AANPCB

Family Nurse Practitioner

Adult-Gerontology Primary Care Nurse Practitioner
Psychiatric Mental Health Practitioner

FNP, AGNP & PMHNP

Certification Certification
Handbook

American Academy of Nurse Practitioners National Certification Board, Inc

TABLE OF CONTENTS
Introduction .............................................................................. 3
Contact Us ........................................................................ 3
About AANPCB ........................................................................ 4
Non-Discrimination Policy ................................................. 4
Name and Address Change .............................................. 5
FNP, AGNP, and PMHNP Eligibility Requirements .................. 6
How to Apply ............................................................................ 7
Online Profile..................................................................... 7
Scheduling an Examination .................................................... 10
Eligibility to Test .............................................................. 10
Approval and Authorization to Test ................................. 10
Schedule, Reschedule, or Cancel an Exam .................... 10
Special Accommodations Request.................................. 11
Preparing for the Exam .......................................................... 12
Exam Information ............................................................ 12
Practice Exam ................................................................. 12
Important Testing Site Information .................................. 13
AANPCB Examination Security Policy ............................ 13
Test Specifications .......................................................... 15
Examination Blueprints ................................................... 16
Exam Scores .......................................................................... 16
Retake Exam .......................................................................... 17
Verification of Certification...................................................... 18
AANPCB Board Certification .................................................. 20
Maintenance of Certification ............................................ 20
Expired Certification ........................................................ 20
NP-C® Credential ............................................................ 21
NP Scope and Standards of Practice .............................. 22
AANPCB Policies ................................................................... 23
Sample Questions .................................................................. 26
Appendix A ............................................................................. 29
Appendix B…………………………………..……………………32
Appendix C............................................................................. 34
Appendix D………………………………………………………..37

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INTRODUCTION

This CANDIDATE HANDBOOK is written for candidates desiring to take the following national certification
examinations offered by the American Academy of Nurse Practitioners National Certification Board, Inc.:
• Adult-Gerontology Primary Care Nurse Practitioner (AGNP)

• Family Nurse Practitioner (FNP)

• Psychiatric Mental Health Nurse Practitioner (PMHNP)

It provides important information on the eligibility requirements, application process, testing information, and
AANPCB policies. Material contained in this handbook supersedes information in previous handbooks and is subject
to change without notice. Information in the AANPCB handbooks and on the certification website is updated on a
regular basis.
Applications may be submitted online. AANPCB does not expedite the processing of applications. Typical
application processing time is 3-6 weeks depending upon receipt of a complete application, required documents,
and applicable fees.
Email is the preferred method for general correspondence.
Paper applications and other documents may be emailed, faxed, or mailed. If an applicant wishes to ensure that
materials are received by AANPCB, it is recommended that a guaranteed courier service be used, and documents
be sent by overnight delivery to the street address.

Contact Us

American Academy of Nurse Practitioners Certification Board (AANPCB)

Website: https://www.aanpcert.org

Email: Certification@aanpcert.org

Email Official Transcripts to: Transcripts@aanpcert.org

Certification Administration: (512) 637-0500

Toll-free Number: (855) 822-6727

Fax: (512) 637-0540 or (512) 637-0334

Mailing Address: Overnight Mailing Address:

P.O. Box 12926 2600 Via Fortuna, Suite 240
Austin, TX 78711-2926 Austin, TX 78746-7006

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ABOUT AANPCB

Mission and Purpose

The American Academy of Nurse Practitioners Certification Board (AANPCB) is a nonprofit organization
incorporated under the name American Academy of Nurse Practitioners National Certification Board, Inc.
Originally it was established as a department within the AANP professional membership association in 1993 for the
purpose of providing a valid and reliable program for evaluation of individuals wishing to enter, continue, and/or
advance in the nurse practitioner profession through the certification process. The business name was changed to
the American Academy of Nurse Practitioners Certification Board (AANPCB) on January 1st, 2017.

Vision: Nurse Practitioners meet the highest standards of excellence and competence to support quality care and
optimal health outcomes.

Mission: Provide excellence in testing and certification for nurse practitioners.

Values: AANPCB operates as an ethical and professional organization, embodying the organizational values and
principles of Quality, Integrity, Respect and Responsiveness.

Our Purpose: To assess the knowledge and practice competencies of nurse practitioners required to provide
safe and quality health care. As a national nursing certification board, AANPCB:
• Facilitates the application processes for NP certification.

• Provides a reliable, valid, competency-based examination for NPs to assess knowledge, skills, and abilities.

• Provides entry into practice certification for the Adult-Gerontology Primary Care Nurse Practitioner, Family
Nurse Practitioner, and Psychiatric Mental Health Nurse Practitioner meeting eligibility requirements for
certification by exam and specialty certification for the Emergency Nurse Practitioner.

• Provides the processes for recertification for the Adult, Adult-Gerontology Primary Care, Family, Emergency,
Gerontologic Nurse, and Psychiatric Mental Health Practitioner meeting current minimum requirements for
renewal.

Non-Discrimination Policy
The American Academy of Nurse Practitioners Certification Board does not discriminate against candidates and
certificants with respect to age, sex, race, color, religion, national origin, ethnicity, disability, marital status, sexual
orientation, gender identity, veteran status, or any other characteristic legally protected by law. Reasonable and
consistent use of non-discrimination and impartiality policies and procedures will apply to all programs of the
AANPCB, to include application processes, testing processes, and business operations.

Accreditation
AANPCB certification programs are accredited by the Accreditation Board of Specialty Nursing Certification
(ABSNC) and the National Commission for Certifying Agencies (NCCA).
• The ABSNC, formerly the American Board of Nursing Specialties (ABNS) Accreditation Council, is the only
accrediting body specifically for nursing certification. ABSNC accreditation is a peer-review mechanism that
allows nursing certification organizations to obtain accreditation by demonstrating compliance with the highest
quality standards available in the industry.

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• The NCCA is the private not-for-profit accrediting branch of the Institute for Credentialing Excellence (ICE),
which is the national standard-setting organization for credentialing groups including certification boards,
licensing boards, and associations. The NCCA uses a peer review process to establish accreditation
standards, evaluate compliance with the standards, recognize programs that demonstrate compliance,
monitor, and enforce continued compliance, and serve as a resource on quality certification.

• Changes to AANPCBs certification programs will align with the certification accreditation standards
promulgated by ABSNC and NCCA. Program accreditation dates may be found on the certification website.

Membership Affiliation
AANPCB is a national nursing certification board affiliated with two membership organizations.
• American Association of Nurse Practitioners (AANP) - As a membership organization, AANP provides
valuable member benefits for NP students and NPs of all specialties. Benefits includes NP advocacy, access
to free CE activities, and reduced conference registration fees for NP students, candidates, and members
attending the AANP's National, Health Policy, and Fall Conferences.

• American Academy of Emergency Nurse Practitioners (AAENP) - Is the membership organization

responsible for the standards, qualifications, knowledge, and practice of emergency nurse practitioners.
AAENP collaborates with AANPCB to develop exam content for the Emergency Nurse Practitioner
certification examination.

• Members of the AANP and AAENP qualify for a $75 USD discount on all certification applications. Include
member number when completing the application to receive the discount.

Name and Address Change

• Applicants and certificants are responsible for keeping their AANPCB account and Online Profile information
current or notifying AANPCB by email of changes to contact information to receive important information from
AANPCB such as application status inquiries, certification program changes, renewal notices, Board of
Commissioner election information, and practice analysis invitations.

• Changes to name and contact information may be made at any time by logging into the Online Profile with
username and password.

• In the event of a legal name change, complete the Name Change Form and submit it, with a copy of
supporting documentation (e.g., court record, marriage license) providing proof of the name change, via
email, fax, or mail to the AANPCB office. Please allow five business days from time of receipt for processing.

• The Name, Address, or Certification Status Change Form is available under the Forms tab on the
navigation bar of the AANPCB website.

• For candidates who have been approved to test, it is recommended that a name change be made after the
examination is taken and preliminary examination score notification has been received to avoid problems with
identification documents at the testing center.

• For name change questions, contact the Verification Department at certification@aanpcert.org.

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FNP, AGNP, AND PMHNP ELIGIBILITY REQUIREMENTS

Educational Program Requirements

Candidates will sit for the certification examination that aligns with their graduate education, role, and population
area. This includes successful completion of:
• The nationally recognized competencies of the nurse practitioner role and the population specialties of
Adult-Gerontology Primary Care, Family/Across the Life Span or Psychiatric Mental Health.

• The APRN core (advanced physical assessment, advanced pharmacology, and advanced pathophysiology).

