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ANCC Adult Nurse Practitioner Practice Test

ANP-BC test Format | Course Contents | Course Outline | test Syllabus | test Objectives

Category Content Domain Number of Questions Percentage
I Assessment 31 21%
II Diagnosis 39 26%
III Clinical Management 65 43%
IV Professional Role 15 10%
TOTAL 150 100%

Body Systems Drug Agents Age Group
1. Cardiovascular 1. Analgesic 1. Infant
2. Endocrine 2. Anti-Infective 2. Preschool
3. Gastrointestinal 3. Cardiovascular 3. School-Age
4. Genitourinary and Renal 4. Endocrine 4. Adolescent
5. Head- Eyes- Ears- Nose- and Throat 5. Eye- Ear- Nose and Skin 5. Young Adult (including late adolescent and emancipated minors)
6. Hematopoietic* 6. Gastrointestinal 6. Adult
7. Immune* 7. Genitourologic 7. Older Adult
8. Integumentary 8. Musculoskeletal 8. Frail Elderly
9. Musculoskeletal 9. Neurological
10. Neurological 10. Psychiatric
11. Psychiatric 11. Reproductive
12. Reproductive 12. Respiratory
13. Respiratory

Assessment
A. Knowledge
1. Evidence-based population health promotion and screening
B. Skill
1. Comprehensive history and physical assessment
2. Focused history and physical assessment
3. Risk assessment (e.g.- genetic- behavioral- lifestyle)
4. Functional assessment (e.g.- cognitive- developmental- physical capacity)
II Diagnosis
A. Knowledge
1. Pathogenesis and clinical manifestations of disease states
B. Skill
1. Differentiating between normal and abnormal physiologic or psychiatric changes
2. Diagnostic test selection and evaluation
III Clinical Management
A. Knowledge
1. Pharmacotherapeutics- pharmacokinetics- pharmacodynamics- and pharmacogenetics
2. Anticipatory guidance (e.g.- developmental- behavioral- disease progression- crisis management- end-of-life care)
3. Age-appropriate primary- secondary- and tertiary prevention interventions
B. Skill
1. Pharmacotherapeutic intervention selection (e.g.- interactions- contraindications)
2. Pharmacotherapeutic intervention evaluation (e.g.- monitoring- side/adverse effects- patient outcomes)
3. Non-pharmacologic intervention selection and evaluation
4. Therapeutic communication (e.g.- motivational interviewing- shared decision making)
5. Culturally congruent practice
6. Resource management (e.g.- accessibility- coordination- cost effectiveness)
IV Professional Role
A. Knowledge
1. Legal and ethical considerations for health care informatics and technology (e.g.- confidentiality- accessibility)
2. Scope and standards for advanced practice registered nurses
3. Regulatory guidelines (e.g.- reportable diseases- abuse reporting)
4. Evidence-based clinical guidelines and standards of care
5. Ethical and legal principles and issues for patients- populations- and systems (e.g.- justice- consent- guardianship- bioethics)
B. Skill
1. Research appraisal (e.g.- design- results- clinical applicability)

The ANCC Family Nurse Practitioner board certification examination is a competency based examination that provides a valid and reliable assessment of the entry-level clinical knowledge and skills of nurse practitioners. This certification aligns with the Consensus Model for APRN Regulation: Licensure- Accreditation- Certification and Education. Once you complete eligibility requirements to take the certification examination and successfully pass the exam- you are awarded the credential: Family Nurse Practitioner-Board Certified (FNP-BC). This credential is valid for 5 years. You can continue to use this credential by maintaining your license to practice and meeting the renewal requirements in place at the time of your certification renewal. The Accreditation Board for Specialty Nursing Certification accredits this ANCC certification.

The ANCC certification examinations are developed consistent with the technical guidelines recommended by the American Educational Research Association- the American Psychological Association- and the National Council on Measurement in Education (AERA- APA- NCME; 1999). Additionally- the ANCC certification examinations meet accreditation standards of the Accreditation Board for Specialty Nursing Certification(ABSNC) and the National Commission for Certifying Agencies (NCCA).
Each examination is developed by ANCC in cooperation with a Content Expert Panel (CEP) composed ofcarefully selected experts in the field. CEPs analyze the professional skills and abilities from role delineationstudies- which provide the evidence for the test content outline (also called the test blueprint).

Test questions or “items” are written by certified nurses and interprofessional content experts in their discipline who have received training by ANCC staff in writing items. The items are then reviewed by the CEP with the ANCC staff and pilot-tested to ensure validity and psychometric quality before being used as scored items on the genuine examinations. ANCC adheres to a variety of guidelines during the development of items to ensure that the items are appropriate for the specialty and certification level (e.g.- APRN vs. RN). This includes editing and coding items- referencing items to the approved test
content outlines and reference books- and screening items for bias and stereotypes.
Items for the examinations are selected that reflect the test content outline and item distributions.
The validity and reliability of the exams are monitored by ANCC staff. Certification examinations are updated approximately every three to five years.

