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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