Family Nurse Practitioner Certification Examination

The American Nurses Credentialing Center (ANCC) offers the Family Nurse Practitioner Certification Examination for certification purposes. This computer-based assessment is for licensed RNs with completed graduate work in an accredited family nurse practitioner program who have earned a master's, post-master's or doctorate degree. Candidates must have taken graduate classes in advanced health assessment, advanced pharmacology, advanced pathophysiology, health promotion and disease prevention and differential diagnosis and disease management. Candidates also need to have completed at least 500 clinical hours in an accredited academic program, and have met specific requirements before taking this test. This test is taken as part of the Family Nurse Practitioner - Board Certified (FNP-BC) credential.

The Family Nurse Practitioner test has 175 questions; 25 questions on the test are not scored, as they are used for pre-trial purposes only, but the candidate will not know which questions are scored and which are not. The score is derived from the remaining 150. Candidates must get a minimum of 105 correct in order to receive a passing raw score. The actual score will be weighted on a 500-point scale, and candidates need a minimum of 350 to pass. If a candidate does not succeed on the assessment exam, an account is provided which will help pinpoint the areas that need improvement. The subject areas of the Family Nurse Practitioner Certification Examination include:

• 53 questions on clinical management
• 7 questions on professional role and policy
• 16 questions on nurse practitioner and patient relationship
• 39 questions on assessment of acute and chronic illness
• 4 questions on research
• 31 questions on health promotion and disease prevention

The questions cover a range of life stages from birth to aging adult (including pregnant women), although some questions may not be precise about the stage of life.

Family Nurse Practitioner Certification Exam Practice Questions

1. The nurse practitioner should order which diagnostic study to confirm a suspected diagnosis of colorectal cancer?

1) Stool Hematest
2) Carcinoembryonic antigen (CEA)
3) Colonoscopy
4) Abdominal computed tomography (CT) scan

2. The nurse practitioner is determining if a client's lesions are indicative of herpes zoster. The best way to determine this is that herpes zoster lesions are typically:

1) grouped vesicles occurring on lips and oral mucous membranes.
2) grouped vesicles occurring on the genitalia.
3) rough, fresh, or gray skin protrusions.
4) grouped vesicles in linear patches along a dermatome.

3. A client with left-sided heart failure comes into the clinic complaining of increasing shortness of breath and is agitated and coughing up pink-tinged, foamy sputum. The nurse practitioner recognizes these findings as signs and symptoms of:

1) right-sided heart failure.
2) acute pulmonary edema.
3) pneumonia.
4) cardiogenic shock.

4. A nurse practitioner is assessing a client with suspected pneumothorax. To confirm the diagnosis, the nurse practitioner should order:

1) arterial oxygen saturation (SaO20) monitoring.
2) arterial blood gas (ABG) studies.
3) hourly chest auscultation.
4) a chest X-ray.

5. What diagnostic study finding helps make a diagnosis of multiple myeloma?

1) Decreased serum creatinine level
2) Hypocalcemia
3) Bence Jones protein in the urine
4) Low serum protein level

6. A nurse practitioner suspects neglect in a 3-year-old child seen in the office. What assessment findings should the nurse practitioner look for?

1) Slapping, kicking, and punching others
2) Poor hygiene and weight loss
3) Loud crying and screaming
4) Pulling hair and hitting

7. A 2-year-old child is brought clinic with a history of upper airway infection that has worsened over the past 2 days. The nurse practitioner suspects the child has croup. Signs of croup include a hoarse voice, inspiratory stridor, and:

1) a barking cough.
2) a high fever.
3) sudden onset.
4) dysphagia.

8. A mother brings her 5-year-old son who is complaining of a fever and sore throat to the clinic. A nurse practitioner documents the client's tonsils as 3+. This rating means the tonsils are:

1) barely visible outside the tonsillar pillar.
2) halfway between the tonsillar pillar and the uvula.
3) touching the uvula.
4) touching each other.

