What to expect on your ENP certification exam

NPCB develops and administers competency-based certification examinations designed to support the continued advancement of nurse practitioner practice and patient care.

competency
Competency-based

The exam is designed to assess essential competencies required for Emergency Nurse Practitioners.

150-question
150 questions

The test consists of 150 multiple-choice questions evaluating readiness for advanced nursing practice.

Here’s the Breakdown

Domain I – Domains % of ENP exam # of scored items # of pretest items
01 – Medical Screening 16% 21 2
02 – Medical Decision Making/ Differential Diagnosis 24% 33 4
03 – Patient Management 36% 48 6
04 – Transitions of Care 16% 22 2
05 – Professional Practices 8% 11 1
Total 100% 35 15
Domain II – Patient Conditions % of ENP exam # of scored items
Thoracic-Respiratory Disorders 10% 14
Cardiovascular Disorders 11% 15
Cutaneous Disorders 6% 7
Abdominal & Gastrointestinal Disorders 13% 17
Musculoskeletal Disorders (Non-traumatic) 7% 10
Renal/Genitourinary Disorders 7% 9
Neurological Disorders 6% 8
Ear, Eye, Nose, Oral/Dental & Throat Disorders 8% 11
Traumatic Disorders 8% 11
Psychobehavioral Disorders 6% 8
Obstetrics and Gynecology 5% 7
Environmental and Toxicological Disorders 3% 4
Systemic Infections and Hematologic and Immune System Disorders 5% 7
Endocrine, Metabolic, and Nutritional Disorders 5% 7
Total 100% 135

Knowledge Areas

  • Anatomy, physiology, and pathophysiology
  • Medical screening examination
  • Focused health history and physical
  • Differential diagnosis/Medical decision making
  • Diagnostic studies (e.g., EKG, radiology, body fluid)
  • Diagnostic/therapeutic procedures
  • Pharmacological therapies
  • Integrative therapies
  • Consultation and collaboration
  • Patient and family education and counseling
  • Resource utilization
  • Documentation (e.g., coding, billing)
  • Professional, ethical, quality, and regulatory/legal issues
  • Pre-hospital and EMS
  • Health equity
  • Vulnerable populations
  • Principles of epidemiology, population health, and social determinants of health
  • Safety and harm reduction
  • Disaster and mass casualty management
  • Resuscitation and stabilization
  • Prioritization
  • Disposition
  • Forensics

Procedures

Airway Techniques
  • Intubation
  • Mechanical ventilation
  • Airway adjuncts
  • Non-invasive ventilatory management
  • Surgical airway
  • Ventilatory monitoring
Resuscitation
  • Cardiopulmonary resuscitation
  • Arterial catheter insertion
  • Neonatal resuscitation
  • Central venous access
  • Pediatric resuscitation
  • Intraosseous infusion
  • Post-resuscitative care
  • Defibrillation
  • Blood, fluid, and component therapy
Anesthesia and Acute Pain Management
  • Local anesthesia
  • Procedural sedation and analgesia
  • Regional nerve block
Abdominal and Gastrointestinal Diagnostic and Therapeutic Procedures
  • Anoscopy
  • Gastrostomy tube replacement
  • Excision of thrombosed hemorrhoid
  • Paracentesis
  • Esophageal/gastric balloon tamponade (e.g., Minnesota/Blakemore/Linton tube)
Cardiovascular and Thoracic
  • Cardiac pacing
  • Pericardiocentesis
  • Cardioversion
  • Thoracentesis
  • ECG interpretation
  • Needle/Tube thoracostomy
Cutaneous
  • Escharotomy
  • Trephination, subungual
  • Incision and drainage
  • Wound closure techniques
Head, Ear, Eye, Nose, and Throat
  • Control of epistaxis
  • Tonometry
  • Drainage of peritonsillar abscess
  • Tooth stabilization
  • Laryngoscopy
  • Corneal foreign body removal
  • Lateral canthotomy
  • Drainage of hematoma (auricular, septal)
  • Slit lamp examination
Musculoskeletal
  • Arthrocentesis
  • Fracture/Dislocation reduction techniques
  • Compartment pressure measurement
  • Spine immobilization techniques
  • Fracture/Dislocation immobilization techniques
  • Fasciotomy
Nervous System
  • Lumbar puncture
Obstetrics and Gynecology
  • Pelvic examination
  • Sexual assault examination
  • Precipitous delivery (including complications)
  • Bartholin cyst incision and drainage
  • Perimortem c-section
Psychobehavioral
  • Violent patient management/Restraint
  • Psychiatric screening examination/medical stabilization
Renal and Urogenital
  • Suprapubic catheter
  • Testicular detorsion
Other Diagnostic and Therapeutic Procedures
  • Foreign body removal
  • Point of care ultrasound
  • Collection and handling of forensic material
  • Interpretation of diagnostic imaging (e.g., ultrasound, MRI, CT, radiographs)
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The ENP certification examination is a competency-based examination that tests clinical knowledge of emergency specialty care across the life span.

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