartal screening
- Cord gases
- Maternal age
- Medical Conditions
-Maternal age
-Diabetes
-Blood disorders
-Infectious diseases
- CMV
- Toxoplasmosis
- syphilis
- herpes
- hepatitis HIV
- gonorrhea
- Chlamydia
- GB
-Maternal depression

- Pregnancy Related
-Hypertensive Disorders
- Eclampsia
- HELLP syndrome
- Amniotic fluid disorders (Amniotic bands, Polyhydramnios, Oligohydramnios)
- Maternal hemorrhage
- Placental abruption
- Placenta previa
- Multiple gestations
- Chorioamnionitis
- Cord Accidents

- Maternal medications during labor and delivery (tocolytics, analgesia, anesthesia)
- Complications of Labor
- Abnormal labor patterns
- Abnormal fetal heart rate patterns (altered variability, decelerations [early, late, variable]; tachycardia, bradycardia (category I, II and III fetal heart rate tracings)
- Operative/instrument assisted birth
- Preterm/postterm
- Meconium
- Breech and other malpresentation
- Life-style and Environmental Conditions
- Substance use
- Teratogen exposure
- Medication use

- Physical and gestational age test Gestational Age
- Physical Characteristics, Etiologies and/or Risks and Complications of
- Preterm
- Term
- Post-term
- Late preterm
- AGA
- SGA
- LGA
- Intrauterine growth restriction
- Symmetrical
- Asymmetrical

- Physical Assessment
- Cardiac examination findings
- Heart rate, rhythms and sounds
- Point of maximal intensity
- Blood pressure
- Peripheral pulses
- Perfusion
- Color
- Respiratory Physical Assessment
- Respiratory rate and breath sounds
- Respiratory patterns
- Thorax and Chest
- Abdominal examination findings
- Stooling patterns
- Neonatal skin exam
- Characteristics of normal neonatal skin
- Musculoskeletal exam
- Neurological exam

- Reflexes
- Moro
- Rooting and sucking
- Palmar grasp
- Plantar grasp
- Stepping
- Babinski
- Tonic neck
- Gag
- Anal wink reflex
- Tone
- Techniques
- Pull to sit
- Truncal tone exam

- Head, ear, eyes, nose, mouth exam
- Fontanelles and cranial sutures
- Neck appearance
- Ear appearance, shape and placement
- Hearing
- Nasal patency
- Symmetry of the mouth
- Evaluation of pigmentation and movement
- Evaluation of cornea/sclera
- Eye prophylaxis
- Complications/Variations
- Skull/neck variations & abnormalities
- Molding
- Cephalhematoma
- Caput succedaneum
- Craniosynostosis
- Craniotabes
- Cystic hygroma
- Pierre Robin
- Variations & abnormalities
- Conjunctivitis
- Cleft lip and palate
- Epsteins pearls
- Natal teeth
- Choanal atresia
- Retinopathy of prematurity
- Tracheomalacia
- Micronathia

- Laboratory and Diagnostic Data
- Blood
- Glucose
- Complete blood count with differential
- Cultures
- Rh (Coombs)
- Blood gases
- Bilirubin
- Electrolytes
- Newborn screening

- Cardiovascular
- Basic physiology and anatomy
- Adaptation to extrauterine life
- Complications/Variations
- Pulmonary vascular resistance
- Abnormal rhythms
- Congenital heart disease
- Patent ductus arteriosus
- Coarctation of the aorta
- Septal defects
- Tetralogy of Fallot
- Transposition of the great vessels
- Congestive heart failure
- Hypertension/Hypotension
- Shock

- Respiratory
- Basic physiology and anatomy
- Adaptation to extrauterine life
- Complications/Variations
- Air leaks
- Apnea of prematurity
- Chronic lung disease
- Pneumothorax
- Pneumomediastinum
- Pneumonia
- Respiratory distress syndrome
- Transient tachypnea of the newborn
- Persistent pulmonary hypertension
- Meconium aspiration syndrome
- Diaphragmatic hernia