• The NP educational program’s required number of faculty-supervised direct patient care clinical hours. The
minimum number of clinical practice hours is 500.

• Completion of a nationally accredited graduate, postgraduate, or doctoral Family, Adult-Gerontology Primary

Care Nurse or Psychiatric Mental Health Practitioner educational program that is accredited by a nursing
accrediting organization recognized by the U.S. Department of Education and/or the Council for Higher
Education Accreditation. Canadian NP educational programs must be approved by the Canadian Council of
Registered Nurse Regulators (CCRNR). The minimum number of clinical practice hours is 500.

Nurse Licensure
• Current, active, professional nurse licensure in the United States, U.S. territory, or Canadian province or
territory.

Academic Transcript
• An official or unofficial transcript showing academic coursework completed to date or final official transcript
showing degree awarded and date conferred is required to begin an application. Mail official transcripts in a
sealed envelope directly from the school registrar to AANPCB or email secure, electronic academic
transcripts directly from the school to transcripts@aanpcert.org

Eligibility Requirement Rationale

• These certification eligibility requirements align with the Consensus Model for APRN Regulation (2008, pp.
6, 11, 15-16). In 2010, AANPCB was one of 48 nursing organizations that endorsed the Consensus Model,
which serves to ensure patient safety by establishing uniformity in education, accreditation, and certification
across states.

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HOW TO APPLY

Online Profile
Visit www.aanpcert.org to create an Online Profile account. Once an account is established:
 Apply for the certification exam.
 Upload a copy of current professional nursing license with expiration date.
 View application status updates.
 Make changes to name, address, or contact information.
 Order verifications to be sent to state boards of nursing and employers.
 Access a printable wallet card when certified.
 Apply for recertification.

How To Videos
• View the How-to Apply Video available on the AANPCB website for information on how to complete the
application process.

Application Process
Apply Online
• Online applications are recommended. Online applications must be completed within 30 days to avoid loss of
data, check your browser’s cookie settings for additional information.

Apply by Paper Application

• A fillable PDF paper application is available on the website for download under Forms on the navigation bar.

• Paper application processing is longer than the online method. A paper processing fee is assessed.

How Early Can I Apply?

• MSN or Post-Graduate Certificate applicants may begin the application process 6 months prior to completion
of their program.

• Doctor of Nursing Practice (DNP) applicants may begin the application process as early as 1 year prior to
completion of their program. A letter from the NP Program Director is required if the candidate is requesting to
test prior to the program completion date.

• Candidates may sit for an examination after they have completed all didactic courses and clinical practice
hours required for their NP program. Some candidates may complete their NP program several weeks before
their scheduled graduation and degree conferral date.

• Program Completion Date is the date all didactic courses and clinical hours are completed. Degree
Conferred Date is the date the graduate degree or post-graduate certificate is awarded. Some candidates
may complete their NP program several weeks before their scheduled graduation and degree conferral date.

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Required Documents
• Current professional nursing license with expiration date and fee payment are required to initiate processing
of an application. A copy may be obtained from the state board of nursing.

• For graduate or post-graduate academic nurse practitioner program applicants, an official or unofficial
transcript showing academic coursework completed to date or final official transcript showing degree awarded
and date conferred is required to begin an application. A final official transcript showing program completion is
required for release of a certification after passing the examination.

• Documents can be uploaded to the online application, or sent via fax, email, or mail after the application has
been submitted.

• Documents sent to AANPCB become the property of AANPCB. Individuals should retain copies of their
records for personal use and for their professional portfolio. AANPCB is under no obligation to return
documents or issue copies of these documents for future use by a certificant.

Signature and Attestation

The applicant’s signature (electronic or written) on the application is required for processing. This signature confirms
that the information provided by the candidate on their application is accurate and true to the best of their ability.
Applicants who apply to take the AANPCB certification examination attest that they:
 Have accessed the Candidate Handbook online at www.aanpcert.org
 Shall maintain current, active professional nursing licensure.
 Are obligated to notify AANPCB of nursing licensure suspension or revocation by a board of nursing or
regulatory body.
 Understand that AANPCB may amend requirements, policies, and procedures.

This signature also confirms that the applicant has read, agrees to adhere to, and understands the following
AANPCB Policies:
 General Principles and Standards of Conduct
 NP Scope and Standards of Practice
 Non-Discrimination Policy
 Confidentiality and Disclosure Policy
 Examination Security Policy
 Disciplinary, Appeals, and Complaints Policy
 Records Retention Policy

Processing Time

• Typical processing time for applications is 3-6 weeks depending upon receipt of a complete application,
required documents, and applicable fees. Applications are processed in a timely manner in the order
received. AANPCB does not expedite processing of applications or charge an expediting fee.

• Applications are screened using eligibility criteria before forwarding to qualified advanced practice nurses for
professional review.

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Notification of Missing Items
• Monitor your Online Profile for application status updates and notification of missing items. Weekly emails
are sent if information is needed to complete an application. (See Correspondence from AANPCB.)

Certification Fees
• Fee payment is required to initiate processing of an application.

• Members of the AANP and AAENP qualify for a $75 USD discount on all certification applications. Include
member number when completing the application to receive the discount.

• Current fees are posted on the AANPCB website and must be paid in U.S. dollars. Fees and refunds are
subject to change without notification.

• There is no charge for processing supporting documents received by AANPCB for the purposes of
certification and recertification (e.g., RN/APRN licenses, CEs, unofficial transcripts).

• AANPCB does not expedite or charge an expediting fee for processing of applications.

• A paper processing fee is charged for paper applications received via mail, email, or fax.

• Refunds are processed according to information available on the AANPCB website home page, FAQs, and
Employers/Credentialing Services sections.

Frequently Asked Questions

• Access the FAQs on the certification website for useful and important information.

Correspondence from AANPCB

• Notification of missing documentation is emailed weekly from certification@aanpcert.org and is viewable on
the applicant’s Online Profile. A reminder is emailed weekly to candidates who have been approved to test
prior to degree completion until a final official transcript is received.

• AANPCB emails the Eligibility to Test and Schedule Exam Notification to the candidate from
certification@aanpcert.org.

• Certificants are notified by email of important information such as Commissioner elections, changes to a
certification program, and invitations to participate in a Practice Analysis. General announcements are posted
on the website.

• Courtesy reminder postcards and emails are sent to the NP's last known contact addresses one year prior to
certification expiration, and again at 6 months prior to expiration if a renewal application has not yet been
received. A letter and email are sent ~6 weeks prior to certification expiration if a renewal application has not
been received.

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SCHEDULING AN EXAMINATION

Visit www.prometric.com or contact a Prometric customer service representative during

Prometric hours of operation for all questions concerning exam administration and testing
site regulations.
Prometric dedicated toll-free customer service number for AANPCB candidates: (800) 742-
8738

Eligibility to Test
Candidates are Eligible to Test when:
• The NP program completion date and the graduation date is less than 30 days apart, OR

• All required didactic and clinical coursework of the candidate’s NP portion of their program is complete (in the
case of DNP candidates).

Approval and Authorization to Test

• When a candidate becomes eligible to test (as verified during the application review process), AANPCB will
export the name of the candidate to Prometric and send an Eligibility to Test and Schedule Exam
Notification email to the candidate from certification@aanpcert.org. This email provides important
instructions for scheduling a testing appointment at Prometric testing centers and authorizes the 120-day
testing window. Check all email inboxes including junk/spam folders for Approval and Eligibility to Test email.

Schedule, Reschedule, or Cancel an Exam

• Log in to your AANPCB account at www.aanpcert.org/signin and select Schedule Exam found under My
AANPCB. You must use your AANPCB login information to schedule your testing appointment.

• Changes to a scheduled examination appointment may be done online by visiting www.prometric.com.

• A request to cancel and reschedule a test appointment, with no additional fee, must be made at least 48
hours before the scheduled test appointment and within the 120-day window-to-test. If canceling and/or
rescheduling a test appointment within 24-48 hours of the scheduled exam, a fee will apply. Exam
appointments cannot be canceled or rescheduled within 24 hours of the exam appointment.

• Candidates must comply with Prometric's procedures for rescheduling or canceling an exam. Candidates who
do not cancel appropriately or fail to report for their scheduled examination appointment will not be entitled to
a refund.

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Extension Requests
• Extensions are granted on a case-by-case basis for reasons of hardship if a candidate is unable to sit for the
examination within their 120-day window to test. Email the request to certification@aanpcert.org

• Any scheduled examination appointment must be cancelled prior to granting an extension.

• If the extension is approved, a one-time 60-day window to test is granted. Candidates who do not test during
the 60-day extension window forfeit applicable fees and will need to reapply to take the exam and pay the
applicable fee.

