The HF-Cert examination consists of 150 multiple-choice questions (125 scored questions and 25 non-scored, pretest questions) across four content domains. Pretest items are interspersed throughout the exam and are not identifiable as pretest items.
All exam content is developed based on practice in the United States.
Candidates will have three (3) hours to complete the computer-based examination. The exam is offered at testing vendor sites across the United States. The HF-Cert exam is offered only in English.
Candidates are encouraged to review the HF-Cert content outline in preparation for the examination.
HF-Cert Exam Content Outline
| HF-Cert Examination Content Domain | Weight |
|---|---|
| I. Prevention | 19 items |
| II. Assessment | 42 items |
| III. Management | 54 items |
| IV. Systems of Healthcare | 10 items |
| Total | 125 items |
| I. Prevention (19 items) |
| A. Understand risk factors and comorbidities and their contribution to heart failure (HF) (e.g. age, Chagas disease, hypertension, renal dysfunction, venous thromboembolism). |
| B. Educate patients regarding positive health behaviors that promote optimal clinical outcomes (e.g. compliance with medication, diet adherence, flexible diuretic regimen, self-care skills). |
| C. Educate patients and caregivers regarding risk of HF symptoms. |
| D. Enhance provider and patient communication in discharge planning and care transitions to reduce hospital readmissions among patients with heart failure. |
| E. Train transitioning HF patients and caregivers in self-monitoring and record keeping (e.g. blood pressure, edema, heart rate, weight gain). |
| II. Assessment (41 items) |
| A. Assess to determine appropriate treatment plan. |
| B. Evaluate risk of HF decompensation in patients with cerebrovascular and peripheral vascular disease. |
| C. Evaluate risk of HF decompensation in patients with acute coronary syndrome and valve disease. |
| D. Evaluate risk of HF decompensation in patients with elevated BP. |
| E. Evaluate risk of HF decompensation in patients with CAD. |
| D. Determine needs for HF treatment interventions (e.g., diagnostic tests, medications, palliative, preventive, surgical). |
| F. Determine differential diagnoses by prioritizing/recognizing urgent and emergent conditions. |
| G. Determine differential diagnoses by synthesizing and analyzing subjective/objective information. |
| H. Determine nutritional causes of cardiomyopathy leading to HF (e.g. sodium and fluid balance, thiamine deficiency from chronic alcoholism). |
| I. Determine criteria for hospital discharge of acute HF decompensation patients. |
| J. Determine criteria for hospital discharge of acute HF decompensation patients. |
| K. Evaluate candidacy for cardiac rehabilitation. |
| L. Evaluate candidacy for referral to advanced care center. |
| M. Establish final diagnoses by ordering, performing, or interpreting additional diagnostic tests. |
| N. Establish final diagnoses by performing or interpreting additional physical examinations. |
| O. Identify relevant changes in clinical status. |
| P. Identify contraindicated drugs based on patient specific parameters. |
| Q. Identify lab-based diagnostic tests for diagnosis and identification of disease stage of HF. |
| R. Interpret multivariable risk scores (e.g. ADHERE, Seattle). |
| S. Obtain comprehensive HF patient history that includes symptoms, social history, family history, past medical history, medications, allergies. |
| T. Review and apply the results of cardiac catheterization. |
| U. Review and apply the results of cardiac imaging (CT, MRI, PET). |
| V. Review and apply the results of cardiac stress test. |
| W. Review and apply the results of echocardiography. |
| X. Review and apply the results of Holter monitor. |
| Y. Review and apply the results of laboratory test. |
| Z. Review and apply the results of X-ray. |
| AA. Perform a comprehensive physical examination. |
| BB. Prescribe lab-based diagnostic tests for diagnosis and identification of disease stage. |
| DD. Provide medication reconciliation. |
| CC. Review discharge follow-up for errors or discrepancies in medications. |
| DD. Review prescription history for adverse reactions (recognize and report). |
| EE. Review prescription history for allergic reactions. |
| FF. Review prescription history for avoidance of drug interactions and complications. |
| III. Management (54 items) |
| A. Advise patient and/or caregiver on guideline directed medical therapy and self-care plan. |
| B. Demonstrate knowledge of social determinants and barriers to implementation of appropriate HF management. |
| C. Assess patient eligibility for advanced therapies. |
| D. Assess patient eligibility for hospice care coordination. |
| E. Assess patient eligibility for recognition of futility in care. |
| D. Evaluate risk of HF decompensation in patients with atrial fibrillation. |
| F. Participate in shared decision-making and advanced directives. |
| G. Coordinate patient, caregiver, and/or surrogate to implement discharge plan. |
| H. Coordinate palliative care for HF patients (e.g. counseling, cultural activities, homecare, medication to reduce pain/suffering, patient education, spiritual activities). |
| I. Determine the effectiveness of the plan of treatment and care based on outcomes by assessing patient response(s). |
| J. Determine the effectiveness of the plan of treatment and care based on outcomes by collecting additional subjective and/or objective information as needed. |
| K. Recognize the importance of health-related quality of life (HRQOL) in patients with HF (e.g. cognitive dysfunction, chronic alcoholism, depression, symptom burden, functional status). |
| L. Establish a patient-centered treatment and care plan that includes considering comorbidities. |
| M. Establish a patient-centered treatment and care plan that includes making referrals to other health professionals and community resources. |
| N. Establish a patient-centered treatment and care plan that includes ordering, performing, supervising, or interpreting results of further tests. |
| O. Establish a patient-centered treatment and care plan that includes prescribing, ordering, or administering non-pharmacologic therapies and/or procedures. |
| P. Establish a patient-centered treatment and care plan that includes prescribing, ordering, or administering pharmacological therapies. |
| Q. Establish a patient-centered treatment and care plan that includes providing for appropriate follow-up. |
| R. Establish a patient-centered treatment and care plan that includes providing relevant education and/or counseling. |
| S. Evaluate the mechanisms of action, pharmacologic features, and dosing of existing and new agents for treating and managing HF. |
| T. Identify drug-drug and drug-disease interactions. |
| U. Recognize appropriate use criteria of specialized procedures specific to a given population(s) (e.g. endomyocardial biopsy, CPX). |
| V. Provide education and or counseling for HF patients (e.g. diet/fluid intake, self-management, self-monitoring, weight). |
| W. Utilize in-patient physical and occupational therapy for HF. |
| IV. Systems of Healthcare (10 items) |
| A. Demonstrate knowledge of quality, safety, performance, value measures, and ethics in HF. |
| B. Apply culturally sensitive methods with transitioning HF patients. |
| C. Comply with Core Measures and best practice standards. |
| D. Develop administrative roles, policies, and protocols for HF treatment and diagnosis. |
| E. Participate in the development of formal and informal educational programs for appropriate health care professionals. |