NBNSC Certified Nutrition Support Clinician Exam

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Exam Number : CNSC
Exam Name : NBNSC Certified Nutrition Support Clinician
Vendor Name : Medical
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NBNSC certification provides an avenue to demonstrate that you have attained the skills and knowledge necessary to provide quality nutrition support care. They 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 test of nutrition support clinicians.

Nutrition Support is an inter-professional field. After conducting extensive research, NBNSC developed a new credential, the CNSC® that is fair and valid for all professional disciplines involved in nutrition support. The dietitians, nurses, pharmacists, physician assistants, and physicians who provide care share a common body of knowledge and expertise that NBNSC has captured in the new test format. The content of the test reflects the tasks that healthcare professionals provide on a daily basis.

I. Nutrition Assessment (32%)
II. Clinical Management (55%)
III. Process Management (3%)
IV. Professional Practice (10%)

- patient history.
- patient current clinical status.
- diet, medication, and supplements for potential impact on nutritional status.
- Evaluate anthropometric data.
- Identify potential or existing nutrition support access.
- Perform nutrition-focused physical exam.
- Evaluate patient for potential complications of initiating nutrition support therapy.

- Determine fluid, nutrient, and electrolyte intake and output from all sources.
- Determine fluid, electrolyte, macronutrient, and micronutrient requirements for nutrition support therapy.
- Evaluate psychological, socio-economic, developmental, functional, behavioral, and quality of life factors.
- Evaluate indication for timing and route of administration for nutrition support therapy.
- Determine etiology, degree, and type of malnutrition.
- Determine nutritional diagnosis or problem.
- Assess patient and caregiver capabilities and limitations related to nutrition support therapy

- administration route and access for nutrition support therapy.
- formulation, rate, and/or volume of nutrition support therapy.
- use of pharmacologic adjunctive agents.
- cost-effective strategies in the provision of nutrition support therapy.
- short-term nutrition support therapy goals.
- long-term nutrition support therapy goals.
- diagnostic tests, procedures, or consultations that may modify the nutrition support plan.
- laboratory tests that may modify the nutrition support plan.
- regimen for initiation, advancement, maintenance, and discontinuation of nutrition support therapy.

- Verify position, location and functionality of nutrition access device.
- tolerance of nutrition support therapy.
- fluid status.
- adherence with nutrition support therapy plan.
- complications of nutrition support therapy.
- laboratory test results to assess adequacy and tolerance of nutrition support therapy.
- nutritional and metabolic response to nutrition support therapy.
- status of nutrition access device.
- nutrition support therapy for safety concerns, including management of product shortages.
- drug-nutrient interaction.
- enteral or parenteral formula stability.


- Modify nutrition support therapy based on changes in patient clinical status and medical plan of care.
- Manage complications related to nutrition support therapy.
- Reevaluate nutrition support therapy goals.
- Reevaluate adjunctive drug therapy.
- Transition or discontinue nutrition support therapy.
- Transition patient from one care setting to another.
- Educate patient, caregiver, and/or health care professionals on nutrition support therapy management.

- Develop or update policies and procedures to guide patient care.
- Implement current guidelines and standards of practice in the provision of nutrition support therapy.
- Develop or update patient education materials.
- Utilize a continuous process improvement model to evaluate nutrition care.
- Apply ethical principles in the application of nutrition support therapy.
- Provide nutrition support therapy in compliance with legal and regulatory standards.
- Evaluate scientific literature and interpret study design, methodology, statistical analysis and results to practice evidence-based nutrition support therapy.
- Apply principles of evidence-based practice in provision of nutrition support therapy.

- Identify patients with malnutrition.
- Identify patients with risk factors for developing malnutrition.
- Review patient history.
- Review patient current clinical status.
- Review diet, medication, and supplements for potential impact on nutritional status.
- Evaluate anthropometric data.
- Identify potential or existing nutrition support access.
- Perform nutrition-focused physical exam.

- Evaluate patient for potential complications of initiating nutrition support therapy.
- Determine fluid, nutrient, and electrolyte intake and output from all sources.
- Determine fluid, electrolyte, macronutrient, and micronutrient requirements for nutrition support therapy.
- Evaluate psychological, socio-economic, developmental, functional, behavioral, and quality of life factors.
- Evaluate indication for timing and route of administration for nutrition support therapy.
- Determine etiology, degree, and type of malnutrition.
- Determine nutritional diagnosis or problem.
- Assess patient and caregiver capabilities and limitations related to nutrition support therapy.


- administration route and access for nutrition support therapy.
- formulation, rate, and/or volume of nutrition support therapy.
- use of pharmacologic adjunctive agents.
- cost-effective strategies in the provision of nutrition support therapy.
- short-term nutrition support therapy goals.
- long-term nutrition support therapy goals.
- diagnostic tests, procedures, or consultations that may modify the nutrition support plan.
- laboratory tests that may modify the nutrition support plan.
- regimen for initiation, advancement, maintenance, and discontinuation of nutrition support therapy.

- Verify position, location and functionality of nutrition access device.
- Evaluate tolerance of nutrition support therapy.
- Evaluate fluid status.
- Monitor adherence with nutrition support therapy plan.
- Monitor for complications of nutrition support therapy.
- Evaluate laboratory test results to assess adequacy and tolerance of nutrition support therapy.
- Monitor nutritional and metabolic response to nutrition support therapy.
- Evaluate status of nutrition access device.
- Assess nutrition support therapy for safety concerns, including management of product shortages.
- Monitor for drug-nutrient interaction.
- Monitor for enteral or parenteral formula stability.

- Modify nutrition support therapy based on changes in patient clinical status and medical plan of care.
- Manage complications related to nutrition support therapy.
- Reevaluate nutrition support therapy goals.
- Reevaluate adjunctive drug therapy.
- Transition or discontinue nutrition support therapy.
- Transition patient from one care setting to another.
- Educate patient, caregiver, and/or health care professionals on nutrition support therapy management.

- Develop or update policies and procedures to guide patient care.
- Implement current guidelines and standards of practice in the provision of nutrition support therapy.
- Develop or update patient education materials.
- Utilize a continuous process improvement model to evaluate nutrition care.
- Apply ethical principles in the application of nutrition support therapy.
- Provide nutrition support therapy in compliance with legal and regulatory standards.
- Evaluate scientific literature and interpret study design, methodology, statistical analysis and results to practice evidence-based nutrition support therapy.
- Apply principles of evidence-based practice in provision of nutrition support therapy.



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