PracticeVideosBlogFlashcardsEspañol
All Practice Exams

100+ Free CSPCC Practice Questions

Pass your Board Certified Specialist in Pediatric Critical Care Nutrition exam on the first try — instant access, no signup required.

✓ No registration✓ No credit card✓ No hidden fees✓ Start practicing immediately
100+ Questions
100% Free
1 / 100
Question 1
Score: 0/0

Which lipid emulsion has been FDA-approved for the treatment of pediatric intestinal failure-associated liver disease (IFALD)?

A
B
C
D
to track
Same family resources

More CDR Dietetics Exams Prep

Continue through related practice pages, study guides, comparisons, and articles from the same exam family.

Practice Pages
CDR Registered Dietitian (RD) Practice200 questionsCDR Registered Dietetic Technician (DTR) Practice199 questionsCDR CSG Board Certified Specialist in Gerontological Nutrition Practice100 questionsCDR CSO Board Certified Specialist in Oncology Nutrition Practice100 questionsCDR CSOWM Interdisciplinary Specialist Certification in Obesity and Weight Management Practice100 questionsCDR CSP Board Certified Specialist in Pediatric Nutrition Practice100 questions
Related Articles
CDR DTR (NDTR) Exam Guide 2026: Pass Dietetic Tech (FREE)27 min readFREE CDN Exam Guide 2026: Pass CDR Renal Nutrition Cert26 min read
2026 Statistics

Key Facts: CSPCC Exam

150

Total Items

125 scored + 25 pretest

3 hrs

Time Limit

CDR

2,000 hrs

Required Experience

PICU/NICU within 5 years

$350

US Exam Fee

$475 international

ASPEN/SCCM

Core Guidelines

2017 PICU + 2023 NICU

5 years

Certification Validity

CDR

The CSPCC (Board Certified Specialist in Pediatric Critical Care Nutrition) exam is administered by CDR. The exam consists of 150 multiple-choice items (125 scored + 25 pretest) over 3 hours. The fee is $350 US / $475 international. Eligibility requires an active RD/RDN credential plus 2,000 hours of PICU/NICU practice within the past 5 years. Year-round PSI testing. The exam covers 7 content areas spanning critical-illness assessment, EN/PN management, disease-specific PICU nutrition, NICU/preterm nutrition, and outcomes.

Sample CSPCC Practice Questions

Try these sample questions to test your CSPCC exam readiness. Each question includes a detailed explanation. Start the interactive quiz above for the full 100+ question experience with AI tutoring.

