How Many Questions Are on the ANCC® Certification Test?

A nurse researching the number of questions on the ANCC® certification test.

The American Nurses Credentialing Center certification exam (also known as the ANCC FNP exam) is defined by the ANCC as a “competency-based examination that provides a valid and reliable assessment of the entry-level clinical knowledge and skills of the FNP.”

Upon completion of eligibility requirements, qualified candidates who wish to become a family nurse practitioner (FNP) must take and pass the ANCC FNP exam (or the American Academy of Nurse Practitioners certification exam — AANP FNP exam) to demonstrate the entry-level competency and clinical knowledge necessary to be a family nurse practitioner.

When you successfully pass the ANCC FNP exam, you earn the credential FNP-BC (Family Nurse Practitioner-Board Certified) from the American Nurses Credentialing Center. This certification is accredited by the Accreditation Board for Specialty Nursing Certification.

How Many Questions Are on the ANCC Certification Test?

There are 175 questions on the exam. However, only 150 of these questions are actually scored. The other 25 questions are known as “pretest” questions and are not scored.

Pretest questions are inserted to determine the quality of the questions before being used as scored ANCC FNP questions on future exams.

Pretest questions are not labeled and are purposely indistinguishable from scored questions. It is important that you complete all 175 questions on your exam.

What Does the ANCC Test?

According to the November 1, 2020 ANCC blueprint, there are four domain areas of the ANCC FNP exam: Assessment, Diagnosis, Clinical Management, and Professional Role. Each of these domains examines knowledge and skill.

  • Assessment: 31 questions; 21% of the exam
    • Knowledge:
      • Evidence-based population health promotion and screening
    • Skill:
      • Comprehensive history and physical assessment
      • Focused history and physical assessment
      • Risk assessment (e.g., genetic, behavioral, lifestyle)
      • Functional assessment (e.g., cognitive, developmental, physical capacity)
  • Diagnosis: 39 questions: 26% of the exa
    • Knowledge:
      • Pathogenesis and clinical manifestations of disease states
    • Skill:
      • Differentiating between normal and abnormal physiologic or psychiatric changes
      • Diagnostic test selection and evaluation
  • Clinical Management: 65 questions; 43% of the exam
    • Knowledge: 
      • Pharmacotherapeutics, pharmacokinetics, pharmacodynamics, and pharmacogenetics
      • Anticipatory guidance (e.g., developmental, behavioral, disease progression, crisis management, end-of-life care)
      • Age-appropriate primary, secondary, and tertiary prevention interventions
    • Skill:
      • Pharmacotherapeutic intervention selection (e.g., interactions, contraindications)
      • Pharmacotherapeutic intervention evaluation (e.g., monitoring, side/adverse effects, patient outcomes)
      • Non-pharmacologic intervention selection and evaluation
      • Therapeutic communication (e.g., motivational interviewing, shared decision making)
      • Culturally congruent practice
      • Resource management (e.g., accessibility, coordination, cost effectiveness)
  • Professional Role: 15 questions; 10% of the exam
    • Knowledge:
      • Legal and ethical considerations for health care informatics and technology (e.g., confidentiality, accessibility)
      • Scope and standards for advanced practice registered nurses
      • Regulatory guidelines (e.g., reportable diseases, abuse reporting)
      • Evidence-based clinical guidelines and standards of care
      • Ethical and legal principles and issues for patients, populations, and systems (e.g., justice, consent, guardianship, bioethics)
    • Skill:
      • Research appraisal (e.g., design, results, clinical applicability)

How Long Is the ANCC FNP Exam?

You are allowed 3.5 hours to complete all 175 questions on the ANCC FNP exam. (Remember: 150 of the 175 questions are scored questions; 25 of the 175 questions are pretest questions.)

What Is a Passing Score on the ANCC FNP Exam?

Upon completion of the ANCC FNP exam, a raw score — the number of test items you answered correctly — is determined. That raw score is then converted to a scale score. The highest possible scale score on the ANCC is 500. In order to pass the exam, you must achieve a scale score of 350 or higher.


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Family nurse Practitioner CERTIFICATION (FNP-BC): ANCC. ANA. (n.d.). Retrieved September 29, 2021, from https://www.nursingworld.org/our-certifications/family-nurse-practitioner/.

Test content outline – american nurses association. (n.d.). Retrieved September 29, 2021, from https://www.nursingworld.org/~48f9cc/globalassets/certification/certification-specialty-pages/resources/test-content-outlines/familynp-tco-may-222.pdf.

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