FNP Exam Blueprint | AANP® and ANCC 

See what’s tested on each family nurse practitioner (FNP) certification exam by reviewing the AANP® Exam Blueprint and ANCC Test Content Outline.
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A future family nurse practitioner reviews the AANP test blueprint and ANCC FNP exam blueprint

To become a family nurse practitioner (FNP), you must complete 1 of 2 available FNP certification exams. While similar, they have a few key content differences to note when pursuing your license. In this guide, we’ll break down each FNP exam blueprint to eliminate surprises on test day.

AANP® vs. ANCC FNP Exam Content: What’s the Difference?

The AANP and ANCC FNP certification exams test essential clinical skills, but the ANCC’s Implementation domain emphasizes legal and regulatory considerations and other professional concepts. The ANCC’s broader scope suits leadership roles, while the AANP’s clinical focus aligns with patient care.

Item FNP-C® Exam FNP-BCTM Exam
Certification board: AANPCB / AANP ANCC
Career alignment: Patient care Leadership roles
Number of questions: 150 total (15 are pretest) 175 total (25 are pretest)
Testing time: 3 hours 3.5 hours
Content domains: 4 total (Assess, Diagnose, Plan, and Evaluate) 5 total (Assessment, Diagnosis, Planning, Implementation, and Evaluation)

Check out our FNP Study Guide for expert advice on how to prepare for your exam.

AANP: FNP-C® Exam Blueprint

The AANP FNP exam has 150 questions, with 135 counting toward your score and 15 as pretest questions. While most are single-answer multiple-choice questions, you may encounter alternate formats, such as multiple-response questions. In the blueprint, you can see approximately how many questions per topic to expect on your exam, sorted by domains and patient age:

Domain/Task # of Items % of Items
Domain 1: Assess 43 32%
Domain 2: Diagnose 36 26.5%
Domain 3: Plan 36 26.5%
Domain 4: Evaluate 20 15%
Total 135 100%
Patient Age # of Items % of Items
Newborn 3 2%
Infant 4 3%
Toddler 5 4%
Child 6 4%
Adolescent* 12 9%
Young Adult* 30 22%
Middle Adult* 35 26%
Older Adult 40 30%
Total 135 100%

*Includes Prenatal

Age parameters are not defined for any population. The AANP uses growth and development when constructing the FNP certification exam.

FNP-C Domains and Tasks

  1. Assess
    1. Obtain elements of subjective patient information (e.g., chief complaint, history, and review of systems).
    2. Perform appropriate physical examination (e.g., focused and complete).
    3. Order, perform, and interpret screening and diagnostic tests.
  2. Diagnose
    1. Synthesize and analyze subjective and objective information to develop differential diagnoses.
    2. Prioritize differential diagnoses and establish a primary diagnosis.
  3. Plan
    1. Establish a patient-centered, evidence-based plan of care.
    2. Initiate interprofessional referrals or consultations.
    3. Prescribe, order, or administer pharmacologic and non-pharmacologic treatments.
    4. Provide education, counseling, and health promotion strategies.
  4. Evaluate
    1. Evaluate the plan of care’s effectiveness.
    2. Monitor and modify the plan of care based on patient outcomes.

FNP-C Knowledge Areas

  • Diagnostic and therapeutic tests
  • Specialized assessments (e.g., developmental, functional, and psychological)
  • Health history
  • Physical examination
  • Anatomy
  • Physiology
  • Pathophysiology
  • Co-morbidities
  • Pharmacologic
  • Non-pharmacologic
  • Integrative
  • Crisis management
  • Diagnostic reasoning
  • Health promotion, harm reduction, and disease prevention
  • Healthcare economics (e.g., cost and billing)
  • Interprofessional practice
  • Legal and ethical issues
  • Patient and family education and counseling
  • Principles of epidemiology, population health, and social drivers of health (SDoH)
  • Procedures
  • Transitions of care
  • Cultural responsiveness
  • Therapeutic communication
  • Pain management

ANCC: FNP-BCTM Test Content Outline

The ANCC FNP exam has 175 questions, with 150 counting toward your score and 25 as pretest questions. In the content outline, you can see approximately how many questions per topic to expect on your exam, sorted by domains. There are also secondary classifications to consider.

Domain # of Questions Percentage*
Domain 1: Assessment 29 19%
Domain 2: Diagnosis 26 17%
Domain 3: Planning 29 19%
Domain 4: Implementation 43 29%
Domain 5: Evaluation 23 15%
Total 150 100%

*The percentages do not add to 100% because of rounding.

