How I Passed the ANCC FNP Exam

how i passed ANCC FNP exam

How Did I Pass the NP Exam?

Many graduating NPs have asked “What did you do to pass your certification test?”

It’s a legit question. I googled it too. At least a hundred times.

I graduated FNP school in May 2019. I studied and passed the ANCC in June 2019 on my first attempt.

The ANCC Exam

The ANCC exam has clinical assessment, diagnosis, and management questions but also has approximately 25% more non-clinical questions than the AANP exam.

Non-clinical questions include questions on ethics, research, leadership, scope of practice, professional responsibility, and regulatory guidelines.
The ANCC FNP exam takes about 4 hours, If you fail the ANCC, you can retest within 60 days but you cannot take the test more than three times in twelve months.

I choose to take the ANCC FNP exam over the AANP exam because I wanted more of a challenge. There was also the pressure from the fact that most of the FNPs in my area were ANCC certified and it was prestige issue.

Hard Work Ahead

Passing the NP certification test is like trying to lose weight. There is no pill to swallow to make it easy. There is no instant gratification to make the process smoother.

I do not have any secret weapon to share.

I do not have any great insights.

But I am willing to share what I did and how I did it in the hope that it will help you on your journey.

If you’re already nearing graduation, you can skip to point #2.

1. Start at the Beginning

There are three specific things I did at the start of NP school:

  • Retrieved the exam content list from the ANCC website
  • Took notes along the way
  • Listened to certification prep lectures

Honestly, the first thing I did was start preparing immediately . . . as in during my first semester of NP school.

I was working full time as a nurse and taking 2 courses per semester. The whole process took me 4 years. But I knew when I started that I didn’t want to wait to start preparing for the certification test even if it was 4 years away.

Yes, I’m a bit uptight when it comes to being prepared, but I’ve come to accept it.

Get the Content List

Right away I checked the American Nurses Credentialing Center (ANCC) website for the examination content outline.

Right as I was about to graduate (in May 2019) the testing content was updated. Regardless, I printed out the content outline in 2015 and followed it. Then I printed it out again when I realized it had changed.
Here is the link for the ANCC FNP board certification exam content outline effective as of 5/22/2019.

If your NP specialty is not FNP, you’ll need to locate your NP specialty on the website of your certifying board of choice. If you have questions about this, please leave a comment. I’m happy to help.

Take Notes Along the Way

Over the next few years, I ensured that my studies focused on the body systems, drugs, and age groups that were in the content list.

This was pretty easy.

If you consider that typical courses in NP school include advanced physical examination, advanced health assessment, advanced pharmacology, health promotion, etc., and all of these courses included a different focus of each item on the content list.

For example, the first body system on the ANCC FNP exam content list is cardiovascular.

During my advanced physical examination course, we probably spent at least one week learning how to examine the heart and vascular system. In advanced pharmacology we probably spent at least one week reviewing cardiovascular drugs.

The first thing I did was create a list of all the body systems and age groups from the content list.

As I studied each topic on the content list during my courses, I added that information under that topic.

I didn’t make separate lists for drugs, I included this information in with the body system or age group that the drug affected.

HOT TIP
I used an iPad Pro for all of my note taking during NP school.
Notability was my note taking app of choice.
If you’d like to see how I took notes on my iPad Pro for NP school, leave me a comment below and I’ll address it in a future post.

Here is the topic list I created within Notability:
Respiratory Disorders
General Assessment
Neurological Disorders
Skin Disorders
Head, Eye, Ear, Nose, And Throat
Cardiac Disorders
Skin Disorders
Gastrointestinal Disorders
Endocrine Disorders
Musculoskeletal Disorders
Hematological and Select Immune Diseases
Psychosocial Disorders
Female Reproductive and Genitourinary Disorders
Genitourinary System
Older Adults
Childbearing
Pediatrics
Misc. Medical

I tried to keep all my pharmacology information within the system folder that the drug addressed. Most of the time this worked out pretty well.

For example, analgesics are used differently for pediatrics and older adults, so those each have their own section for analgesics specifically.

Bottom line: Throughout the NP program I ensured that my note taking aligned with the content list. So when it came time to study from the content list in preparation for the exam, all of the information I needed was already in place.

Listen to Certification Prep Lectures

It’s too early at the beginning of NP school to take a certification prep course or to start reviewing the material in bulk.