Exam Withdrawal
• Applicants wishing to withdraw from taking the examination must email a written request for withdrawal to
certification@aanpcert.org

• The registration fee, less a processing fee, will be refunded within 30 days if the request for withdrawal is
received before expiration of the 120-day testing window and the candidate has not scheduled a test
appointment.

Special Accommodations Request

Candidates receive a 120-day window to test. This window allows applicants the flexibility of scheduling the exam
around one’s personal schedule, employment schedule, or religious needs without requiring the need for additional
accommodations or forms.

Special Arrangements for Candidates with Disabilities

• All test centers are equipped to provide access in accordance with the Americans with Disabilities Act (ADA)
of 1990, and every reasonable accommodation will be made in meeting a candidate’s needs.

• Applicants with disabilities or those who would otherwise have difficulty taking the test will need to complete
the Special Accommodation Request online using this link. The request will be reviewed, and a Prometric
Special Accommodations Team Member will contact the candidate within 3-5 business days to confirm the
approved accommodations. DO NOT schedule your examination until your completed Prometric Special
Accommodations Request Form and required documentation has been received and approved by the
Prometric Testing Accommodations Department.

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PREPARING FOR THE EXAM

Exam Information
• Examinations are computer-based: Candidates have 3 hours to take the exam.

• There are 150 questions on each exam: Of the 150 questions, 15 are pretest questions that cannot be
distinguished from those that are scored. Pretest questions are included to determine how they perform
statistically to vet them for use on future exams. A candidate's score is based solely on 135 scored questions.

• Multiple choice, objective format: The exams are limited to content that can be tested in an objective
format, competency-based focused solely on requirements for safe clinical practice.

• Candidates receive a 120-day window to test: This window allows applicants the flexibility of
scheduling the exam around one’s personal schedule, employment schedule, or religious needs without
requiring the need for additional accommodations or forms.

• Age Parameters: The Consensus Model for APRN Regulation does not define specific age parameters for
any of the population foci, therefore, growth and development are used as the basis of age-related changes
for constructing the certification exams and for NP practice.

• New Examinations: Exams are developed annually and released every January. All items are reviewed to
ensure consistency with therapeutic clinical guidelines and references published at the time exams are
developed.

Practice Exam
• AANPCB Practice Examinations meet the same test specifications (exam blueprint) as noted in this
handbook. NP content experts develop the practice exam questions.

• Practice exams provide the candidate with an opportunity to familiarize themself with the format of test
questions on the certification exam. Practice Exams are an optional assessment tool and not a study guide for
the certification exam.

• Performance on the Practice Exam is not a predictor of whether a candidate will pass the competency-based
certification examination. Taking a Practice Exam is not required and does not give any advantage over the
candidate who chooses not to take a practice test.

• Visit the Practice Exams tab on the navigation bar of the AANPCB website for more information.

FNP, AGNP and PMHNP Reference List

• A current reference list is available under the Reference Lists tab on the navigation bar of the website.

Sample Questions
• Examination questions range from knowledge of pathophysiology, pharmacology, physical assessment,
diagnosis, treatment, and follow-up care for synthesis of information in clinical decision-making while carrying

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 out those activities. Sample Questions provided in this handbook are examples of the format of questions on
the certification exams. These questions are not updated, and no correct answers are provided.

Important Testing Site Information

• Scheduling Procedures and Testing Regulations: Visit the AANPCB scheduling page on
www.prometric.com for the following information:

 Schedule an Exam
 Required Identification for Exam Site
 Special Accommodations
 Testing Center Regulations
 Reschedule an Exam or Canceling a Scheduled Exam

• Testing Sites: Certification examinations are administered via computer-based testing format at Prometric
testing centers located globally.

• Identification: Names must match on the AANPCB application, Prometric test registration, and forms of
identification presented at the testing center for an eligible candidate to sit for their scheduled examination.

• Late or missed appointment: If you arrive late for your scheduled examination time, do not cancel at
least 24 hours before the scheduled exam date, miss your scheduled exam appointment, or arrive without
required identification … you will not be able to take the examination as scheduled, you will be
responsible for paying any applicable testing center fees, require a new registration number, and
forfeit your fee.

AANPCB Examination Security Policy

Federal copyright law protects AANPCB examinations, and the items contained therein. The certification
examinations and all items on the examinations are the exclusive property of the American Academy of Nurse
Practitioners National Certification Board, Inc. Candidates who apply for the certification examination
acknowledge that they understand and agree to the following prior to taking the examination:
• Retention, possession, copying, distribution, disclosure, discussion, or receipt of any AANPCB certification
examination question, in whole or in part, by written, electronic, oral, or other form of communication,
including but not limited to emailing, copying or printing of electronic files, and reconstruction through
memorization and/or dictation, before, during or after the certification examination is strictly prohibited.

• Disclosure, discussion, or receipt of any AANPCB certification examination questions and/or the examination,
in whole or in part, on social media networking, in study groups, or by other methods is strictly prohibited.

• Theft or attempted theft of examination content is punishable by law.

• Candidate participation in any irregularity occurring during or after the examination, such as giving or
obtaining unauthorized information or aid, as evidenced by observation or subsequent statistical analysis,
may be sufficient cause to terminate participation, invalidate results of the examination, or necessitate other
appropriate action per AANPCB Disciplinary Policy. Incidents regarding examination administration security
will be reported to the AANPCB Board of Commissioners. Grounds for sanction may be warranted.

Test-Taking Tips
• A resource document containing Test-Taking Tips is available under the Reference Lists tab.
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Overview of AANPCB Examination Development
• Competency-based certification examinations: Are developed to provide a reliable, valid,
competency-based examination for NPs to assess knowledge, skills, and abilities for practice.

• Process-focused: Are based on the assessment, diagnosis, planning, and evaluation components of
patient care and NP role, specialty population, wellness-illness continuum, and associated problem areas.

• Industry-accepted, psychometrically sound: Are developed and maintained in partnership with

contracted test development organizations. A program director and psychometric consultants help to ensure
generally accepted psychometric principles and best education testing practices are used. Industry-accepted,
psychometrically sound performance standards are used to establish the Passing Point for all new exams.

• NP content experts: Panels of qualified certified nurse practitioner content subject matter experts (SME’s)
engaged in clinical practice in a variety of healthcare settings and diverse geographical areas assist in exam
development, and review all items for content relevance, competency level, currency, and importance. SMEs
must meet requirements for impartiality related to education and training leading to certification.

• Item Bank Ownership: AANPCB maintains ownership of all items that are secured in an Exam Item Bank.
Access is restricted to authorized personnel requiring approval of the CEO.

• Bias and Sensitivity: Items are screened for bias and sensitivity. Editorial staff review each item for
grammar, spelling, and usage. Additional panels of SMEs conduct a final review of each certification exam.

• Item Development: Items are directly linked to the Examination Blueprint to guarantee consistent
emphasis on content areas from one form of an examination to another.

Practice Analysis
• The Examination Blueprints are based on a Practice Analysis: an objective measure of the knowledge and
skills required of competent NPs. Practice Analyses provide the foundation for defining AANPCB Knowledge
Areas and Testing Domains and must be conducted to maintain recognition and accreditation of our
certification programs by the Accreditation Board of Specialty Nursing Certification (ABSNC) and the
National Commission for Certifying Agencies (NCCA).

• Practice analyses are typically conducted every 3 to 5 years, depending on the rate of change in the
profession that the certification program represents. A Family Examination Practice Analysis was conducted
in 2015, 2020 and again in 2023. The FNP examination blueprints for the 2021, 2022 and 2023 examinations
are in Appendix A. The FNP examination blueprints for the 2024 examinations are in Appendix B. Adult-
Gerontology Primary Care Examination Practice Analyses were conducted in 2016 and 2021. The blueprint
for the AGNP examinations is in Appendix C. Psychiatric Mental Health Examination Practice Analysis was
conducted in 2023. The blueprint for the 2024 PMHNP is in Appendix D.

• SMEs delineate commonly seen patient conditions and identify procedures performed in clinical practice
utilizing nationally established NP core and population specific competencies. This information is validated via
survey research by NPs who are engaged in clinical practice, work with different patient populations, and
reside in different U.S. geographical areas.

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Test Content
• Graduate Core Competencies: Defined as the integrated knowledge, skills, judgment, and abilities
deemed essential and required of an NP to practice safely and ethically in a designated role and setting
regardless of specialty. NPs are expected to apply knowledge of the Graduate Core Competencies to the
processes of assessment, diagnosis, and management of patients in their care.