FNP-BC Domains

  1. Assessment
    1. Knowledge
      1. Evidence-based population health promotion and screening
    2. Skill
      1. Comprehensive history and physical assessment
      2. Focused history and physical assessment
      3. Functional assessment (e.g., cognitive, developmental, physical capacity, and family and caregiver roles)
      4. Risk assessment (e.g., genetic, behavioral, lifestyle, and cultural)
  2. Diagnosis
    1. Knowledge
      1. Pathogenesis and clinical manifestations of disease states
    2. Skill
      1. Diagnostic test selection
      2. Differentiating between normal and abnormal physiologic changes
      3. Formulating differential diagnoses
  3. Planning
    1. Knowledge
      1. Age-appropriate primary, secondary, and tertiary prevention
      2. Anticipatory guidance (e.g., developmental, behavioral, disease progression, crisis management, and end-of-life care)
      3. Evidence-based clinical guidelines and standards of care
      4. Pharmacotherapeutics, pharmacokinetics, pharmacodynamics, and pharmacogenetics
    2. Skill
      1. Culturally sensitive practice
      2. Research appraisal (e.g., design, results, and clinical applicability)
  4. Implementation
    1. Knowledge
      1. Legal and ethical implementations for healthcare and technology (e.g., Health Insurance Portability and Accountability Act (HIPAA), confidentiality, and accessibility)
      2. Non-pharmacologic intervention and treatment selection (e.g., procedures, splinting, biopsies, sutures, and imaging)
      3. Pharmacotherapeutic intervention selection (e.g., interactions and contraindications)
      4. Regulatory guidelines (e.g., reportable diseases and abuse reporting)
      5. Scope and Standards for Advanced Practice Registered Nurses
    2. Skill
      1. Comprehensive documentation
      2. Patient-specific education
      3. Resource management (e.g., accessibility, coordination, and cost-effectiveness)
      4. Therapeutic communication (e.g., motivational interviewing and shared decision making)
  5. Evaluation
    1. Knowledge
      1. Ethical and legal principles and issues for patients, populations, and systems (e.g., justice, consent, guardianship, and bioethics)
      2. Non-pharmacologic intervention and treatment outcomes
      3. Pharmacotherapeutic intervention and treatment outcomes (e.g., monitoring, side/adverse effects, and patient outcomes)
    2. Skill
      1. Test results evaluation, management, and reporting

FNP-BC Secondary Classifications

  1. Cardiovascular
  2. Endocrine
  3. Gastrointestinal
  4. Genitourinary and Renal
  5. Head, Eyes, Ears, Nose, and Throat
  6. Hematopoietic*
  7. Immune*
  8. Integumentary
  9. Musculoskeletal
  10. Neurological
  11. Psychiatric
  12. Reproductive
  13. Respiratory

*Less emphasis compared to other body systems.

  1. Analgesic
  2. Anti-Infective
  3. Cardiovascular
  4. Endocrine
  5. Eye, Ear, Nose, and Skin
  6. Gastrointestinal
  7. Genitourologic
  8. Musculoskeletal
  9. Neurological
  10. Psychiatric
  11. Reproductive
  12. Respiratory
  1. Infant
  2. Preschool
  3. School-Age
  4. Adolescent
  1. Young Adult (including late adolescent and emancipated minors)
  2. Adult
  3. Older Adult
  4. Frail Elderly
Pass the FNP exam with confidence.
Pass the FNP exam with confidence

Frequently Asked Questions (FAQs)

You should choose between the AANP and ANCC FNP exams based on your career goals:

  • Choose the AANP exam if you want a clinical-focused career working with patients, such as in primary care, outpatient settings, or urgent care. Most new FNPs pick this.
  • Choose the ANCC exam if you want to pursue a career in leadership, academia, research, or policy roles. These can take place in hospitals, universities, or larger health organizations.
  • The AANP FNP-C exam has 150 total questions, of which 135 count toward your score and 15 are ungraded pretest questions.
  • The ANCC FNP-BC exam has 175 total questions: 150 count toward your score, and 25 are ungraded pretest questions.
No. Pretest questions look the same as graded questions to ensure accurate data is collected. The pretest questions can then be properly vetted for potential use as graded questions on future exams. They do not affect your final score.
  • Download your exam’s official blueprint.
  • Build a detailed study plan based on your available time.
  • Allocate study time based on exam topic weights.
  • Focus on your weakest areas first, while making time for full coverage.
  • Practice with exam-style questions to build confidence.

Read More About the FNP Exam

FNP Exam Information

Explore an overview of both AANP and ANCC exams, including key differences in structure, content focus, and test format to help guide your certification decision.

FNP Study Guide

Get expert prep strategies, topic breakdowns, and practice tips tailored to the FNP exam so you can study smarter and feel confident on test day.

FNP Registration, Cost, and Eligibility Page

Find detailed steps to register, understand eligibility requirements, and review associated fees for both certification exams.

FNP Scoring Guide

Learn how the FNP exams are scored, what counts toward your result, and how to interpret your performance for both AANP and ANCC formats.

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