Clinical Nurse Specialist in Adult Health


A Clinical Nurse Specialist in Adult Health (ACNS) is an advanced nursing practitioner who participates in the advanced care of seriously ill, adult patients. This profession is involved with all aspects of adult care, from assessment to treatment and management of outcomes.

Credentialing Organization

American Nurses Credentialing Center. You will be required to take a computer-based examination, the fee for which will depend on whether you are a member of the American Nurses Association or the National Association of Clinical Nurse Specialists. Upon passing the examination, you will be given the following credential: ACNS-BC (Adult Clinical Nurse Specialist-Board Certified). You'll need to renew your certification after five years. Please apply to the American Nurses Credentialing Center at least three months before your current certificate expires.


Before being certified as a Clinical Nurse Specialist in Adult Health, you'll need:

  • Hold a current license as a registered nurse (RN). This license should either be issued by an official body in the United States or by a legally recognized licensing body elsewhere.
  • Have a degree on at least the Master's level from an educational body accredited by one of these two bodies: the National League for Nursing Accrediting Commission (NLNAC) or the Commission on the Collegiate of Nursing Education (CCNE).
  • 500 or more hours as a clinical nurse specialist supervised by faculty as part of your degree program.
  • Course work in the following subjects:
    • advanced health assessment
    • advanced pathophysiology
    • advanced pharmacology

About the Certification Exam

The exam consists of 175 questions divided into six domains: Nursing Science (62 questions 41.3 percent of the test), Organization/Network/HealthSystem (23 questions or 15.3 percent of the test), Basic and Applied Science (16 questions or 10.7 percent of the test), Research (11 questions or 7.3 percent of the test), Education (17 questions or 11.3 percent of the test), and Professional Attitudes (21 questions or 14 percent of the test). Of these questions, 150 count toward the final score. (The remainder are questions being statistically tested for inclusion in future exams.)

CNS Certification Options

Free CNS Adult Practice Test Questions

1. An 85-year-old female is admitted to the nursing unit. She has a huge hematoma around her left orbit, bruises on her left shoulder, and a history of hypertension. She says she fell asleep while sitting on the side of the bathtub. What will the clinical nurse specialist instruct the nursing staff to watch for in the next 24 hours?

  1. Changes in neurological status of the client
  2. Increases in bruising
  3. A proper-fitting slipper or shoe
  4. A possible fall risk

2. A 39-year-old pregnant client presents to the clinic at 30 weeks gestation with 2+ edema, the worst headache of her life, and a blood pressure of 198/102. Which action will the clinical nurse specialist anticipate?

  1. To discuss diet restrictions with the client
  2. To discuss fluid restrictions with the client
  3. To arrange for admission to the labor and delivery unit to monitor mother and fetus
  4. No action is needed as this is normal for this stage of gestation in pregnancy

3. An outside company has been hired to help with the reorganization of a healthcare facility. What would the clinical nurse specialist understand to be the reason behind such a corporate decision?

  1. It will promote financial security within the facility
  2. It is a political move unrelated to patient care
  3. It will allow for analysis of the facility for a buyout
  4. It will provide an independent objective analysis to improve performance

4. A clinical nurse specialist has a longtime rapport with a client who has been moved to another state by his children. He calls the unit to discuss his symptoms and treatment options. Which statement describes the concerns for the clinical nurse specialist before he/she answers the client's questions?

  1. When did the client last take medications?
  2. Is the client taking narcotic medications?
  3. What legal implications does speaking with a client across state lines have on the clinical nurse specialist?
  4. What confidentiality questions arise with phone communications?

5. Which education theory would be demonstrated by being mentored by a peer?

  1. Social cognitive theory
  2. Visual learning adult theory
  3. Visual imaging adult theory
  4. Social guided theory


  1. A: Bruises to the orbit, face, and shoulder and increased blood pressure can indicate a risk for TIA, stroke, or post-epidural bleeding. Frequent assessments for changes in neurological status must be thorough and complete. The other choices may be included in patient care of an elderly client but do not pose an immediate or life-threatening risk.
  2. C: Admission to a labor and delivery unit to monitor and treat preeclampsia would be the standard of care for a pregnant client with those symptoms. Medications, fetal monitoring, and bedrest are most often prescribed as well as monitoring for seizure activity.
  3. D: An outside company is often hired to do an objective analysis to improve performance, increase financial reimbursements as related to process, and to offer an objective report on how a facility functions and can improve.
  4. C: The clinical nurse specialist must be concerned with the scope of practice across state lines.
  5. A: When peers mentor peers it is an example of social cognitive theory and is an effective way to educate adults.

CNS Adult Health Exam Fall Prevention Training:

CNS Test Secrets

CNS Adult Health test blueprint and breakdown


Last Updated: 07/05/2018

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