• APRN Core Content: NPs are expected to apply knowledge of the APRN Core Content (required
graduate-level APRN educational curriculum in the areas of advanced pathophysiology, advanced
pharmacology, and advanced health assessment) to the processes of assessment, diagnosis, and
management of patients in their care.

• AGNP Population-Focus: The AGNP exam tests clinical knowledge of the population-focus of adult-
gerontology: adolescents including emancipated minors, young adults, adults, older adults, and elderly. Age
Parameters are not defined for any population.

• FNP Population-Focus: The FNP exam tests clinical knowledge of the population-focus of
family/individual across the life span: prenatal, pediatric, adolescent, adult, elderly, and frail elderly primary
care. Age Parameters are not defined for any population.

• PMHNP Population-Focus: The PMHNP exam tests clinical knowledge of psychiatric mental health in
individuals across the life span.

Test Specifications
• Domains: Are the areas of major responsibility that make up a profession, mutually exclusive, and
encompass all the tasks performed in practice. Domains contain the knowledge and skills required of a Family
Nurse Practitioner or an Adult-Gerontology Primary Care Nurse Practitioner to competently perform tasks.

• Test specifications: Are used to identify the proportion of questions related to each of the domains and
tasks that appear on certification exams. Test specifications derived from the Practice Analysis serve as the
Examination Blueprint and are based on Domain parameters.

 Domain I: Assess, Diagnose, Plan, Evaluate

 Domain II: Developmental Parameters

• Content Outlines: identify the proportion of questions from each domain that appear on the specialty
certification exam. Percentages are used to determine the number of test questions related to each domain
and task that appear on the multiple-choice examinations. Percentage weights and the number of test
questions in each domain on the examinations are shown in the Examination Blueprints.

• Knowledge Areas: Information acquired necessary to perform job tasks. Includes the ability to perform
skills/procedures and reflects the characteristics of the individual worker performing the job. Knowledge areas
serve as the basis for the test blueprints. Knowledge Areas are listed in the Examination Blueprints.

• Tasks: Discrete work elements/activities within domains that are distinct, identifiable, and practice related.

• Procedures: Learned cognitive and psychomotor actions that must be performed correctly to successfully
complete one or more job tasks.

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Examination Blueprints
See Appendices for the examination blueprints. The FNP examination blueprint content outline is in Appendix A
and B. Appendix C contains the AGNP examination blueprint. Appendix D contain the PMHNP examination
blueprint.

EXAM SCORES

How are Exams Scored?

The certification examinations are Criterion-referenced Examinations designed to assess knowledge required
for competent practice as a nurse practitioner. The passing score represents absolute standards and is
determined using psychometrically accepted standard-setting methodology (modified-Angoff). It is a complex
scoring system that assesses standards that define what minimally competent candidates would know and
answer correctly.

• Passing Score: In a criterion-referenced examination, a candidate must obtain a score equal to, or higher
than, the passing score to pass the test. A minimum passing scaled score of 500 must be obtained to pass
the exam. The total number of correct responses is called the total raw score which is converted to a scaled
score ranging from 200 to 800 points using statistical procedures equivalent for all administrations of the
exam. Exam results are reported as a “scaled score” which is neither a “number correct” nor a “percent
correct” score. Performance on the exam is not compared to the performance of others taking the exam.

• Preliminary Pass or Fail status: Candidates may obtain a preliminary Pass or Fail status at the testing
center upon completion of the examination. A preliminary report of Pass from the testing site is not official
notification, does not indicate active NP certification status, and may not be used for employment or licensure.

• Examinations are computer-based and electronically scored. Errors in scoring are virtually non-
existent. Candidates who wish to appeal their exam score will be charged a fee. (See Appeals Policy).

Exam Score Release

• Score Report: An official letter with the exam score and relative performance (from strongest to weakest) in
the Testing Domains will be mailed to candidates when all requirements for score release have been met.
Exam score results will not be given out by telephone or fax. Exam scores are considered confidential
information and will not be disclosed to anyone other than the candidate without specific written instructions
from the candidate indicating to whom and why the information is to be disclosed. The score letter authorizes
use of the NP-C credential for a 5-year period only.

• Graduate academic program: To release a certification upon passing the examination, AANPCB must
receive an Official final transcript via (1) mail or delivery in the original sealed envelope or (2) email via
secured website from the Registrar's office. An official final transcript must have the university insignia,
degree completed, and the date degree awarded/conferred. Transcripts faxed by a candidate and unsealed or
tampered transcripts are not official.

• Post-graduate (post-master’s) certificate program: To release a certification upon passing the

examination, AANPCB must receive and process an official MSN transcript in addition to a transcript with
educational program coursework for the FNP or AGNP certificate program and a transcript or certificate
showing the post-graduate certificate awarded.

16
• The certification start date is not the date the exam was taken. A certification start date will be the date the
score is released by AANPCB and will be viewable on the Online Profile.

• State Board of Nursing Verification and Primary Source Verification requests will be processed and sent one
business day following score release (See Verification Requests).

RETAKE EXAM

Retake Examination Requirements

• Testing Domain Performance: AANPCB will email candidates who do not pass the certification
examination an official Fail Letter with their final exam score and relative performance (from strongest to
weakest) in the Testing Domains.

• Examination Blueprint: Candidates should review the Practice Analysis Domains and Tasks for the
applicable examination blueprint for content that describes each testing domain in detail. Refer to Exam
Development and Test Blueprint section in this Handbook for content information.

• Further study requirements: Candidates are required to complete a minimum of 15 hours of advanced
practice nursing continuing education from an accredited CE provider in the areas of weakness as indicated
on their score report. Since performance in a testing domain is based on fewer items and is therefore less
reliable than performance on the whole exam, a general NP certification examination review course is
recommended, but not required. CE must be completed after the examination date which the candidate did
not pass.

Retake Application
• A final score report must be released before an individual can complete an application online to retake the
examination.

• Complete CE and then apply online. A paper application is available.

• Two opportunities to test per calendar year: Candidates are not allowed to take the certification
examination more than TWICE between January 1st to December 31st to avoid exam item compromise.

17
VERIFICATION OF CERTIFICATION

Primary Source Verification

Primary Source Verification is the process whereby confirmation of specific information from the original source is
provided to determine the qualifications of an individual. Requests received from a state board of nursing or third-
party vendor for verification of a certification reflect the status of “certified” or “not certified”.
AANPCB provides the following upon written request:
• Confirmation of nurse practitioner certification status (certified/not certified) to State Boards of Nursing,
employers, third-party vendors, and the public.

• Verification of candidate eligibility-to-test to State Boards of Nursing.

Information on Primary Source Verification, verification request forms, and fees is available under the Verify tab
on the navigation bar of the AANPCB website.

State Boards of Nursing Notification

• AANPCB does not automatically notify a SBON of a candidate’s authorization to test, an exam taken, or
certification status change (active or expired).

• Completion of a State Board of Nursing Notification Form.

• A SBON may request candidate exam pass or failure status or NP certification status (active or expired).

• State Boards of Nursing (SBON) and active-duty military personnel will not be charged a fee for processing a
verification of certification.

• Requests are usually processed within one business day of receiving a SBON Notification Form. Individual
state boards of nursing determine their preference by email or regular mail of a verification.

Third Party Vendors

• Primary Source Verification Order Form: A completed form is required to send employers an official
letter of verification of current NP certification status.

• Prepaid Verification Vouchers: Employers and related organizations may purchase Vouchers to order
primary source verification of individuals holding active AANPCB certification. The voucher process is
available online under the tab Verify.

• Signature Release: Verification requests must be accompanied by a current signed release from the NP
and dated within 6 months of the request.

• Processing time and Fee: Processing time for a third-party vendor verification request of certification
may take up to 10 business days from receipt of request for a fee as noted on the AANPCB website.

• Verification letters: Will be sent via email. Mailed embossed hard copies are available upon request.

18
Important Information
• Requests by telephone for verification information will not be accepted.

• State Board of Nursing Verification and Primary Source Verification requests will be processed and sent one
business day following score release.

• To protect the confidentiality, a signed release authorizing disclosure of eligibility to test or NP certification is
required from the candidate or certificant before information is released regarding an individual’s scores or
status in the certification program. Disclosure will not take place if it violates an applicant, candidate, or
certificant right of privacy.

• Information accessed through this process reflects AANPCB records. Requests for verification submitted and
processed the same week that a candidate tests may reflect that the individual “is not certified” due to
examination score importing times (e.g., A Verification request is received, processed, and letter emailed at 8
a.m.; scores are imported and certification complete is released at 2 p.m. same day).

• While every effort is made to ensure that information provided is accurate and reliable, processes for updating
and posting data resulting in the delay of correct information or human/mechanical error remain a possibility.
AANPCB will not be liable for any damages resulting from use of information obtained through the verification
process.

