FNP-BC vs. FNP-C: Learn the Difference Between These Nurse Practitioner Certifications
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Every new family nurse practitioner (FNP) must earn certification in order to legally practice. However, the new FNP may feel confused about whether the FNP-BC or the FNP-C credential is the best choice.
Read further to learn the differences and similarities between the FNP-BC vs. FNP-C certifications, and how to choose the right certification to become a skilled family nurse practitioner.
What is FNP Certification?
FNP certification is how every graduate of a family nurse practitioner program qualifies to practice legally. Certification exams measure the entry-level competency after FNP program completion.
There are two well-respected organizations that offer slightly different certification exams for FNPs: the American Academy of Nurse Practitioners Certification Board (AANPCB), and the American Nurses Credentialing Center (ANCC). The ANCC offers the FNP-BC exam and certification, while the AANPCB offers the FNP-C exam and certification.
FNP-BC vs. FNP-C Certification
The FNP-C and FNP-BC certifications are different enough. In the sections below, we clarify exam competencies, eligibility requirements, certification costs, and the maintenance and renewal requirements of both the FNP-BC and FNP-C certifications.
Exam Competencies
The ANCC will change FNP-BC exam competencies slightly as of September 2022. The competencies prior to that date and recommended references can be found on the ANCC website. The competencies as of September 28, 2022 are offered below.
The FNP-BC exam consists of 150 questions covering the following competencies:
- Assessment: 29 (19%)
- Diagnosis: 26 (17%)
- Planning: 29 (19%)
- Implementation: 43 (29%)
- Evaluation: 23 (15%)
The exam covers all major body systems, with less emphasis on the immunological and hematopoietic systems. Patient age groups include: infant, preschool, school-age, adolescent, young adult, adult, older adult, and frail elderly.
The FNP-C exam consists of 135 questions covering the following competencies:
- Assessment: 36 (27%)
- Diagnosis: 35 (26%)
- Planning: 34 (25%)
- Evaluation: 30 (22%)
Age groups include: prenatal, newborn, infant, child, early adolescent, later adolescent, young adult, middle adult, older adult, elder adult.
Knowledge areas tested include:
- Anatomy
- Physiology
- Pathophysiology
- Comorbidities
- Pharmacologic therapies
- Non-pharmacologic therapies
- Integrative therapies
- Polypharmacy
- Pain management
- Cultural competence/sensitivity
- Diagnostic and therapeutic tests
- Functional assessment
- Health history
- Mental health assessment
- Physical examination across the lifespan
- Signs and symptoms
- Therapeutic communication
- Clinical decision-making
- Crisis management
- Differential diagnosis
Notable differences between the two exams:
- The FNP-C exam includes prenatal and newborn, and more subsets of adolescent and adult patients.
- The FNP-C exam includes concepts such as cultural competence, mental health, therapeutic communication, crisis management, integrative therapies, among others.
- The FNP-BC exam includes 150 scored and 25 unscored pretest questions vs. the FNP-C’s 135 scored and 15 unscored questions. Pretest questions are used to determine if questions will be utilized in the future. The candidate cannot identify the pretest questions, and responses do not impact the candidates test score.
Eligibility Requirements
The FNP-C exam offered by the AANPCB has the following eligibility requirements:
- Completion of APRN core courses (advanced physical assessment, pharmacology, and pathophysiology)
- Nationally recognized FNP competencies across the lifespan
- Completion of an accredited FNP or doctorate of nursing practice (DNP) program (Note: Candidates may sit for an exam before their graduation date as long as all coursework and clinical hours are completed.)
- Current, active RN license
- Academic transcripts
The FNP-BC exam offered by the ANCC has the following eligibility requirements:
- Current, active RN license
- Completion of an accredited FNP or DNP program (Note: Candidates may sit for an exam before their graduation date as long as all coursework and clinical hours are completed.)
- Completion of APRN core courses (advanced physical assessment, pharmacology, and pathophysiology)
- Completion of content related to health promotion and/or health maintenance
- Completion of content related to differential diagnosis and disease management, including pharmacologic and nonpharmacologic interventions
Cost of Certification
The cost of the FNP-BC certification exam through the AANC is $295 for members of the American Nurses Association, and $395 for nonmembers. AANP members pay $340, and AANP student members pay $290. The cost of the FNP-C certification exam through the AANPCB is $240 for AANP members and $315 for non-members.
Maintenance and Renewal
Requirements for ANCC FNP-BC maintenance and renewal:
- Current, active license
- Current ANCC board certification (renew prior to certification expiration)
- Completion of 75 continuing education hours (including 25 hours of pharmacology)
Students fulfill hours through academic credits, continuing education courses, professional presentations, involvement in evidence-based practice or quality improvement projects, publication in peer-reviewed journals, retaking the certification exam, certain types of volunteer service, 120 hours logged as a preceptor or supervisor in a fellowship, academic program, etc., minimum of 1,000 practice hours.
Requirements for AANPCB FNP-C certification maintenance and renewal:
- Current AANPCB board certification (Renew prior to certification expiration)
- Current, active licensure
- Minimum 1,000 practice hours
- 100 continuing education hours (including 25 hours of pharmacology)
(Student precepting or faculty supervision may be converted to CE hours) - NPs may choose to recertify by examination
In both cases, there is a great deal of extra work if an FNP chooses to recertify after their certification expires. The AANP FNP-BC offers alternative options for qualifying for recertification. Both offer the option of recertifying by exam.
Choosing Between FNP-BC vs. FNP-C Certification
Employers find merit in both certifications as long as an FNP is licensed, certified, and in good standing. Personal preference determines which certification you pursue. When choosing between FNP-BC vs. FNP-C certification, there are certain differences to keep in mind.
FNPs with either certification can treat patients, but the FNP-C certification through the AANPCB includes more clinical information (e.g.: prenatal and newborn care) and is often favored by those seeking to practice as clinicians.
As mentioned above, the FNP-C certification also includes key issues like diversity and cultural competence, polypharmacy, communication, integrative therapies, functional assessment, etc.
The FNP-BC certification appeals to FNPs who are more likely to pursue opportunities in academia. Note that the average salary for an NP in primary care is $106,370. For those interested in a role in academia, professors earn an average of $76,193.
According to the Bureau of Labor Statistics (BLS), FNPs can look forward to 45% job growth between 2020 and 2030.
Frequently Asked Questions About FNP Certification
What does FNP-BC mean?
The designation FNP-BC means board-certified family nurse practitioner. The American Nurse Credentialing Center (ANCC) offers this designation.
What does FNP-C mean?
The designation FNP-C means certified family nurse practitioner. The American Association of Nurse Practitioners Certification Board (AANPCB) offers this credential.
What is the difference between FNP-C and FNP-C?
There are a number of differences between the FNP-C and FNP-BC certifications. The FNP-C certification has a more robust clinical focus and includes information about more diverse subcategories of patient populations. Those pursuing careers in academia often favor the FNP-BC credential.
There are small differences in the cost of certification and the number of questions on each exam. FNP-C recertification requires 100 continuing education hours compared to the 75 hours required for FNP-BC recertification.
How hard is the family nurse practitioner exam?
The FNP-BC and FNP-C are robust competency-based exams that test candidates on clinical practice and knowledge. The FNP-C exam covers a broader variety of patient populations and includes areas of practice such as cultural competence, integrative therapies, and therapeutic communication. Applicants for either exam prepared through intensive study and preparation.
Page last reviewed: July 27, 2022
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