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Certified Continence Care Nurse Practice Test

WOCNCB-CCCN test Format | Course Contents | Course Outline | test Syllabus | test Objectives

Exam Code: WOCNCB-CCCN
Exam Name: WOCNCB-CCCN Certified Continence Care Nurse (CCCN)
Number of questions: The test contains ~110 scored questions + ~10 unscored (pre-test) items.
Time allotted: 2 hours (120 minutes) for the exam.
Passing mark / score required: WOCNCB does not publish a fixed number of questions required to pass; they use a scaled-score criterion-referenced approach.

Domain I: Assessment
Task 1: Obtain patient health history through interviews, established medical records, and questionnaires to determine the patient’s current health and risk status.

- Principles of continence (e.g., normal micturition and defecation)
- Principles of patient-centered care (e.g., psychosocial, health literacy, cultural beliefs, informed consent)
- Etiologies and contributing factors (e.g., diet, fluid intake, obstruction, functional impairment, neurological factors, retention, muscle damage, urethral hypermobility, bladder irritants, infection)
- Pediatric voiding and bowel dysfunction (e.g., enuresis, encopresis, congenital anomalies)
- Available resources (e.g., support and advocacy, supply access, post-acute care)
- Evaluating the effectiveness of the current treatment plan (e.g., medication, voiding/bowel diaries, nutrition and fluid, surgical interventions, catheters/devices)
- Interpreting lab values and diagnostic test results (e.g., urodynamics, postvoid residual, anorectal manometry and defecography)

Task 2: Assess health-related quality of life of patients with voiding dysfunction, urinary incontinence, bowel dysfunction and fecal incontinence.

- Psychosocial factors affecting care (e.g., patient and caregiver ability to learn and perform care, economic implications, education, coping mechanisms)
- Special considerations (e.g., population, cultural beliefs, changes in body image, intimacy)
- Interpreting pain/coping using verbal and nonverbal tools

Task 3: Perform focused assessments to determine continence status.

- Types of voiding dysfunction (e.g., stress, urge, reversible, mixed, reflex, functional, nocturnal enuresis)
- Types of bowel dysfunction (e.g., constipation, diarrhea, fecal impaction and incontinence, motility disorders)
- Behavioral strategies (e.g., biofeedback, bladder/bowel training, pelvic floor muscle exercise)
- Reversible causes of incontinence (e.g., delirium, infection, stool impaction)
- Causes of voiding and bowel dysfunction (e.g., motility disorders, trauma, malignancy)
- Assessment tools (e.g., Bristol stool chart, Urinary incontinence severity index, Timed up and Go)
- Conducting physical assessments (e.g., digital exam, sensory awareness, pelvic exam, skin health)
- Identifying continence complications (e.g., fungal skin infection, UTI, IAD, ITD)

Domain II: Intervention
Task 1: Recommend and/or provide interventions to manage voiding dysfunction and urinary incontinence.

- Address reversible causes
- Recommend medications (e.g., anti-spasmodic, anti-cholinergic)
- Behavioral strategies (e.g., diet and fluid modification, bladder training, pelvic floor muscle exercise, timed voiding/scheduled toileting, double-voiding, “Knack”)
- Initiating voiding diaries
- Skin health and protection (e.g., skin barriers, cleansers)
- Pediatric voiding dysfunction (e.g., environmental and behavioral)

Task 2: Recommend and/or provide interventions to manage bowel dysfunction and fecal incontinence.

