Gerontological Nurse Practitioner Certification Examination 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 pretest questions that are not scored. Pretest questions are used to determine how well these questions will perform before they are used on the scored portion of the examination. The pretest questions cannot be distinguished from those that will be scored, so it is important for a candidate to answer all questions. A candidate's score, however, 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.

Please note that various categories and subcategories through out this test content outline are associated with major problem/issue areas. These problem/issue areas are listed in the notes located at the end of this document. These notes are:

• Note 1: Systems and Focus Areas
• Note 2: Syndromes

Test Content Outline

1. Health Promotion and Disease Prevention (19%)
   1. Epidemiology/risk analysis (what puts the patient at risk, i.e., substance use, health habits, environmental influences; as associated with Note 1 or Note 2)
   2. Genetics (down syndrome, cancer dementias; as associated with Note 1)
   3. Health behavior guidelines/Risk reduction (nutrition, exercise, health habits, immunization; as associated with Note 1 or Note 2)
   4. Growth and development (physiological aging, psychosocial aging; as associated with Note 1 or Note 2)
   5. Diagnostic tests (screening, diagnosis, monitoring; as associated with Note 1 or Note 2)
   6. Wellness assessment (health-promoting behaviors such as nutrition, exercise, immunization; As associated with Note 1 or Note 2)
2. Assessment of Acute and Chronic Illness (22%)
   1. Epidemiology/disease control (infections, disease progression, public health issues; As associated with Note 1 or Note 2)
   2. Pathophysiology (such as comorbidity, disease states; as associated with Note 1 or Note 2)
      1. physiological aging versus pathology
      2. anatomy (deviations from normal in the aged; implications for functional status)
      3. microbiology (laboratory analysis, diagnostic testing)
   3. Psychopathology (depression, anxiety disorders, substance use disorder, family dysfunction, delirium, dementia, psychosis, behavioral assessment; as associated with Note 1 and Note 2)
   4. Diagnostic reasoning (such as differential diagnosis, prioritizing, comorbidity; as associated with Note 1 or Note 2)
   5. Health Assessment (e.g., exam techniques; as associated with Note 1 or Note 2)
3. Clinical Management (28%)
   1. Standards of practice (professional recommendations for practice; as associated with Note 1)
   2. Clinical guidelines (evidence based practice—pathways, protocols; as associated with Note 1 or Note 2)
   3. Pharmacotherapeutics (as associated with Note 1 or Note 2)
      1. drug interactions
      2. pharmacogenetics
      3. pharmacokinetics (absorption, excretion, metabolism, distribution)
      4. pharmacodynamics (adverse reactions/side effects, contraindications, comorbidities)
   4. Clinical therapeutics (as associated with Note 1 or Note 2)
      1. nutrition
      2. rehabilitation therapies
      3. complementary/alternative therapy
      4. exercise
      5. procedures (such as cerumen removal, wound debridement, tube insertion, nail care, joint injections, biopsy, casts and splints, suture)
   5. Clinical decision-making (as associated with Note 1 or Note 2)
      1. applied ethics (advance directives, end of life, quality of life, autonomy)
      2. coordination of care (culturally/age-appropriate individualized care, coordination across settings/transitions in care)
      3. diagnostic reasoning (triage/prioritizing)
   6. Safety (as associated with Note 2)
   7. Theory (as associated with Note 2)
      1. application of frameworks
4. The Nurse Practitioner and Patient Relationship (9%)
   1. Cultural competence (as associated with Note 1 or Note 2)
      1. health beliefs and practices
      2. ethnic considerations
      3. family systems
      4. spirituality
   2. Therapeutic communication (verbal, non-verbal. written; as associated with Note 1 or Note 2)
      1. educational level (patient, caregiver)
      2. culturally and linguistically appropriate communication
   3. Teaching/coaching (as associated with Note 1 or Note 2)
      1. anticipatory guidance
      2. teaching strategies/learning styles
      3. self-care/caregiver care
   4. Patient advocacy
      1. empowerment (patient, caregiver)
      2. quality of life
      3. end of life care
5. Professional Role and Policy (as associated with Note 1 or Note 2; 16%)
   1. Health care/Public policy
      1. laws and regulations
      2. poverty level
      3. autonomy
   2. Ethics
      1. advocacy
      2. decision-making capacity
      3. health status continuum (degree of wellness)
   3. Scope of practice (as associated with Note 1 or Note 2)
      1. assessment
      2. diagnosis
      3. plan of care
      4. implementation
      5. evaluation
   4. Access to care (as associated with Note 1 or Note 2)
      1. treatment cost-effectiveness
      2. poverty
      3. transportation
      4. health disparity
   5. Coordination of care (as associated with Note 1 or Note 2)
      1. care management
      2. drug costs
      3. multidisciplinary teams
      4. community resources
      5. care continuum
   6. Documentation (as associated with Note 1 or Note 2)
      1. assessment
      2. diagnosis
      3. plan of care (consultation, referral)
      4. implementation
      5. evaluation
6. Research (6%)
   1. Research process and utilization (applied and clinical research)
   2. Continuous process improvement
      1. quality improvement/quality assurance/total quality management
      2. peer review
   3. Outcomes evaluation (as associated with Note 1 or Note 2)