9. A nurse practitioner is conducting a well-baby examination of an 8-month-old infant. Which reflex does the nurse practitioner anticipate to be present?

1) Stepping
2) Moro
3) Plantar grasp
4) Palmar grasp

10. An obese 14-year-old adolescent says that he wants to lose weight. Besides dietary intake and physical activity, what's the most important factor to assess?

1) The adolescent's metabolic rate
2) Who prepares the adolescent's meals
3) How food is used in his home
4) His educational interests

---

Family Nurse Practitioner Certification Exam Answer Key

1. Answer: 3) Used to visualize the entire colon, colonoscopy aids in the detection of colorectal cancers. A stool Hematest detects the presence of blood in the stool; it doesn't confirm a diagnosis of colorectal cancer. CEA may be elevated in colorectal cancer but isn't considered a confirming test. Abdominal CT scan is used to stage the presence of colorectal cancer.

2. Answer: 4) Herpes zoster, or shingles, is an acute inflammation of the dorsal root ganglia, causing localized, vesicular skin lesions that follow a dermatome. Herpes simplex type 1 is a viral infection affecting the skin and mucous membranes, usually producing cold sores or fever blisters. Herpes simplex type 2 primarily affects the genital area, causing painful clusters of small ulcerations. Warts appear as rough, fresh, or gray skin protrusions.

3. Answer: 2) Because of decreased contractility and increased fluid volume and pressure in clients with heart failure, fluid may be driven from the pulmonary capillary beds into the alveoli, causing pulmonary edema characterized by shortness of breath, agitation, and pink-tinged, foamy sputum. In right-sided heart failure, the client exhibits hepatomegaly, jugular vein distention, and peripheral edema. In pneumonia, the client should have a temperature spike, and sputum that varies in color. Cardiogenic shock involves signs of hypotension and tachycardia.

4. Answer: 4) A chest X-ray confirms the diagnosis of pneumothorax by revealing air or fluid in the pleural space. SaO2 values may initially decrease with a pneumothorax, but they typically return to normal in 24 hours. ABG levels may show hypoxemia, possibly with respiratory acidosis and hypercapnia not related to a pneumothorax. Chest auscultation determines overall lung status, but it's difficult to determine if the chest is reexpanded sufficiently.

5. Answer: 3) Presence of Bence Jones protein in the urine almost always confirms multiple myeloma; however absence doesn't rule it out. Serum calcium levels are elevated because calcium is lost from the bone and reabsorbed in the serum. Serum electrophoresis shows elevated globulin spike. The serum creatinine level may also be increased.

6. Answer: 2) Neglect can involve failure to provide food, bed, shelter, health care, or hygiene. Slapping, kicking, punching, pulling hair, and hitting are signs of physical abuse. Loud crying and screaming aren't abnormal findings for a 3-year-old child.

7. Answer: 1) Croup is an acute viral respiratory illness characterized by a barking cough. Fever is usually low-grade. Croup has a gradual onset, and dysphagia isn't a symptom.

8. Answer: 3) Tonsils that touch the uvula are rated 3+. Tonsils barely visible outside the tonsillar pillar are rated 1+. Tonsils between the tonsillar pillar and the uvula are rated 2+. Tonsils that touch each other are given a 4+ rating.

9. Answer: 3) The plantar grasp reflex is present until approximately age 9 months. The stepping reflex is present only until age 3 months so it shouldn't be present in an 8-month-old infant. The Moro reflex is present until approximately age 5 months. The palmar grasp is present until age 3 or 4 months.

10. Answer: 3) The nurse practitioner must assess how food is used in the adolescent's home because food habits and eating behaviors are largely related to cultural patterns and family preferences. Although the adolescent's metabolic rate and educational interests might be useful in motivation, they don't add to the dietary history. Rather than assessing who prepares the meals, it's better to assess the complete nutritional environment, including such factors as the school cafeteria.

Nurse Practitioner Certification Review