1A 6-year-old admitted to the PICU with septic shock has lost 9% of usual body weight over the past 4 weeks and is consuming less than 25% of estimated needs. According to the ASPEN/AND pediatric malnutrition consensus indicators, how should the dietitian classify this child's malnutrition?
A.Mild malnutrition
B.Moderate malnutrition
C.Severe malnutrition
D.No malnutrition because BMI z-score is normal
Explanation: Per the 2014 ASPEN/AND pediatric malnutrition indicators, weight loss greater than 7.5% over 1 month or intake less than 25% of estimated needs for greater than 5 days meets the threshold for severe malnutrition when a single data point is used. Either criterion alone is sufficient. BMI z-score is one of several anthropometric indicators but is not required when intake/interval weight loss criteria establish severity.
2Which anthropometric measurement is MOST useful for assessing acute changes in nutrition status in a critically ill, edematous PICU patient on continuous renal replacement therapy?
A.Daily weights
B.Mid-upper arm circumference (MUAC)
C.BMI-for-age
D.Triceps skinfold trended weekly
Explanation: In edematous, fluid-overloaded patients on CRRT, body weight is confounded by fluid shifts and extracorporeal volume. Mid-upper arm circumference is relatively unaffected by edema and is the preferred anthropometric for nutrition assessment in this setting. BMI and weight-based measures are unreliable; skinfolds also become unreliable with edema and are not useful for acute changes.
3A 14-month-old admitted to the PICU has a weight-for-length z-score of -2.4 and a MUAC z-score of -2.1, with no documented intake history. Using the WHO/ASPEN single-point criteria, the dietitian should diagnose:
A.Mild malnutrition
B.Moderate malnutrition
C.Severe malnutrition
D.Stunting only
Explanation: A single anthropometric z-score between -2 and -2.99 meets criteria for moderate malnutrition under the ASPEN/AND consensus indicators (-1 to -1.9 mild; -2 to -2.9 moderate; less than or equal to -3 severe). Stunting requires length-for-age, not weight-for-length. Both indicators are in the moderate range here.
4Which laboratory marker is LEAST useful for assessing nutrition status in a critically ill child?
A.C-reactive protein
B.Albumin
C.Prealbumin
D.Body weight trend
Explanation: Albumin and prealbumin are negative acute-phase reactants that fall during inflammation independent of nutrition status, and ASPEN explicitly recommends against using them as nutrition markers in critical illness. Prealbumin is the LEAST useful of those listed because it is most often misinterpreted as a nutrition marker. CRP is helpful to interpret the inflammatory state, and weight trends remain useful when fluid status is accounted for.
5A previously healthy 9-year-old is admitted with multisystem trauma. Within the first 24 hours of ICU admission, the dietitian should:
A.Defer all nutrition assessment until hemodynamic stability is achieved
B.Complete a full nutrition assessment and identify those at high nutrition risk for early intervention
C.Initiate parenteral nutrition empirically
D.Wait for the family to provide a 24-hour dietary recall
Explanation: ASPEN/SCCM 2017 pediatric critical care nutrition guidelines recommend nutrition screening and assessment within 48 hours of PICU admission to identify high-risk patients who benefit from early intervention. Hemodynamic instability is not a barrier to assessment; only EN initiation is influenced by escalating vasoactive support. Empiric PN is not warranted, and dietary recall is impractical and not a priority in trauma admission.
6Which screening tool was developed and validated specifically for hospitalized pediatric patients?
A.MUST
B.STAMP
C.NRS-2002
D.SGA
Explanation: STAMP (Screening Tool for the Assessment of Malnutrition in Pediatrics) was developed for hospitalized children ages 2-16. STRONGkids and PYMS are also pediatric-specific. MUST and NRS-2002 are adult tools; SGA has both adult and pediatric variants but the originals are adult-focused. STAMP is the best answer for a pediatric-validated tool.
7A 3-year-old with cerebral palsy is admitted with respiratory failure. The mother reports the child only eats pureed foods and the child's weight-for-age z-score is -2.8 but length-for-age is -3.2. The MOST appropriate nutrition diagnosis is:
A.Acute severe malnutrition (wasting)
B.Chronic malnutrition (stunting)
C.Inadequate energy intake
D.Failure to thrive
Explanation: Length-for-age z-score less than or equal to -3 indicates severe stunting, which reflects chronic malnutrition. The weight-for-age decrease in stunted children largely reflects the height deficit. Acute malnutrition is best identified by weight-for-length or BMI-for-age, which would need to be evaluated. In children with neurologic impairment, growth charts specific to the condition should be used when available, but stunting is the predominant finding here.
8When using the Nutrition Care Process to document a PIES/PES statement for a critically ill child, which component represents the etiology?
A.The diagnostic label
B.The cause or contributing factor amenable to intervention
C.The signs and symptoms supporting the diagnosis
D.The intervention selected
Explanation: In a PES statement (Problem-Etiology-Signs/Symptoms), the etiology is the cause or contributing factor that the dietitian's intervention will address. For a critically ill child, an etiology might be 'related to increased nutrient needs from sepsis and prolonged mechanical ventilation.' The intervention should target the etiology when possible.
9A 4-month-old former 28-week preterm infant is admitted to the PICU with bronchiolitis. The dietitian should plot the infant's growth using:
A.WHO growth standards using chronological age
B.CDC growth charts using chronological age
C.Fenton growth chart using chronological age until 50 weeks postmenstrual age, then WHO with corrected age
D.Chronological age on the WHO chart with no correction
Explanation: For preterm infants, the Fenton 2013 growth chart is used until at least 50 weeks postmenstrual age. After that, WHO standards are used with corrected age (chronological age minus weeks of prematurity) until at least 24-36 months of age. Chronological age underestimates growth in preterm infants and may misclassify normal growth as failure.
10The dietitian is calculating an ideal body weight for nutrition assessment of an 8-year-old child with obesity. The MOST appropriate method is:
A.Use the actual body weight for all calculations
B.Use the weight at the 50th percentile for the child's height-age
C.Use a fixed BMI of 22 multiplied by height in meters squared
D.Use the McLaren or Moore formula adjusted for age
Explanation: For pediatric IBW, the most common method is to use the weight at the 50th percentile for the child's height-age (the age at which the child's measured length/height is at the 50th percentile). For children with obesity, this allows for energy and protein calculation that does not overfeed. Adult BMI-based methods are inappropriate for children.

About the CSPCC Exam

Specialty certification for Registered Dietitians providing clinical nutrition care in pediatric critical care settings (PICU, NICU, cardiac ICU, burn unit). The CSPCC validates expertise across critical-illness nutrition assessment, evidence-based energy and protein recommendations (ASPEN/SCCM 2017 PICU, 2023 NICU), enteral and parenteral nutrition management in the critically ill child, disease-specific protocols (sepsis, ARDS, ECMO, TBI, burns, cardiac surgery, NEC), and the unique nutritional needs of preterm and ELBW infants.

