Certified Continence Care Nurse (CCCN) Exam Review
The Certified Continence Care Nurse is for the RN with a Bachelor Degree who has completed certification by the Wound, Ostomy, and Continence Nursing Certification Board and, additionally, successfully passed the exam enabling them to use the title of Certified Continence Care Nurse. The specialized certification provides the extra training necessary to adequately care for and treat patients who have issues with continence along with the physical, psychological, and potential safety concerns associated with this.
In order to sit for the CCCN exam, the applicant must be an RN with a Bachelor Degree and has either completed an accredited education program or qualifies via the Experiential Pathway. An application to sit for the CCCN exam must be submitted by the published application deadlines. The cost to take the Certified Continence Care Nurse exam is $300. The exam contains 90 questions and it is must be completed in 90 minutes. It is offered at testing centers throughout the United States and test takers are advised if they passed or not once the exam is completed.
The exam questions focus on testing the Nurse's knowledge of care of the patient with continence issues. These can address the physiological processes involved with elimination, along with the psychosocial and behavioral needs of the patient.
Certification as a Continence Care Nurse is valid for 5 years. At that time, the Nurse can retake the exam to recertify, or requirements for the Professional Growth Program are met to qualify for recertification. This program utilizes a mixture of direct patient care and continuing education activities to meet specific requirements necessary to maintain certification.
Certified Continence Care Nurse (CCCN) Practice Questions
1. A woman with a coccygeal ulcer has occasional urinary incontinence but has no urinary infection. Which should be the INITIAL step in controlling her incontinence?
- Limited fluid intake
- Insertion of Foley catheter
- Anticholinergic medication (such as oxybutynin)
- Scheduled urination
2. Which is the BEST solution for chemical trauma in the perianal and genital area from incontinence of urine and feces in an 87-year-old patient?
- Apply moisture barrier paste
- Apply solid moisture barrier
- Apply skin barrier powder
- Leave skin open to the air
3. Which of the following occurs during phase I (filling/storing) of the urination process?
- Spinal nerves contract the detrusor muscles
- Spinal nerves relax internal sphincter muscles
- Neurotransmitters signal the detrusor muscles to relax
- External sphincter muscles relax
4. Which test measures the pressure of the anal sphincter muscles, degree of rectal sensation, and neural reflexes?
- Anal wink
- Bulbocavernosus reflex
- Endoanal ultrasound
- Anal manometry
5. Overuse of phosphate enemas to control constipation puts a person at risk for
- Hypermagnesemia and hypocalcemia
- Hypomagnesemia and hypercalcemia
- Hypophosphatemia and hypercalcemia
- Hyperphosphatemia and hypocalcemia
Certified Continence Care Nurse (CCCN) Answer Key
1. Answer: D
The initial step in controlling occasional urinary incontinence is scheduled urination, in which the patient is asked to urinate at scheduled intervals. Fluids should not be limited, as dehydration can impair wound healing. Foley catheters should be avoided if at all possible because they pose considerable risk of urinary and systemic infections. Anticholinergic medications can be used if other efforts fail and if incontinence is due to muscle spasms.
2. Answer: A
Moisture-barrier pastes are ointments with powder added to improve absorption and make them more durable and solid, providing a thick skin barrier. Many are zinc oxide-based, making them somewhat difficult to remove. Mineral oil is often used to remove the paste. Some paste products now on the market are transparent so the skin can be monitored. Pastes are frequently used over denuded or excoriated tissue to absorb exudate and protect from drainage, urine, or feces, so they are used for both perianal and periwound tissues. Pastes are usually reapplied with each dressing/disposable diaper change without being completely removed.
3. Answer: C
Phase I: Filling/storing is triggered by emptying the bladder. Neurotransmitters in the brain signal the detrusor muscle to relax and the bladder to expand, drawing urine from the kidney and ureters. When the bladder reaches capacity (8 to 16 ounces), nerves send a signal back to the brain. Voluntarily tightening the external sphincter muscles retains the urine. Phase II: Emptying occurs when the nervous system signals the voiding reflex, and spinal nerves contract the detrusor muscle and relax internal sphincter muscles, allowing urine to flow to the urethra. Relaxing external sphincter muscles allows urination.
4. Answer: D
Anal manometry measures the pressure of the sphincter muscles, the degree of sensation in the rectum, and whether the neural reflexes that control normal bowel movements are intact. Anal wink (anocutaneous reflex), reflexive contraction of the anus in response to gentle stroking or stimulation of the skin around the rectum, and bulbocavernosus reflex, reflexive contraction of the anus in response to natural or electrical stimulation of the bulbocavernosus muscle of the penis, are used to determine if there is an interruption or defect in the reflex arc. Endoanal ultrasound is used to diagnose perianal fistulas and abscesses and to assess sphincter damage.
5. Answer: D
Phosphate (Fleet) enemas come prepackaged for one-time use with about 120 mL of solution. They stimulate contractions and, because they are hypertonic, draw fluid back into the intestines. Frequent use can result in hyperphosphatemia (>4.5 mEq/L) when too much phosphate is absorbed into the bloodstream. Symptoms include tachycardia, muscle cramping, hyperreflexia, tetany, nausea, and diarrhea. Hypocalcemia (< 8.2 mg/dL) can also result. Symptoms include tetany, tingling, seizures, altered mental status, and ventricular tachycardia.
Last Updated: 04/18/2018