I am not recommending that you take a certification review course at this point. I repeat: do not take a review course yet!

But . . here’s what I did.

In 2017, I bought last year’s FNP review on MP3 which was created by Advanced Practice Education Associates (APEA). I did this so that I could begin to listen to each lecture as I was learning each system in my classes.

APEA is a company created by nurse practitioner, Amelie Hollier. APEA offers certification in family, adult-gero, and adult.

I chose this lecture series for two reasons. First, last year’s lecture series was on sale on their website. Second, I watched a few of Amelie’s lectures online and found her voice and her thought processes easy to follow.

You can access the APEA website here. There are many, many resources.

2. Finish Strong

The Final Year

In my last year of NP school, I started to get serious about certification preparation and move beyond collecting notes and passive lecture listening.

I did five things to prepare for the exam between fall 2018 and spring 2019.

1. Downloaded the Fitzgerald Health Education Associates (FHEA) question app and began practicing exam questions and rationals.

2. Purchased the Maria Leik

I read every chapter of this book and answered every question. It took months to get through it, but was well worth the effort.

I especially like the way she has Clinical Pearl sections throughout! One of my friends read the whole book then reviewed only the Clinic Pearls sections as a second read through.

3. Bought the Board Vitals.

There were so many questions, I wasn’t able to finish them all before my exam. So Board Vitals gets an A+ for number of practice questions provided.

Because I was taking the ANCC exam, I focused on all of their non-clinical exam questions first.

What I found was that they were reviewing things that neither Fitzgerald nor Leik even mentioned. There were too many questions on how to calculate an odds ratio or the number needed to treat.

Although these things interested me, I didn’t really need to know it for practice or for the exam. Those were things I needed to understand but not master. So I moved on to questions in areas that I was weak in, such as musculoskeletal.

I felt their disease and diagnostic questions were thorough, but that meant that each question was long and involved with an equally long and involved explanation.

I tried to do at least 50 questions per week. There were at least 2 to 3 questions/answers each week that I felt were weak or just plain wrong and would send in my thoughts on that particular question and answer. Mostly because I felt like I had just paid good money to spent 10 minutes of my life reading and thinking about this question and didn’t learn anything because somebody got it all wrong.

When it was all said and done, I wouldn’t recommend Board Vitals unless you have a lot to time.

5. Practiced The Daily Write

As I was completing Fitzgerald and Leik I would review questions I got wrong. Why did I get them wrong? Were they all related to one system, process, or disease?

What I discovered was that I was missing a lot details.

There are some things you just have to memorize and know. So I created what I called The Daily Write.

I got a notebook (again, I used my “>Apple pencil with my Notability app) and began writing down every single question I got wrong.

Each day to begin my study period I would review this list (which grew to be enormous over the course of several months!).

Eventually I began using this format to practice active recall, which is a studying strategy that actively stimulates memory.

For example, I noticed that I kept getting a lot of asthma treatment related questions wrong. So I created an asthma chart outlining the severity levels and the corresponding symptoms, SABA use, night time awakenings, and FEV1.

Each day I would write this out—from memory—until I could do it without looking.

I also did this to learn Hep A, B, and C and their corresponding blood tests.

I wrote from memory all of the anemia’s and all of the oral diabetic medications and their classifications.

I would often have to look first or would get part of it right and then have to look at what I missed. But after doing this every single day right up to the exam, I had my weak areas mastered and details memorized.

I had learned everything so well, that I didn’t even feel like I needed to write things on my blank sheet during the exam until I actually had a question about one of those things.

For example, I had a question on a diabetic medication. I wrote out the diabetic meds as I had memorized them, and then was able to sit back and go through the question to find the right answer.

I spent a lot of time practicing active recall but for me, it helped considerably.

how I passed the ANCC FNP exam

The Final Semester

I scheduled my ANCC exam in the middle of the week, so I could be sure to have the two days before the exam off work.

Then I scheduled a live FHEA review course. I purposely scheduled the live review about 8 weeks prior to my testing date. That would leave me time to review the material from the course, completed the online portion of the review, and take the practice exams to identify weak spots.

FHEA was created by nurse practitioner Margaret Fitzgerald. The live review I went to featured presenter and nurse practitioner Wendy Wright.

I will try not to be biased, but Wendy was amazing!

I could not have been happier with my presenter choice. She is outstanding in her own right as owner of two nurse practitioner operated clinics. She’s also a speaker, an author, and professor.

