All About FNP - ANCC® and AANP® Exams
Passing the ANCC or AANP exams is a requirement to work as a Family Nurse Practitioner (FNP) in the U.S. The exams are regulated by The American Academy of Nurse Practitioners Certification Board® (for the AANP®) and The American Academy of Nurse Practitioners Certification Board® (for the ANCC®). While each exam represents a critical milestone to becoming an FNP, their content, format, and purposes vary.
The ANCC exam for FNPs is composed of questions that assess an examinee's knowledge of clinical information and Nurse Practitioner professional practice, as well as their decision-making ability. In contrast, the AANP exam for FNPs focuses more on common procedures performed in an office (i.e., injections, skin biopsy, wound closure, etc.). In short, the ANCC emphasizes research and theory, while the AANP leans toward primary care or family health center work.
Whether you've already decided which exam you want to take or are still trying to decide, the following article will provide you with all the information you need concerning ANCC/AANP exam requirements, format and structure, subjects, and more.
ANCC & AANP FNP Certification Requirements
To become ANCC or AANP FNP certified (FNP-BC or FNP-C), you must fulfill the following requirements:
- Complete a master's degree, a post-graduate certificate, or a Doctor of Nursing Practice (DNP) from an FNP program accredited by the Commission on Collegiate Nursing Education (CCNE), the Accreditation Commission for Education in Nursing (ACEN), or the National League for Nursing (NLN) Commission for Nursing Education Accreditation (CNEA).
- Log a minimum of 500 FNP faculty-supervised clinical hours.
- Pass the ANCC-FNP or AANP-FNP certification test.
- Apply for a state-specific FNP license.
ANCC FNP Exam Format, and Structure
Examinees have three-and-a-half hours to answer 175 questions. Of these, only 150 questions determine your score. The remaining 25 are ungraded pilot questions for future exams. Assume that all questions are graded, as there is no way to identify the difference.
| Category | Content Domain | Number of Questions | Percentage |
|---|---|---|---|
| I | Assessment | 29 | 19% |
| II | Diagnosis | 26 | 17% |
| III | Planning | 29 | 19% |
| IV | Implementation | 43 | 29% |
| V | Evaluation | 23 | 15% |
| TOTAL | 150 | 100%* | |
| *Total does not come to 100 because of rounding | |||
What changed on the ANCC FNP Exam in 2022?
The most significant change in the ANCC FNP test outline is in the content domains represented in exam questions.
- Assessment- Evidence-based population health promotion and screening.
- Diagnosis- Pathogenesis and clinical manifestations of disease state.
- Planning- Age-appropriate primary, secondary and tertiary prevention, anticipatory guidance, evidence-based clinical guidelines, standards of care, and pharmacotherapeutics.
- Implementation- Legal and ethical implementations for healthcare and technology; nonpharmacologic intervention and treatment selection, pharmacotherapeutic intervention selection, regulatory guidelines, and APRN scope and standards.
- Evaluation- Ethical and legal principles and issues for patients, populations, and systems, nonpharmacologic intervention and treatment outcomes, and pharmacotherapeutic intervention and treatment outcomes.
What subjects are covered on the new ANCC FNP exam?
The following table demonstrates which topics are covered in the ANCC FNP exam:
| Body Systems | Drug Agents | Age Group |
|---|---|---|
1. Cardiovascular |
Analgesic | Infant |
2. Endocrine |
Anti-Infective | Preschool |
3. Gastrointestinal |
Cardiovascular | School-Age |
4. Genitourinary and Renal |
Endocrine | Adolescent |
5. Head, Eyes, Ears, Nose, and Throat |
Eye, Ear, Nose, and Skin | Young Adult (including late adolescent and emancipated minors) |
6. Hematopoietic* |
Gastrointestinal | Adult |
7. Immune* |
Genitourology | Older Adult |
8. Integumentary |
Musculoskeletal | Frail Elderly |
9. Musculoskeletal |
Neurological | |
10. Neurological |
Psychiatric | |
11. Psychiatric |
Reproductive | |
12. Reproductive |
Respiratory | |
13. Respiratory |
||
| * Less emphasis to be placed on this body system relative to others | ||
How many times can you take the ANCC FNP Exam?
Candidates may take the exam up to three times in any 12-month period. You must wait 60 days after failing an exam to retake it.
AANP FNP Exam Format and Structure
There are 150 multiple-choice questions on the AANP FNP exam. However, only 135 are scored. Fifteen of the questions on the exam are known as "pretest" questions and are used to gather statistical information. Pretest questions do not affect scoring.
Candidates are given 180 minutes (3 hours) to complete the AANP FNP exam. Sample questions and a short tutorial are given to candidates before the test, so they are comfortable and know how the test works. The 180 minutes you have to finish the test do not include the time you spend on the tutorial and sample questions.
| DOMAIN I- PRACTICE | #ITEMS | % ITEMS | DOMAIN II- PATIENT AGE* | # ITEMS | % ITEMS |
|---|---|---|---|---|---|
| 01- Assess | 36 | 27% | Prenatal | 3 | 2% |
| 02- Diagnose | 35 | 26% | Newborn | 3 | 2% |
| 03- Plan | 34 | 25% | Infant | 4 | 3% |
| 04- Evaluate | 30 | 22% | Child | 8 | 6% |
| TOTAL | 135 | 100% | Early Adolescent | 7 | 5% |
| Late Adolescent | 7 | 5% | |||
| Young Adult | 26 | 19% | |||
| Middle Adult | 32 | 24% | |||
| Older Adult | 30 | 22% | |||
| Elder Adult | 10 | 8% | |||
| TOTAL | 135 | 100% | |||
| *Age Parameters are not defined for any population. AANPCB uses growth and development for constructing the certification exams. | |||||
What subjects are covered on the AANP FNP exam?
The FNP certification exam is a competency-based, entry-level test that covers content from prenatal, pediatric, adolescent, adult, and geriatric primary care. See the table below for a breakdown of each topic.
- Anatomy
- Physiology
- Pathophysiology
- Comorbidities
- Pharmacologic therapies
- Non-pharmacologic therapies
- Integrative therapies
- Polypharmacy
- Pain management
- Cultural competence/sensitivity
- Diagnostic and therapeutic tests
- Functional assessment
- Health history
- Mental health assessment
- Physical examination across the lifespan
- Signs and symptoms
- Therapeutic communication
- Clinical decision-making
- Crisis management
- Differential diagnosis
- Health promotion, harm reduction, and disease prevention
- Healthcare economics
- Interprofessional practice
- Legal and ethical issues
- Patient and family education and counseling
- Principles of epidemiology, population health, and social determinants of health
- Procedures
- Transitions of care
How many times can you take the AANP FNP Exam?
It is AANPCB policy to limit a candidate to two (2) testing attempts per calendar year (January to December).
