NP Certification Exams 101: Getting Certified as a Nurse Practitioner

Margaret A. Fitzgerald, DNP, FNP-BC, NP-C, FAANP, CSP, FAAN, DCC, FNAP

Are you preparing to take the nurse practitioner (NP) certification exam? Are you confused about which organizations offer certification or what kind of certification these agencies offer? Do you wonder about test content or focus? Here are the answers to common questions about NP certification.

Q: What agencies offer NP certification exams?

A: NP certification is offered by a variety of nongovernmental agencies: The American Academy of Nurse Practitioners Certification Board (AANPCB) offers year-round, computer-based testing for family, adult-gerontology primary care, and emergency NP certification. The AANPCP in collaboration with the American Academy of Emergency Nurse Practitioners (AAENP) launched the Emergency Nurse Practitioner certification (ENP-C) exam for family NPs (FNPs) in January 2017. Details about the ENP certification exam can be found in the ENP Certification Handbook on the AAENP website.

  • In response to the Consensus Model for APRN Regulation, the AANPCB retired the adult NP (ANP) certification exam in December 2016. ANPs certified by AANPCB can maintain their certification through clinical practice hours and continuing education, but the option to renew through examination is no longer available.
  • The American Association of Critical-Care Nurses (AACN) offers year-round computer-based testing for adult-gerontology acute care nurse practitioner certification (ACNPC-AG). See the AACN website for details on application deadlines and examination availability.
  • The American Nurses Credentialing Center(ANCC) offers year-round, computer-based testing for family (primary care), adult-gerontology acute care and adult-gerontology primary care, and psychiatric-mental health NP certification (lifespan). The ANCC retired the exam for pediatric primary care NP certification due to a low number of test takers for initial certification. In addition, in response to the Consensus Model for APRN Regulation, the ANCC retired the following certification exams: acute care, adult, adult psychiatric & mental health, and gerontological. As a result, renewal of these certifications can be done only by demonstrating evidence of continual learning and competence through professional development activities. See the ANCC website for details on all application deadlines and examination availability.
  • The National Certification Corporation (NCC) offers year-round, computer-based testing for women’s health care and neo-natal NP certification.
  • The Pediatric Nursing Certification Board (PNCB) offers year-round, computer-based testing for primary care pediatric and acute care pediatric NP certification.

Q: How many questions are on the NP certification examinations?

A: The AANPCP exams consist of 150 test items, including 15 embedded pretest, or pilot, items as sample questions that do not contribute to your final score. Your results are determined on the basis of your performance on 135 questions. The pilot questions are integrated throughout the exam rather than being listed in a separate section. Such questions are found in other NP certification examinations.

The AACN exam for ACNPC-AG consists of 175 multiple-choice items, of which 150 are scored and the remaining 25 questions are pilot test items.

The current ANCC exams consist of 175 questions, and of these 150 are scored test items and 25 are pilot test items that might be used on future exams but do not con-tribute to your exam score.

The NCC women’s health and neonatal NP exams include up to 175 items, with 25 embedded pretest items.

The PNCB acute care and primary care pediatric NP exams contain 175 questions each, including 25 unscored sample items.

Q: What questions are asked on the NP certification examinations?

A: The NP certification examinations assess the broad base of knowledge and the critical thinking skills necessary for entry-level NP practice. The largest proportion of exam items focuses on assessment and treatment of the health problems common to the area of practice for the specified certification track. Each exam also contains items that require the examinee to select the appropriate diagnostic studies and screening tests for given clinical scenarios, as well as interpret subsequent findings and evaluate response to care.

Questions related to intervention cover both pharmacologic and nonpharmacologic therapies, as well as principles of therapeutic communication.

Other areas of practice assessed on the certification exams include professional issues, health promotion, and disease prevention.

Q: How do I approach studying for the NP boards?

A: For both the exam room and as part of the larger healthcare system, the best approach to learning and acquiring information is to understand concepts and apply knowledge so you know what to do and why you are doing it. The Fitzgerald Nurse Practitioner Certification Examination Review & Advanced Practice Update, with hundreds of practice questions, prepares you in the why, how, and what of NP practice, while helping to prepare you for success on the NP boards.

The Fitzgerald Method of NP review begins with a summary of the vast body of knowledge needed for evidence-based NP practice and for successfully passing the NP boards. This summary is followed by sample practice questions to help you hone your clinical decision-making and test-taking skills.

Use practice questions to wrap up, not start, your NP certification review. If you are not scoring well on practice questions, you need additional study of the content area associated with those questions. Keep in mind that Fitzgerald has courses to help you with areas where you need further study (examples include: laboratory data, diabetes, hypertension, and anemia).

Taking additional prep tests once you have finished your review course can both confirm your knowledge and bolster your confidence. The Fitzgerald Test Bank contains Comprehensive 350-Question Prep Tests that feature detailed rationales for every question and analysis of knowledge gaps to help you focus your study.