- Gastrointestinal and Genitourinary
- Basic physiology and anatomy
- Complications/Variations
- Diastasis of recti muscles
- Duodenal atresia
- Bowel obstruction
- Esophageal atresia/tracheoesophageal fistula
- Imperforate anus
- Omphalocele/gastroschisis
- Umbilical hernia
- Meconium ileus/plug
- GE reflux
- Necrotizing enterocolitis
- Short gut syndrome
- Malrotation/Volvulus
- Renal function/urinary output
- Complications
- Hypospadias
- Undescended testes
- Testicular abnormalities
- Hydrocele
- Inguinal hernia
- Vaginal discharge/abnormalities
- Renal abnormalities
- Circumcision
- Postoperative care

- Musculoskeletal and Integumentary
- Musculoskeletal Complications
- Congenital hip dysplasia
- Metatarsus adductus
- Polydactyly and syndactyly
- Torticollis
- Talipes equinovarus
- Fracture
- Physiologic basis for general skin care
- Variations
- Erythema toxicum
- Milia
- hyperpigmented skin lesions
- Hemangiomas/birth marks
- Petechiae
- Cafe au lait spots
- Other skin lesions, e.g. pustules, vesicles
- Umbilical cord
- Fat necrosis
- Diaper Dermatitis

- Neurological
- Basic physiology
- Motor function
- Complications/Variations
- Seizures
- Jitteriness
- Intracranial hemorrhage (subdural)
- Intraventricular hemorrhages
- Periventricular leukomalacia
- Hydrocephalus
- Neuromuscular birth Injuries
- Brachial plexus injuries
- Facial nerve injuries
- Neural tube defects
- Therapeutic hypothermia

- Hematology and hyperbilirubinemia
- Basic physiology
- Interpret lab values (CBC; hematocrit, hemoglobin, retic, platelets, total and direct serum bilirubin, direct and indirect antibody tests)
- Complications
- Anemia (Physiologic and non-physiologic)
- Bleeding disorders
- ABO/Rh incompatibility
- Polycythemia/hyperviscosity
- Sickle Cell
- Administration of blood and blood products
- Hyperbilirubinemia
- Basic physiology
- Complications
- Jaundice
- Physiologic jaundice
- Pathologic jaundice
- Breast feeding and jaundice
- Kernicterus
- Phototherapy
- G6PD

- Genetic, Metabolic and Endocrine Genetic Disorders
- Patterns of Inheritance
- Autosomal recessive, autosomal dominant, sex linked
- Complications
- Common chromosomal abnormalities (trisomy 21, 18 & 13)
- Birth defects/congenital anomalies
- Skeletal dysplasia
- Cystic Fibrosis
- DiGeorge (22q11.2 deletion syndrome)
- Turners
- Endocrine/Metabolic
- Interpreting lab values (Calcium, phosphorus, magnesium, glucose)
- Metabolic Disorders (PKU, Thyroid, CAH, Galactosemia)
- Complications
- Hypoglycemia
- Hypocalcemia
- Rickets/metabolic bone disease
- Infant of a diabetic mother

- Resuscitation and Stabilization
- General test of status and need for resuscitation
- Management of resuscitation
- Airway
- Breathing
- Circulation
- Drug Therapy
- Evaluation of effectiveness of interventions
- Apgar scores
- CHD Screening