19
AANPCB BOARD CERTIFICATION

Individuals board-certified by AANPCB have completed specific educational requirements that assess national
competencies of the APRN core, nurse practitioner role, and population focus area of practice and successfully
passed the national certification examination demonstrating professional knowledge in the NP role and the
population focus for entry into practice.

Certification is time-limited
• Certification is time-limited and granted for 5-year periods only. NP certification expires at the end of the 5-
year certification period. Individuals who allow their AANPCB certification to expire are not authorized to use
the NP-C credential and may not represent themselves as being certified by AANPCB.

• The AANPCB Board of Commissioners has determined that a 5-year cycle of certification meets requirements
to ensure continued competence based on review of literature and consultation with credentialing experts.
This decision is reviewed periodically in conjunction with subsequent practice analyses.

• Nurse Practitioners certified by AANPCB must meet the minimum current requirements for renewal within the
5-year period of certification granted to continue to (1) be certified, (2) maintain the same certification number,
and (3) use the NP-C credential.

Maintenance of Certification
• It is the NPs professional responsibility to renew their certification before their certification expires.

• Knowledge and skills required for professional and competent NP practice evolve over time. NPs must
maintain professional competency based on current information and knowledge affecting clinical practice.
Maintaining clinical practice and participating in advanced practice nurse practitioner-related continuing
education activities on an ongoing basis or passing the certification examination allows certificants to
demonstrate maintenance of knowledge and skills in their specialty area of certification as a certified NP.

• Recertification requirements serve to measure and reassure the public of NP continued professional
competence. Recertification provides a mechanism to assure the public that nurse practitioners have
undergone periodic evaluation and met current professional standards of qualifications and knowledge for
practice required to maintain and validate certification. Individuals who are board-certified by AANPCB shall
renew certification via an established certification renewal process.

• Current, active, professional nurse licensure in the United States, U.S. territory, or Canadian province or
territory, another component of continuing competence, is required for certification. An individual whose
nursing license expires or is revoked is not authorized to use the NP-C credential and may not represent
themselves as being certified by AANPCB.

• For information on the renewal process, see the Recertification Handbook.

Expired Certification
• An individual certified by AANPCB as a nurse practitioner who allows their NP certification to expire may not
use the NP-C credential or present themself as an AANPCB-certified nurse practitioner.

• A certificant who is unable to renew their certification through practice hours and CE will need to meet current
certification eligibility requirements and apply for the examination as an Initial Applicant.
20
• State Boards of Nursing regulate APRNs’ ability to practice, therefore, an individual whose NP certification
has expired is responsible for contacting their SBON regarding their ability to work with expired certification.

• Individuals whose certification expires risk potential loss of employment, wages, insurance reimbursement, or
credentialing privileges depending upon the state in which they are licensed as an APRN, the employer, and
the provider credentialing organization. AANPCB will not be held responsible for financial damages occurring
with respect to expiration of certification or loss of employment if a certificant fails to renew prior to expiration
of current certification.

• Requests received from a state board of nursing or third-party vendor for verification of a certification reflect
the status of “certified” or “not certified”.

NP-C® Credential
NP-C is the registered mark and credential authorized for use by individuals who have met the standards,
qualifications, and testing requirements established by AANPCB to indicate nurse practitioner certification status.
• First use of the NP-C credential was in 1999. NP-C stands for “Nurse Practitioner-Certified”.

• The certification mark is owned by the American Academy of Nurse Practitioners National Certification
Board, Inc. and registered with the United States Patent and Trademark Office.

• AANPCB awards the NP-C credential. As the owner of the “Nurse Practitioner-Certified” certification mark,
AANPCB controls its use.

• NPs currently dual-certified by AANPCB as an ANP and a GNP are eligible to convert the certifications to the
Adult-Gerontology Primary Care Nurse Practitioner.

How do I sign my name?

• The first letter of the patient population-foci (A, AG, E, F, G, PMH) precedes the certification number and is
printed on both the official embossed certificate and wallet card.

• In general, there is a standard way to for a nurse to list professional post-nominal credentials. This is
important because consumers, insurance companies, credentialing and government entities may require or
expect it. The highest earned academic degree is usually listed first, followed by nurse licensure or APRN
designation, then nursing certifications (which are required or voluntary), and then nursing fellowships. Nurses
are legally obligated to comply with the licensing requirements in the state where he or she is practicing and
should check with state regulatory agencies regarding legal titling. Example: Pat Doe, MSN, APRN, FNP-C,
FAANP

 Adult Nurse Practitioner ANP-C

 Adult-Gerontology Primary Care Nurse Practitioner AGNP-C
 Emergency Nurse Practitioner ENP-C
 Family Nurse Practitioner FNP-C
 Gerontologic Nurse Practitioner GNP-C
 Psychiatric Mental Health Nurse Practitioner PMHNP-C

21
NP Scope and Standards of Practice
NP certification is a component of meeting entry into advanced practice requirements and does not limit ongoing
professional development after one becomes initially certified and licensed nor does it address practice settings.
Clinical practice should be based on educational training in providing safe and appropriate patient care as an NP.
• NPs shall maintain continuing competence in the NP profession by acquiring new knowledge in the
professional role on an ongoing basis.

• Holding the NP-C credential does not confer permission to manage patients beyond the scope of the
individual’s professional practice. Boundaries of legal professional scope of practice are determined by each
state or territory. Nurse Practice Acts guide and govern nursing practice. Job functions are determined by
the employer, not the credential.

• NP Certificants shall reference and subscribe to the:

 Scope of Practice for Nurse Practitioners (American Association of Nurse Practitioners)

 Standards of Practice for Nurse Practitioners (American Association of Nurse Practitioners)

General Principles and Standards of Conduct

Applicants, candidates, and certificants shall:
 Be truthful, forthcoming, prompt, and cooperative in their dealings with AANPCB.
 Be in continuous compliance with AANPCB policies.
 Comply with their state board of nursing licensing Rules and Regulations.
 Respect AANPCB intellectual property rights and will abide by AANPCBs Examination Security
Policy and federal copyright law protecting AANPCBs examination item content.
 Abide by AANPCB and the testing vendor test administration rules.
 Abide by laws related to advanced nursing practice and public health and safety.
 Conduct professional work as an NP in a competent manner.

Wall Certificate and Wallet Card

• Candidates who pass the certification examination receive a packet with score letter, certification number,
personalized certificate, wallet card, and lapel pin by mail approximately 3 weeks after the score is released.

• The score letter authorizes use of the NP-C credential for a 5-year period only.

• The certificate and wallet card will have the certification beginning and expiration date.

• A printable wallet card may be accessed on the individual’s Online Profile under “My Wallet Cards”.

• For information on ordering a duplicate wall certificate, see FAQs – Duplicate Wall Certificate Requests.

22
AANPCB POLICIES

Confidentiality and Disclosure Policy

Candidate information and scores are considered confidential information. Sensitive and confidential information
received by AANPCB is used solely for the purposes of certification and verification and cannot be shared without
written permission or as required by law. Disclosure will not take place that violates an applicant, candidate, or a
certificant’s right of privacy. Individual scores are not included in the verification documents sent to Boards of
Nursing or other entities unless specifically requested in writing by the certificant or required by law. Individuals who
wish to have their individual scores sent to their education program must request that service in writing to AANPCB.
The Confidentiality and Disclosure Policy may be viewed online under Certification Board Policies.

Examination Security Policy

Federal copyright law protects AANPCB examinations, and the items contained therein. The certification
examinations and all items on the examinations are the exclusive property of the American Academy of Nurse
Practitioners National Certification Board, Inc. Candidates who apply for the certification examination must
acknowledge that they understand and agree to the policy prior to taking the examination. The Exam Security
Policy may be viewed in this handbook and online under Certification Board Policies.

Aggregate Score Report Policy

Data summary reports for each specialization are compiled annually for NP educational programs for the purpose
of providing information on program graduates examination performance. To protect candidate confidentiality, score
data are provided only when three or more program graduates test for a given specialization during a calendar year.
If a candidate wishes to have individual scores sent to their education program, they must request that service in
writing to AANPCB. Information regarding the disclosure of examination scores may be viewed online in the
Confidentiality and Disclosure Policy under Certification Board Policies.

