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Category Content Domain Number of Questions Percentage
I Assessment 31 21%
II Diagnosis 39 26%
III Clinical Management 65 43%
IV Professional Role 15 10%
TOTAL 150 100%

Body Systems Drug Agents Age Group
1. Cardiovascular 1. Analgesic 1. Infant
2. Endocrine 2. Anti-Infective 2. Preschool
3. Gastrointestinal 3. Cardiovascular 3. School-Age
4. Genitourinary and Renal 4. Endocrine 4. Adolescent
5. Head, Eyes, Ears, Nose, and Throat 5. Eye, Ear, Nose and Skin 5. Young Adult (including late adolescent and emancipated minors)
6. Hematopoietic* 6. Gastrointestinal 6. Adult
7. Immune* 7. Genitourologic 7. Older Adult
8. Integumentary 8. Musculoskeletal 8. Frail Elderly
9. Musculoskeletal 9. Neurological
10. Neurological 10. Psychiatric
11. Psychiatric 11. Reproductive
12. Reproductive 12. Respiratory
13. Respiratory

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

The ANCC Family Nurse Practitioner board certification examination is a competency based examination that provides a valid and reliable exam of the entry-level clinical knowledge and skills of nurse practitioners. This certification aligns with the Consensus Model for APRN Regulation: Licensure, Accreditation, Certification and Education. Once you complete eligibility requirements to take the certification examination and successfully pass the exam, you are awarded the credential: Family Nurse Practitioner-Board Certified (FNP-BC). This credential is valid for 5 years. You can continue to use this credential by maintaining your license to practice and meeting the renewal requirements in place at the time of your certification renewal. The Accreditation Board for Specialty Nursing Certification accredits this ANCC certification.

The ANCC certification examinations are developed consistent with the technical guidelines recommended by the American Educational Research Association, the American Psychological Association, and the National Council on Measurement in Education (AERA, APA, NCME; 1999). Additionally, the ANCC certification examinations meet accreditation standards of the Accreditation Board for Specialty Nursing Certification(ABSNC) and the National Commission for Certifying Agencies (NCCA). Each examination is developed by ANCC in cooperation with a Content Expert Panel (CEP) composed ofcarefully selected experts in the field. CEPs analyze the professional skills and abilities from role delineationstudies, which provide the evidence for the test content outline (also called the test blueprint).

Test questions or “items” are written by certified nurses and interprofessional content experts in their discipline who have received training by ANCC staff in writing items. The items are then reviewed by the CEP with the ANCC staff and pilot-tested to ensure validity and psychometric quality before being used as scored items on the genuine examinations. ANCC adheres to a variety of guidelines during the development of items to ensure that the items are appropriate for the specialty and certification level (e.g., APRN vs. RN). This includes editing and coding items, referencing items to the approved test content outlines and reference books, and screening items for bias and stereotypes. Items for the examinations are selected that reflect the test content outline and item distributions. The validity and reliability of the exams are monitored by ANCC staff. Certification examinations are updated approximately every three to five years.

ANCC reports its examinees test score results as pass or fail. If an examinee fails, the score report includes diagnostic feedback for each of the major content areas covered on the examination.
ANCC examinations are criterion-referenced tests, which means that an examinees performance on the examination is not compared to that of other examinees in determining the examinees pass/fail status.
In a criterion-referenced test, an examinee must achieve a score equal to or greater than the minimum passing score for the examination. The minimum passing score represents the absolute minimum standards that the examinee must achieve to demonstrate the ability to practice the profession safely and competently. With the guidance of a measurement expert (e.g., a psychometrician), a panel of subject matter experts in the nursing specialty sets the minimum passing score for each ANCC examination. In setting the minimum passing score, ANCC uses the Modified Angoff Method, which is well-recognized within the measurement field.
Each exam contains between 150 to 175 scored test items plus 25 pilot test items that do not count towards the final score. For specific information on the number of items each exam contains, please refer to the test content outline associated with that exam.
Scores on ANCC examinations are reported on a scale with a maximum possible score of 500. To pass the ANCC examination, an examinee must achieve a scale score of 350 or higher. Prior to conversion of an examinees score to this scale, the examinees raw score on the examination is determined, which is simplythe number of test items that the examinee answered correctly (e.g., 105 out of 150). The raw score is then converted to a scale score, using a conversion formula.
For examinees who do not achieve a scale score of at least 350, the score report will show the scale score achieved, “fail” status, and diagnostic feedback for each of the content areas covered by the examination