Family nurse practitioner candidates seeking certification by the American Academy of Nurse Practitioners Certification Board (AANPCB) will take exams based on a new test blueprint starting Jan. 2, 2024. The blueprint incorporates a slightly higher percentage of questions reflecting assessment, diagnosis, and planning, and a redistribution of patient populations according to age.

The AANPCB released the new FNP blueprint, along with an updated candidate handbook, on its website in December. The blueprint and handbook contain essential information that guides certification preparation. APEA’s Nurse Practitioner Education Specialists — Kathy Baldridge, DNP, FNP-BC, FAANP, Lindsey Luther, DNP, APRN, FNP-C, CNE, and Jennifer Smith, MSN, APRN, FNP-C, ENP-C — recommend that all NP candidates carefully review the exam blueprint, reference list, and candidate handbook to guide their study.

“As you prepare for your exam, the first step is always to review the test blueprint and reference list,” Dr. Luther advised. “The biggest change in the AANP FNP blueprint in 2024 is the increased emphasis on the Assessment domain and a reduced emphasis on the Evaluation domain. Don’t neglect your review of how to evaluate a management plan, but do put increased focus on how to assess and screen for primary care problems.”

What’s in the new test blueprint for FNPs?

The new breakdown of FNP question content for each testing domain is as follows:

• 43 questions (32%) reflecting Domain 01, Assess
• 36 questions (26.5%) reflecting Domain 02, Diagnose
• 36 questions (26.5%) reflecting Domain 03, Plan
• 20 questions (15%) reflecting Domain 04, Evaluate.

The differences between the 2024 blueprint and the 2023 blueprint are in the percentage of questions allocated for each domain. Specifically:

• The number of questions in the Assess domain increased from 36 to 43.
• The number of questions in the Diagnose domain increased from 35 to 36.
• The number of questions in the Plan domain increased from 34 to 36.
• The number of questions in the Evaluate domain decreased from 30 to 20.

Changes to the age distribution in FNP exam questions

The AANPCB made notable revisions in the distribution and categorization of questions reflecting patient populations by age. Starting in 2024, prenatal has been removed as an age category and prenatal health knowledge will be assessed in questions about adolescent, young adult, and middle adult populations rather than standalone test items. The blueprint also introduced a toddler category and removed the elder adult category.

The question breakdown, shown below, is a reminder that success on the FNP exam requires pediatric knowledge: 20% of the exam covers newborns through adolescents. Pregnancy-related questions are now embedded into adolescent, young adult, and middle adult categories.

The new patient population breakdown is:

• 3 questions reflecting newborn health
• 4 questions reflecting infant health
• 5 questions reflecting toddler health
• 6 questions reflecting child health
• 12 questions reflecting adolescent health
• 30 questions reflecting young adult health
• 35 questions reflecting middle adult health
• 40 questions reflecting older adult health.

In conjunction with the test content breakdown by population above, the AANPCB posted the following information: Age parameters are not defined for any population. AANPCB uses growth and development to construct content on its certification exams.

Testing domains on the FNP exam: What are they?

The AANPCB exam for FNPs assesses knowledge in the four testing domains the board has deemed essential for entry-level nurse practitioner practice:

Domain 01: Assess — This testing domain determines whether the candidate can obtain subjective information from patients, perform appropriate physical examinations, and order, perform, and interpret screening and diagnostic tests.

Domain 02: Diagnose — This testing domain determines whether the candidate can synthesize and analyze subjective and objective information to develop a differential diagnosis list, prioritize the differentials, and establish a diagnosis.

Domain 03: Plan — This testing domain determines whether the candidate can establish a patient-centered, evidence-based plan of care; initiate referrals or consultations to other health professionals; prescribe, order, or administer pharmacologic and nonpharmacologic treatments; and deliver education, counseling, and health promotion.

Domain 04: Evaluate — This testing domain determines whether the candidate can evaluate the effectiveness of their plan of care and then monitor and modify the plan of care based on patient outcomes.

Common questions about the AANPCB exam for FNPs

How many questions are on the AANPCB FNP exam?

The exam contains 150 questions, and a candidate’s score is determined based on their answers to 135 of the questions. Fifteen of the 150 questions are not factored into the score because they are pilot questions being considered for future exams.

How much time do I have to complete the AANPCB FNP exam?

Each candidate is allowed 3.5 hours to complete the exam. Information about requests for special accommodations is available here.

What is the application fee for the AANPCB FNP exam?

The cost for online application to take an FNP examination is $240 for AANP members and $315 for nonmembers. Paper application fees are higher: $290 for members and $365 for nonmembers.

Where are AANPCB exams administered?

AANPCB exams are administered at Prometric testing centers. Click here for information on testing dates and sites.

For additional information, see the AANPCB's FAQs here.

For assistance in developing study plans, overcoming test anxiety, and ensuring readiness for NP certification success, APEA is here to help. Our faculty provide free guidance every month in the APEA NP Power Hour for NP students. To be notified of upcoming Power Hours, sign up for our email list using the signup form at the bottom of this page.

---