Questions

150 scored questions

Time Limit

3 hours

Passing Score

Scaled

Exam Fee

$350 US / $475 international (CDR)

CSPCC Exam Content Outline

22%

Nutrition Assessment & Diagnosis

Critical-illness assessment, ASPEN/AND pediatric malnutrition, NCP/PES

14%

Energy & Macronutrient Requirements

ASPEN/SCCM targets, indirect calorimetry, predictive equations

16%

Enteral Nutrition Management

Early EN, gastric vs post-pyloric, advancement, formula selection

12%

Parenteral Nutrition Management

PN initiation, composition, IFALD prevention, complications

18%

Disease-Specific PICU Nutrition

Sepsis, ARDS, ECMO, TBI, burns, cardiac, AKI/CRRT, transplant, SBS

14%

NICU & Preterm Nutrition

ELBW, NEC, donor human milk, fortification, BPD, ROP

4%

Monitoring, Outcomes & Professional Practice

Outcomes, EBP, QI, transitions, family-centered care

How to Pass the CSPCC Exam

What You Need to Know

  • Passing score: Scaled
  • Exam length: 150 questions
  • Time limit: 3 hours
  • Exam fee: $350 US / $475 international

Keys to Passing

  • Complete 500+ practice questions
  • Score 80%+ consistently before scheduling
  • Focus on highest-weighted sections
  • Use our AI tutor for tough concepts

CSPCC Study Tips from Top Performers

1Master ASPEN/SCCM 2017 PICU guidelines: indirect calorimetry preferred; if not available use Schofield or WHO equations WITHOUT stress factors; protein minimum 1.5 g/kg/d, ≥2 g/kg/d for trauma/sepsis/burns/critical illness <2y
2Know early EN principles: start within 24-48h, no routine GRV monitoring, gastric vs post-pyloric (post-pyloric for aspiration risk or feeding intolerance), volume- or rate-based advancement protocols
3Understand IFALD (intestinal failure-associated liver disease) prevention: cycle PN when feasible, use omega-3-based lipid emulsions (SMOFlipid, Omegaven), reduce manganese and aluminum, monitor LFTs
4Memorize ECMO nutrition: feed enterally when possible, energy ~110% of REE, beware insensible losses, watch for medication-circuit binding
5Know burn nutrition: hyperphagia, fluid resuscitation impact, increased calories per Galveston/Curreri formulas, glutamine supplementation, immunonutrition consideration

Frequently Asked Questions

Who is eligible for the CSPCC exam?

You need an active CDR Registered Dietitian (RD or RDN) credential plus a minimum of 2,000 hours of documented PICU and/or NICU clinical nutrition practice within the past 5 years. The exam is offered year-round through PSI test centers.

What energy and protein recommendations should I master?

Use ASPEN/SCCM 2017 PICU guidelines: measured indirect calorimetry preferred; predictive equations (Schofield, WHO) WITHOUT stress factors since most ventilated children are NOT hypermetabolic; energy goal 60% of needs by EN day 7. Protein: 1.5 g/kg/d minimum, >2 g/kg/d for trauma/sepsis/burns/critical illness in <2 years. ASPEN/SCCM 2023 added NICU-specific recommendations.

What's the recommended approach to enteral nutrition in PICU?

Start EN within 24-48 hours of PICU admission when feasible. Gastric route is preferred for most patients; post-pyloric for high gastric residual or aspiration risk. Routine GRV monitoring is NOT recommended (per ASPEN/SCCM 2017). Use volume-based or rate-based advancement protocols. Hold or reduce EN if escalating norepinephrine/epinephrine for shock.

What NICU-specific content is heavy on the exam?

ELBW nutrition fundamentals (early aggressive PN with protein 3.5-4 g/kg/d and lipids 2-3 g/kg/d, advance EN cautiously), NEC prevention (donor human milk, careful advancement) and post-NEC feeding (NPO + bowel rest, cautious reintroduction), fortification of expressed breast milk (HMF after EN reaches ~80-100 mL/kg/d), BPD nutrition (energy-dense, fluid restriction), and post-resection short bowel management (cycled PN, intestinal adaptation, fish oil-based lipids for IFALD).

How should I study for the CSPCC exam?

Plan 60-100 hours over 8-12 weeks. Focus on the disease-specific domains (PICU + NICU = 32% combined) plus assessment + energy requirements (36% combined). Master ASPEN/SCCM 2017 PICU and 2023 NICU guidelines, AND/ASPEN pediatric malnutrition criteria, IFALD prevention with SMOF lipid emulsions, refeeding syndrome management, and the unique nutritional protocols for sepsis, ECMO, burns, cardiac surgery, and NEC.