How to pass the CNSC Exam.

A year and a half into becoming a clinical dietitian, the thrill of not having any school or homework wore off and I decided that I once again wanted to progress my career in some way. I feel like I am always searching for some way to push myself or gain more knowledge, which is sometimes a good thing but sometimes also exhausting. I decided that I was going to take the Certified Nutrition Support Clinician Exam (CNSC) which would not also make me more credible as a clinical dietitian but it would also make me more “attractive” if I wanted to find another job.

Now why would I decide to do this and what does it mean to be a CNSC? I stole this definition off of – ASPEN CNSC (go here for information on how to register/sign up)

Why Certify?

NBNSC certification provides an avenue to demonstrate that you have attained the skills and knowledge necessary to provide quality nutrition support care. We have determined the body of knowledge needed to have an understanding of nutrition support and developed a fair and valid means to test care providers including physicians, dietitians, pharmacists, physician assistants, and nurses.

Certified professionals are recognized as quality providers of nutrition support by the public, their colleagues, other members of the healthcare team, and administrators. The Certified Nutrition Support Clinician ® (CNSC®) certification can provide job mobility, open up job opportunities, and, in some cases, lead to promotion and monetary gain.

Objectives of Certification

To promote enhanced delivery of safe and effective care through the certification of qualified clinicians in nutrition support by:

  • Recognizing formally those individuals who meet eligibility requirements of the National Board of Nutrition Support Certification, Inc. and pass the certification examination for nutrition support clinicians.
  • Encouraging continued professional growth in the practice of nutrition support.
  • Establishing and measuring the level of knowledge required for certification by a nutrition support clinician.
  • Providing a standard of minimum knowledge deemed appropriate for clinicians practicing nutrition support; thereby assisting the public, healthcare professionals, and employers in the assessment of nutrition support clinicians.

So you want to know how I passed?

  • 6 months of studying, the first two months I studied pretty extensively and continuously. The last two months I was so over studying and barely even reviewed before the exam (probably wouldn’t recommend that method).
  • Study materiel:  The A.S.P.E.N Adult Nutrition Support Core Curriculum (2nd Edition), A.S.P.E.N Self Assessment Study Questions, and The A.S.P.E.N Pediatric Nutrition Support Core Curriculum.


Examples of ASPEN/CNSC questions and topics to study!

1. anemia types (what causes microcytic anemia?

2. What foods contain gluten and what foods are gluten free (multiple choice questions)

3.  TPN and chemo interactions (contraindications?)

4. Ethical questions about what to do in certain situations (power of attorney/what is a health care proxy/what does autonomy and beneficence mean. etc).

5. What medications cause hypokalemia/hyperkalemia

6. When are certain feeding tubes indicated or contraindicated (PEG, NG, NJ)

7. Multiple TPN calculation questions.

8. Pediatric questions  about fluid needs (know how to calculate fluid needs based on the Holiday Seger Method)

10. Adult fluid calculation questions.

11. Nitrogen balance equation

12. What to do in cases of hypokalemia and hyperkalemia?

13. Lots of questions that gave a case study on a pt and you had to choose what was the appropriate feeding regimen (oral/tubefeeding/TPN)

14. Need to know the different types of TPN access devices and when to use them (long-term/short term, etc.)

15. Types of TPN infection depending on the pt sign’s and symptoms and what to do first when evaluating for infection (obtain blood culture, get labs drawn, etc.)

16.When do you need to replace TPN access device?

17. Hang time of TPN.

18. Hang time of EN

21. What is pinch off syndrome?

23. What increases calcium-phosphate solubility (PH, temp)

24.What does medicare cover (goes into specific types of medicare, like what does medicare part B cover and what does medicare part A care?)

25. What lab tests need to be regularly checked in TPN patients? (how often do you need to check labs, how often do you need to check Iron levels, how often do you need to check triglycerides)

26.    What is an appropriate triglyceride level with TPN (when do you d/c lipids, when do you add lipids)

27. What lab do you use to assess for EFAD, what lab would signify EFAD, what are signs of EFAD?

28. Signs/symptoms of nutrient deficiency’s/toxicity’s?

I hope these topics give you a better idea of how you need to study for the exam, take the full four hours and try to troubleshoot all the questions and go with your gut feeling. I went through the test twice and re-read all the questions just to ensure that I was answering them correctly. Good luck and I hope this helps you too become a Certified Nutrition Support Clinician.


2 thoughts on “How to pass the CNSC Exam.

  1. Hi, great blog. I was wondering if you could help me. I really wanted to get my certification in nutrition support but I no longer work in that arena. I really love tube feedings and worked at a hospital and nursing home but now I work at a clinic. Should I still do it?

    1. Hmmm, good question. I think that if you would benefit from it, like if your clinic would increase your pay rate or aid you in helping pay for the test material and/or the test then I would definitely do it. It makes you much more competitive when you are applying for jobs if you are looking for a switch in the future. I probably wouldn’t do it unless your current job gave you benefits or aided you in paying though, mine didn’t and I didn’t get a pay raise or anything. I know it will help me in the long run but I also know a lot of RD’s whose company paid for everything regarding the test and the material, if you could hold out for something like that it would be perfect. Let me know if you have any other questions!


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