CERTIFIED AESTHETIC NURSE SPECIALIST
CANS Exam
2026/2027
150 verified questions and answers aligned with 2026-
2027 examination content domains: facial anatomy and
physiology, botulinum toxin therapy, dermal fillers and
volumizers, energy-based devices, patient safety, and
professional practice.
150 Verified Questions and Answers
10 Sections · 25% Recall / 50% Application / 25% Analysis
2026/ 2027 ED I TI ON
,CANS Exam | 2026/2027 | 150 Verified Questions and Answers
CANS Exam | 2026/2027
150 Verified Questions and Answers for Certified Aesthetic Nurse Specialist Preparation
Aligned with the 2026-2027 CANS examination content domains | 10 sections | Cognitive mix: 25% recall, 50% application, 25%
analysis | Verified answer key with CANS-specific rationales included
SECTION 1 · QUESTIONS 1-22
Facial Anatomy and Physiology
Facial bones, muscles of facial expression, vascular supply, and nerve distribution
Q1. Which facial bone forms the anterior forehead and the superior orbital rim, serving as the primary
bony landmark when palpating the brow prior to forehead filler placement?
A. Frontal bone [CORRECT]
B. Zygomatic bone
C. Nasal bone
D. Maxilla
Correct Answer: A
Rationale: The frontal bone forms the forehead and the superior orbital rim, making it the key palpable landmark
for supraperiosteal forehead filler placement and frontalis toxin mapping. The zygomatic bone forms the lateral
cheek and malar eminence, the maxilla forms the midface and inferior orbital rim, and the nasal bone forms the
bridge of the nose; none of these provides the anterior forehead surface. Recognizing these bony foundations is
foundational CANS anatomy content because injection planes and danger zones are defined relative to them.
Q2. A patient develops immediate blanching and severe pain during a bolus filler injection into the
glabella. Which artery is MOST likely compromised, given that it emerges from the medial orbit and
ascends the forehead above the brow?
A. Infraorbital artery
B. Transverse facial artery
C. Angular artery
D. Supratrochlear artery [CORRECT]
Correct Answer: D
Rationale: The supratrochlear artery exits the medial orbit and travels superiorly on the forehead roughly 1.5 to 2
cm from the midline, making it the dominant vessel endangered by glabellar injections and the classic cause of
glabellar necrosis. The angular artery courses along the nasofacial groove lateral to the nose, the infraorbital artery
supplies the midface through its foramen, and the transverse facial artery crosses the cheek; none occupies the
glabellar bed. The glabella is a watershed danger zone with limited collateral circulation, which is why blanching
there demands immediate intervention.
Certified Aesthetic Nurse Specialist Preparation 1
,CANS Exam | 2026/2027 | 150 Verified Questions and Answers
Q3. Vertical glabellar frown lines (the '11s') are primarily produced by contraction of which muscle
pair?
A. Corrugator supercilii [CORRECT]
B. Orbicularis oculi
C. Procerus
D. Frontalis
Correct Answer: A
Rationale: The corrugator supercilii muscles originate near the medial brow and pull the brows medially and
downward, producing the oblique and vertical components of the glabellar '11' lines; they are primary botulinum
toxin targets. The procerus creates horizontal lines across the radix, the frontalis elevates the brows and creates
horizontal forehead lines, and the orbicularis oculi acts as the periorbital sphincter producing crow's feet. Accurate
muscle-to-wrinkle mapping is a signature CANS testing point because treatment selection depends on it.
Q4. When treating masseter hypertrophy with botulinum toxin, the injector should place the needle:
A. Just deep to the skin within the dermis over the mandibular angle
B. Into the belly of the masseter inferior to the zygomatic arch, confirmed by having the patient
clench [CORRECT]
C. Supraperiosteally over the body of the zygoma
D. Along the posterior border of the mandibular ramus near the parotid gland
Correct Answer: B
Rationale: Botulinum toxin must be delivered intramuscularly into the masseter belly, which is mapped by
palpation during forced clenching below the zygomatic arch so that the strongest contractile bulk is targeted.
