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Exam Code: ACCNS-AG
Exam Name: Acute Care Clinical Nurse Specialist - Adult Gerontology
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 coronary syndrome
- Acute inflammatory disease (e.g., myocarditis,endocarditis, pericarditis)
- Cardiac surgery
- On-pump
- Off-pump
- Valve procedures
- Hybrid procedures
- Revascularization procedures
- Cardiac tamponade
- Cardiac trauma (blunt and penetrative)
- Cardiogenic shock
- Cardiomyopathies (e.g., hypertrophic, dilated,restrictive, idiopathic)
- Coronary artery disease
- 9Dyslipidemia
- Dysrhythmias
- Heart failure
- Acute
- Chronic
- Advanced
- Hypertension
- Hypertensive urgencies or emergencies
- Peripheral vascular insufficiency (e.g., acutearterial occlusion, carotid artery stenosis,endarterectomy, peripheral stents andFem-Pop bypass)
- Pulmonary edema
- Ruptured or dissecting aneurysm
- Structural heart defects and disease (acquiredand congenital)
- Mechanical circulatory support
- IABP
- VA ECMO
- VV ECMO
- Impella
- LVAD
Respiratory
- Acute pulmonary embolus
- Acute respiratory distress syndrome (ARDS)
- Acute respiratory failure
- Air-leak syndromes (e.g., pneumothorax,pulmonary interstitial emphysema,pneumopericardium, pneumomediastinum)
- Airway obstruction (e.g., angioedema, mucusplug, air space-occupying lesions)
- Aspiration
- Asthma/reactive airway disease
- Chronic lung disease (e.g., COPD exacerbation,interstitial pulmonary fibrosis, cystic fibrosis)
- Chronic respiratory failure (e.g., ventilatordependency)
- Obstructive sleep apnea
- Pulmonary hemorrhage
- Pulmonary arterial hypertension
- Pulmonary infections (e.g., pneumonia,tuberculosis)
- Thoracic surgery (e.g., lung reduction,pneumonectomy, lobectomy, tracheal, lungtransplant)
- Thoracic and pulmonary trauma andinjuries (e.g., lung contusions, fractured ribs,hemothorax)
- Restrictive lung disease (e.g., obesityhypoventilation, tumor metastasis, pulmonaryfibrosis)
- Pleural effusion
Endocrine/Hematology/Gastrointestinal/Renal/Integumentary
- Endocrine
- Adrenal disorders
- Diabetes mellitus
- Diabetic ketoacidosis (DKA) and hyperglycemichyperosmolar state (HHS)
- Hyperglycemia
- Hypoglycemia
- 6Pituitary disorders
- Syndrome of inappropriate secretion of antidiuretic hormone (SIADH)
- Diabetes insipidus (DI)
- Thyroid disorders
- Hematology/Immunology/Oncology
- AIDS and HIV
- Anemias (e.g., microcytic, macrocytic)
- Autoimmune diseases
- Coagulopathies (e.g., VTE, DIC,hypercoagulable states)
- Congenital and acquired immunosuppression
- HELLP syndrome
- Myelosuppression (e.g., neutropenia, anemia,thrombocytopenia)
- Sickle cell disease
- Gastrointestinal
- Abdominal trauma
- GI hemorrhage
- Bowel infarction/obstruction/perforation
- Gastroesophageal reflux
- Gastrointestinal infectious disorders
- GI motility disorders (e.g., constipation,diarrhea, ileus, gastroparesis)
- GI surgeries
- Hepatorenal syndrome
- Liver disease (e.g., hepatitis, hepatic failure)
- Malnutrition
- Nausea/vomiting
- Pancreatitis
- Peptic ulcer disease
- Renal/Genitourinary
- Acute kidney injury (AKI)
- Chronic kidney disease (CKD)
- Contrast-induced nephropathy
- Electrolyte imbalances
- Fluid volume imbalances
- Incontinence
- Infections (e.g., UTI, PID, STIs)
- GU Trauma
- Integumentary
- Exfoliative skin disorders (e.g., StevensJohnson syndrome)
- Extravasation
- Pressure injuries
- Wounds (surgical and nonsurgical)
Musculoskeletal/Neurology/Psychosocial
- Musculoskeletal
- Mobility disorders (e.g., immobility, debilitysecondary to acute, chronic or critical illness)
- Infections (e.g., necrotizing fasciitis,osteomyelitis)
- Neuromuscular dysfunction related to illness
- Osteoarthritis
- Spinal disease (e.g., scoliosis, kyphosis, discdisease)
- Musculoskeletal trauma
- Neurology
- Brain death
- Cerebral salt wasting
- Encephalopathy
- Head and brain trauma/injury
- Hydrocephalus
- Intracranial hypertension
- Intracerebral hemorrhage
- Neurologic infectious diseases
- 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)
- Capacity for decision-making
- Delirium
- Dementia
- Maltreatment
- Medical nonadherence
- Mood disorders (e.g., depression)
- Personality disorders (e.g., anti-socialbehaviors, schizophrenia)
- Post-ICU syndrome
- Substance use disorder
- Suicidal behavior
Factors Influencing Health Status (risk exam, prevention and wellness)
- Advance care planning
- Cancer prevention (e.g., tobacco cessation,sunscreen)
- Caregiver burden
- Life stage transitions
- Immunizations
- Mental health screenings (e.g., depression,suicidal ideation, eating disorders)
- Nutrition and weight management
- Pain prevention and management
- Prudent heart living
- Risk-taking behaviors (e.g., substance use,unprotected sex)
- Secondary prevention (e.g., cardiac rehab,pulmonary rehab)
- Sleep hygiene
- Vulnerable population screens(e.g., intimate partner violence, human trafficking)
- Social determinants of health (e.g., access to care, socioeconomic factors, health literacy)
- Population health
- Team-based care
Multisystem
- Acid-base imbalances
- Bariatric care issues
- Burns
- Compartment syndrome
- Distributive shock (e.g., anaphylaxis,neurogenic)
- End-of-life issues
- Failure to thrive
- Hospital-acquired conditions (e.g., CAUTI,CLABSI, falls, pressure injuries)
- Hypovolemic shock
- Hypoxic ischemic encephalopathy
- Infectious diseases (e.g., viral, bacterial)
- Methemoglobinemia
- Multisystem trauma
- Nonfatal drowning
- Pain
- Palliative care issues
- Rhabdomyolysis
- Sensory impairment (e.g., hearing loss)
- Sepsis/septic shock and MODS
- Toxic exposures, ingestions and inhalations(e.g., overdose, carbon monoxide, lead,asbestos)
- Transgender care issues
- Withdrawal (e.g., alcohol, opioids,benzodiazepines)
- Antimicrobial stewardship