Developing a Study Plan for the NP Certification Examination

As a newly prepared nurse practitioner (NP), you are to be congratulated on your success to date. After completing a rigorous graduate program, your days of study are not yet over but continue with a new focus. You need to continue to develop, expand and refine your NP knowledge base to assure success with certification. But how do you do this? Here is advice I provide in response to commonly asked questions about preparing for certification.

In preparing for the NP certification exam, where should I start?
Start with reviewing the information on the exam content. Make a list of the areas where you feel your knowledge base is secure and where just reviewing material to refresh your memory will likely suffice. Also, make a second list where you identify areas of weakness and topics where you need to concentrate your review. If you have taken an NP review course, you are likely aware that the content of certain parts of the program were truly review, where other sections help to point out areas where you need to expand on your knowledge base. Knowing what areas you need to focus on helps you decide how to allocate your study time.

As you study, please keep in mind that the NP certification examination tests your ability to know the following:
·  Why a patient is at risk for a problem.
·  How a clinical problem has developed.
·  What is the most likely clinical presentation of the condition?
·  Why a given intervention is effective.
·  How that intervention works.
·  What is the most likely clinical outcome?
·  Why this clinical problem is of significance to the overall healthcare system.
 
Therefore, a poor approach to preparing for the exam and practice is to memorize information so you know what to do but not why you are doing it, in both the exam room and as part of the larger healthcare system. A better approach to preparing for the exam and practice is to understand concepts and apply knowledge so you know what to do and why you are doing it. The FHEA NP Certification Examination Review and Advanced Practice Update prepares you in the why, how and what of NP practice, while helping to prepare you for success on the NP boards.

How much time should I allow to prepare for my examination?
This issue of time needed for certification preparation is unique to each exam candidate. That said, one of the major pitfalls in study is the failure to put aside the time to prepare. Map out the demands on your time in the first months after completing your NP program, including work hours, family, personal and professional commitments, as well as time you have perhaps set aside for a well-deserved vacation. After doing this, set up a schedule of study time, allot a greater amount of time to areas of knowledge deficit and less to areas of where you only need to refresh your knowledge base. Make sure you cover all areas listed as possible exam content. Plan your date for certification only after a period of well-planned, systematic certification-focused study.

How should I organize my study time?
Consider using an NP review course as the start of your study. Dates and locations for the FHEA NP Certification Exam and Advanced Practice Update course can be found here: http://fhea.com/store/browselive.aspx?Id=2. This program is also available on audio CDs, live on-line, or  on-line recordings, more information can be found at: http://fhea.com/Store/browserecordings.aspx?Id=2. The Fitzgerald Method of NP review starts with a summary of the vast body of knowledge needed for evidence-based NP practice and to successfully pass the NP boards. This summary is followed by sample practice questions to help you hone your clinical decision-making and test-taking skills.

Allow a minimum of 4-6 weeks of planned study post review course to maximize your likelihood of success on this important high-stakes exam. Sit down with your calender and develop a study schedule, 2-3 hours at a time, 5-6 days per week, giving yourself one day off a week so you do not feel trapped or overwhelmed. Then analyze what you have already reviewed, noting your stronger and weaker points. For example, if you really understand all the cardiac information and the NP review course was truly review, then you are set in this portion of your study. If you are still struggling with thyroid issues, then you know you need additional study in that area. While this seems obvious, often people who are studying for a high-stakes exam gravitate back to the familiar as it is comforting to review what you know. Mark your areas of review to the schedule, i.e. - Monday night, 7-9 p.m., I will study thyroid disease using the Fitzgerald book and FHEA review materials; Tuesday, 4-7 p.m., I will review health promotion using my class notes from my NP program as well as the Fitzgerald resources. If you plan out that well, you will have a great handle on the test and, as importantly, your new practice.