Check out her bio here and her clinic website here. Just seeing all she has accomplished as a nurse is beyond encouraging!

I choose the Fitzgerald live review course because, as I already stated, I like to be prepared. This course has a reputation as being “more than is needed for the certification exam.” But I don’t see it that way.

My goal was to be so prepared for practice, that passing the certification exam was a piece of cake. And that’s what Fitzgerald provided for me: the detailed instructions on NP practice.

The live course was intense and lasted two and a half days. You are given a workbook to take notes but it also included several hours of online work to be completed independently after the live course.

It’s a lot, I know!

I knew the course would be thorough and inclusive.

This is what I needed and wanted, even if it did take a bit longer than other courses out there.

The Final Month

This last month prior to the exam I did two main things: reviewed the Fitzgerald info and signed up for one month of Walden Exam Solutions.

I reviewed the online material from my the FHEA live review and reviewed all of the material in the book again. The online material included new information and two practice exams, which I took after completing and reviewing all the material again.

I passed the first one with a score in the high 70s and the last one with a score in the high 80s.

Between the practice exams, I examined which questions I got wrong, identified my weak areas and restudied those subjects again in both the Fitzgerald book and the Leik book. I added the weak areas to my Daily Write exercise.

At that time, Walden Exam Solutions had a Bronze package of 2 or 3 videos in which she reviewed FNP material. She had a live ANCC review, but I wasn’t able to get in to that.

The Bronze videos at that time provided a concise review of most of the material I had been studying in Fitzgerald and Leik.

Watching her videos, I don’t feel there was anything new to learn (which is good actually) but did find that her way of reviewing the information helped me solidify the information I already knew. This was very helpful. I think I watched all the videos I had access to at least twice.

The Walden Exam Solutions review was helpful. I would recommend it. She has other videos specific for ANCC available now.

I continued practicing exam questions on the FHEA app.

The Final Week

The week before the exam, the only things I did were the FHEA question of the day, a few Board Vitals questions, and The Daily Write.

I had leaned everything I was going to learn by that point and it was time to keep the flow going.

The day before the exam I made sure I wasn’t scheduled to work so that I could stay home, relax, and rest. I did The Daily Write, but that was more out of habit at this point.

The Day of the Exam

I purposely scheduled the exam for noon, so I could go to bed early and sleep in a little, get my workout done, and not feel rushed. I usually don’t eat until 11am each day, so I wanted to be able to eat a small bite and feel energized and fresh.

I went in feeling confidant and ready.

I won’t lie, even after all that, it wasn’t easy.

There were some photos of skin issues that I struggled with. Six pictures on an average sized computer screen and I was supposed to pick out the one that showed dermatitis?

When I finished I wasn’t feeling all that confidant any more. I had flagged about 6 questions and went back to look them over. I remember learning that unless I had a good reason to change an answer, DO NOT change an answer because your initial gut reaction is usually right.

I had tested this hypothesis during my practice exams and found it to be fairly accurate for me, so I didn’t change any answers. It was hard, because I was questioning myself so much.

It took me several minutes to persuade myself to click complete. While the screen was spinning and calculating my score, I still had my doubts if I had done enough, if I really knew enough.

The suddenly, I passed and the screen when black.

If I had looked away for a second, I would have missed the word “passed”.

I cannot describe the sense of relief and wonder. I was finally an FNP-BC!

Read this post about certification test taking tips that I used.

Other Things I Did Along the Way But Not Really For Exam Study

–At the beginning of every Daily Write, I would write out my goal just to remind myself: Julie Nyhus FNP-BC. This is also the only thing I initially wrote down on my cheat sheet prior to the exam.

—Created my own cheat sheets and reviewed other people’s cheat sheets.

–Used Anki to create flash cards (for FREE!) for each NP class from semester to semester.

—Used the Pomodoro method of studying.

If you’re interested to learn how I studied as an NP student throughout school, read this blog post.

Need more info? Have questions about my journey? Leave a comment; I’m glad to help.

Cheers!

Julie don't forget your power

Need more helpful study info? Check out these posts:

Seven Ways to Curb Certification Test Anxiety

Motivation Tips for Managing Study Time

Creating More Focus During Study TIme

Retention for The Nurse Practitioner Student

Top 5 Books You Really Should Own if You’re a Family Nurse Practitioner Student

how I passed ANCC FNP

You may also like