Non-Discrimination Policy
The American Academy of Nurse Practitioners Certification Board does not discriminate against an individual with
respect to age, sex, race, color, religion, national origin, ethnicity, disability, marital status, sexual orientation, gender
identity, veteran status, or any other characteristic legally protected by law. Reasonable and consistent use of non-
discrimination and impartiality policies and procedures will apply to all programs of the AANPCB, to include
application processes, testing processes, and business operations. AANPCB complies with applicable federal,
state, and local laws and policies shall be administrated in a non-discriminatory way. AANPCB business operations
includes, but is not limited to, the selection of volunteers and vendors, volunteer, or staff member conduct, hiring
and firing of certification staff, and compliance with the Americans with Disabilities Act (ADA) of 1990, updated
2010. Examinations will be job-related and developed based on the certification program’s current role delineation
studies and close adherence to the test specifications. Publicly available information related to the examinations is
also reviewed for bias and sensitivity.
All requests for Special Accommodations/Arrangements are processed by our testing vendor, Prometric LLC. All
Prometric examination centers are equipped to provide reasonable and appropriate arrangements for applicants
with a disability in accordance with the ADA. Candidates who wish to request special arrangements because of a
disability must follow Prometric special accommodations procedures.

23
Appeals Policy
Applicants Who Do Not Meet Eligibility Criteria
Applicants may appeal a denial in the event an application for certification is denied for eligibility reasons.
Appropriate documentation must be submitted along with the required fee before the appeal can be reviewed.

Exam Rescore
Examinations are computer-based and electronically scored. A review process for candidates who do not pass the
examination and wish to have their exam results reevaluated is available. Exam rescore is limited to verifying that
the responses scored by the examinee were correctly transformed into a scaled score. The rescore service is not
a review of the exam content, what the correct answer should be, the acceptability of testing conditions, or a
reconsideration of the passing standard. Examinees are discouraged from requesting this service. Extensive and
rigorous quality control procedures are employed to ensure the accuracy of results. In all previous score challenges,
no record of a score discrepancy has been detected. Candidates will be charged a fee for hand scoring by the
testing vendor ($150.00 USD subject to change).
The Appeals Policy and process for submitting an appeal may be viewed online under Certification Board
Policies.

Records Retention Policy

Certification records are considered confidential information, and includes but is not limited to, nursing licenses,
transcripts, continuing education documents, education records as defined by the Family Educational Rights and
Privacy Act (FERPA) of 1974, financial data, and individual identifiable information/unique identifiers as defined by
the Health Insurance Portability and Accountability Act of 1996 (HIPAA).
Effective 2010, the repository for all certification and recertification applications, files, and pertinent and associated
information is the AANPCB Certification Management System (CMS). Information from paper records received
is entered in the CMS and becomes a permanent electronic record. Individuals should retain copies of their records
for personal use. AANPCB is under no obligation to return or issue copies of these documents for future use by an
applicant, candidate, or certificant.
AANPCB implements a Records Management and Retention Policy and institutes best business practices with
regards to retention, security, and disposal of paper and electronic records received from applicants and certificants.
These processes are reviewed annually and may be modified at any time for compliance with local, state, and
federal laws affecting record retention. All documents submitted for application consideration become the property
of AANPCB. At such time that a paper record is no longer required for processing of an application or valued for its
information, the paper record is destroyed per policy. In the event of a circumstance involving litigation, disposal of
any documents pertaining to the litigation will be suspended.

Abandoned Applications
Incomplete applications will be considered abandoned if a final official transcript showing the degree awarded is
not received. The period of abandonment is 1 year after taking the national certification examination for graduates
of a master’s or post-graduate certificate program, and 2 years after taking the national certification examination
for graduates of a doctoral program. Exception to this, due to extenuating circumstances, must be submitted in
writing and is subject to approval.

24
Complaints and Disciplinary Policies
The American Academy of Nurse Practitioners National Certification Board, Inc., a national certifying body,
develops and administers nurse practitioner certification programs for individuals wishing to enter, continue and/or
advance in the NP profession through established certification processes. To be eligible for certification or
recertification, an individual must comply with AANPCB policies and procedures, and standards of conduct as set
forth in the Disciplinary Policy. As the owner of the Nurse Practitioner-Certified certification mark, AANPCB
controls its use and awards the NP-C credential.
The AANPCB Disciplinary Policy articulates standards of conduct for individuals seeking certification and
recertification, for individuals holding certification, and has an established fair process for addressing
noncompliance. Individuals who bring forth complaints are not entitled to relief or damages by virtue of this process.
Actions taken by AANPCB do not constitute enforcement of the law, although referral to appropriate federal, state
or local government agencies, including boards of nursing, law enforcement, public health agencies, or employers
may be made about a certificant’s conduct in appropriate situations. The Board of Commissioners may amend the
Disciplinary Policy and procedures without prior notice.
Violations and Sanctions
Actions which constitute a violation of AANPCB Policy include, but are not limited to:
• Cheating on an examination.
• Providing false information.
• Misrepresenting certification status.
• Misuse of AANPCB property.
• Being subject to any regulatory, criminal, or civil action related to the practice as a certified NP.

Grounds for sanctions are as follows:

• Conviction of a felony or other crime of moral turpitude under federal or state law in a matter related to the
practice of, or qualifications for professional activity.
• Gross negligence or willful misconduct in the performance of professional services or other unethical or
unprofessional conduct based on the formal determination of a licensing body.
• Fraud or misrepresentation of the registered NP-C credential.

Complaints can range from procedural frustration to reporting behavior that may require disciplinary action. A
complaint must be submitted in writing and sent via email, mail, or fax. The Complaints and Disciplinary Policy
and process for submitting a complaint may be viewed online under Certification Board Policies.

25
SAMPLE QUESTIONS

Listed below are examples of the type of questions that are on the certification examinations. They range
from knowledge of pathophysiology, pharmacology, physical assessment, diagnosis, treatment, and follow-up to
testing for synthesis of information in clinical decision making while carrying out those activities.
The following questions are examples only. These questions are not updated annually like the
actual examinations. No correct answer is given since answers may change with evolving
evidence.

1. A patient who presents with fever, cervical lymphadenopathy, tonsillar exudate, and fine maculopapular rash most
likely has:
a. streptococcal pharyngitis
b. secondary syphilis
c. pharyngeal candidiasis
d. mononucleosis

2. An adult presents with complaints of difficulty swallowing, muscle weakness, diarrhea, sweating, jitteriness, and fine
hand tremors at rest. Laboratory tests reveal WBCs = 7300 cells/μL [normal = 4000-10,000 cells/μL], sodium = 138
mEq/L [normal = 135-145 mEq/L], potassium = 4.5 mEq/L [normal = 3.5-5 mEq/L], TSH = 0.05 μU/mL [normal = 0.4-
5.4 μU/mL], and free thyroxine (FT4) = 2.9 mcg/dL [normal = 4.5-11.5 mcg/dL]. Which of the following would be the
nurse practitioner’s next step?
a. encourage the patient to take over-the-counter kelp.
b. start methimazole, 10 mg daily.
c. start levothyroxine, 50 mcg every morning.
d. order an iodine-123 thyroid uptake scan.

3. To determine the presence of postural hypotension, blood pressure should be taken in which of the following
positions?
a. sitting to standing
b. supine to sitting
c. supine to standing
d. standing to supine

4. Conductive hearing loss involves the:

a. inner ear
b. middle ear
c. 5th cranial nerve
d. 8th cranial nerve

5. A 78-year-old patient presents with complaints of left-sided "rib pain" during the past few days. The patient also
complains of headache, a feverish feeling, and general malaise. Physical examination reveals an area of papular
eruptions with a few vesicles on the left side of the chest. The most likely cause of the patient's symptoms is:
a. herpes zoster
b. eczema
c. intertrigo
d. actinic keratosis

26
6. An older female with urinary stress incontinence should be instructed to:
a. perform abdominal strengthening exercises twice a day
b. perform pelvic floor muscle (Kegel) exercises 100 times per day
c. perform pelvic floor (Kegel) exercises 35-40 times per day
d. void frequently

7. An adult diagnosed with hypertension has been treated with a low sodium diet and hydrochlorothiazide (HCTZ) 50
mg daily for the past two months. The patient denies a family history of cardiovascular disease. At this visit,
BP=150/90 and T=I00 F. Physical examination reveals no bruits, clear chest, no atrial gallop, edema and tenderness
of the left ankle, and an intact neurological system. Which laboratory values will provide the most useful follow-up
information?
a. serum sodium and potassium
b. total serum cholesterol and serum glucose
c. serum uric acid and complete blood count
d. blood urea nitrogen and creatinine

8. A 38-year-old patient presents at the clinic with fatigue, dyspnea, palpitations, and decreased exercise tolerance.
Laboratory work reveals the following: Hgb = 10.8 (normal value = 12–15.5 g/dL), Hct = 34% (35%–45%), MCV = 78
(80–100 fL), MCHC = 28 (31–36 g/dL). The nurse practitioner would recognize that these values indicate which type
of anemia?
a. normocytic hypochromic
b. macrocytic hyperchromic
c. microcytic hypochromic
d. normocytic normochromic

