Gerontological Nurse Certification Exam Content Outline

This is a computer-based test (CBT)

There are 175 questions on this examination. Of these, 150 are scored questions and 25 are non-scored pretest questions. Questions are pre-tested to determine how well they perform before they are used in the scored portion of the examination. The pretest questions cannot be distinguished from those that will be scored, so it is important that a candidate answer all questions. However, a candidate's score is based solely on the 150 scored questions. Performance on pretest questions does not affect a candidate's score.

This Test Content Outline identifies the areas that are included on the examination. The percentage and number of questions in each of the major categories of the scored portion of the examination are also shown.

Test Content Outline

1. Aging as It Relates to the Older Adult (2.00%)
   1. Stages of development (theories related to stages of development such as Erickson's Developmental Stages)
   2. Physical development (e.g., differentiate between normal and abnormal aging process)
   3. Cognitive development (e.g., differentiate between normal and abnormal aging process, ability to learn)
2. Health Issues (30.00%)
   1. Pathophysiology
      1. Cardiovascular problems (e.g., hypertension and hypotension, congestive heart failure, myocardial infarction, peripheral vascular disease, arteriosclerotic heart disease, arrhythmias)
      2. Respiratory problems (e.g., chronic obstructive pulmonary disease, pneumonia, carcinoma, tuberculosis, restrictive airway disease, allergies)
      3. Gastrointestinal problems (e.g., constipation and diarrhea, fecal incontinence and fecal impaction, obstructions, nutrition and hydration, oral and dental conditions, dysphagia, ulcer disease, hiatal hernia, carcinoma, hepatic diseases)
      4. Urinary and reproductive problems (e.g., benign prostatic hypertrophy, carcinomas, sexual dysfunctions, urinary incontinence, urinary tract infections, end-stage renal disease, vaginitis)
      5. Hematological problems (e.g., anemias, leukemias)
      6. Musculoskeletal problems (e.g., osteoporosis, mobility and gait disorders, arthritis, fractures, falls, deformities)
      7. Metabolic and endocrine problems (e.g., hypothermia and hyperthermia, diabetes mellitus, thyroid disease, electrolyte imbalance, postmenopausal conditions)
      8. Immunologic problems (e.g., human immunodeficiency virus (HIV)/Acquired Immunodeficiency Syndrome (AIDS), immunosuppression, infections)
      9. Neurologic problems (e.g., dementia, delirium, sleep and insomnia, stroke, Parkinson disease, mental retardation and other developmental disabilities)
      10. Psychiatric and psychosocial problems (e.g., chronic grief, depression, schizophrenia, bipolar, anxiety disorders, substance abuse, impaired coping mechanisms, loneliness and isolation, sexual dysfunction, suicide, confusion and disorientation)
      11. Integumentary problems (e.g., pressure ulcers, carcinomas, herpes zoster, scabies, bruises and abrasions, dermatitis, eczema, burns)
      12. Sensory problems (e.g., hearing, vision, taste and smell, touch, sensory overload and sensory deprivation)
      13. Pain (acute, chronic)
   2. Pharmacology (e.g., drug interactions, polypharmacy, over-the-counter, herbal, recreational, complementary, prescription, therapeutic drug levels, gerontological dosage)
   3. Nutrition (e.g., dysphagia, dysphasia, fluid and food imbalances, supplements, routes, functional impairments, nutritional lab monitoring, specialty diets, dentition, nutritional guidelines)
3. Communication (8.67%)
   1. Confidentiality issues (e.g., building/maintaining a trusting relationship, "need to know": who, what, how much related to disclosure)
   2. Interviewing skills and techniques (e.g., knowing the objective of the interview, incorporating therapeutic skills within an interview)
   3. Therapeutic skills (e.g., active listening, clarification, client communication style and ability, boundary issues, verbal vs. nonverbal, client sensitivity, cultural/spiritual awareness, environment, rapport-building)
   4. Written communication/documentation
      1. Requirements (e.g., accuracy, timeliness, legibility, patient/resident/client-specific)
      2. Forms of communication (e.g., plan of care, discharge instructions, patient education)
   5. Professional communication (e.g., interdisciplinary communication, organizational communication, public)
   6. Communication barriers/accessibility
      1. Barriers (e.g., interpersonal, physical disabilities, family dynamics)
      2. Accessibility (e.g., interpreters, technology, printed materials)
4. Nursing Process (16.00%)
   1. Gerontological nursing scope of practice (e.g., roles of the gerontological nurse)
   2. Physical/psychosocial assessment
      1. Process (including skills; e.g., using clinical critical thinking to perform age/system-specific inspection, palpation, percussion, auscultation; problem-based)
