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ACCNS-P exam Format | ACCNS-P Course Contents | ACCNS-P Course Outline | ACCNS-P exam Syllabus | ACCNS-P exam Objectives

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

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