9. A seven-year-old presents with two lesions on the extremities is diagnosed with impetigo. Which topical treatment is
most appropriate?
a. clotrimazole (Lotrimin) cream
b. mupirocin (Bactroban) cream or lotion
c. hexachlorophene emulsion (pHisoHex)
d. acyclovir (Zovirax) ointment

10. An older adult presents with a history of recurrent right upper quadrant pain associated with intermittent nausea and
vomiting. Laboratory tests reveal isolated elevations of serum alkaline phosphatase and normal amylase levels.
Physical examination results are within normal limits. The tentative diagnosis is:
a. biliary obstruction
b. peptic ulcer
c. chronic pancreatitis
d. hepatic dysfunction

11. A 16-year-old patient presents with an edematous ankle. Your examination reveals a pinpoint wound at the lateral
aspect of the ankle and X-rays show a distal fibular fracture. In addition to managing the fracture, which intervention
is most appropriate?
a. administer tetanus prophylaxis and submit wound scraping for culture
b. irrigate the wound and apply topical antibiotic
c. administer tetanus prophylaxis and prescribe oral antibiotics
d. apply topical antibiotic and cover the wound with a sterile dressing

27
12. The hormone responsible for producing a positive pregnancy test is:
a. human chorionic gonadotropin
b. estradiol
c. human growth hormone
d. progesterone

13. A 24-year-old patient complains of intermittent heartburn, which has become worse since starting a new job. The
discomfort is worse after eating and at night and is relieved by antacids. Your most likely diagnosis is:
a. diffuse esophageal spasm
b. infectious esophagitis
c. gastroesophageal reflux disease
d. carcinoma of the esophagus

14. An obese, 58-year-old patient presents with mild fatigue over the past month. The nurse practitioner takes a history,
performs a physical examination, and orders fasting laboratory work. Hct = 49%, TSH = 3.2, glucose = 128 mg/dL,
and cholesterol = 289 mg/dL. Which of the following is the most likely diagnosis?
a. hypothyroidism
b. anemia
c. depression
d. type 2 diabetes mellitus

28
Appendix A
2023 FNP Examination Blueprint
* 2023 FNP Examination Blueprint will be used until December 30, 2023. The 2024 FNP Examination
Blueprint will be used for exams released after January 1, 2024.
Test specifications are based on two domain parameters:
• Domain I Practice – Assess, Diagnose, Plan, Evaluate
• Domain II Patient Age – Developmental Parameters

A total of 135 scored items are on each examination. These exam items are distributed across Domain I and then
further divided across Domain II. Percentage weights and number of test questions in each domain are shown in
the Examination Blueprint. *Age Parameters are not rigidly defined for any population. AANPCB uses growth and
development for constructing certification exams.

DOMAIN I - Practice # of scored items % items

01 – Assess 36 27%
02 – Diagnose 35 26%
03 – Plan 34 25%
04 – Evaluate 30 22%
TOTAL 135 100%

DOMAIN II - Patient Age * # of scored items % items

Prenatal 3 2%
Newborn 3 2%
Infant 4 3%
Child 8 6%
Early Adolescent 7 5%
Late Adolescent 12 9%
Young Adult 26 19%
Middle Adult 32 24%
Older Adult 30 22%
Elder Adult 10 8%
TOTAL 135 100%

29
DOMAIN 01 - ASSESS
• Obtain subjective patient information, such as relevant medical history, social history, family history, chief
complaint, history of present illness, and review of systems
• Perform physical examination to obtain objective information based on patient age or developmental
level, health history, and comorbidities
• Order, perform, and interpret screening and diagnostic tests

DOMAIN 02 - DIAGNOSE
• Synthesize and analyze subjective and objective information to formulate differential diagnoses
• Prioritize potential differential diagnoses, including recognizing urgent and emergent conditions
• Establish primary diagnoses

DOMAIN 03 - PLAN
• Establish an individualized, patient-centered plan of care that is consistent with best evidence
• Make referrals to and engage in consultation within interprofessional teams
• Prescribe, order, and administer pharmacologic and non-pharmacologic therapies
• Provide education, counselling, and health promotion strategies

DOMAIN 04 - EVALUATE
• Evaluate the effectiveness of the plan of care
• Identify existing barriers
• Modify the plan of care as appropriate based on patient outcomes
• Coordinate follow-up and initiate referrals and consultations
• Monitor ongoing plan of care

30
 Patient Age Category # of items
Prenatal 3
Newborn 3
Infant 4
Child 8
Early Adolescent 7
Late Adolescent 12
Young Adult 26
Middle Adult 32
Older Adult 30
Elder Adult 10
A\

FNP Knowledge Areas

Pathophysiology
• Anatomy
• Physiology
• Pathophysiology
• Co-morbidities
Pharmacology
• Pharmacologic therapies
• Non-pharmacologic therapies
• Integrative therapies
• Polypharmacy
• Pain management
Physical Assessment
• Cultural competence/sensitivity
• Diagnostic and therapeutic tests
• Functional assessment
• Health history
• Mental health assessment
• Physical examination across the lifespan
• Signs and symptoms
• Therapeutic communication
Evidence-Informed Practice
• 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 counselling
• Principles of epidemiology, population health, and social determinants of health
• Procedures
• Transitions of care
31
Appendix B
2024 FNP Examination Blueprint
* 2023 FNP Examination Blueprint will be used until December 30, 2023. The 2024 FNP Examination Blueprint
will be used for exams released after January 1, 2024.
Test specifications are based on two domain parameters:
• Domain I Practice – Assessment, Diagnosis, Plan, Evaluation
• Domain II Patient Age – Developmental Parameters

A total of 135 scored items are on each examination. These exam items are distributed across Domain I and then
further divided across Domain II. Percentage weights and number of test questions in each domain are shown in the
Examination Blueprint. *Age Parameters are not rigidly defined for any population. AANPCB uses growth and
development for constructing certification exams.

DOMAIN I - Practice # of scored items % items

01 – Assess 43 32%
02 – Diagnose 36 27%
03 – Plan 36 27%
04 – Evaluate 20 15%
TOTAL 135 100%

DOMAIN II - Patient Age * # of scored items % items

Newbon 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

DOMAIN 01 - ASSESS
• Obtain elements of subjective patient information (e.g., chief complaint, history, review of systems)
• Perform appropriate physical examination (e.g., focused, complete)
• Order, perform, and interpret screening and diagnostic tests

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DOMAIN 02 – DIAGNOSE
• Prioritize differential diagnoses and establish primary diagnosis
• Prioritize differential diagnoses and establish primary diagnosis

DOMAIN 03 - PLAN
• Establish a patient-centered, evidence-based plan of care
• Initiate interprofessional referrals or consultations
• Prescribe, order or administer pharmacologic and non-pharmacologic treatments
• Provide education, counseling, and health promotion strategies

DOMAIN 04 – EVALUATE
• Evaluate the effectiveness of the plan of care
• Identify existing barriers
• Modify the plan of care as appropriate based on patient outcomes
• Coordinate follow-up and initiate referrals and consultations
• Monitor ongoing plan of care

FNP Applied Knowledge Areas A\

Health Assessment
• Diagnostic and therapeutic tests
• Specialized assessments (e.g., developmental, functional, psychological)
• Health history
• Physical examination
Pathophysiology
• Anatomy
• Physiology
• Pathophysiology
• Co-morbidities
Therapeutics
• Pharmacologic
• Non-pharmacologic
• Integrative

Evidence-Informed Practice
• Crisis management
• Diagnostic reasoning
• Health promotion, harm reduction, and disease prevention
• Healthcare economics (e.g., cost, billing)
• Interprofessional practice
• Legal and ethical issues
• Patient and family education and counselling
• Principles of epidemiology, population health, and social drivers of health (SDoH)
• Procedures
• Transitions of care
• Cultural responsiveness
• Therapeutic communication
• Pain management

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Appendix C
AGNP Examination Blueprint
Test specifications derived from the 2021 practice analysis serve as the Examination Blueprint for exams
available after January 1, 2023. Test specifications are based on two domain parameters:
• Domain I Practice – Assess, Diagnose, Plan, Evaluate
• Domain II Patient Age – Developmental Parameters

A total of 135 scored items are on each examination. These exam items are distributed across Domain I and then
further divided across Domain II. Percentage weights and number of test questions in each domain are shown in
the following Examination Blueprint. *Age Parameters are not defined for any population. AANPCB uses growth
and development for constructing certification exams.

