Neonatal Nurse Practitioner Exam

The NNP-BC exam is a computer-based exam offered year-round by appointment, either at a PSI test center or through live remote proctoring from a quiet, private location. Every question is multiple choice with a single best answer and three answer choices.

Key Facts About the NNP-BC Exam

To sit for the exam you need a current registered nurse license in the United States or Canada and you must have completed an accredited graduate nurse practitioner program that prepares neonatal nurse practitioners. Your license must stay current in your NCC account. After NCC approves your application, you receive a 90-day eligibility window and should schedule your appointment within the first 30 days of it so you can get the date you want.

The official content outline has five domains.

NNP-BC Content Outline Weights

General Assessment covers maternal history and fetal assessment, the neonatal physical examination and gestational age assessment, laboratory and diagnostic studies, procedures and equipment, family integration and discharge planning. General Management covers thermoregulation, resuscitation and stabilization, growth and nutrition, and fluids and electrolytes. Pharmacology covers pharmacokinetics, pharmacodynamics and the common neonatal drug therapies, including drugs and breastfeeding. The systems domain covers cardiac, respiratory, gastrointestinal, renal and genitourinary, endocrine and metabolic, hematopoietic, infectious disease, musculoskeletal, integumentary, genetic, neurological, and ear, eye, nose and throat conditions. Professional Issues covers ethics, legal and regulatory issues, evidence-based practice, quality improvement and safety. The score report combines Pharmacology and Professional Issues into one reporting area.

Only the 150 scored questions count. NCC uses a criterion-referenced standard: you are measured against a fixed level of knowledge, not against other candidates, and the different exam forms are statistically equated so that no form is easier to pass than another. There is no fixed percentage score to aim for, and there is no penalty for a wrong answer, so answer every question. You cannot tell which 25 questions are unscored pretest questions, so give every question your best effort.

• Case-based questions that ask for the most likely diagnosis
• Questions that ask for the next diagnostic step or the most appropriate management
• Medication questions about drug choice, dosing principles, monitoring and adverse effects
• Data interpretation: blood gases, laboratory panels, ventilator settings, fetal heart rate tracings described in words, radiograph and echocardiogram findings
• Delivery room and stabilization questions that follow the Neonatal Resuscitation Program
• Family counseling, discharge, ethical, legal and quality questions

Because each question has only three choices, the two wrong answers are usually close to the right one. Read every word of the stem, especially the gestational age, the hours or days of life and the trend in the data.

• You receive a pass or fail result.
• Your score report describes your performance in each content area with words such as weak, average or strong rather than percentages, which tells you where to focus if you need to retest.
• If you do not pass, you may reapply after 45 days from your exam date, with a new application and the full fee. You may take the same exam no more than twice in a calendar year.