- Why a One-Page Review Matters for This Exam
- Exam Format and Numbers at a Glance
- Eligibility, Fees, and Scheduling Facts
- The Four-Domain Map
- Domain 1: Anatomy and Physiology
- Domain 2: Lymphedema, Vascular, and Related Disorders
- Domain 3: Patient Evaluation and Treatment Planning
- Domain 4: Management of Lymphedema and Related Disorders
- Original Practice Questions
- Retakes, Renewal, and Recertification
- Sequencing Your Review Around the Weights
- Where the Credential Leads
- Frequently Asked Questions
- The exam has 130 four-option questions: 110 scored, 20 unidentified research items, 150 minutes total.
- Passing means a scaled score of 700 out of 1000, not 70% raw accuracy.
- Domains 2 and 4 are each 30% of the exam, together 60% of content.
- Eligibility needs a qualifying license, 135+ CDT training hours, and 12 college science credit hours (with exemptions).
Why a One-Page Review Matters for This Exam
The LANA Certified Lymphedema Therapist credential, abbreviated CLT-LANA, is awarded by the Lymphology Association of North America. It is a closed-book, English-language exam, so everything you need has to live in your head on test day. A cheat sheet will not replace months of coursework in complete decongestive therapy (CDT), but it gives you a compact reference for the numbers, rules, and high-yield concepts that candidates most often blur together in the final week.
This page is written for candidates who have already completed, or are close to completing, their CDT training and want a structured final review. If you are earlier in the process, start with the CLT-LANA study guide and the requirements breakdown first, then come back here to consolidate. You can also test your recall with timed questions on the main practice test site. Note that CLT-LANA Exam Prep is independent exam preparation and is not affiliated with LANA.
Exam Format and Numbers at a Glance
Memorize this table first. Format facts are easy points to secure on logistics and pacing, and they shape how you manage your 150 minutes.
| Item | What to Know |
|---|---|
| Certifying body | Lymphology Association of North America (LANA) |
| Credential designation | CLT-LANA |
| Total questions | 130, four options each, single best answer |
| Scored questions | 110 |
| Unidentified research items | 20 (you cannot tell which they are) |
| Testing time | 150 minutes |
| Passing standard | Scaled score of 700 out of 1000 |
| Language and rules | English-language, closed book |
| Delivery | Prometric-supported; test center or approved remote proctoring |
What the 20 research items mean for you
Twenty of the 130 questions do not count toward your score, but they are mixed in and unlabeled. The practical consequence: never skip effort on a question because it "feels like a throwaway." Treat every item as scored. If a question seems strangely worded or covers an obscure point, do not let it rattle your pacing, because it may well be one of the research items.
Pacing math
With 130 questions and 150 minutes, you have a little over a minute per question. A reasonable approach is to move steadily on the first pass, flag anything requiring lengthy reasoning, and reserve the last stretch of the clock for flagged items. Clinical scenario questions take longer than recall questions, so bank time on the quick ones.
Eligibility, Fees, and Scheduling Facts
Many candidates lose weeks to paperwork they could have handled earlier. Confirm each requirement before you pay for anything. The detailed walk-through is in the CLT-LANA requirements guide, but here is the condensed version.
The Three Eligibility Pillars
Candidates must document all of the following:
- Professional credential: an accepted professional license, registration, or equivalent qualifying credential.
- CDT training: at least 135 hours of qualifying complete decongestive therapy training that includes an in-person skills assessment.
- Science coursework: 12 college science credit hours, with specified professional-licensure exemptions.
The April 2026 training policy
LANA's April 2026 policy permits remote delivery of theoretical instruction but requires on-site practical laboratory instruction. If you are choosing a training program, verify that its hands-on component is in person. Hybrid programs that front-load theory online and then bring you to a lab for manual technique and bandaging practice fit this model. Our CLT-LANA training overview covers what to look for.
Fees and the price change
| Fee | Current | Scheduled Increase |
|---|---|---|
| Exam fee | $430 | $480 on April 1, 2027 |
| Recertification fee | $200 | $250 on January 1, 2027 |
If you are on the fence about timing, the exam-fee increase on April 1, 2027 is a concrete reason to schedule sooner rather than later, provided your eligibility documents are in order. The certification cost breakdown explains how these fees fit into your total investment, and the exam dates and scheduling guide covers the booking process. The candidate booklet uses IQT scheduling terminology, so do not be surprised when you see that language during registration.
The Four-Domain Map
The exam blueprint has four content domains. Two of them carry 30% each, which means 60% of the exam sits in just two areas.
| Domain | Weight |
|---|---|
| 1. Anatomy and Physiology | 25% |
| 2. Lymphedema, Vascular, and Related Disorders | 30% |
| 3. Patient Evaluation and Treatment Planning | 15% |
| 4. Management of Lymphedema and Related Disorders | 30% |
A common mistake is to over-invest in Domain 1 because anatomy feels like the "safe" place to study. It is worth 25%, but Domains 2 and 4 together are worth more than twice that. For a deeper treatment of each area, see the complete domains guide.
