Nurse Practitioner Certification Examination
NEWS & INFORMATION (ANCC and AANPCB certification exams) 
ANCC New Question Formats
The link for the new question formats are on the ANCC FNP exam page. Read the exam instructions on top of the Sample Test Questions. There is a link "click here" on that page. It will move you to a Prometric site. 

ANCC FNP Sample Test Questions

For BOTH ANCC and AANPCB exams:
The majority of exam questions are still in the classic multiple choice format with 4 answer options. 
There will be a few multiple choice questions with 5 to 6 answer options, you will be asked to pick two or three answers (multiple choice multiple response). 

EKG strip
You may (or may not) have one EKG strip on your exam.  You do not have to figure out a heart block or anything fancy.
​I will discuss which strips may show up on the exam.

Chest radiograph/Chest x-ray film
One chest x-ray film may (or may not) be included in your version of the exam. I will discuss and tell you which ones are important in my review course. 

In addition to the above question formats, there are other formats that are used only in the ANCC exam. These are:

Hot Spot Items  
You will see a graphic image, and the question will request that you click on a particular feature or within a particular area on the image. To answer this question, click once with your mouse on the area that answers the question most accurately. To change your answer, you may click a different area on the image.

Colored Images (Photos)
There will be MANY color photos of skin and eye conditions. 
It may ask you about the diagnosis, treatment, or which is an emergent condition.   

Drag and Drop Items
There are two set of panels - the source panel on the left and the target panels on the right. To answer it, use the mouse to click and "drag" each source panel and to "drop" it on the appropriate target panel. This format is commonly used for Evidence-based Medicine articles. Your job is to rate the studies from the best evidence (#1 panel), moderate evidence (#2 panel), and the worst evidence (#3 panel).

I discuss (and give samples) of the new ANCC question formats in all my review courses. 

What is the difference between the ANCC and the AANPCB certification exams for FNPs and AGPCNPs?
Legally, they are both equivalent. Both are accepted by the State Boards of Nursing, Medicare, Medicaid, VA health system, HMOs, PPOs, provider panels, and others. If you are from Canada, check the Board of Nursing website.

Ask around where you plan to practice  about the type of board certification that is preferred in your area. I have been recommending for many years that students take both exams within a few days to one week apart, especially if you have a job offer. 

Overall, what is the major difference between ANCC and AANPCB certification exams for FNPs and AGNP/AGPCNPs?​
The ANCC exams contain more non-clinical topics than the AANPCB exam.  The AANPCB exam has very few non-clinical questions. In contrast, the ANCC exams may contain about 33% to 40% non-clinical questions.  

When are the new versions of the ANCC board certification exams released?
ANCC FNP exam: May 22, 2019
There is a 4-day test suspension period to transition to the new exam. You may test before May 18 (older exam) or after May 22, 2019 (new exam).
ANCC AGPCNP exam: December 16, 2019

AANPCB exams:  released on Spring 2018

Heads up!!!
The new ANCC exams will contain only 175 questions (150 scored  plus 25 pretest questions not scored). The exam time  allowed is 3.5 hours. The previous exam had 200 questions/4 hours time.

ANCC FNP (release date is May 22, 2019)
Time allowed: 3.5 hours
# Questions: 175 total (25 not graded)
Passing Score: 350 points (range 100 - 500)

Current ANCC AGPCNP exam (Dec. 2015)
Time allowed: 4 hours
# Questions: 200 total (25 not graded)
Passing Score: 350 points (range 200-500)

New ANCC AGPNP (December 12, 2019)
Time allowed: 3.5 hours
# Questions: 175 total (25 not graded)
Passing Score: 350  points (range 100 - 500)

Time allowed: 3 hours
# Questions: 150 total (15 not graded)
Passing Score: 500 points (range 200-800) 

​How many times per year can I retake the exams?
ANCCup to 3 times per calendar year (at least 60 days apart)
AANPup to 2 times per calendar year (submit 15 contact hours continuing education). You can use the credit hours from the Leik Review Courses to fulfill this requirement.

When do I get my scores?
ANCC and AANPCB: you will find out right away, after you complete your exam. Ask the proctor to print your scores.
It will be in "Pass/Fail" format (unofficial scores). If you fail, you will get also get the categories/domains. If you applied for the exam before you graduated, your "official score" will not be released  by the ANCC/AANPCB  until they receive your final transcripts. Certification is good for 5 years.