Note 1: Systems and Focus Areas (with examples)

1. Head, Eyes, Ears, Nose, Throat:
   1. Eye disorders—macular degeneration, cataracts, glaucoma, dry eyes, conjunctivitis
   2. Ear—wax impaction, hearing loss
   3. Nose—sinusitis, rhinitis
   4. Throat—pharyngitis, oral cancer, dental conditions
2. Cardiovascular: congestive heart failure, arrhythmia, blood pressure control, coronary artery disease, myocardial infarction, hyperlipidemia, valvular heart disease, chest pain, edema, peripheral vascular disease
3. Respiratory: chronic obstructive pulmonary disease (copd), pneumonia, asthma, lung cancer, pulmonary embolus
4. Gastrointestinal: constipation, gastronintestinal esophageal reflux disease (gerd), peptic ulcer disease, dysphagia, diverticulitis, cancers, diarrhea, hepatitis, abdominal pain
5. Genitourinary/ Reproductive: urinary tract infection, prostate hypertrophy, renal function, sexual dysfunction, hypogonadism, cancer, hormone deficiency, vaginitis, urinary retention
6. Musculoskeletal: arthritis, osteoporosis, myalgias, gout, infections, injuries, joint pain, muscle wasting
7. Neurological: stroke; movement disorders (such as Multiple Sclerosis, Parkinson's tremors), seizure disorders, headache, transient ischemic attack, head trauma, dizziness, neuropathy, syncope
8. Skin: cancers, lesions, ulcers, wounds, rashes, scabies, herpes, zoster, zerosis, bites, pruritis
9. Psychology/Mental Health: depression, anziety, psychosis, substance use disorder, behavioral management
10. Immune/Lymphatic: infectious/communicable disease, HIV/AIDS, cancers, influenza, tuberculosis, tetanus
11. Metabolic/Endocrine: diabetes, thyroid, hypogonadism, fluid-electrolyte imbalance, fever
12. Hematology: anemias, blood dyscrasia, coagulation disorder
13. Multisystem: comorbidity, altered presentation

Note 2: Syndromes (with Examples)

1. Nutrition: failure to thrive, obesity
2. Functional/mobility limitations: driving
3. Falls
4. Pain
5. Incontinence
6. Sleep disorders
7. Relocation
8. Delirium
9. Sensory loss
10. Dementia
11. Abuse/neglect: patient supervision, restrains, medication administration—patient/caregiver
12. Multiple loss syndrome
13. End of life care/ Palliative care
14. Constipation

This page last revised 1/25/2007.