FNP-C vs FNP-BC: What’s the Difference?

Nurse Types / Nurse Practitioner / FNP-C vs FNP-BC

Family Nurse Practitioners (FNPs) are highly skilled, advanced practice nurses with specialized training that allows them to treat a broad range of patients in family practice settings. 

If you’ve considered the type of nursing role you want to pursue and have decided to become an FNP, there is more than one certification you can pursue depending on your final career goal and focus of care you intend to deliver.

In this article, we’ll break down the difference between the FNP-C and FNP-BC certifications. To help you decide which certification is the right one for you, we’ll cover:

• What’s the difference between the FNP-C and FNP-BC?
• What is the FNP-C?
• What is the FNP-BC?
• Where do you get a Family Nurse Practitioner certification?
• What are some resources for test takers?

What’s the difference between the FNP-C and FNP-BC?

What is the FNP-C?

Let’s take a closer look at the FNP-C, and what you need to know about it.

Definition

The Family Nurse Practitioner-Certified (FNP-C) exam evaluates entry-level nurse practitioners for the ability to care for patients of all ages. 

Exam 

The questions on the FNP-C exam relate to clinical knowledge. Nurses taking this exam can expect: 

• 150 multiple-choice test questions, 15 of which are pre-test questions that do not count toward the final score
• Questions relating to nursing practice areas such as assessing, diagnosing, planning care, and evaluating outcomes
• Questions relating to the care of patients from each age group, from prenatal to elder adult
• Topics such as anatomy and physiology, pharmacologic and non-pharmacologic treatments, diagnostic tests, mental health assessment, cultural sensitivity, clinical decision making, and more

A test question might look like this:

An adult diagnosed with hypertension has been treated with a low sodium diet and hydrochlorothiazide (HCTZ) 50 mg daily for the past two months. The patient denies a family history of cardiovascular disease. At this visit, BP=150/90 and T=I00 F. Physical examination reveals no bruits, clear chest, no atrial gallop, edema and tenderness of the  left ankle, and an intact neurological system. Which laboratory values will provide the most useful follow-up information?

• serum sodium and potassium
• total serum cholesterol and serum glucose
• serum uric acid and complete blood count
• blood urea nitrogen and creatinine

Who can take it?

To be eligible to sit for the FNP-C exam, there are requirements you must meet. They include the following:

• You must hold a current RN license
• Complete a minimum of 500 clinical practice hours as part of an advanced practice degree program
• Completion of APRN core courses (advanced health assessment, advanced physiology/pathophysiology, and advanced pharmacology)
• Complete a graduate, post-graduate, or doctoral Family or Adult-Gerontology Primary Care Nurse Practitioner program at an accredited educational institution

Why the FNP-C is needed 

Advancing your degree to the advanced practice nurse level is only the first requirement of becoming an FNP. To be licensed to practice as an FNP, you must also pass a national certification exam such as the FNP-C. These are the steps to FNP licensure with an FNP-C:

• Obtain a Bachelor of Science in Nursing (BSN)
• Pass the NCLEX-RN
• Receive your RN license
• Enroll in a graduate degree nursing program 
• Pass the FNP-C exam
• Receive your NP license

What is the FNP-BC?

Although similar to the FNP-C, the FNP-BC has its own qualities you should understand before choosing between these two certification exams. 

Definition

The Family Nurse Practitioner-Board Certified (FNP-BC) exam, like the FNP-C, evaluates entry-level nurse practitioners for competency in clinical skills. 

Exam 

Nurses earning their FNP-BC credentials can expect topics similar to the FNP-C exam with the following format and content: 

• 175 questions on the FNP-BC exam, 25 of which are pre-test questions that do not count toward the final score.
• Questions relating to assessment, diagnosis, implementation, planning, and evaluation of patient outcomes
• Questions relating to care of patients from every age group
• Topics related to resource management like coordination of care
• Evaluation of skills related to research appraisal
• Nursing theory topics like the ethical implementation of healthcare technology

A test question might look like this:

A 40-year-old patient has had a generalized, nonpruritic skin eruption with intermittent exacerbations over the past 10 years. Currently, a well-circumscribed erythematous plaque appears over the patient’s left gluteal fold. The lesion is covered with scales and has some fissuring. The family nurse practitioner makes a diagnosis of: 

• atopic dermatitis.
• ichthyosis.
• psoriasis.
• tinea corporis.

Who can take it

The following criteria must be met to be eligible to sit for the FNP-BC exam:

• Hold a current RN license
• Complete a minimum of 500 faculty-supervised clinical hours in an FNP program
• Complete APRN core courses (advanced health assessment, advanced physiology/pathophysiology, and advanced pharmacology)
• Hold a master’s, post-graduate, or doctoral degree from an accredited FNP educational program

Why the FNP-BC is needed 

As with the FNP-C, an FNP-BC allows a nurse who has completed an advanced practice (APRN) degree to obtain FNP licensure. After passing the FNP-BC examination, you are qualified for a state license to practice at the FNP level.

Where do you get a Family Nurse Practitioner certification?

The FNP certification you decide to pursue determines which credentialing organization you will have to go through to take the exam.

• FNP-C: through the American Academy of Nurse Practitioners (AANP)
• FNP-BC: through the American Nurses Credentialing Center (ANCC)

Which certification should you get?

Aspiring nurse practitioners who are interested in primarily clinical practice and offering direct care to patients may choose to pursue an FNP-C. For those who would prefer a role as an FNP in an academic or research setting, an FNP-BC may be a better choice.

What are some resources for test takers? 

Before the big test day arrives, you’ll want to be well-prepared. Fortunately, there are some resources you can use to help yourself succeed.

The AANP recommends allowing at least 6-12 weeks to prepare for the FNP-C. They suggest considering a review course, creating a study plan, and taking practice tests before the actual exam day. 

For the FNP-BC, the ANCC has developed a guide with helpful tips to pass the certification exam. It includes tips such as reviewing the ANCC guidebook and ANCC resources for how the test is structured including sample test questions.

The ANCC also recommends steps like creating a study plan for yourself and taking available review courses.

Next steps

The path to becoming a Family Nurse Practitioner is a wise career move. Although you’ll invest time and effort, NPs command a robust average salary, and the demand for NPs continues to grow annually. 

As of May 2021, the BLS reports an average salary for all nurse practitioners in the United States at $118,040.

Once you’ve successfully passed either of these credentialing exams, you can apply for your FNP license through your state board of nursing. With your FNP license and the FNP-C or FNP-BC credentials attached to your name, you can then officially begin your job search for an FNP role and achieve your career goals.

FAQs