      2. Tools/equipment (risk assessment, e.g., skin integrity such as the Braden and Norton scales, falls, pain, mental status such as the Mini-Mental State Examination (MMSE), safety, involuntary movement such as the Abnormal Involuntary Movement Scale (AIMS), nutrition/weight change)
      3. Diagnostic (e.g., laboratory, radiology)
   3. Plan of care (e.g., patient goals, cost-effective care, resources for continuing care including types of health care delivery systems [assisted living, residential facilities, foster and group homes, nursing facilities, day care, senior centers, foster care, respite, acute, subacute, rehabilitative])
   4. Interventions (e.g., pain management, alternative therapies, evidence-based, hospice, palliative care, restorative care, supportive care, protocols/clinical paths, nonviolent crisis intervention, rehabilitative care, case management)
   5. Evaluation (outcome measurements, measuring effectiveness of interventions, determining progress toward goals)
5. Lifestyle, Health Changes, and Vulnerability in the Older Adult (16.67%)
   1. End of life/death and dying (e.g., stages/phases of death and dying, individual beliefs and traditions)
   2. Coping and adjustment (including grief and loss, psychological responses, life transitions; e.g., change of residence, loss of spouse, loss of independence, loss of autonomy, ageism, intergenerational issues, support systems)
   3. Human sexuality (e.g., companionship, self-esteem, self-image, impact of chronic health problems, relationships, availability of partner)
   4. Cultural, ethnic, spiritual diversity (including beliefs and practices)
   5. Addictions (e.g., alcohol, prescription medications, long-term effects, tobacco, gambling, sexual, recreational drugs)
   6. Abuse and neglect/vulnerable adult (e.g., active and passive, reporting responsibilities, types of abuse [e.g., verbal, physical, sexual, financial exploitation, mental/psychological/emotional, involuntary seclusion])
6. Education (3.33%)
   1. Adult learning principles (e.g., motivation, age-appropriate education, alternative learning styles)
   2. Educational outcomes and evaluation (e.g., ability to perform self-care, compliance, comprehension, return demonstration)
7. Health Promotion and Wellness (10.00%)
   1. Wellness principles (e.g., weight management, exercise, sleep, hygiene, alcohol/tobacco/illicit drug intake, stress management, mental aerobics)
   2. Safety issues (e.g., car seat belts, smoke alarms, maintain assistive devices, call/personal alarms, medication dose boxes, environmental risks)
   3. Immunizations (e.g., influenza, pneumococcal, hepatitis, travel)
   4. Community-based outreach screening and programs (e.g., blood pressure, cholesterol, diabetes, skin and prostate cancer, hearing, depression)
   5. Epidemiology and risk factors (e.g., Methicillin-resistant Staphylococcus Aureus (MRSA), Vancomycin-resistant Enterococci (VRE), Clostridium difficile (C. diff), tuberculosis (TB))
8. Management/Leadership (7.33%)
   1. Quality improvement (e.g., client record review, tracking, identifying issues/problems, implementing effective problem solving strategies)
   2. Strategies of leadership/management (e.g., collaboration, team-building, delegation and supervision of licensed and unlicensed health caregivers, conflict resolution, advocacy, positive feedback, accessibility/visibility to staff/family/caregiver)
   3. Organizational (e.g., mission statement and vision, infrastructures, policies and procedures)
   4. Professional development (e.g., mentoring, role modeling, continuing education, specialty certifications, resources for obtaining current evidence-based practices)
9. Legal and Ethical Issues (4.67%)
   1. Regulatory guidelines
      1. Health Insurance Portability and Accountability Act (HIPAA) (e.g., confidentiality)
      2. Informed consent and patient self-determination (e.g., do not resuscitate (DNR), advance directives, human subject protection)
      3. Reimbursement
         1. Types (e.g., social security, Medicaid, Medicare, Tricare, long-term care insurance, managed care, supplemental insurance)
         2. Documentation requirements
      4. Nurse Practice Act (e.g., scope of practice, licensing, educational requirements, malpractice, negligence, nursing delegation)
      5. Omnibus Budget Reconciliation Act (OBRA)
      6. Older Americans Act/Ombudsman
      7. Americans with Disabilities Act (ADA)
      8. State
   2. Patients/residents' Bill of Rights
   3. Ethical principles/decision-making (e.g., dilemmas, Nursing Code of Ethics, ethics committee)
10. Research (1.33%)
    1. Understanding the research process (e.g., generalizability, interpretation and applicability of study findings to the local situation)
    2. Evidence-based practice (e.g., application of current guidelines and processes, informal [clinical practice based on tracking and trending in a specific setting])

This page last revised 1/24/2007.