How long does it take to process an application?
It depends. If all your documentation  requirements are met, it will take about 3 - 4 weeks. Only the ANCC has an Expedited Application option (extra fees). If your final transcripts has not been released yet, an expedited application will be delayed.

How many copies do I need of my official final transcript?
I suggest you order 4 copies of your final transcripts. Open one copy to make sure there are no errors, it should list the type of degree with the NP specialty.

What about certification renewal?
For both, your certification has to be renewed every five years by fulfilling continuing education requirements, 1000 hours of clinical practice (in your specialty area), and other categories. The ANCC certification accepts more categories for renewal such as presentations, Quality Improvement (QI) project/publication, preceptor hours, as a volunteer in a medical mission trip (link here). So, the ANCC is easier to renew because is has six renewal categories. The AANPCP requires continuing education with 1000 clinical hours of practice (in your specialty). Another way to renew is to take the exams again (if it has not been retired).

Passing Rates (as of  MAY 22, 2019)
ANCC (2016 exam version)
FNP: 82%  
AGPCNP: 82% 

AANPCB (2018 exam version)
 FNP: 85%
 AGNP: 83%

​*ANCC uses the designation of "AGPCNP-BC" or Adult-Gerontology Primary Care Nurse Practitioner. 
The AANPCB designation is "AGNP-C" 
United States Department of Labor
Bureau of Labor Statistics

Occupational Employment and Wages for Nurse Practitioners: MAY 2016 (latest available)

National Estimates
Mean Annual Wage: $104,610 (increased). It was            $92,670.00 on 2015.
Mean hourly wage: $50.30

By Industry
Physician Offices: $103,030 (increased). 
It was $99,760 on 2015.

General Medical and Surgical Hospitals: $109,030

Specialty Hospitals (except psychiatric/substance abuse): 117,120 (increased). It was  $105,690 on 2015

Outpatient Care Centers: $107,160 (increased).
 It was $103,710 on 2015. 

University/Colleges/Professional schools: $96,750 (increased). It was $94,050 on 2015.

​Personal Care Services: $136,280.

Top 5 States with the Highest Pay for NPs
Annual Mean Wage By State

Alaska: $121,250 (was $111,800 in 2015)

California: $124,330 (was $110,590 in 2015)

Massachusetts $117,860

Hawaii: $117,180

New Jersey: $115,230

More states listed, visit link. They also list several cities and mean wage in those area.

Top Paying By Metropolitan Area

Altoona, PA: $180,520

San Francisco-Redwood City, CA:

Peabody-Salem-Beverly,MA: $155,320

San Jose-Sunnyvale-Santa Clara, CA: $145,480

Bridgeport-Stamford-Norwalk, CT: $136,450

Panama City, FL: $136,020

FNP Exam Procedures (AANPCB Exam)

LINK: AANP FNP Exam Blueprint

Minor lesion removal
Incision and drainage
Diagnostic interpretation of ECG
Pap tests
Diagnostic interpretation of X-ray
Joint aspirations and injections
Cerumen removal
Skin biopsy
Pulmonary function testing & office spirometry
Therapeutic injections
Fluorescein dye
Wound closure
Long-term contraceptive management
Long-term hormonal implantation
Foreign body removal
Wound management
Nail removal
A-GNP Exam Procedures (AANPCB Exam)
LINK: AGNP Exam Blueprint

Minor lesion removal
Pap tests
Joint aspirations and injections
Wound debridement
Incision and drainage
Therapeutic injections
Foreign body removal

Application Tips:
When you apply, make sure that the name in the application form matches the name on the primary ID that you will be using for the testing center. A primary ID has your picture and signature, it is the original government-issued ID (unexpired) such as a drivers license. 

Do not forget to send your official FINAL transcript (from the school registrar or from you) to complete your application. If you applied early to the AANPCB, your official scores will not be released until they receive your official final transcript.

Check the State Board of Nursing (SBON) website for the requirements  on how to become licensed as an advanced practice nurse/nurse practitioner in your state.  Some states issue DEA numbers for NPs, you will need to check the SBON website of your state.

Which hypertension treatment guidelines is applicable for the ANCC or AANPCB exam?

The current  AANPCB exams will be using both the 2017 ACC/AHA hypertension guidelines and the JNC 8 guidelines. 

The ANCC exam (older versions) will be using the JNC 8. 
The new ANCC FNP exam (release May 22, 2019) and the new version of the ANCC AGPCNP (to be released on December 12, 2019) will be using the 2017 ACC/AHA hypertension guidelines.