CCN exam Format | Course Contents | Course Outline | exam Syllabus | exam Objectives
The Clinical Nutrition Certification Board (CNCB) is a 501(c)(3) non-profit tax-exempt certification agency which provides professional training, examination and certification for health care practitioners.
The discipline of Human Clinical Nutrition applies principles derived from current biochemical and physiological scientific knowledge for the purpose of promoting optimal health while recognizing biochemical individuality. The Certified Clinical Nutritionist assesses a persons nutritional needs to achieve normal physiological function. Assessment includes the use of appropriate test and observations such as case history, anthropomorphic measurements, physical signs, laboratory tests, and nutrition/lifestyle analysis to determine an educational nutrition program. Assessment also provides the basis for referral to a licensed physician, or other health care professional.
The educational protocol may include, among other information, nutrition / lifestyle modification, nutritive supplementation, understanding of physiological/biochemical pathways, and evoking of regenerative processes.
The Certified Clinical Nutritionist (CCN) Examination establishes reputable standards of excellence.
Creation of a quality examination, based on a validated scope of practice which appropriately represents the field of clinical nutrition.
Candidate access to the broad scope of clinical nutrition training and a mechanism for recertification every five years, recognizing continued competency in the field.
The CCN Examination Candidate must:
Satisfy the CORE Requirements
Submit Credential Review Application and College Transcripts
Obtain Credential Review Approval
Complete the Post Graduate Studies in Clinical Nutrition Program (PGSCN)™
Achieve a passing score on the online CCN Examination
The CCN Examination processes and the examination data bank are reviewed and revised annually, in accordance with the specifications of the Role Delineation Study. The CNCB utilizes a criterion referenced passing point for each section of the certification examination.
- Biochemistry of Essential Vitamins
- Biochemistry of Essential Minerals
- Biochemistry of Essential Trace Minerals
- Biochemistry of Essential Amino Acids and Accessory Nutrients
- Optimal Human Nutrition
- Environmental Health Issues
- Drug Induced Nutritional Deficiencies
- Free Radicals & Antioxidants
- Biochemistry of Fats and Oils
- The Human Microflora
- Cognitive Enhancing Drugs and Nutrients
- Alternative Cancer Therapies
- Women’s Health Conditions
- Cardiovascular Disease
- Hyperinsulinemia
- Allergies and Asthma
- ADD and ADHD
- Health Assessment & Medical Symptom
- Introduction to Human Toxicity
- Bowel Terrain
- Toxic Conditions, Allergies and Sensitivities
- Established Need for Detoxification
- Therapy Modality - Homeopathy
- Phytotherapy
- Therapy modality - Herbology
- Clinical Nutrition Counseling with Alternative Therapies
- Rationale for Laboratory Assessment
- Vitamins - the Working “Hands” of Enzymes
- Minerals & Laboratory Testing
- Amino Acids & Laboratory Testing
- Fatty Acids & Laboratory Testing
- Organic Acids & Laboratory Testing
- Gastrointestinal Disorders & Laboratory
- Testing: Digestion & Absorption
- Microbial Flora
- Gastric and Pancreatic Function
- Intestinal Function & Permeability
- Leaky Gut Syndrome
- Dysbiosis
- Bacterial & Protozoal Markers
- Food Allergy & Test Results
- Detoxification Testing
- Urinary Markers
- Hormones & Laboratory Testing
- Aging and Oxidant Stress
- Urinary Metabolic Markers
- Case Reports and Case Outcomes
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CCN
CNCB Certified Clinical Nutritionist 2025
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Question: 453
A patient with a history of metabolic syndrome shows elevated levels of organic acids in the urine, particularly succinic and fumaric acids. What metabolic dysfunction might these findings suggest?
1. Impaired beta-oxidation of fatty acids
2. Mitochondrial dysfunction
utathione deficiency er: B
nation: Elevated succinic and fumaric acids can indicate mitochondrial dysfunction, as they a ediates in the citric acid cycle, which may be impaired in this metabolic condition.
ion: 454
inical setting, a patient is suspected of having heavy metal toxicity. Which of the following tory tests would be most appropriate to confirm the presence of lead in the body?
um creatinine
hour urine lead excretion test um calcium
mplete blood count er: B
nation: The 24-hour urine lead excretion test is the most specific test for assessing lead expos xicity, as it measures the amount of lead being excreted from the body.