In addition to putting aside the time, setting up a system of study can further enhance the success of a review session. One method is the SQ4R system, where the study information is surveyed to established goals.
·  Questions about the information are formulated. What do you need to learn about this topic so that you have a firm grasp on the concepts? Are you able to consider the pathophysiology of a condition, how this manifests in the clinical presentation, and how a given intervention modifies or corrects the disease process?
·  Read to answer these questions. Study background information so you can correctly answer the questions above.
·  Recite the responses to the original questions. Consider writing up a short summary of what you have learned from your study.
·  Review to see if the original goals were met.


At this point, a series of practice exam questions is a great way to wrap up your study on a topic and demonstrate your mastery of the information. Post study, you should be scoring in the 85-100 % range on practice questions. Use practice questions to wrap up, not start, your NP certification review. If you are not scoring well on practice questions, you need additional study of the content area associated with those questions.

What about forming a study group?
Study groups can be helpful and are a terrific vehicle for sharing information and resources. Alternatively, study groups can yield a poor return on time invested if all members are not similarly committed. I hear about study groups that meet in person as well as groups who use technology such as Skype to meet. Here are some guidelines for forming a successful study group.

All group members must treat attendance and participation as they would any other professional commitment, such as work or school. Well in advance, set a schedule, place and time to meet, as well as a topic for the meeting. Plan a start and end time, with a clear objective for the session. Study groups usually work best when a group member volunteers to research and present information on a subject at a predetermined schedule. The presentation is typically followed with a discussion of the issue and review of sample exam questions and rationales for the correct response. The leader of a given session should also assume responsibility for keeping the discussion on track, facilitating the efficient use of time and resources.

In order to help avoid the group deteriorating into a chat session, plan for a short period of socialization following high-yield study sessions. Here is an example of a session planned by a highly successful study group with three members, Sarah, Ben and Helena.

"The session will start at 7 p.m. and end at 9 p.m. with the objective of identifying the clinical presentation, assessment and intervention in community-acquired pneumonia. Sarah is the presenter and also group-leader for the evening and is responsible for keeping us on track. A social period from 9-9:30 p.m. will follow. We will meet at Helena’s apartment. Ben is responsible for refreshments."

I feel anxious just thinking about the NP certification exam!
Stress yields anxiety, anxiety yields stress; one can be viewed as the product of the other. The stress of preparing for an important exam triggers the sympathetic nervous system (SNS). With this SNS activation, the NP is focused during study. This is a helpful and normal response to preparing for a high-stakes test.

However, protracted stress can be exhausting and contributes to a lack of focus and difficulty studying and test-taking. Learn a relaxation technique to use prior to studying or test taking. Start the session by reading or repeating a positive message about being successful on the exam. Avoid excessive amounts of caffeinated beverages that can add to anxious feelings. Eat a light but nourishing meal containing complex carbohydrates, fruit and/or vegetables, and high quality protein to feed the body and mind prior to your study as well as the test. Avoid eating energy-sapping foods that include excessive refined sugars and fat. Importantly, so-called energy drinks and the like are typically loaded with caffeine and sugar, substances can negatively impact your ability to focus and should be avoided prior to study or the boards.

The night before your test date, plan to spend a quiet evening reviewing a few crucial last points. Avoid cramming for the examination. Respect the work you have put into your NP studies by getting a good night’s sleep.

What study resources do you recommend using?
You likely have some helpful resources on hand. In particular, take out your health assessment text and use it to review health history taking and differentiating normal from abnormal physical examination findings. Here is a list of additional resources that will help in your exam preparation and practice.


A resource that will be helpful in developing test-taking skills:
·  Sefcik, Donald. (2012) How to Study for Standardized Tests, Sudbury, MA: Jones & Bartlett Publishers.

Dr. Fitzgerald’s comprehensive study guide for NP review featuring more than 1,400 sample questions and 160 quick-look tables:
·  Fitzgerald, M.A. (2010) Nurse Practitioner Certification Examination and Practice Preparation, 3rd Edition, Philadelphia: F. A. Davis.
 
Additional sources of practice questions for the family and adult NP certification examinations:
·  Fitzgerald, M. A. Practice Tests for NP Certification, available at www.fhea.com/npexpert
·  Winland-Brown, J. (2013) Adult and Family Nurse Practitioner Certification Examination: Review Questions and Strategies, 4th Edition, Philadelphia: F. A. Davis.
 