Placement too superiorly risks diffusion into the zygomaticus muscles with smile asymmetry, while posterior
placement risks parotid trauma. Dermal or supraperiosteal placement fails to achieve chemodenervation and
wastes product. Clench-guided intramuscular injection is the standard technique tested on the CANS examination.
Q5. Which branch of the facial nerve (CN VII) innervates the frontalis muscle, such that its injury
results in brow ptosis and loss of forehead rhytids?
A. Marginal mandibular branch
B. Temporal branch [CORRECT]
C. Zygomatic branch
D. Buccal branch
Correct Answer: B
Rationale: The temporal branch of CN VII crosses the zygomatic arch superficially and innervates the frontalis,
superior orbicularis oculi, and corrugator muscles, so injury produces ipsilateral brow ptosis and forehead
smoothing. The zygomatic and buccal branches serve the midface and perioral musculature, and the marginal
mandibular branch controls the lower lip depressors. This is why procedures over the temple and lateral brow carry
documented temporal branch risk and require superficial-plane awareness.
Certified Aesthetic Nurse Specialist Preparation 2
, CANS Exam | 2026/2027 | 150 Verified Questions and Answers
Q6. Following an aesthetic procedure along the body of the mandible, a patient is unable to fully
depress the corner of the mouth and the lower lip appears asymmetric with a raised appearance on that
side. Which nerve branch was MOST likely injured?
A. Marginal mandibular branch of the facial nerve [CORRECT]
B. Zygomatic branch of the trigeminal nerve
C. Cervical branch of the facial nerve
D. Temporal branch of the facial nerve
Correct Answer: A
Rationale: The marginal mandibular branch courses along the inferior mandibular border superficial to the
platysma and innervates the depressor anguli oris and depressor labii inferioris; injury paralyzes these depressors
so the mouth corner cannot be pulled downward, creating a raised asymmetric smile. The temporal branch affects
the brow, the cervical branch largely serves the platysma, and the trigeminal nerve is sensory to the face rather
than motor to the lip depressors. This anatomy is exactly why depressor anguli oris injections are kept medial and
superficial, and why deep dissection along the mandibular border is high risk.
Q7. At which anatomic location can the facial artery be reliably palpated as a pulse, making it an
important landmark and danger zone during lower facial filler procedures?
A. As it crosses the inferior border of the mandible anterior to the masseter muscle [CORRECT]
B. Within the parotid gland posterior to the mandibular ramus
C. At the supraorbital notch along the superior orbital rim
D. At the zygomatic arch midway between the tragus and lateral canthus
Correct Answer: A
Rationale: The facial artery crosses the inferior mandibular border just anterior to the masseter, where its pulse is
easily palpated; from there it courses toward the medial canthus becoming the angular artery. It does not run
within the parotid posteriorly, at the zygomatic arch, or at the supraorbital notch. Knowing this crossing point is
critical because jawline and marionette filler injections in this region can intravascularly cannulate the facial
artery, so aspiration and low-pressure retrograde technique are emphasized in CANS safety training.
Q8. A nurse plans tear trough and nasolabial fold correction and maps the vessel that runs along the
lateral nose toward the medial canthus, which is a terminal continuation of the facial artery. This vessel
is the:
A. Superficial temporal artery
B. Dorsal nasal artery arising from the ophthalmic system only
C. Angular artery [CORRECT]
D. Greater palatine artery
Correct Answer: C
Rationale: The angular artery is the terminal continuation of the facial artery, ascending along the nasofacial
groove toward the medial canthus where it anastomoses with the dorsal nasal branch of the ophthalmic artery. This
anastomosis is the anatomic basis for retrograde embolization causing blindness in nasal and tear trough injections.
The superficial temporal artery supplies the temple region, and the greater palatine artery is intraoral. Recognizing
the angular artery's course is central to CANS vascular danger-zone questions.