DOMAIN I - Practice # of scored items % items

01 – Assess 37 28%
02 – Diagnose 34 25%
03 – Plan 34 25%
04 – Evaluate 30 22%
TOTAL 135 100%

DOMAIN II - Patient Age * # of scored items % items

Adolescent 3 2%
Young Adult 18 13%
Adult 38 28%
Older Adult 54 40%
Elderly 22 17%
TOTAL 135 100%

DOMAIN 01 - ASSESS
• Obtain subjective patient information, such as relevant medical history, social history, family history,
chief complaint, history of present illness, and review of systems
• Perform physical examination to obtain objective information based on patient age or developmental
level, health history, and comorbidities
• Order, perform, and interpret screening and diagnostic tests

DOMAIN 02 - DIAGNOSE
• Synthesize and analyze subjective and objective information to formulate differential diagnoses
• Prioritize potential differential diagnoses, including recognizing urgent and emergent conditions
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 • Establish primary diagnoses

DOMAIN 03 - PLAN
• Establish an individualized, patient-centered plan of care that is consistent with best evidence
• Initiate referrals and consultations and collaborate with interprofessional teams
• Prescribe, order, and administer pharmacologic and non-pharmacologic therapies
• Provide education, counselling, and health promotion strategies

DOMAIN 04 - EVALUATE
• Evaluate the effectiveness of the plan of care
• Identify existing barriers
• Modify the plan of care as appropriate based on patient outcomes
• Coordinate and monitor ongoing plan of care

AGNP Knowledge Areas

Health Assessment
• Health history
• Signs and symptoms
• Mental health assessment
• Physical examination
• Functional assessment
• Diagnostic and therapeutic tests
• Cultural competence/sensitivity
• Therapeutic communication
Pathophysiology
• Anatomy
• Physiology
• Pathophysiology
• Comorbidities
Therapeutics
• Pharmacologic therapies
• Non-pharmacologic therapies
• Integrative therapies
Evidence-informed Practice
• Clinical decision-making
• Crisis management
• Differential diagnosis
• Health promotion, harm reduction, and disease prevention
• Patient and family education and counselling
• Principles of epidemiology, population health, and social determinants of health
• Disaster preparedness / public health emergency response
• Procedures
• Transitions of care (transfer, end-of-life care, etc.)
• Care of diverse populations
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 • Healthcare finance, economics, and policy
• Interprofessional practice
• Legal and ethical issues

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Appendix D
PMHNP Examination Blueprint
PMHNP examination applications will be available January 2024. PMHNP testing appointments will be
available in spring 2024.

• Domain I Practice – Assess, Diagnose, Plan, Evaluate

• Domain II Patient Age – Developmental Parameters

A total of 135 scored items are on each examination. These exam items are distributed across Domain I and then
further divided across Domain II. Percentage weights and number of test questions in each domain are shown in
the following Examination Blueprint. *Age Parameters are not defined for any population. AANPCB uses growth
and development for constructing certification exams.

DOMAIN I - Practice # of scored items % items

01 – Assess 45 33%
02 – Diagnose 28 21%
03 – Plan 35 26%
04 – Evaluate 27 20%
TOTAL 135 100%

DOMAIN II - Patient Age * # of scored items % items

Infant and Child 8 6%
Pre-Adolescent 11 8%
Adolescent 22 16%
Adult 67 50%
Elderly 27 20%
TOTAL 135 100%

DOMAIN 01 - ASSESS
• Establish and evaluate therapeutic alliance
• Perform a developmentally appropriate comprehensive psychiatric evaluation, including relevant
medical and psychiatric history and social determinants of health
• Perform mental status exam and a comprehensive risk assessment
• Review patient records and gather collateral information from relevant sources
• Order and/or administer evidence-based instruments (e.g., scales, screening tools, and diagnostic
and laboratory tests)
• Assess readiness for change and barriers to learning and/or care

DOMAIN 02 - DIAGNOSE
• Interpret results of scales, screening tools, and diagnostic and laboratory tests to inform diagnosis
37
 • Synthesize and analyze subjective and objective information to formulate differential diagnoses
• Prioritize potential differential diagnoses, including recognizing urgent and emergent conditions and
considering pertinent medical diagnoses
• Establish primary diagnosis and any relevant secondary and/or tertiary diagnoses

DOMAIN 03 - PLAN
• Establish a collaborative, patient-centered plan of care that is consistent with best evidence
• Provide risks, benefits, alternatives, and potential side effects of psychopharmacotherapies
• Select and prescribe pharmacotherapeutics
• Provide psychotherapeutic interventions
• Provide psychoeducation, including health promotion, and risk and illness prevention strategies
• Engage in consultation and/or collaboration with interprofessional teams
• Make referrals to other providers, specialists, or programs as indicated
• Determine most appropriate level of care and facilitate transitions to ensure continuity of care
• Manage psychiatric emergencies and crises
• Ensure safety of clients, practitioners, and others
• Document client encounters and use appropriate coding and terminology

DOMAIN 04 - EVALUATE
• Evaluate efficacy of plan of care based on outcomes
• Monitor for and manage side effects and adverse events
• Monitor adherence to plan of care, while considering barriers (e.g., financial, cultural, side effects)
• Modify plan of care as appropriate
• Engage in quality improvement initiatives at the individual and/or systems level
• Practice in conformance with ethical guidelines and legal requirements
• Practice in conformance with scope and standards

PMHNP Knowledge Areas

Scientific Foundations
• Anatomy and physiology
• Neuroanatomy and neurophysiology
• Pathophysiology
• Epidemiology of psychiatric disorders
• Psychiatric and medical comorbidities
• Growth and development

Pharmacology
• Pharmacologic therapies, pharmacodynamics, and pharmacokinetics
• Psychopharmacology
• Interactions between classes of medication
• Medication monitoring
• Polypharmacy
• Pharmacogenetic testing
• Complementary and alternative medicine

Nonpharmacological Therapies
• Electroconvulsive therapy (ECT)
• Repetitive transcranial magnetic stimulation (rTMS)
• Complementary and alternative therapies
38
Psychotherapies
• Psychotherapeutic foundations
• Individual psychotherapy theories and methods
• Group psychotherapy theories and methods
• Family psychotherapy theories and methods
• Theories of change
Assessment and Diagnosis
• Clinical interviewing
• Components of a psychiatric evaluation
• Components of a targeted physical assessment
• Mental health screening and assessment instruments
• Diagnostic and laboratory tests
• Diagnostic decision-making using DSM
Care Practices
• Developmentally- and age-appropriate care practices
• Mental health promotion and preventive health
• Risk assessment and safety planning
• Harm reduction
• Crisis management and de-escalation techniques
• Least restrictive interventions
• Vulnerable populations
• Trauma-informed care
• Cultural awareness and humility
• Social determinants of health
Professional Role
• Evidence-based practice
• Ethical issues and legal requirements
• Scope and standards
• Interprofessional practice
• Professional boundaries
• Provider self-care and wellness
• Therapeutic communication
• Implicit biases
• Health systems and levels of care
• Quality improvement
• Electronic medical records and informatics
• Billing and coding schemes
• Telehealth

PMHNP Disorders
Disorders
Test items on the PMHNP exam may relate to clinical disorders from the current version of the DSM. These
disorders are organized into three major groupings indicating the general frequency with which items will be
sampled on any given exam form. Disorders in the first group will be more frequently included on a given exam

39
form; disorders in the second group will be included somewhat frequently on a given exam form; and disorders in
the third group will be included least frequently or rarely on a given exam form.

Most Frequently Included

• Depressive disorders
• Anxiety disorders
• Bipolar and related disorders
• Trauma- and stressor-related disorders
• Substance-related and addictive disorders
• Sleep-wake disorders
• Personality disorders
Somewhat Included
• Schizophrenia spectrum and other psychotic disorders
• Neurodevelopmental disorders
• Obsessive-compulsive and related disorders
• Disruptive, impulse-control and conduct disorders
• Neurocognitive disorders
• Breathing-related sleep disorders
• Gender dysphoria
• Sexual dysfunctions
• Somatic symptom and related disorders
• Feeding and eating disorders
Least Frequently Included
• Parasomnias
• Other mental disorders
• Dissociative disorders
• Elimination disorders
• Paraphilic disorders

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The American Academy of Nurse Practitioners National Certification Board, Inc.
PO Box 12926
Austin, TX 78711
Main (512) 637-0500
Toll-free (855) 822-6727
Fax (512) 637-0540
certification@aanpcert.org
www.aanpcert.org

© AANPCB 2023 ALL RIGHTS

RESERVED AGNP, FNP & PMHNP
Handbook 12/2023