AANP or ANCC Certification Exam?

As family nurse practitioner students and adult-gerontology nurse practitioner students near the end of their programs, most arrive at the following question: Which certification exam should I take? As the leader in NP certification preparation since 1997, APEA has developed a deep understanding of the differences between the two exams. This article contains an overview of the exams as well as details on particular differences between the two. Your decision about which exam to take depends on your preferences and career plans.

Two Certifying Bodies for FNPs and AGNPs

NP certifications in family and adult-gerontology primary care roles are available from two credentialing bodies, the American Association of Nurse Practitioners Certification Board and the American Nurses Credentialing Center. Each organization and its certification offerings are outlined below.

The American Association of Nurse Practitioners (AANP) is a national membership organization representing NPs. The AANP Certification Board (AANPCB) is an independent nonprofit organization incorporated separately from AANP. AANP members receive a $75 discount on AANPCB certification applications.

AANPCB national certification examinations are competency-based exams for nurse practitioners that reflect their knowledge and expertise in the role and population area of education. The AANPCB family NP and adult-gerontology primary care NP certification programs are accredited by the Accreditation Board of Specialty Nursing Certification (ABSNC) and the National Commission for Certifying Agencies (NCCA). Certifications available from AANPCB are family nurse practitioner (FNP), adult-gerontology primary care nurse practitioner (A-GNP), and emergency nurse practitioner (ENP).

The American Nurses Credentialing Center (ANCC) is a subsidiary of the American Nurses Association (ANA) that seeks to promote excellence in nursing and healthcare through credentialing programs. ANCC is not a membership organization; ANA is a membership organization for all types of nurses. ANCC's credentialing programs certify and recognize nurses in primary care and specialty practice areas. ANCC also recognizes healthcare organizations that promote nursing excellence and quality patient outcomes, most notably through its Magnet program.

The ANCC certifications available to graduates of nurse practitioner programs are: adult-gerontology primary care nurse practitioner (AGPCNP-BC), family nurse practitioner (FNP-BC), adult-gerontology acute care nurse practitioner (AGACNP-BC), and psychiatric-mental health nurse practitioner (PMHNP-BC). Find information on ANCC certification for new NPs here.

Consider five things when deciding which exam to take: your career plans, your testing style, your testing content preference, the number of questions on the exam, and the time limit for the exam.

Your Career Plans

Do you want to work as a clinician or in an educational or academic role? AANP certification enables FNPs and AGNPs to work in any clinical setting in any state, and to be reimbursed by insurers including Medicare and Medicaid. ANCC certification also enables FNPs and primary care AGNPs to work in any clinical setting in any state, and to be reimbursed by insurers including Medicare and Medicaid.

At one time, ANCC’s exam content was considered more appealing for NPs pursuing academic positions because it included questions on nursing research and theory. However, ANCC test content shifted considerably in 2019 and no longer has a significant amount of theory questions. If you are interested in working in an academic role, we recommend talking with university-based nurse practitioners to determine whether ANCC certification may be preferred for that career track.

A question we sometimes hear at APEA review courses is about whether ANCC certification is required to work at a Magnet hospital. Current Magnet requirements do not state that ANCC certification is required of hospital nursing staff. The only published requirement for nurse leaders at Magnet hospitals is for a BSN degree or higher.

Your Testing Style

The AANP exam is a multiple choice exam. The ANCC exam contains several question types: multiple choice, multiple response, drop and drag, and hot spot. If you are not comfortable with question formats that are not multiple choice, AANP testing may be a good choice for you.

Testing Content Preference

The AANP exams for FNPs and AGNPs focus solely on clinical content, with 35% of questions reflecting patient assessment, 24% of questions reflecting diagnosis, 23% of questions reflecting planning, and 17% of questions reflecting evaluation. These blueprints are in effect in 2021.

In addition, the AANP exams for FNPs and AGNPs include questions on commonly performed minor procedures in the office setting: minor lesion removal, incision and drainage, microscopy, diagnostic interpretation of ECGs, Pap tests, diagnostic interpretation of X-rays, joint aspirations and injections, cerumen removal, skin biopsy, pulmonary function testing and office spirometry, therapeutic injections, fluorescein dye, wound closure, long-term contraceptive management, splinting, long-term hormonal implantation, casting, foreign body removal, wound management, and nail removal. The APEA Live Review Course and Clinical Update contains a lecture covering many of these procedures. You can also find skills workshops in the APEA CE Library and Live Continuing Education Events calendar.

The ANCC exams for FNPs and AGNPs consist of questions on clinical information and decision making and NP professional practice (licensure, scope of practice, privileges).

The exam content breakdown for the ANCC exam for FNPs is: 43% clinical management, 26% diagnosis, 21% assessment, and 10% professional role. This content blueprint took effect May 22, 2019. The breakdown of the ANCC exam for AGNPs is: 62% plan of care, 23% patient assessment, and 15% professional practice. This content blueprint took effect on Dec. 16, 2019.

Numbers and Details

The number of questions and the length of time permitted for testing are other issues to consider. The AANP exam for FNP candidates contains 150 questions. One hundred thirty-five of these are scored; the remaining 15 are “pretest” questions that are being considered for inclusion for scoring on future exams. The AANP exam for AGNP candidates also contains 150 questions. A candidate’s score is based only on the 135 questions that are scored; the remaining 15 questions are pretest questions to be analyzed for potential use in the future.

The ANCC exam for FNP candidates contains 175 questions. One hundred fifty of these are scored; the remaining 25 are “pretest” questions that are being considered for inclusion on future exams. The ANCC exam for AGNP candidates also contains 175 questions. Of these, 150 are scored and the remainder are pretest questions for analysis and consideration.

With regard to time, a certification candidate has 3 hours to answer the 150 questions on the AANP exams for FNPs and AGNPs. A certification candidate sitting for either of the ANCC exams has 3.5 hours to answer 175 questions.

Both AANP and ANCC exams are given at contracted testing centers where timed, computerized testing is available. When you apply to take your certification exam, the certifying body will provide location options. AANP currently uses PSI Testing Centers, while ANCC currently uses Prometric Centers. Both companies have testing locations throughout the country, but you may have to travel to get to one in your area.

What about fees? The testing fee for an AANP exam by an AANP member is $240. For nonmembers, it is $315. The testing fee for an ANCC exam is $295 for ANA members and $395 for nonmembers. For AANP members, ANCC provides a discount rate of $340.

Download and review the AANP test blueprint and the ANCC test content outline (blueprint) for your role (FNP, AGNP) to further guide your decision. After you have decided which exam to take, study the appropriate test blueprint thoroughly and plan your study according to the information it contains. These documents are posted on the AANPCB and ANCC websites.

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