ANCC Introduces New FNP Exam Blueprint

APEA Staff

ANCC Introduces New FNP Exam Blueprint

The American Nurses Credentialing Center (ANCC) has released a new blueprint for its family nurse practitioner (FNP) certification exam, and this means changes for the way FNP candidates should prepare and study. The new test content outline will take effect with ANCC FNP exams administered on Sept. 28, 2022, and later. This update is in line with the usual schedule of ANCC exam blueprint revisions, which occur approximately every 3 to 5 years.

New Testing Domains

The most significant change in the test outline is in the content domains that are represented in exam questions. Content domains reflect the components of the nurse practitioner role. The previous ANCC FNP blueprint contained four testing domains: Assessment, Diagnosis, Clinical Management, and Professional Role. In the new blueprint that takes effect Sept. 28, 2022, the Professional Role domain has been removed, and five domains are listed. The five testing domains reflected in the new ANCC exam for FNPs are:

  • Assessment — reflects knowledge of evidence-based population health promotion and screening
  • Diagnosis — reflects knowledge of the pathogenesis and clinical manifestations of disease states
  • Planning — reflects knowledge of age-appropriate primary, secondary and tertiary prevention; anticipatory guidance; evidence-based clinical guidelines; standards of care; and pharmacotherapeutics
  • Implementation — reflects knowledge of legal and ethical implementations for healthcare and technology; nonpharmacologic intervention and treatment selection; pharmacotherapeutic intervention selection; regulatory guidelines; and APRN scope and standards
  • Evaluation — reflects knowledge of ethical and legal principles and issues for patients, populations, and systems; nonpharmacologic intervention and treatment outcomes; and pharmacotherapeutic intervention and treatment outcomes.

Although the Professional Role domain is no longer on the blueprint, FNP candidates should still expect to see questions that incorporate components of the professional role of nurse practitioners. For example, within the Planning domain, answering exam questions about anticipatory guidance may require knowledge of specific theories. Likewise, the Implementation domain may include exam questions to determine knowledge of legal and ethical issues.

Number of Questions in Each Domain

The new ANCC test content outline specifies the percentage and approximate number of questions reflected in each of the major testing categories (domains). This breakdown is as follows:

  • Assessment: 29 questions (approximately 19% of the exam)
  • Diagnosis: 26 questions (approximately 17% of the exam)
  • Planning: 29 questions (approximately 19% of the exam)
  • Implementation: 43 questions (approximately 29% of the exam)
  • Evaluation: 23 questions (approximately 15% of the exam)

Subject Areas Covered

The subject areas covered on the new exam are based on ANCC’s consideration of the following secondary classifications. Areas marked with an asterisk have less emphasis relative to other subjects on the exam.

  • Body Systems — Cardiovascular; Endocrine; Gastrointestinal; Genitourinary & Renal; Head, Eyes, Ears, Nose & Throat; Hematopoietic*; Immune*; Integumentary; Musculoskeletal; Neurologic; Psychiatric; Reproductive; Respiratory
  • Drug Agents — Analgesic; Anti-Infective; Cardiovascular; Endocrine; Eye, Ear, Nose & Skin; Gastrointestinal; Genitourologic; Musculoskeletal; Neurologic; Psychiatric; Reproductive; Respiratory
  • Age Group — Infant; Preschool; School-Aged; Adolescent; Young Adult; Adult; Older Adult; Frail Elderly

New Reference List

As you review the new ANCC test content outline for FNP candidates, Advanced Practice Education Associates strongly advises that you carefully read the reference list for the new exam and use it to plan your study. This reference list provides examples of the authoritative texts used to develop the test questions. Of importance, ANCC explains that “the list is provided to help you prepare for the examination and is not intended to be all inclusive.”

Here is a sampling of some of the 19 references listed:

  • American Nurses Association. (2021). Nursing: Scope and Standards of Practice. (4th ed.). Wolters Kluwer.
  • Dipiro, J.T., Yee, G.C., Posey, M., et al. (Eds.) (2020). Pharmacotherapy: A Pathophysiologic Approach. (11th ed.). McGraw-Hill.
  • Dunphy, L.N., Winland-Brown, J.E., Porter, B.O., et al. (2019). Primary Care: Art and Science of Advanced Practice Nursing. (5th ed.) FA Davis.
  • U.S. Department of Health & Human Services. Healthy People 2030.

Additional Exam Prep Resources

Since 1997, Advanced Practice Education Associates (APEA) has been a valued resource for nurse practitioner development and nurse practitioner practice. APEA is committed to your success throughout your NP education and throughout your clinical practice. Check out the additional resources below or reach out to our support team with questions. Email us at or call us at (800) 899-4502.

Visit the APEA YouTube channel for in-depth study strategies and videos on how to develop a detailed study plan: Study Strategies series; Live Q&A sessions with APEA NP educators; and two Virtual Town Halls for NP students: How to Stay on Track When Your NP Education Has Been Derailed and How to pass your NP Boards.


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APEA Staff