- Address reversible causes
- Recommend medications (e.g., anti-diarrheal, laxatives)
- Behavioral strategies (e.g., diet and fluid modification, bowel training, exercise)
- Initiating bowel diaries
- Skin health and protection (e.g., skin barriers, cleansers)
- Pediatric bowel dysfunction (e.g., environmental and behavioral)

Domain III: Treatment
Task 1: Manage voiding dysfunction and urinary incontinence.
- Protecting skin health (e.g., skin barriers, cleansers)
- Manage urinary retention (e.g., intermittent catheterization, prevention of infection)
- Manage containment modalities (e.g., absorbent pads, urethral inserts)
- Catheter/device management (e.g., external, indwelling, straight/CIC, pessary)
- Treating incontinence complications (e.g., fungal skin infection, MASD)

Task 2: Manage bowel dysfunction and fecal incontinence.
- Protecting skin health (e.g., skin barriers, cleansers)
- Manage containment modalities (e.g., absorbent pads, fecal diversion systems)
- Treating incontinence complications (e.g., fungal skin infection, MASD)
- Treating bowel dysfunction (e.g., medications, digital stimulation, exercise, bowel training, diet)

Domain IV: Care Planning
Task 1: Develop a patient-centered plan of care by using health history and assessments to establish goals for the management of voiding and bowel dysfunction.

- Principles of patient-centered care (e.g., psychosocial, health literacy, access to care and supplies, cultural beliefs, coping mechanisms)
- Special considerations (e.g., populations, disabilities, changes in body image, intimacy)
- Identifying and supporting patient and caregiver goals (e.g., self-care, activity)

Task 2: Evaluate the patient-centered plan of care by using periodic assessments to promote continence and prevention of complications.
- Evaluating the effectiveness of the current treatment plan
- Interpreting patient responses to interventions
- Modifying interventions based on revised patient needs and goals

Domain V: Education and Referral
Task 1: Educate patients and caregivers across the lifespan on care principles and techniques to encourage patient autonomy.

- Etiologies and contributing factors (e.g., diet, fluid intake, obstruction, functional impairment, neurological factors, retention, muscle damage, urethral hypermobility, bladder irritants, infection)
- Modifiable risk factors (e.g., tobacco cessation, exercise, safety awareness, diet)
- Healthy bladder/bowel habits (e.g., bowel and bladder training, skin care, preventing UTI)
- Maintaining voiding/bowel diaries
- Skin health and protection (e.g., skin barriers, cleansers)
- Behavioral strategies (e.g., bladder/bowel training, pelvic floor muscle exercise)
- Management techniques (e.g., continence devices, fluid management, digital stimulation, medication)
- Manage containment modalities (e.g., absorbent pads, urethral inserts)
- Catheter/device management (e.g., external, indwelling, straight/CIC, pessary, fecal diversion systems)
- Incontinence complications (e.g., fungal skin infection, MASD, urinary tract infection)
- Special considerations (e.g., populations, disabilities, cognition, changes in body image, intimacy, cultural beliefs, psychosocial factors)

Task 2: Educate other health care professionals on care principles and techniques to promote optimal management and prevent complications.
- Etiologies and contributing factors (e.g., diet, fluid intake, obstruction, functional impairment, neurological factors, retention, muscle damage, urethral hypermobility, bladder irritants, infection)
- Modifiable risk factors (e.g., tobacco cessation, exercise, safety awareness, diet)
- Healthy bladder/bowel habits (e.g., bowel and bladder training, skin care, preventing UTI)
- Maintaining voiding/bowel diaries
- Skin health and protection (e.g., skin barriers, cleansers)
- Behavioral strategies (e.g., bladder/bowel training, pelvic floor muscle exercise)
- Management techniques (e.g., continence devices, fluid management, digital stimulation, medication)
- Manage containment modalities (e.g., absorbent pads, urethral inserts)
- Catheter/device management (e.g., external, indwelling, straight/CIC, pessary, fecal diversion systems)
- Incontinence complications (e.g., fungal skin infection, MASD, urinary tract infection)
- Special considerations (e.g., populations, disabilities, cognition, changes in body image, intimacy, cultural beliefs, psychosocial factors)

Task 3: Multidisciplinary care collaboration and referrals to support patient-centered care.
- Available resources (e.g., support groups and advocacy, supply access, post-acute care)
- Referrals for diagnostic testing (e.g., urodynamics, anorectal manometry and defecography)
- Referrals for other services (e.g., rehabilitation/biofeedback/pelvic floor, nutrition, social services, mental health)
- Facilitate appropriate consultations (e.g., surgery, GI/GU, oncology, gynecology)
- Provide handoff communication across care settings