Increased ethanol metabolism
3. Gl
Answ
Expla re
interm
Quest
In a cl labora
A. Ser B. 24-
1. Ser
2. Co
Answ
Expla ure
and to
Question: 455
In a comprehensive assessment of a patient with osteoporosis, which combination of vitamins and minerals should be evaluated through laboratory testing to ensure optimal bone health and what specific tests would you recommend?
1. Vitamin K and calcium; Serum calcium and prothrombin time
2. Vitamin D and magnesium; Serum 25-hydroxyvitamin D and serum magnesium levels
3. Vitamin C and iron; Serum ascorbic acid and serum ferritin
4. Vitamin A and phosphorus; Serum retinol and serum phosphorus levels Answer: B
Explanation: Vitamin D and magnesium are crucial for bone health. Serum 25-hydroxyvitamin D and magnesium levels should be assessed to evaluate their status.
Question: 456
year-old woman presents with severe premenstrual syndrome (PMS) symptoms, including m bloating, and breast tenderness. Which of the following dietary interventions may help alle
mptoms? (Select All That Apply)
reasing omega-3 fatty acid intake
ducing refined carbohydrate consumption pplementing with vitamin D
reasing caffeine consumption er: A, B, C
nation: Research suggests that omega-3 fatty acids can reduce inflammation and Boost mo educing refined carbohydrates can help stabilize blood sugar levels. Vitamin D is linked to tion and may alleviate PMS symptoms. Caffeine can exacerbate anxiety and bloating, so its se is not recommended.
ion: 457
of the following lipoproteins is primarily responsible for transporting dietary triglycerides fr ne to peripheral tissues?
w-density lipoprotein (LDL)
y low-density lipoprotein (VLDL)
A 35- ood
swings, viate
her sy
1. Inc
2. Re
3. Su
4. Inc Answ
Expla od,
while r mood
regula increa
Quest
Which om the
intesti
1. Lo
2. Ver
3. High-density lipoprotein (HDL)
4. Chylomicrons Answer: D
Explanation: Chylomicrons are the lipoproteins responsible for transporting dietary triglycerides from the intestines to peripheral tissues after a meal.
Question: 458
In assessing a patient for food allergies, which of the following testing methods is considered the most reliable for IgE-mediated reactions? (Select All That Apply)
1. Skin prick tests
2. Serum specific IgE testing
3. Elimination diet followed by food challenge
4. IgG food sensitivity testing Answer: A, B, C
nation: Skin prick tests and serum specific IgE testing are reliable for identifying IgE-mediat es. An elimination diet followed by a food challenge can confirm food allergies. IgG testing versial and not considered reliable for diagnosing food allergies.
ion: 459
atient with chronic stress and digestive issues, which herbal remedies could be considered to both the nervous and digestive systems? (Select All That Apply)
mon Balm sionflower amomile ndelion
er: A, B, C
nation: Lemon Balm and Passionflower are known for their calming effects on the nervous sy hamomile can soothe digestive disturbances. Dandelion is more focused on liver health and ectly impact stress or anxiety.
ion: 460
Expla ed
allergi is
contro
Quest
In a p support
1. Le
2. Pas
3. Ch
4. Da
Answ
Expla stem,
while C may
not dir
Quest
In a study on the effects of dietary fats on cardiovascular health, researchers measured the impact of omega-3 fatty acids on inflammation. Which biochemical mechanism explains how omega-3 fatty acids exert their anti-inflammatory effects?
1. They compete with arachidonic acid for incorporation into cell membranes, reducing pro- inflammatory eicosanoid production.
2. They increase the synthesis of leukotrienes from arachidonic acid.
3. They enhance the production of inflammatory cytokines.
4. They inhibit the absorption of cholesterol in the intestines.
Answer: A
Explanation: Omega-3 fatty acids compete with arachidonic acid, leading to the production of less inflammatory eicosanoids, thereby reducing overall inflammation.
