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Examination Content Outline - CFCN® Exam

Overall Cognitive Level Distribution: 17 Recall, 46 Application, 17 Analysis

1. ASSESSMENT 40 items
   1. History
      1. Collect health history
      2. Assess medication history
   2. Physical Assessment
      1. Assess patient for functional disabilities (e.g., gait, mobility, balance, visual, cognitive)
      2. Assess patient for health habits (e.g., smoking, exercise, hygiene, nutrition)
      3. Assess foot circulation by palpation (e.g., pulses, blanching, capillary refill)
      4. Assess foot circulation by Doppler
      5. Assess legs and feet for temperature
      6. Assess hair growth on legs and feet
      7. Assess foot skin integrity (e.g., fissures, ulcers, corns, calluses, dermatitis)
      8. Assess physical/musculoskeletal function of the foot (e.g., range of motion, deformities, strength)
      9. Assess sensation (e.g., monofilament testing, vibration)
      10. Assess toenails and cuticles
      11. Determine ankle brachial index (ABI)
   3. Risk Assessment
      1. Establish risk of ulceration on assessment
      2. Establish risk of amputation based on assessment
      3. Assess for issues of quality of life related to foot pathology
   4. Footwear and Mobility Aid Assessment
      1. Inspect footwear and socks/stockings
      2. Inspect mobility aids (e.g., canes, walkers)
2. NURSING INTERVENTIONS 25 items
   1. Skin care
      1. Perform hygiene
      2. Identify appropriate interventions for managing hyperkeratotic areas
      3. Implement off-loading
      4. Apply padding
      5. Identify the need for compression therapy (e.g., to manage edema)
      6. Apply moisturizers to skin
      7. Perform cuticle care
      8. Identify and make recommendations for skin conditions:
         1. Blisters
         2. Plantar warts
         3. Trauma
         4. Tinea pedis
         5. Paronychia
         6. Maceration
         7. Other skin conditions
      9. Identify the need for use of therapeutic interventions (e.g., topical therapy) for skin conditions
   2. Nail care
      1. Define free nail border (i.e., remove debris)
      2. Conduct debridement of toenails
      3. Perform cleaning and sterilization of equipment
      4. Use personal protective equipment
      5. Maintain infection control for tinea pedis and candidiasis
      6. Identify and make recommendations for the following conditions:
         1. Onychomycosis
         2. Trauma
         3. In-growing/ingrown toenail
         4. Other conditions of the toenails
3. EDUCATION AND REFERRAL 15 items
   1. Education
      1. Provide patient/caregiver education related to:
         1. foot care (e.g., hygiene, skin care, inspection, nail care)
         2. pathophysiology affecting the foot
         3. age-specific changes of the foot
         4. proper footwear
         5. problems that should be reported
         6. anatomy and physiology of the foot
         7. plan for follow-up care
         8. weight management
         9. prevention of specific problems
   2. Referral
      1. Identify the need for appropriate referrals (i.e., primary care provider, podiatry, orthopedics, dermatology, endocrinology, vascular surgery, general surgery, physical therapy, occupational therapy, pedorthist/orthotist, home health, pain management, diabetes education, smoking cessation, case/care manager or social worker, wound care)
      2. Act as patient advocate regarding issues of foot care

Total Items* 80

* Plus 10 unscored pretest items