Clinical Nurse Specialist in Adult Health Practice Test
A Clinical Nurse Specialist in Adult Health (ACNS) is a member of the nursing profession with graduate level expertise in taking care of seriously ill adult patients. All aspects of that care fall into the domain of the ACNS, from assessment to treatment to management of outcomes.
How Do You Become a Certified Clinical Nurse Specialist?
You’ll need to take a certification exam from a recognized certifying body. For the ACNS specialty, the most widely recognized credentialing body is the American Nurses Credentialing Center, a subsidiary of the American Nurses Association (ANA). They offer computer-based examinations at a number of locations around the United States. The fee for the exams varies depending on whether you are a member of the American Nurses Association or the National Association of Clinical Nurse Specialists. Certification will need to be renewed every five years. After successfully taking the examination, you will earn a credential as an ACNS-BC (Adult Clinical Nurse Specialist-Board Certified).
Who Is Eligible for the Certification Exam?
Not everyone is eligible to take the American Nurses Credentialing Center examination. You’ll need nursing credentials before applying for the exam. For instance, you’ll need to hold a current license as a registered nurse (RN) and that license must be legally recognized in the United States. You must also have a degree on the Master’s level or higher from an educational body accredited by either the National League for Nursing Accrediting Commission (NLNAC) or the Commission on the Collegiate of Nursing Education (CCNE). You must have 500 or more hours as a clinical nurse specialist supervised by faculty as part of your degree program and course work in the following subjects: advanced health assessment, advanced pathophysiology, and advanced pharmacology.
A Look at the Exam
The exam consists of 175 questions. Of these questions, 150 count toward the final score. (The remainder are questions being statistically tested for inclusion in future exams.) The questions are divided into six domains:
- Nursing Science (62 questions)
- Organization/Network/Health System (23 questions)
- Basic and Applied Science (16 questions)
- Research (11 questions)
- Professional Attitudes (21 questions)
- Clinical Nurse Specialist in Adult Health
- Clinical Nurse Specialist in Child/Adolescent Psychiatric & Mental Health
- Clinical Nurse Specialist in Gerontology
- Clinical Nurse Specialist in Pediatrics
- Clinical Nurse Specialist in Advanced Oncology (AOCNS)
CNS Practice Questions
1. What is an accepted and effective treatment for an elevated potassium level of 6.9 in an adult client?
A. Giving antidotal enemas
B. Holding potassium until the next dose
C. Holding potassium supplements for 24 hours
D. Initiating regular insulin and dextrose intravenous infusions
2. The clinical nurse specialist is caring for an elderly widow with chronic disease. What is the best way of assessing this client’s level of pain?
A. Reports from family members
B. A numeric pain scale
C. A written questionnaire
D. Observation of the client’s behavior
3. What symptom(s) should the clinical nurse specialist understand as typical for acute myocardial infarction in female clients?
A. Esophageal pain
B. Fatigue and inability to sleep, with or without chest discomfort
C. Left-sided classic chest pain
D. Absence of pain entirely
4. Which selection shows that the clinical nurse specialist understands evidence-based practice for an adult with CHF?
A. The clinical nurse specialist calls a cardiologist before assessing a client
B. The clinical nurse specialist never orders the same thing twice on heart patients
C. The clinical nurse specialist follows an evidence-based clinical pathway for CHF in adult clients
D. The clinical nurse specialist uses no guidelines to develop the plan of care
5. Which is NOT a model or principle of quality improvement?
A. Six Sigma
B. Failure mode and effects analysis (FMEA)
C. Serta Six
D. Root cause analysis
1. D: Giving glucose and insulin reverses symptoms of hyperkalemia until the cause can be diagnosed and treated.
2. B: A numeric pain scale rating pain from one (minimum pain) to ten (extreme pain) is the most accurate way to assess the level of pain the adult patient is experiencing.
3. B: Women often experience fatigue, an absence of pain, and an inability to sleep as symptoms associated with a myocardial infarction.
4. C: The clinical nurse specialist following a CHF clinical pathway is aware of evidence-based practice and appropriate standards of care.
5. C: Serta Six is a made-up term. The other choices offer resources to guide quality improvement by either offering guidelines or assessment tools.