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WOCNCB Certified Continence Care Nurse
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Question: 1
Which medication is commonly prescribed to treat chronic diarrhea associated
with irritable bowel syndrome?
A. Duloxetine
B. Oxybutynin
C. Metoclopramide
D. Loperamide
Answer: D
Explanation: Loperamide is an antidiarrheal medication commonly prescribed
to treat chronic diarrhea associated with irritable bowel syndrome (IBS). It
helps to slow down the movement of the intestines, reducing the frequency and
urgency of bowel movements.
Question: 2
Which of the following foods is known to promote bowel motility?
A. White rice
B. Red meat
C. Cheese
D. Bananas
Answer: D
Explanation: Bananas are known to promote bowel motility due to their high
fiber content, particularly soluble fiber. Soluble fiber helps to soften the stool
and facilitate its passage through the digestive system, promoting regular bowel
movements.
Question: 3
What is the primary purpose of an indwelling fecal diversion system?
A. To prevent diarrhea
B. To promote bowel continence
C. To collect and divert fecal matter
D. To stimulate bowel motility
Answer: C
Explanation: An indwelling fecal diversion system, such as a colostomy or
ileostomy, is designed to collect and divert fecal matter away from the rectum
and anus. It is used when the normal passage of stool through the rectum is not
possible or needs to be temporarily bypassed.
Question: 4
Which of the following behavioral strategies is commonly used to treat pelvic
floor muscle dysfunction?
A. Medication therapy
B. Bowel training
C. Dietary modification
D. Surgical intervention
Answer: B
Explanation: Bowel training is a behavioral strategy commonly used to treat
pelvic floor muscle dysfunction, which can contribute to bowel dysfunction and
incontinence. It involves establishing a regular toileting routine and using
techniques to Excellerate coordination and control of bowel movements.
Question: 5
Which of the following factors is a common cause of fecal impaction?
A. High-fiber diet
B. Normal bowel motility
C. Dehydration
D. Intestinal obstruction
Answer: C
Explanation: Dehydration can contribute to the formation of hard, dry stools
that are difficult to pass, leading to fecal impaction. Adequate fluid intake is
important for maintaining soft and easily passable stools.
Question: 6
Which surgical intervention is performed to repair a damaged anal sphincter?
A. Sphincteroplasty
B. Colostomy
C. Ileostomy
D. Fecal diversion
Answer: A
Explanation: Sphincteroplasty is a surgical intervention performed to repair a
damaged anal sphincter, which can occur due to childbirth, trauma, or other
factors. The procedure aims to restore the integrity and function of the
sphincter muscles to Excellerate bowel control.
Question: 7
Which of the following containment strategies is most suitable for managing
severe fecal incontinence?
A. Absorptive products
B. Rectal pouch
C. Bowel training
D. Biofeedback
Answer: B
Explanation: A rectal pouch, also known as an anal pouch or fecal pouch, is a
surgical option for managing severe fecal incontinence. It involves creating a
reservoir in the rectum to collect and store fecal matter, which can then be
emptied at regular intervals.
Question: 8
Which of the following medications is commonly used to treat chronic
constipation?
A. Duloxetine
B. Loperamide
C. Psyllium
D. Bisacodyl
Answer: C
Explanation: Psyllium is a bulk-forming laxative commonly used to treat
chronic constipation. It absorbs water and forms a gel-like substance that helps
soften the stool and promote regular bowel movements.
Question: 9
Which of the following cleansers is recommended for gentle skin care in
individuals with fecal incontinence?
A. Alcohol-based cleanser
B. Antimicrobial soap
C. Harsh detergent cleanser
D. pH-balanced mild cleanser
Answer: D
Explanation: A pH-balanced mild cleanser is recommended for gentle skin care
in individuals with fecal incontinence. Harsh cleansers, alcohol-based cleansers,
and antimicrobial soaps can be drying and irritating to the skin, potentially
causing further skin damage.
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