Certification Exam: Myths and Realities

by Margaret A. Fitzgerald, DNP, FNP-BC, NP-C, FAANP, CSP, FAAN, DCC

AS YOU NEAR GRADUATION, you are thinking more about the certification exam and trying to glean information about it. Unfortunately, misinformation is sometimes disseminated regarding this very important step toward becoming a practicing NP. Learn the facts about the exam below.

Myth: Practice tests represent the best way to prepare.
Reality: While practice tests are a helpful study aid, this method is best used to finish, not start, your study. Your study time is best spent developing a deep understanding of the nature of NP practice. Knowing what to expect on the exam will help you prepare for the test as well as for clinical practice. Taking a review course is also great preparation and will help you determine the areas where you are weaker, thus enabling you to focus on those areas. (Dr. Fitzgerald’s Certification Q&A: Developing a Study Plan)

Myth: You should have at least 6 months of NP practice experience prior to sitting for the certification exam.
Reality: The certification examination content is focused primarily on entry-level NP knowledge. As adult learners, NPs tend to feel greater ownership of information they have used in clinical practice. As a result, you might feel more comfortable sitting for the examination after a few months of practice. However, some states limit the length of time or put other restrictions on NP practice prior to obtaining certification. In addition, you cannot apply for reimbursement by Medicare and some private insurers until you are certified. As a result, a potential employer could require certification as a condition of employment.

Myth: The content of the test tends to be limited to a few areas.
Reality: Examination content tends to be broad, reflecting the depth and breadth of NP practice. It represents the array of patients seen in the average NP's practice over an extended period of time, such as a year, rather than the mix seen in an average day. The examination candidate who reports that the test content was narrowly focused likely can only recall the areas in which he or she had the most difficulty.

Myth: The test questions are presented in topic groups.
Reality: The topics covered in the exam are presented in random order. For example, a family NP candidate could face a question about a middle-aged man with diabetes mellitus, followed by a question about a child with a fever, followed by one about prescribing an antimicrobial for a pregnant woman with a urinary tract infection. An acute care NP candidate might face a question about a person with altered mental status, followed by a question about a person presenting with chest pain.

Myth: On the computer-based tests, you cannot go back to change an answer or review a question.
Reality: The computer-based NP exams do have a mechanism for flagging questions for review. You can also change an answer prior to signing off.

Myth: Many certification candidates run out of time and are unable to complete the test.
Reality: The length of time provided to complete the examinations is sufficient for most candidates, allowing for both answering the questions and reviewing difficult items. The American Nurses Credentialing Center allots 3½ to 4 hours for a 175- to 200-item test, depending on the credential being pursued (ANCC), while the American Academy of Nurse Practitioners Certification Program allows 3 hours for a 150-item test (AANPCP). The National Certification Corporation allots 3 hours for a test of up to 175 items (NCC), while the Pediatric Nursing Certification Board allows 3½ hours for a 200-item test (PNCB). The credentialing programs also allot an additional 15 or more minutes for candidates to become oriented with the exam software.

Revised 11.19.13.