Oh how I wish there were more tips out there when I went to study for this exam. It may have saved me hundreds! It’s hard to believe with the internet and youtube there were no dietitians putting themselves out there with tricks and tips for this exam like there are for nursing exams (at least that I’ve found). Only very few words from a couple people on Dietitian Central …booo!
Anyways, passing the CNSC has been a year in the making for me as I had the unfortunate experience of failing (I literally missed by 1 point :P). It’s getting more challenging too as it has become more comprehensive to even the playing field for dietitians, physicians, and pharmacists alike.
Here are my latest tips as of May 2015.
1) Review the Book (ASPEN Adult Nutrition Support Core Curriculum)! Don’t spend forever reading it, but do speed read and believe me you will get something out of it. I have an awful memory and it still helped me.
2) Review all the chapters. Yes, all the chapters. The first time I took the exam I had completely skipped the sections on policies and names of QA programs as I didn’t think they would be that important. I thought the main focus would be on calculating enteral and parenteral nutrition, but the exam is really quite well rounded and I unfortunately ended up getting a lot of questions from these sections. Ouch!
3) Experience. If you are even attempting this exam, you must know the ins and outs of calculating tube feeding and parenteral nutrition. These are the basics (for example- common percentages of macronutrients of enteral formulas, kcal/gram of macronutrients for parenteral nutrition, how to calculate osmolarity etc.).
4) Statistics/ Research. Be familiar with research terminology and types of studies. The book does not have all of this information so I suggest you read up on statistics on your own if you are not familiar with the subject (p values, independent/ dependent variables etc.). The Nutrition Support Fundamentals and Review Course does have a section on this now. It did not a couple years back (2013) if you are using older materials. *Note: I also recommend familiarizing yourself with this if you plan on attending Clinical Nutrition Week which I highly recommend.
5) Equations. You need to memorize them! I did not do this the first time as I usually just carry my binder with me at work and refer to them as needed. You won’t have to memorize any equations for estimated needs (such as Harris Benedict or MSJ), but do know: nitrogen balance, corrected calcium, and free water deficit.
6) Pediatrics. There are not many questions on peds so I wouldn’t spend additional money on the Pediatric Core Curriculum, but do know how to determine their basic calorie and fluid needs. I got questions on how to determine their fluid needs multiple times (using Holliday-Segar).
Also know anything nutritionally unique about them with regards to TF formulas/ amino acids. I would review the section from the review course.
7) General. Do study: vitamin/ mineral needs in EN/ PN, signs and symptoms of vitamin/ mineral deficiency, medication interactions, fluid/ electrolyte disorders and correction, acids/ bases, EN/PN stability.
8) A Word on the Modules. Overall these did not help me significantly. My fellow co-workers and I purchased these and studied them each week. I knew all the answers, researched everything related to these questions, and made tons of online flashcards with the help of Anki (a flashcard program that helps you study). There were maybe two questions out of hundreds of flashcards that I made. It was a gut wrenching feeling having spent hours on these and then going into the exam feeling like I had not prepared. Take my word for it and don’t put all your focus on those modules. Take them into consideration, but don’t think you can just buy and study the modules and you’ll be good to go.
9) Keep Up with the Latest. ASPEN does a great job of keeping up with the latest research and updating the test content accordingly. The last time I took the exam, they had already included some questions on physical examination which is fairly new for dietitians. Get on the ball and read up on this, including how to evaluate bowel activity through a stethoscope.
Now get studying! :)