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Getting Ready for theNP Certification ExamDeveloped and presented by:Margaret A. Fitzgerald,DNP, FNP-BC, NP-C, FAANP, CSP, FAAN, DCCPresidentFitzgerald Health Education Associates, Inc.Family Nurse PractitionerGreater Lawrence (MA) Family Health CenterEditorial Board, The Nurse Practitioner Journal,Medscape Nursing, The Prescriber’s Letter,American Nurse TodayMember, Pharmacy and Therapeutics CommitteeNeighborhood Health Plan, Boston, MANP Certification: An Overview Fitzgerald Health Education Associates, Inc.2In the First 15 Years ofthe NP Role’s Establishment The scope of practiceexpanded, matchedwith the increasingcomplexity of healthcare Fitzgerald Health Education Associates, Inc.31

In the First 15 Years ofthe NP Role’s Establishment(continued) Need to define Part of thisand credential the credentialingprofessionincluded theestablishment ofthe NP certificationexamination. Fitzgerald Health Education Associates, Inc.4NP Certification Certificationpart of APRNlicensure innearly all of theUS states Exceptions– Kansas– New York– California– To read more clickon Dr. Fitzgerald’sQ&A athttp://fhea.epubxp.com/i/180801/0 Fitzgerald Health Education Associates, Inc.5Agencies Offering NP Certification American Academy of Nurse Practitioners Certifying body retains “Academy” designation– www.aanpcertification.org FNP, adult-gero, ANP certification American Nurses Credentialing Center– www.nursecredentialing.org FNP, adult-gero primary care, ANP, GNP,PMHNP, PNP, ACNP, adult-gero acute care NPcertification Fitzgerald Health Education Associates, Inc.62

Agencies Offering NP Certification(continued) AACN Certification Corporation– www.aacn.org Adult Acute Care NP National Certification Corporation– www.nccwebsite.org WHNP, neonatal NP Fitzgerald Health Education Associates, Inc.7Agencies Offering NP Certification(continued) Pediatric NursingCertification Board– www.pncb.org Primary care PNP,acute care PNP Fitzgerald Health Education Associates, Inc.8How do the certifying organizationsdescribe certification and the NPcertification examination? Per the ANCC– “Certification is the process by whicha nongovernmental agency or anassociation grants recognition to anindividual who has met certainpredetermined qualifications.” Fitzgerald Health Education Associates, Inc.93

How do the certifying organizationsdescribe certification and the NPcertification examination? (continued) “Certification can be used for entryinto practice, validation ofcompetence, recognition ofexcellence, and/or for regulation. Itcan be mandatory or voluntary.” Fitzgerald Health Education Associates, Inc.10How do the certifying organizationsdescribe certification and the NPcertification examination? (continued) “Certification validates anindividual’s knowledge, skills, andabilities in a defined role andclinical area of practice, based onpre-determined standards.”– Source- www.nursecredentialing.org/certification.aspx. Fitzgerald Health Education Associates, Inc.11How do the certifying organizationsdescribe certification and the NPcertification examination? (continued) “The Nurse Practitioner (NP)certification examination tests theknowledge, skills, and abilitiesneeded for entry into advancedpractice.”– Source- www.nursecredentialing.org/certification.aspx. Fitzgerald Health Education Associates, Inc.124

How do the certifying organizationsdescribe certification and the NPcertification examination? (continued) According to the NCSBN, the NPcertification programs provide alegally defensible examinationsuitable for the regulation ofadvanced practice nurses. Fitzgerald Health Education Associates, Inc.13Question Style Most often, four option test items– A stem (question itself) and four possiblechoices or options Exception- NCC for WHNP 3 options No penalty for incorrect items– An incorrect answer is point or value neutral. Fitzgerald Health Education Associates, Inc.14Question Style(continued) Other styles– Chose all that arecorrect, more than1 answer correct.– Correctly identifyan image, ECGtracing, others Fitzgerald Health Education Associates, Inc.155

Test Availability Computer-based– Year-round or nearly so Multiple test sites across the country Paper and pencil option– WHNP only, one day per year Fitzgerald Health Education Associates, Inc.16Availability of Results For computer-basedexams– Results provided,pass or fail, at endof the examination Fitzgerald Health Education Associates, Inc.17Comparison of Exams Recognition for NP licensure– All aforementioned exams Credential– AANP example- NP-C, can add letter todesignate area of certification, such as FNP-C,AGNP-C, ANP-C– ANCC example- FNP-BC, ANP-BC, PNP-BC,ACNP-BC, PMHNP-BC, AGPCNP-BC, AGACNP-BC– PNCB example- CPNP-PC, CPNP-AC– NCC example- WHNP-BC Fitzgerald Health Education Associates, Inc.186

What is common to allNP examinations? No matter what patient population– Family (entire lifespan), adult ( 13 y),gerontology, adult-gero, women’shealth, pediatric (up to age 22 years) Practice setting– Primary care (ANP, FNP, AGNP, PNP,WHNP), acute care (ACNP, AGACNP) Fitzgerald Health Education Associates, Inc.19What is common to allNP examinations?(continued) Anatomy, physiology,pathophysiology,pharmacology– Mechanism of disease,how drug therapiesmodify disease Fitzgerald Health Education Associates, Inc.20What is common to allNP examinations?(continued) Health promotionand diseaseprevention– Principles ofprimary,secondary andtertiaryprevention Fitzgerald Health Education Associates, Inc.217

