Emergency Nurse Practitioner (ENP)
The ENP certification examination is a competency-based examination for certified Family Nurse Practitioners with specialty education and practice in emergency care.
How many questions are on the examination?
- There are 150 questions on each examination. A candidate's score is based solely on the 135 scored questions. Of the 150 questions, 15 are pretest questions.
- Pretest questions are used on the examinations to obtain statistical information for determining how well they perform prior to vetting them for use on the scored portion of the examination. The pretest questions cannot be distinguished from those that are scored. A test-taker’s score on pretest questions does not affect a candidate's final score.
2023 ENP EXAMINATION BLUEPRINT
DOMAIN I - Domains |
% of ENP exam |
# of scored items
(135 items) |
# of pretest items
(15 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% |
135 |
15 |
PATIENT CONDITIONS/TYPE
DOMAIN II - Patient Conditions |
% of ENP exam |
# of scored items
(135 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 |
DOMAINS AND TASKS
DOMAIN 01 - Medical Screening
- Perform a focused history and physical exam based on chief complaint
- Establish patient acuity level to determine need for rapid intervention
DOMAIN 02 - Medical Decision Making/ Differential Diagnosis
- Identify differential diagnoses based on the greatest likelihood of occurrence
- Prioritize differential diagnoses, considering risk of morbidity or mortality
- Evaluate diagnostic studies based on the differential diagnoses
DOMAIN 03 - Patient Management
- Rapidly intervene to resuscitate/stabilize patient
- Prescribe appropriate pharmacologic agents
- Initiate non-pharmacologic therapeutic interventions
- Perform diagnostic and therapeutic procedures/skills
- Consult with other healthcare providers to optimize patient management
- Re-evaluate for changes in patient condition
- Prioritize and manage multiple patients of varying acuity simultaneously
DOMAIN 04 - Transitions of Care
- Determine appropriate and timely patient disposition including admission, discharge, observation, or transfer as appropriate
- Formulate a specific disposition plan with appropriate resource utilization
- Engage patient and/or caregiver to effectively coordinate transitions of care
DOMAIN 05 - Professional Practices
- Integrate diverse, equitable, and inclusive practices into patient management
- Manage unique needs of vulnerable populations
- Demonstrate knowledge of EMTALA regulations
- Adhere to professional, ethical, quality, safety, and regulatory/legal standards in emergency care
ENP 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
ENP 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
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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