ANCC reports its examinees test score results as pass or fail. If an examinee fails- the score report includes diagnostic feedback for each of the major content areas covered on the examination.
ANCC examinations are criterion-referenced tests- which means that an examinees performance on the examination is not compared to that of other examinees in determining the examinees pass/fail status.
In a criterion-referenced test- an examinee must achieve a score equal to or greater than the minimum passing score for the examination. The minimum passing score represents the absolute minimum standards that the examinee must achieve to demonstrate the ability to practice the profession safely and competently. With the guidance of a measurement expert (e.g.- a psychometrician)- a panel of subject matter experts in the nursing specialty sets the minimum passing score for each ANCC
examination. In setting the minimum passing score- ANCC uses the Modified Angoff Method- which is well-recognized within the measurement field.
Each test contains between 150 to 175 scored test items plus 25 pilot test items that do not count towards the final score. For specific information on the number of items each test contains- please refer to the test content outline associated with that exam.
Scores on ANCC examinations are reported on a scale with a maximum possible score of 500. To pass the ANCC examination- an examinee must achieve a scale score of 350 or higher. Prior to conversion of an examinees score to this scale- the examinees raw score on the examination is determined- which is simplythe number of test items that the examinee answered correctly (e.g.- 105 out of 150). The raw score is then converted to a scale score- using a conversion formula.
For examinees who do not achieve a scale score of at least 350- the score report will show the scale score achieved- “fail” status- and diagnostic feedback for each of the content areas covered by the examination

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Question: 64
Which is the most significant procedure in screening for benign prostatic
hypertrophy?
A. PSA
B. DRE
C. TRU
D. Prostate biopsy
Answer: B - PSA, or Protein Specific Antigen, is a tool for detecting prostate
disease; however, digital rectal examination, where the prostate can be palpated
through the rectal wall, would be a more definitive diagnosis. Hard nodule or
benign enlargement of the prostate can be felt through DRE. An increasing PSA
may indicate prostate cancer.
Question: 65
A patient is diagnosed with diabetes insipidus after a series of diagnostic tests.
Which of the following signs and symptoms is indicative of this disorder?
A. Polydipsia
B. Weight gain
C. Hypertension
D. Changes in level of consciousness
Answer: A
Diabetes insipidus is hyposecretion of aldosterone, a hormone that increases the
absorption of sodium and water. This disorder is manifested by signs of fluid
deficit. Diabetes insipidus is manifested by polydipsia, polyuria, dehydration,
fatigue, inability to concentrate urine, and postural hypotension. Options B, C,
and D are common signs of syndrome of inappropriate antidiuretic hormone.
Question: 66
You suspect a patient has Type I Diabetes. The following statements are true
about Type I Diabetes except:
A. May be linked to autoimmunity
B. Onset usually prior to age 20
C. Beta islet cells destroyed
D. Does not require insulin injections
Answer: D
Type 1 Diabetes Mellitus is caused by the destruction of Beta islet cells in the
pancreas, which ensue a deficiency of insulin. Type 1 DM is formerly known as
juvenile-onset DM since it afflicts the younger population, usually prior to the age
of 20. The recommended treatment for this condition is insulin replacement (thru
injection) therapy.
Question: 67
A female patient complains of an enlarged thyroid gland, and protruding eye ball.
Further evaluation reveals that the patient has hypertension, nervousness, and fine
tremors of the hands. Which of the following medications should be ordered for
the patient?
A. Propylthiouracil (PTU)
B. Levothyroxine (Synthroid)
C. Liotrix (Thyrolar)
D. Liothyronine (Cytomel)
Answer: B
Propylthiouraciis an anti-thyroid medication that inhibits the synthesis of thyroid
hormones. The other medications are thyroid hormones that control the metabolic
balance rate of tissues.
Question: 68
A newly diagnosed client is prescribed with insulin. The patient is taught to rotate
injection sites when administering insulin to prevent which of the following
reasons complications?
A. Increased resistance to insulin
B. Insulin lipodystrophy
C. Hypersensitivity
D. Increased bleeding and bruises
Answer: B
Rotating injection sites are essential to prevent insulin lipodystrophy, which may
result in decreased or altered absorption of insulin. The other options are not
correct.
Question: 69
The following statements are true regarding Burkitt�s lymphoma, except:
A. Close association with Epstein Barr virus
B. High-grade T-cell malignancy
C. Cytogenic chromosomal change is seen
D. It is a form of non-Hodgkin lymphoma
Answer: B
Burkitt�s lymphoma is a rare and highly aggressive type of Non-Hodgkin�s
lymphoma that usually affects children. It is a rapid-growing B-cell lymphoma
that involves parts of the body other than the lymph nodes. Burkitt�s lymphoma is
highly associated with the chromosomal translocation of the c-myc gene.
Numerous cases of this lymphoma have decreased resistance to EBV (Epstein-
Barr virus).
Question: 70
The following are characteristics of nephrogenic diabetes insipidus, except:
A. Sensitized kidney tubules to ADH
B. A genetic (sex-linked) predilection in men
C. Normal ADH production and secretion
D. Large volumes of dilute urine are produced
Answer: A
Unlike Central Diabetes Insipidus, Nephrogenic diabetes insipidus is caused by
the kidney�s resistance to ADH rather than a deficiency of this hormone. This
results in a decreased ability of the kidneys to concentrate the urine. The disease
is rare, but 90% of the known cases are believed to be X-linked, which causes the
vasopressing receptor to not function properly. The primary symptom of NDI is
excessive thirst and excretion of large amount of urine. Dehydration is a common
complication of the disease.
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