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Exam Code: ACCNS-P
Exam Name: Clinical Nurse Specialist - Wellness through Acute Care (Pediatric)
Exam format: Computer-based, linear (fixed form)
Number of Questions: 175 multiple choice questions
Number of scored items: 150 scored questions (25 are unscored “pretest” items used for statistical data)
Time allotted: 3½ hours (3.5 hours)
Passing score / cut score: 94 correct out of the 150 scored items
Certification valid for: 5 years

- Cardiovascular
- Acute inflammatory disease (e.g., myocarditis,endocarditis, pericarditis, vasculitis,Kawasaki)
- Cardiac surgery
- Cardiac tamponade
- Cardiogenic shock
- Cardiomyopathies (e.g., hypertrophic, dilated,restrictive, idiopathic)
- Dysrhythmias
- Heart failure (acute and chronic)
- Hypertension
- Hypertensive urgencies or emergencies
- Pulmonary edema
- Structural heart defects and disease (acquiredand congenital)
- Vasculitis

- Respiratory
- Acute lung injury (ALI), acute respiratorydistress syndrome (ARDS)
- Acute pulmonary embolus
- Acute respiratory failure
- Air-leak syndromes (e.g., pneumothorax,pulmonary interstitial emphysema,pneumopericardium, pneumomediastinum)
- Airway obstruction
- Aspiration
- Asthma/reactive airway disease
- Chronic lung disease (e.g., bronchopulmonarydysplasia, exacerbation, interstitialpulmonary fibrosis)
- Congenital and acquired anomalies
- Cystic fibrosis
- Exacerbation of chronic lung disease
- Inhalation injuries
- Obstructive sleep apnea
- Pleural effusion
- Pulmonary hemorrhage
- Pulmonary hypertension
- Pulmonary infections
- Thoracic and pulmonary trauma and injuries
- Thoracic surgery (e.g., lung reduction surgery,pneumonectomy, lobectomy, trachealsurgery)

Endocrine/Hematology/Gastrointestinal/Renal/Integumentary

- Endocrine
- Adrenal insufficiency
- Diabetes mellitus
- Diabetic ketoacidosis (DKA) andhyperglycemic hyperosmolar state (HHS)
- Hyperglycemia
- Hypoglycemia
- Inborn errors of metabolism
- Pituitary disorders
- Syndrome of inappropriate antidiuretichormone secretion
- Thyroid disorders

- Hematology/Immunology/Oncology
- Anemia
- Anticoagulation
- Autoimmune diseases
- Bleeding disorders
- Blood and blood-product transfusion
- Coagulopathies
- Congenital and acquired immunosuppression
- Hematologic and solid tumors
- Hyperbilirubinemia
- Myelosuppression (i.e., neutropenia,thrombocytopenia)
- Organ and tissue transplantation andassociated problems
- Sickle cell disease
- Venous thromboembolism

- Gastrointestinal
- Abdominal trauma
- Bowel infarction/obstruction/perforation
- Gastroesophageal reflux
- GI infectious disorders
- GI abnormalities (congenital and acquired)
- GI hemorrhage
- GI motility disorders (congenital and acquired)
- GI surgeries
- Inflammatory bowel disease
- Liver disease (e.g., hepatitis, hepatic failure)
- Malnutrition
- Nausea/vomiting
- Pancreatitis

- Renal/Genitourinary
- Acute kidney injury
- Chronic kidney disease (CKD)
- Renal/genitourinary abnormalities (congenitaland acquired)
- Nephrotoxic medication-associated kidneyinjury (NAKI)
- Electrolyte imbalances
- Fluid volume imbalances
- Incontinence
- Infections (e.g., UTI, PID, STIs)
- Renal trauma

- Integumentary
- Dermatologic disorders (e.g., incontinenceassociated dermatitis, impetigo, coxsackie,atopic dermatitis)
- Exfoliative skin disorders (e.g., StevensJohnson, TEN, epidermolysis bullosa)
- Infectious skin disorders
- IV infiltration and extravasation
- Pressure injuries
- Wounds

Musculoskeletal/Neurology/Psychosocial

- Musculoskeletal
- Congenital anomalies
- Functional issues (e.g., immobility, debility,falls, gait disorders, myopathies)
- Infections (e.g., necrotizing fasciitis,osteomyelitis)
- Rhabdomyolysis
- Spinal disease (e.g., scoliosis, kyphosis, discdisease)
- Sports injuries
- Fractures

- Neurology
- Brain death
- Cerebral salt wasting
- Congenital neurological abnormalities
- Encephalopathy
- Head and brain trauma/injury
- Hydrocephalus
- Intracerebral hemorrhage
- Intracranial hypertension
- Migraine headaches
- Neurologic infectious diseases
- Neuromuscular disorders
- Seizure disorders
- Space-occupying lesions
- Spinal cord injury
- Stroke
- Vascular malformation

- Psychosocial/Behavioral/Cognitive Health Issues
- Aggression
- Agitation
- Anxiety disorders (e.g., PTSD, OCD, fears,phobias)
- Attention-deficit/hyperactivity disorder
- Autism spectrum disorders
- Delirium
- Developmental delays and regression
- Eating disorders
- Learning disabilities and disorders
- Maltreatment (e.g., abuse and neglect)
- Medical nonadherence
- Mood disorders (e.g., depression)
- Personality disorders (e.g., antisocialbehaviors, schizophrenia)
- Post ICU syndrome
- Self-harm
- Sleep disorders
- Substance-use disorder
- Suicidal behavior

Multisystem

- Factors Influencing Health Status (risk exam, prevention and wellness)
- Advanced care planning
- Care transition
- Caregiver burden
- Developmental care
- Genetic counseling
- Growth and development (e.g., anticipatoryguidance, milestones)
- Immunizations/vaccinations
- Injury prevention (e.g., shaken baby, helmets,car seats, environmental modification, gunsafety)
- Behavioral health screenings
- Nutrition and weight management
- Pain prevention and management(e.g., needle stick, chronic pain syndromes)
- Physical health screenings
- Risk-taking behaviors (e.g., unprotected sex,substance use)
- Safe sleep
- Vulnerable population screenings(e.g., child abuse, intimate partner violence,human trafficking, bullying)
- Social determinants of health (e.g., access tocare, socioeconomic factors, health literacy)
- Population health
- Team-based care
- Gender-affirming care
- Patient and family-centered care
- Interventions for health promotion
- Transition to adult care
- Health policy
- Dyslipidemia (early-onset screening)

- Multisystem
- Acid-base imbalances
- Burns
- Neonatal opioid withdrawal syndrome
- Compartment syndrome
- Distributive shock (e.g., anaphylaxis,neurogenic)
- End-of-life issues
- Failure to thrive
- Hospital-acquired conditions (e.g., CAUTI,CLABSI, VAP, falls)
- Hypovolemic shock
- Hypoxic ischemic encephalopathy
- Infectious diseases (e.g., perinatal, viral,bacterial)
- Morbid obesity
- Multisystem trauma
- Near-drowning
- Pain
- Palliative care issues
- Patient safety issues
- Post-resuscitation care
- Sensory impairment (e.g., hearing, visual,speech, tactile)
- Sepsis/septic shock and MODS
- Toxic exposure (acute and chronic)
- Toxic ingestions and inhalations