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Exam Code: WOCNCB-CCCN
Exam Name: WOCNCB-CCCN Certified Continence Care Nurse (CCCN)
Number of questions: The exam 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 patients 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