Certified Aesthetic Nurse Specialist Preparation 3
CANS Exam
2026/2027
150 verified questions and answers aligned with 2026-
2027 examination content domains: facial anatomy and
physiology, botulinum toxin therapy, dermal fillers and
volumizers, energy-based devices, patient safety, and
professional practice.
150 Verified Questions and Answers
10 Sections · 25% Recall / 50% Application / 25% Analysis
2026/ 2027 ED I TI ON
,CANS Exam | 2026/2027 | 150 Verified Questions and Answers
CANS Exam | 2026/2027
150 Verified Questions and Answers for Certified Aesthetic Nurse Specialist Preparation
Aligned with the 2026-2027 CANS examination content domains | 10 sections | Cognitive mix: 25% recall, 50% application, 25%
analysis | Verified answer key with CANS-specific rationales included
SECTION 1 · QUESTIONS 1-22
Facial Anatomy and Physiology
Facial bones, muscles of facial expression, vascular supply, and nerve distribution
Q1. Which facial bone forms the anterior forehead and the superior orbital rim, serving as the primary
bony landmark when palpating the brow prior to forehead filler placement?
A. Frontal bone [CORRECT]
B. Zygomatic bone
C. Nasal bone
D. Maxilla
Correct Answer: A
Rationale: The frontal bone forms the forehead and the superior orbital rim, making it the key palpable landmark
for supraperiosteal forehead filler placement and frontalis toxin mapping. The zygomatic bone forms the lateral
cheek and malar eminence, the maxilla forms the midface and inferior orbital rim, and the nasal bone forms the
bridge of the nose; none of these provides the anterior forehead surface. Recognizing these bony foundations is
foundational CANS anatomy content because injection planes and danger zones are defined relative to them.
Q2. A patient develops immediate blanching and severe pain during a bolus filler injection into the
glabella. Which artery is MOST likely compromised, given that it emerges from the medial orbit and
ascends the forehead above the brow?
A. Infraorbital artery
B. Transverse facial artery
C. Angular artery
D. Supratrochlear artery [CORRECT]
Correct Answer: D
Rationale: The supratrochlear artery exits the medial orbit and travels superiorly on the forehead roughly 1.5 to 2
cm from the midline, making it the dominant vessel endangered by glabellar injections and the classic cause of
glabellar necrosis. The angular artery courses along the nasofacial groove lateral to the nose, the infraorbital artery
supplies the midface through its foramen, and the transverse facial artery crosses the cheek; none occupies the
glabellar bed. The glabella is a watershed danger zone with limited collateral circulation, which is why blanching
there demands immediate intervention.
Certified Aesthetic Nurse Specialist Preparation 1
,CANS Exam | 2026/2027 | 150 Verified Questions and Answers
Q3. Vertical glabellar frown lines (the '11s') are primarily produced by contraction of which muscle
pair?
A. Corrugator supercilii [CORRECT]
B. Orbicularis oculi
C. Procerus
D. Frontalis
Correct Answer: A
Rationale: The corrugator supercilii muscles originate near the medial brow and pull the brows medially and
downward, producing the oblique and vertical components of the glabellar '11' lines; they are primary botulinum
toxin targets. The procerus creates horizontal lines across the radix, the frontalis elevates the brows and creates
horizontal forehead lines, and the orbicularis oculi acts as the periorbital sphincter producing crow's feet. Accurate
muscle-to-wrinkle mapping is a signature CANS testing point because treatment selection depends on it.
Q4. When treating masseter hypertrophy with botulinum toxin, the injector should place the needle:
A. Just deep to the skin within the dermis over the mandibular angle
B. Into the belly of the masseter inferior to the zygomatic arch, confirmed by having the patient
clench [CORRECT]
C. Supraperiosteally over the body of the zygoma
D. Along the posterior border of the mandibular ramus near the parotid gland
Correct Answer: B
Rationale: Botulinum toxin must be delivered intramuscularly into the masseter belly, which is mapped by
palpation during forced clenching below the zygomatic arch so that the strongest contractile bulk is targeted.