- Nutrition and Feeding
- Growth patterns (Growth curves)
- Fluid/Calorie requirements
- CHO, Fats, Proteins
- Lactation
- Anatomy and physiology of lactation
- Composition of breast milk
- Maternal nutritional needs
- Normal breastfeeding process
- Positioning
- Latch On
- Suck/swallow/sequence
- Timing (frequency and duration)
- Feeding cues
- Contraindications to breastfeeding
- Maternal Complications
- Latch on problems
- Nipple problems
- Breast engorgement
- Insufficient milk supply
- Medication effects
- Therapeutic medications
- Infection/Mastitis
- Maternal illness
- Perinatal substance abuse (TCN)
- Maternal/newborn separation
- Breast reduction/augmentation
- Newborn complications
- Drug screening
- Multiple births
- Prematurity
- Patient Education
- Breast/nipple care
- Use of supplementary/ complementary feedings
- Use of breastfeeding devices
- Expressing and storing breast milk
- Colostrum
- Complications/Contraindications
- Donor milk
- Formula feeding
- Composition of formula
- Techniques
- Special needs (e.g. cleft palate, PKU)
- Dietary Supplements (Iron, MCT, Vitamins, probiotics, Fortifiers)
- Feeding techniques
- Tube feedings
- Feeding cues
- Special Nutritional considerations
- Chronic Lung Disease (CLD)
- Prematurity
- Short Gut syndrome

- Pharmacology, Pharmacokinetics and Pharmacodynamics
- Principles of administration
- Dosage
- Route
- 5 rights of medication administration
- Blood drug levels (toxic vs therapeutic)
- Pharmacokinetics
- Common drugs used in neonates
- Vitamin K
- Antibiotics
- Antibiotics
- Anticonvulsants
- Antimicrobials
- Antiretroviral
- Immunologic agents
- Bronchodilators
- CNS stimulants (Caffeine, etc)
- Diuretics
- Drugs for NAS
- Eye prophylaxis
- Vaccines
- Pain Assessment and Management
- Signs and symptoms
- Nonpharmacological interventions
- Pharmacological interventions

- Fluid, Electrolytes and Glucose Homeostasis
- Normal fluid and electrolyte requirements
- Monitoring fluid and electrolyte status
- electrolytes
- urine output
- Parenteral nutrition (indication, composition, complications)
- Lipids
- Metabolic panel
- PICC lines or midlines
- Umbilical lines
- Hypoglycemia

- Oxygenation, non-invasive ventilation and Acid-base balance
- Oxygenation: interpretation and management
- Hypoxia/hypoxemia
- Oxygen saturation (SaO2)
- Methods of oxygenation/ventilation
- non-invasive ventilation (high flow NC, CPAP, Nasal cannula, hood)
- Blood gas: interpretation and management
- Metabolic acidosis/alkalosis
- Respiratory acidosis/alkalosis
- Mixed

- Neurodevelopmental Care
- Neurobehavioral development
- habituation
- motor organization
- sensory/interaction capabilities
- state/sleep cycles
- Environmental impact on development
- Interventions (Reducing noise, light level, diurnal patterns, handling, positioning, kangaroo care/skin to skin)
- Nonnutritive sucking
- Complications of Substance Exposure in Utero
- Alcohol
- Heroin
- Methadone
- Cocaine
- Nicotine
- Subutex
- Cannabis (marijuana)
- Prescription drug abuse
- Neonatal Abstinence Syndrome (NAS)
- Methadone
- Cocaine
- Nicotine
- Subutex
- Cannabis (marijuana)
- Prescription drug abuse

- Infection and Immunology Immune System
- Basic physiology
- Interpret laboratory values
- WBC and differential
- CRP
- Antibody function
- IgA
- IgG
- IgM
- Infection Control
- Handwashing
- Visitation
- Standards precautions
- Complications/Variations
- Neonatal sepsis
- Septic shock
- Viral and fungal infections
- AIDS/HIV
- Cytomegalovirus
- Rubella
- Hepatitis B
- Varicella
- Toxoplasmosis
- Herpes
- Human papilloma virus
- Enterovirus
- Bacterial infections
- Group B streptococcus
- Staphylococcus
- E. coli
- Sexually Transmitted infections
- Gonorrhea
- Chlamydia
- Syphilis
- Early and late onset infections

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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