What is common to allNP examinations?(continued) Obtaining thehealth history– Interviewtechniques,analyzingcontent ofsubjectiveinformation Fitzgerald Health Education Associates, Inc.22What is common to allNP examinations?(continued) Evaluation of signs and symptoms– Symptom analysis, developing workingdiagnosis Physical examination– Knowledge of normal, abnormal finding,synthesizing findings with health historyto hone diagnosis Fitzgerald Health Education Associates, Inc.23What is common to allNP examinations?(continued) Laboratory,diagnostic testing– Ordering orperforming tests tohelp supportdiagnosis and/orcontribute to thetreatment plan Fitzgerald Health Education Associates, Inc.248

What is common to allNP examinations?(continued) Evidence-based practice (EBP)– Developing the plan of care based onsupporting scientific evidence and clinicalguidelines All Fitzgerald Health reviewcourses are based on the latest inevidence-based practice andexam blueprints. Fitzgerald Health Education Associates, Inc.25What is common to allNP examinations?(continued) Legal and ethicalissues*– Malpractice,confidentiality(HIPPA), patientadvocacy andcompetency Fitzgerald Health Education Associates, Inc.26What is common to allNP examinations?(continued) For more information onmalpractice, seeAvoiding Malpractice inthe FHEA newsletter:http://fhea.epubxp.com/i/180801/0 Fitzgerald Health Education Associates, Inc.279

What is common to allNP examinations?(continued) Community resources– Recognizing andutilizing communityresources to aid incare of patient andfamily Fitzgerald Health Education Associates, Inc.28What is common to allNP examinations?(continued) Cultural competence– Incorporating commonly encounteredcultural beliefs and practices Principles of epidemiology– Considering sensitivity, specificity ofdiagnostics, prevalence, incidence, others Fitzgerald Health Education Associates, Inc.29What is common to allNP examinations?(continued) Healthcare economics– Providing cost-effective care,Medicare, Medicaid, privateinsurances, nation healthcarefinancing issues Healthcare management– APRN as a healthcare leader Fitzgerald Health Education Associates, Inc.3010

What are the differences in theNP certification examinations? ANCC exams– When compared to other agencies,generally higher percent focused onprofessional issues, healthcare policy, etc.– Example- 25% of family, adultgerontology exams Check with ANCC website for specifics. Fitzgerald Health Education Associates, Inc.31What are the differences in theNP certification examinations?(continued) Other certifying bodies– Section on professional issues eithernot found as a special section (AANP)or small amount (WHNP 2%) Fitzgerald Health Education Associates, Inc.32Healthcare policy, leadership, ethnicand ethical considerations inhealthcare are covered in theFitzgerald Health Review courses. Fitzgerald Health Education Associates, Inc.3311

Exams Retiring Soon(by end 2015) Acute Care Nurse Practitioner– ANCC Adult Nurse Practitioner– ANCC and AANP Gerontological NP– ANCC and AANP Adult Psychiatric/Mental Health NP– ANCC Fitzgerald Health Education Associates, Inc.34What happens if you hold or willhold one of these certifications? Keep certification current! Check to make sure you meet applicationdeadlines.– If your certification lapses, you may notbe able to renew your existingcertification or your license to practice. Your credential is NOT retiring! Fitzgerald Health Education Associates, Inc.35Passing Score on NP Boards:Examples for Current ExamsANCCAANP 350/500 500/800 Fitzgerald Health Education Associates, Inc.3612

Typical Percentage of ExamineesWho Pass the ExaminationANCCAANPTypically, 85%Translates to a scoreof 350 (minimumpassing score) 15th%tileTypically, 85%Translates to score of500 (minimumpassing score) 15th%tile Fitzgerald Health Education Associates, Inc.37Procedure if Failure: ExamplesANCCAANPApply to retest after60 daysApply to retest, 15 h CEprior to retesting, nomore than two times ina calendar year Fitzgerald Health Education Associates, Inc.38Recertification Every 5 Years: ExamplesANCCAANPPractice hours plus CE Practice hours plus CEhours and selecthoursprofessional activities Fitzgerald Health Education Associates, Inc.3913

True or false? On the national NP certificationexam, you should expect to findspecific questions on your state’sAPRN practice act. Fitzgerald Health Education Associates, Inc.40True or false? You plan to sit for the certificationexam in a state where NPs havelimited substance prescribingauthority. As a result, yourcertification exam will not containquestions about prescribing opioids. Fitzgerald Health Education Associates, Inc.41True or false? Once an NP has achieved nationallyrecognized certification from a stateand nationally recognizedcertification agency, this person cannow practice as a nurse practitioner. Fitzgerald Health Education Associates, Inc.4214

With all certification examinations,keep in mind the following. Fitzgerald Health Education Associates, Inc.Entry-level NP practiceNationally andinternationallyrecognized standardsof care and clinicalguidelines, evidencebased practice (EBP)43Evidence-based practice(EBP) defined- The deliveryof individualized healthcareon the basis of an awarenessof the impact and strength ofrelated scientific evidence*Examples CDC for immunizationsNAEPP EPR-3 for asthmaADA for DMAAP for pediatric primary actice.html. Fitzgerald Health Education Associates, Inc.The broad stroke ofpractice, not themix you see in atypical clinical day.Common diseasesoccur commonly,not an examinationof the esoteric.44As much thyroid as DMAs much male GU asfemale GYNMost nursing practiceat the RN level is oneof exceptions ratherthan rules. Fitzgerald Health Education Associates, Inc.4515

The NP certification examination testsyour ability to know Fitzgerald Health Education Associates, Inc.46 Why a patient is at risk for aproblem. How a clinical problem hasdeveloped. What is the most likely clinicalpresentation of the condition? Fitzgerald Health Education Associates, Inc.47 Why a given intervention iseffective. How that intervention works. What is the most likely clinicaloutcome? Fitzgerald Health Education Associates, Inc.4816