Domain 1: Anatomy and Physiology (25%)
Must-Know Anatomy and Physiology
This domain underpins everything else. Expect questions that ask you to reason from structure to function, not just recite names.
- Lymphatic vessel hierarchy: initial lymphatics (lymphatic capillaries), precollectors, collectors, lymphatic trunks, and the lymphatic ducts, plus where each region drains.
- Lymphangions and the intrinsic pump: the contractile segments of collectors, the role of valves, and how vessel contraction moves lymph.
- Lymph nodes: structure, function, regional groups, and the concept of watersheds between drainage territories.
- Fluid dynamics: capillary filtration and reabsorption, the Starling principle, lymphatic load versus transport capacity, and the idea of safety factor.
- Superficial versus deep systems: fascial relationships, anastomoses, and the pathways that can be recruited as alternative drainage routes.
- Connections to circulation: venous return, where lymph rejoins the blood circulation, and how venous pressure interacts with lymph flow.
Think in terms of pathways. When a scenario describes a specific surgical or radiation history, you should be able to identify which drainage territory is compromised and where lymph could be rerouted. That pathway reasoning is exactly what the therapist applies in treatment, so the exam rewards it.
Domain 2: Lymphedema, Vascular, and Related Disorders (30%)
This is one of the two heaviest domains, and it is where differentiation skills get tested. The blueprint explicitly includes primary and secondary lymphedema, fat disorders, and arteriovenous disease, so be ready for questions that ask you to tell similar-looking presentations apart.
High-Yield Differentiation Topics
Practice comparing conditions side by side rather than studying each in isolation.
- Primary versus secondary lymphedema: typical causes, onset patterns, and clinical clues that distinguish them.
- Lymphedema versus lipedema: distribution, symmetry, tenderness, foot involvement, and why this distinction changes management.
- Lymphedema versus chronic venous insufficiency: skin changes, pitting behavior, and how the two can coexist as phlebolymphedema.
- Arterial disease considerations: why arterial compromise matters before applying compression.
- Other edema causes: cardiac, renal, hepatic, medication-related, and inflammatory contributors.
- Staging concepts: how stages describe progression from latent through irreversible fibrotic change.
- Complications: cellulitis and infection risk, fibrosis, skin breakdown, and rare but serious conditions that require medical referral.
For a candid look at how this content feels on exam day, the exam difficulty guide is a useful companion.
Domain 3: Patient Evaluation and Treatment Planning (15%)
This is the smallest domain, but do not dismiss it. Evaluation drives every decision in Domain 4, so the concepts overlap heavily.
What Candidates Must Understand
Expect scenario-based questions that ask what to assess first, what findings mean, and how to build a plan.
- History taking: onset, surgical and oncologic history, infections, medications, and comorbidities that alter the plan.
- Physical findings: pitting versus non-pitting, skin texture and integrity, Stemmer sign, and fibrosis assessment.
- Measurement: circumferential measurements, limb volume calculation concepts, and consistent landmarks for tracking change over time.
- Red flags: findings that warrant physician referral before treatment proceeds.
- Goal setting: distinguishing the intensive reduction phase from the maintenance phase, and tailoring goals to the individual.
- Patient factors: ability to self-manage, access to garments and supplies, and education needs.
Domain 4: Management of Lymphedema and Related Disorders (30%)
The other 30% domain is where your CDT training gets applied. Questions here are practical: what do you do, in what order, and why.
The Components of Complete Decongestive Therapy
Know each component, its purpose, and the situations that modify it.
- Manual lymphatic drainage: the principles behind clearing proximal regions first, directional logic, and how technique adapts to different limb or truncal involvement.
- Compression bandaging: short-stretch materials, padding, layering, gradient principles, and the difference between working pressure and resting pressure.
- Compression garments: when to transition from bandaging, garment classes and styles, fit and replacement considerations.
- Exercise: why muscle contraction against compression assists lymph return, and appropriate activity guidance.
- Skin and nail care: infection prevention, hygiene, and patient education on early warning signs.
- Self-management: teaching self-bandaging and self-massage, and building adherence.
- Adjuncts and special cases: considerations for genital, head and neck, and truncal involvement, and how related conditions alter standard approaches.
Key Takeaway
Domains 2 and 4 are mirror images: Domain 2 asks "what is this condition and what are the risks?" while Domain 4 asks "what do I do about it?" Study them together, and for every condition you review, ask what changes in the treatment plan because of it.
Original Practice Questions
These original practice items mirror the four-option, single-answer style of the exam. They are written by this site for independent exam preparation and are not drawn from the actual exam.
Question 1 (Domain 4)
A therapist begins a manual lymphatic drainage session for a patient with unilateral arm lymphedema. Which sequencing principle is most appropriate?
