CWOCN Exam

The WOCNCB offers each specialty exam as a computer-based test delivered by PSI at testing centers. You apply online, and after approval you schedule your exams within your eligibility window. You may take the exams one after another on the same day or on separate days.

Key Facts About the CWOCN Exams

If you pass only the wound and ostomy exams within the 12-month window, you earn the CWON credential. Exams passed outside the window earn the single-specialty credentials: CWCN for wound care, COCN for ostomy care and CCCN for continence care.

All three exams use the same five domains: Assessment, Intervention, Treatment, Care Planning, and Education and Referral. The weights differ by specialty.

Wound Care Exam (110 scored questions)

Ostomy Care Exam (110 scored questions)

Continence Care Exam (110 scored questions)

Treatment is the largest domain on the wound exam, so dressing selection, debridement, compression and advanced therapies deserve extra study time. On the continence exam, Education and Referral is almost as large as Assessment, so expect many questions about what to teach and whom to refer to.

The outlines also set the thinking level of the questions: recall, application and analysis. Most questions describe a patient and ask you to apply what you know, so practice reasoning through scenarios rather than memorizing lists.

Each exam is criterion-referenced: you are measured against a passing standard, not against other candidates. The WOCNCB sets the standard through a formal standard-setting study, and results are reported as scaled scores. The number of correct answers needed to pass is not published and can vary slightly from one exam form to another.

Only the 110 scored questions count, and you cannot tell which 10 questions are pretest items, so give every question your best effort. There is no penalty for a wrong answer, so answer every question. You receive your pass or fail result before you leave the testing center.

• Wound scenarios that ask you to identify the etiology, stage a pressure injury or interpret an ankle-brachial index
• Dressing, debridement and compression choices based on exudate, depth, infection and perfusion
• Pouching problems such as leaks, flush or retracted stomas, high output and peristomal skin damage
• Stoma site marking, postoperative care and teaching for each type of fecal and urinary diversion
• Fistula, tube and drain management, including containment and skin protection
• Matching the type of urinary or fecal incontinence to behavioral, medication and device options
• Teaching, care planning and referral questions that ask for the best next step or the most appropriate resource

• Hold a current registered nurse license and a bachelor's degree or higher.
• Traditional pathway: graduate from an accredited wound, ostomy and continence nursing education program within the past five years.
• Experiential pathway: for each specialty, complete 50 contact hours of continuing education and 1,500 clinical hours in that specialty within the past five years, with at least 375 of those hours in the year before you apply. For all three specialties, that totals 4,500 hours. The hours must be earned as a registered nurse after your bachelor's degree.
• Certification lasts five years. You recertify each specialty either by retaking the exam or through the WOCNCB Professional Growth Program, and you may choose a different route for each specialty.

If you do not pass an exam, you must wait at least 30 days before retaking it, and you may retake it up to three times within your eligibility window. A retake fee applies. Check the WOCNCB Candidate Handbook and fee schedule before you apply, because fees and policies are updated from time to time.