Question: 461
changes may be recommended based on exact research? (Select All That Apply)
ducing artificial food colorings reasing processed food intake ding more whole foods
miting sugar-sweetened beverages er: A, C, D
nation: Reducing artificial food colorings and limiting sugar-sweetened beverages can help m symptoms, while increasing whole foods supports overall health. Processed food intake is lly discouraged.
ion: 462
year-old female with chronic digestive issues undergoes testing for dysbiosis. Which of the ing results would likely indicate the presence of opportunistic pathogens?
gh Lactobacillus Firmicutes
h Clostridia
anced gut microbiota
A child diagnosed with ADHD is being evaluated for dietary interventions. Which of the following dietary
1. Re
2. Inc
3. Ad
4. Li
Answ
Expla anage
ADHD
genera
Quest
A 40-
follow
1. Hi
2. Low
3. Hig
4. Bal Answer: C
Explanation: An increased presence of Clostridia is often associated with dysbiosis and can indicate the proliferation of opportunistic pathogens in the gut.
Question: 463
In a case study involving a patient with anxiety and digestive issues, which of the following homeopathic
remedies could be considered for their dual effect? (Select All That Apply)
1. Argentum Nitricum
2. Phosphorus
3. Lycopodium
4. Kali Phosphoricum Answer: A, C
tory issues, and Kali Phosphoricum is a nerve tonic but less specific for this case.
ion: 464
ent with a history of recurrent digestive issues undergoes a food allergy assessment. Which of ing results would most likely indicate a non-IgE mediated reaction?
vated serum IgE itive skin prick test
reased IgG levels for specific foods rmal histamine levels
er: C
nation: Elevated IgG levels indicate a non-IgE mediated immune response, often associated w ntolerances or sensitivities.
ion: 465
of the following lifestyle modifications should a clinical nutritionist recommend for a patie ted in detoxification, particularly concerning heavy metal exposure? (Select All That Apply)
Explanation: Argentum Nitricum is known for addressing both anxiety and digestive complaints, while Lycopodium may help with digestive issues linked to stress. Phosphorus is primarily for respiratory and circula
Quest
A pati the
follow
1. Ele
2. Pos
3. Inc
4. No
Answ
Expla ith
food i
Quest
Which nt
interes
1. Regular exercise
2. Saunas or steam baths
3. High-fiber diets
4. Increased alcohol consumption Answer: A, B, C
Explanation: Regular exercise helps with overall detoxification processes, saunas can promote sweating and toxin elimination, and high-fiber diets support digestive health. Increased alcohol consumption would
be counterproductive to detoxification.
Question: 466
A patient with chronic exposure to environmental toxins is evaluated for detoxification capacity. Which of the following findings would most likely indicate a compromised detoxification system?
1. High levels of phase II metabolites
vated liver enzymes rmal bilirubin levels
er: B
nation: Low levels of phase I enzymes suggest compromised detoxification ability, as these es are critical for converting fat-soluble toxins into water-soluble forms for elimination.
ion: 467
ager with ADD is experiencing challenges with focus and attention. Which of the following components may support cognitive function in this case? (Select All That Apply)
mega-3 fatty acids h sugar snacks
mplex carbohydrates cessed foods
er: A, C
nation: Omega-3 fatty acids and complex carbohydrates support cognitive function, while hig nacks and processed foods can lead to energy crashes and negatively impact focus.
Low levels of phase I enzymes
2. Ele
3. No
Answ Expla
enzym
Quest
A teen dietary
1. O
2. Hig
3. Co
4. Pro Answ
Expla h
sugar s
Question: 468
In evaluating a patient for potential metabolic disorders, which urinary marker would be most indicative of impaired carbohydrate metabolism?
1. Hydroxybutyric acid
2. Acetoacetate
3. Urobilinogen
4. 2-Hydroxybutyric acid
Answer: A
Explanation: Hydroxybutyric acid is a ketone body that indicates fat metabolism when carbohydrate metabolism is impaired. Its presence suggests potential metabolic dysfunction, particularly in states of insulin resistance.
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