Placement too superiorly risks diffusion into the zygomaticus muscles with smile asymmetry, while posterior
placement risks parotid trauma. Dermal or supraperiosteal placement fails to achieve chemodenervation and
wastes product. Clench-guided intramuscular injection is the standard technique tested on the CANS examination.
Q5. Which branch of the facial nerve (CN VII) innervates the frontalis muscle, such that its injury
results in brow ptosis and loss of forehead rhytids?
A. Marginal mandibular branch
B. Temporal branch [CORRECT]
C. Zygomatic branch
D. Buccal branch
Correct Answer: B
Rationale: The temporal branch of CN VII crosses the zygomatic arch superficially and innervates the frontalis,
superior orbicularis oculi, and corrugator muscles, so injury produces ipsilateral brow ptosis and forehead
smoothing. The zygomatic and buccal branches serve the midface and perioral musculature, and the marginal
mandibular branch controls the lower lip depressors. This is why procedures over the temple and lateral brow carry
documented temporal branch risk and require superficial-plane awareness.
Certified Aesthetic Nurse Specialist Preparation 2
, CANS Exam | 2026/2027 | 150 Verified Questions and Answers
Q6. Following an aesthetic procedure along the body of the mandible, a patient is unable to fully
depress the corner of the mouth and the lower lip appears asymmetric with a raised appearance on that
side. Which nerve branch was MOST likely injured?
A. Marginal mandibular branch of the facial nerve [CORRECT]
B. Zygomatic branch of the trigeminal nerve
C. Cervical branch of the facial nerve
D. Temporal branch of the facial nerve
Correct Answer: A
Rationale: The marginal mandibular branch courses along the inferior mandibular border superficial to the
platysma and innervates the depressor anguli oris and depressor labii inferioris; injury paralyzes these depressors
so the mouth corner cannot be pulled downward, creating a raised asymmetric smile. The temporal branch affects
the brow, the cervical branch largely serves the platysma, and the trigeminal nerve is sensory to the face rather
than motor to the lip depressors. This anatomy is exactly why depressor anguli oris injections are kept medial and
superficial, and why deep dissection along the mandibular border is high risk.
Q7. At which anatomic location can the facial artery be reliably palpated as a pulse, making it an
important landmark and danger zone during lower facial filler procedures?
A. As it crosses the inferior border of the mandible anterior to the masseter muscle [CORRECT]
B. Within the parotid gland posterior to the mandibular ramus
C. At the supraorbital notch along the superior orbital rim
D. At the zygomatic arch midway between the tragus and lateral canthus
Correct Answer: A
Rationale: The facial artery crosses the inferior mandibular border just anterior to the masseter, where its pulse is
easily palpated; from there it courses toward the medial canthus becoming the angular artery. It does not run
within the parotid posteriorly, at the zygomatic arch, or at the supraorbital notch. Knowing this crossing point is
critical because jawline and marionette filler injections in this region can intravascularly cannulate the facial
artery, so aspiration and low-pressure retrograde technique are emphasized in CANS safety training.
Q8. A nurse plans tear trough and nasolabial fold correction and maps the vessel that runs along the
lateral nose toward the medial canthus, which is a terminal continuation of the facial artery. This vessel
is the:
A. Superficial temporal artery
B. Dorsal nasal artery arising from the ophthalmic system only
C. Angular artery [CORRECT]
D. Greater palatine artery
Correct Answer: C
Rationale: The angular artery is the terminal continuation of the facial artery, ascending along the nasofacial
groove toward the medial canthus where it anastomoses with the dorsal nasal branch of the ophthalmic artery. This
anastomosis is the anatomic basis for retrograde embolization causing blindness in nasal and tear trough injections.
The superficial temporal artery supplies the temple region, and the greater palatine artery is intraoral. Recognizing
the angular artery's course is central to CANS vascular danger-zone questions.
Certified Aesthetic Nurse Specialist Preparation 3
