Preparing for the CNS Certification Examination

The certification examination is designed to test the knowledge and skills acquired by those who have successfully completed both the academic and experiential criteria of the CNS and CNS-S. While we may approve those who have not yet completed the experience requirement to sit for the examination, evidence shows that those with experience perform better than those without.

The examination contains 200 multiple-choice, single answer questions, and will cover the broad spectrum of basic and applied nutritional science, based on an explicit set of competencies. These have been determined through a job analysis study conducted on practitioners. The competencies are grouped into domains, subdomains and tasks. As the examination may only assess knowledge pertaining to these competency statements, they serve as the outline, or blueprint for the examination. Click here to see the exam Content Outline.

This Content Outline is your key tool for preparing for the examination, and should be used to identify your strengths and weaknesses. Since the examination covers a broad spectrum of topics, it is likely that most candidates will require preparation in one or more content areas. The reference list below is intended to assist candidates in addressing these areas. BCNS does not endorse any specific study preparation method, course or reference as being relevant, correct or complete for the examination. We have assembled the following list based on reports that previous candidates have found these references to be helpful for preparation.

The method used by BCNS to determine the passing score for the examination is known as the Angoff method, and is in accordance with the standards set by the National Commission for Certifying Agencies (NCCA), which has fully accredited the CNS certifying program. The Angoff method requires the Examination Development Committee’s analysis on an item-by-item basis. If an item is considered by the Committee to be more difficult, the expectation of candidate performance is lower than if an item is considered by the committee to be less difficult. These committee judgments of difficulty are expressed as numeric performance indices. The pass/fail cut score reflects these item performance indices, and is expressed as a percentage equivalent.

For each examination, the pass/fail cut score will vary somewhat based on the exam’s difficulty level, but the cut scores are equated such that an equivalence of difficulty is maintained. Historically, cut scores have ranged between 60 and 69%. This historic range represents outcomes to date but should not be considered policy; it is possible for a future cut score to fall outside of this range.

Reference List

Domain I: Fundamental Principles of Nutrition

  • Gehlbach, SH, Interpreting the Medical Literature, McGraw-Hill, 2006.
  • Gropper and Smith. Advanced Nutrition and Human Metabolism, 6th ed., Wadsworth Cengage Learning, 2012.
  • Mahan LK, Raymond JL, Escott-Stump S. Krause’s Food & Nutrition Therapy, 13th ed. Saunders 2011.
  • Nelms M, Sucher KP, Lacey K, Roth SL: Nutrition Therapy & Pathophysiology, Brooks/Cole Cengage Learning, 2011.
  • Stipanuk MH and Caudill MA, Biochemical, Physiological and Molecular Biological Aspects of Human Nutrition, 3rd ed., Elsevier, 2013.

Domain II: Nutrients and Human Health

  • Berdanier C, Dwyer J, and Feldman, E, Handbook of Nutrition and Food, 3rd ed., CRC Press, 2013.
  • Bowman B, Russell RM, Present Knowledge in Nutrition, International Life Sciences Institute, 10th ed., 2012.
  • Gropper and Smith, Advanced Nutrition and Human Metabolism, 6th ed., Wadsworth Cengage Learning, 2012.
  • Ross AC, Caballero B, and Cousins R Tucker KL, and Ziegler, TR, Modern Nutrition in Health and Disease, 11th ed., Lippincott, Williams & Wilkins 2012.
  • Stipanuk MH and Caudill MA, Biochemical, Physiological and Molecular Biological Aspects of Human Nutrition, 3rd ed., Elsevier, 2013.

Domain III: Nutrition Assessment

  • Bouchard C and Ordovas JM, editors, Recent Advances in Nutrigenetics and Nutrigenomics, volume 108, Elsevier, 2012.
  • Escott-Stump S, Nutrition and Diagnosis-Related Care, 7th ed., Lippincott, Williams and Wilkins, 2011.
  • Lee RD and Neiman DC, Nutritional Assessment, 6th edition, 2012.
  • Lord RS and Bralley JA, Laboratory Evaluations for Integrative and Functional Medicine, 2nd ed., 2008.
  • Mahan LK, Raymond JL, Escott-Stump S. Krause’s Food & Nutrition Therapy, 13th ed. Saunders 2011.
  • Nelms M, Sucher KP, Lacey K, Roth SL: Nutrition Therapy & Pathophysiology, Brooks/Cole Cengage Learning, 2011.
  • Pagana, KD and Pagana TJ, Mosby’s Manual of Diagnostic and Laboratory Tests, 5th ed., Elsevier Mosby, 2013.

Domain IV: Clinical Intervention and Monitoring

  • Bauer K, Liou D, Sokolik CA, Nutritional Counseling and Educational Skill Development, Cengage Learning, 2011
  • Escott-Stump S, Nutrition and Diagnosis-Related Care, 7th ed., Lippincott, Williams and Wilkins, 2011.
  • Hark L, and Morrison, G, Medical Nutrition and Disease: A Cased-Based Approach, 4th ed., Wiley-Blackwell Publishing, 2007.
  • Jones D, Quinn S, Textbook of Functional Medicine, 3rd ed., Institute for Functional Medicine, 2010.
  • Mahan LK, Raymond JL, Escott-Stump S. Krause’s Food & Nutrition Therapy, 13th ed. Saunders 2011.
  • Nelms M and Roth SL, Medical Nutrition Therapy, A Case Study Approach, 4th ed., Cengage Learning, 2013.
  • Nelms M, Sucher KP, Lacey K, Roth SL: Nutrition Therapy & Pathophysiology, Brooks/Cole Cengage Learning, 2011.
  • Pizzorno JE, Murray MT, Joiner-Bey H. The Clinicians Handbook of Natural Medicine, 2nd ed. Churchill Livingstone/Elesvier, 2008.

Domain V: Professional Issues

  • Bauer K, Liou D, Sokolik CA, Nutritional Counseling and Educational Skill Development, Cengage Learning, 2011
  • National Restaurant Association, ServSafe Coursebook, 6th edition, 2012.