Additional sources of practice questions for the acute care NP certification examination:
·  Miller, S.K. (2010) Acute Care Nurse Practitioner Certification Study Question Book, 2nd Edition, Sudbury, MA: Jones & Bartlett Publishers.
 
Resources which are particularly helpful for NPs sitting for specialty boards including the gerontological, women’s health and pediatric NP exams as well as the family, adult and adult-gero NP candidates who would like additional practice questions in specific areas:
·  Kazer, M. (2011) Gerontologic Nurse Practitioner Certification Review, New York, Springer Publishing.
·  Kelsey, B. (2011) Midwifery & Women’s Health Nurse Practitioner Certification Review Guide, 2nd Edition, Sudbury, MA: Jones & Bartlett Publishers.
·  Kelsey, B. (2011) Midwifery & Women’s Health Nurse Practitioner Certification Study Question Book, 2nd Edition, Sudbury, MA: Jones & Bartlett Publishers.
·  Silbert-Flagg, J. (2011) Pediatric Nurse Practitioner Certification Review Guide: Primary Care, 5th Edition, Sudbury, MA: Jones & Bartlett Publishers.
·  Silbert-Flagg, J. (2011) Pediatric Nurse Practitioner Certification Study Question Book, 3rd Edition, Sudbury, MA: Jones & Bartlett Publishers.
 
A helpful resource for honing high level assessment and differential diagnosis skills:
·  Goolsby, M. J. (2011) Advanced Assessment: Interpreting Findings and Formulating Differential Diagnoses, 2nd Edition, Philadelphia: F. A. Davis.
 
A helpful overall guide to primary care NP practice:
·  Cash, J. (2010) Family Practice Guidelines, 2nd Edition, New York, Springer Publishing.
 
A comprehensive guide to diagnostic imaging and laboratory diagnosis that uses an algorithmic approach to choosing the best study:
·  Ferri, F. (2009) Ferri’s Best Test: A Practical Guide to Clinical Laboratory Medicine and Diagnostic Imaging, 2nd Edition, St. Louis: Elsevier Health Sciences.
 
A clear, concise guide to laboratory diagnosis that uses an algorithmic approach to choosing the best lab test:
·  Desai, S. (2009) Clinician's Guide to Laboratory Medicine: Pocket, Houston, TX: MD2B.
 
Fully illustrated in a unique format, this is one of the clinical resources I find most helpful in my practice:
·  Habif, T. (2012) Dermatology DDxDeck, 2nd Edition, St. Louis: Elsevier Health Sciences.
 
The “go-to” guide on the science and art of prescribing contraception:
·  Hatcher, R. (2011) Contraceptive Technology, 20th Edition, Dawsonville, GA: Ardent Media, Inc.
 
Two helpful guides for GYN care:
·  Hawkins, J.W. (2011) Guidelines for Nurse Practitioners in Gynecologic Settings, 10th Edition, New York, Springer Publishing.
·  Carcio, H., Secor, M. (2010) Advanced Health Assessment of Women Clinical Skills and Procedures, 2nd Edition, New York, Springer Publishing.
 
 
A must-have resource for practice with nursing moms:
·  Hale, T. (2012) Medications and Mother’s Milk, 15th Edition, Amarillo: Hale Publishing.
 
All resources listed are available to review and purchase at live FHEA NP Certification Review and Advance Practice Update courses as well as on-line at www.fhea.com/store. 

Specially priced review course/book combo packages as well as student NP/new grad packages are available at: http://fhea.com/store/browseSOSP.aspx?SOSP=2

 
Conclusion
Successfully passing your certification exam not only marks a critical rite of passage, but also tangible evidence of your considerable achievement. Make sure you do all that is possible to maximize your likelihood of success.
 
Click here for a full list of Fitzgerald Health’s NP Certification Exam Review and Advance Practice Update Courses
 
Updated 4.1.13