- Begin at the most swollen distal area and work upward
- Prepare proximal regions and pathways first before working toward the affected distal area
- Apply deep pressure over fibrotic tissue before any other work
- Begin with the unaffected limb only and do not treat the affected side
Answer: B. Clearing proximal areas first creates capacity for fluid to move out of the congested region.
Question 2 (Domain 2)
Which finding most strongly favors lipedema over lymphedema?
- Unilateral swelling that includes the dorsum of the foot
- Symmetric fat accumulation in the legs with relative sparing of the feet
- Marked fibrosis with a positive Stemmer sign
- Swelling that began after lymph node removal
Answer: B. Symmetric distribution with foot sparing is a classic distinguishing feature.
Question 3 (Domain 3)
During an initial evaluation, a patient reports a sudden onset of warmth, redness, and fever in the swollen limb. What is the most appropriate action?
- Proceed with a full compression bandaging session
- Increase the intensity of manual drainage
- Hold treatment and refer promptly for medical evaluation of possible infection
- Schedule a routine follow-up in several weeks
Answer: C. These signs suggest possible acute infection, which requires medical attention before decongestive treatment.
For more realistic timed practice, use the question bank on the practice test site.
Retakes, Renewal, and Recertification
Retake Rules
Know these cold, because they affect planning if you need a second attempt.
- A six-month wait is required between attempts.
- A maximum of three attempts is allowed within 24 months.
- After three failed attempts, an additional 12-month wait applies.
Renewal Rules
The credential is not permanent, so factor maintenance into your career planning.
- Certification renews every six years.
- Renewal requires 24 contact hours of qualifying education or other approved activities, or re-examination.
- A current qualifying professional credential must be maintained.
- The recertification fee is $200, increasing to $250 on January 1, 2027.
Because retakes carry a mandatory waiting period, a failed attempt costs months, not just money. That is a strong argument for treating your first attempt seriously. The pass rate article discusses what is and is not publicly known about outcomes.
Sequencing Your Review Around the Weights
You do not need an elaborate system. Allocate time in proportion to the blueprint, and put your weakest high-weight domain first. Here is one way to structure a four-week final review.
Domain 2 Foundations
- Build side-by-side comparison charts for lymphedema, lipedema, and venous disease
- Review staging, complications, and referral red flags
Domain 4 Applications
- Walk through each CDT component and its modifications
- Practice scenario questions that ask what to do first and why
Domain 1 and Domain 3
- Trace drainage pathways and fluid dynamics from first principles
- Review evaluation findings, measurement, and goal setting
Integration and Timed Practice
- Complete timed mixed sets under 150-minute pacing
- Revisit missed questions by domain and rebuild weak points
Putting Domains 2 and 4 early works because they carry the most weight and because they feed on each other. Anatomy and evaluation then reinforce them from underneath. For a longer plan, the study guide expands on this approach.
Where the Credential Leads
CLT-LANA is a specialty credential layered on top of an existing professional license or registration. It tends to be held by clinicians in rehabilitation, oncology support, and wound or vascular care settings, and by therapists building lymphedema-focused practices. Employers value it as evidence of advanced, specialized training. We deliberately avoid quoting figures here, since pay depends heavily on setting, region, and experience. If you want to explore the career side, see the CLT-LANA jobs overview, the salary guide, and the ROI analysis.
If you are still orienting yourself to the terminology, these short explainers cover the basics: what CLT-LANA is, what it stands for, and the broader certification overview.
Frequently Asked Questions
The exam has 130 four-option, single-answer multiple-choice questions. Of these, 110 are scored and 20 are unidentified research items. You cannot tell which are which, so treat every question as if it counts. You have 150 minutes of testing time.
No. Passing requires a scaled score of 700 out of 1000, which is not the same as 70% raw accuracy. Scaling adjusts for differences between exam forms, so there is no fixed number of correct answers you can count on.
Domain 2 (Lymphedema, Vascular, and Related Disorders) and Domain 4 (Management of Lymphedema and Related Disorders) are each 30% of the exam. Domain 1 (Anatomy and Physiology) is 25%, and Domain 3 (Patient Evaluation and Treatment Planning) is 15%.
You need an accepted professional license, registration, or equivalent qualifying credential; at least 135 hours of qualifying CDT training with an in-person skills assessment; and 12 college science credit hours, with specified professional-licensure exemptions. LANA's April 2026 policy allows remote theory instruction but requires on-site practical laboratory instruction.
A six-month wait applies before a retake. You may make a maximum of three attempts in 24 months, and after three failures an additional 12-month wait is required. Because of these waiting periods, thorough preparation before your first attempt is the most efficient path.
Use this cheat sheet as a final-week checklist rather than a first read. Confirm the numbers, rehearse the Domain 2 and Domain 4 reasoning, and then pressure-test yourself with timed practice on the CLT-LANA Exam Prep practice site. This site is independent exam preparation and is not affiliated with or endorsed by LANA.