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Exam Overview
Both certifying exams are computer-based tests given at Prometric test centers. You apply to the certifying body first, and once your application is approved you receive authorization to schedule a seat within a 120-day testing window.
| Feature | ANCC | AANPCB |
|---|---|---|
| Credential | PMHNP-BC | AANPCB PMHNP certification |
| Total questions | 175 | 150 |
| Scored questions | 150 (plus 25 unscored pretest) | 135 (plus 15 unscored pretest) |
| Testing time | 3.5 hours | 3 hours |
| Question format | Multiple choice | Multiple choice |
| Passing score | Scaled score of 350 (scale maximum 500) | Set by a standard-setting study; not reported as a percentage |
| Test fee | $395 non-member; $295 ANA member; $340 AANP, ISPN or GAPNA member; $290 AANP student member; $220 APNA member | Posted on the AANPCB website; AANP members receive a discount |
| Delivery | Prometric test centers; test within a 120-day window | Prometric test centers; test within 120 days |
| Retake rule | After 60 days; no more than 3 attempts in any 12-month period | Up to 2 attempts per calendar year |
| Certification period | 5 years | 5 years |
ANCC fees include a $140 non-refundable administrative fee. Fees and policies change from time to time, so confirm them on the certifying body's website before you apply.
Eligibility
Both boards require a current, active registered nurse license and graduation from an accredited PMHNP (across the lifespan) master's, doctoral or post-graduate certificate program with three separate graduate courses in advanced pathophysiology, advanced health assessment and advanced pharmacology, and at least 500 faculty-supervised clinical hours. ANCC also requires program accreditation by CCNE, ACEN or NLN CNEA, content in health promotion and in differential diagnosis and disease management, and clinical training in at least two psychotherapeutic treatment modalities. ANCC may authorize you to test once all coursework and clinical hours are complete, before your degree is conferred, using a validation of education form; the credential is issued after your final transcript arrives.
What the ANCC Exam Covers
| Domain | Scored Questions | Share |
|---|---|---|
| I Scientific Foundation | 33 | 22% |
| II Advanced Practice Skills | 41 | 27% |
| III Diagnosis and Treatment | 33 | 22% |
| IV Psychotherapy and Related Theories | 17 | 11% |
| V Ethics, Legal Principles and Cultural Care | 26 | 17% |
Scientific Foundation covers advanced pathophysiology, pharmacology and psychopharmacology (including movement-related side effects and neuroleptic malignant syndrome), neuroanatomy, neurophysiology, neurodevelopment, psychopharmacogenomics and advanced physical assessment. Advanced Practice Skills, the largest domain, covers clinical interviewing and motivational interviewing, health promotion, mental health and substance use screening tools and withdrawal scales, the mental status examination, psychiatric emergencies including suicidal and homicidal ideation, risk assessment, psychoeducation and recovery. Diagnosis and Treatment covers DSM-5-TR criteria, differential diagnosis, laboratory and diagnostic tests, evidence-based selection and monitoring of medications and psychotherapy, off-label use and complementary treatments. Psychotherapy and Related Theories covers cognitive behavioral, humanistic, interpersonal and behavioral therapies, change theories, developmental and family theories and the therapeutic alliance. Ethics, Legal Principles and Cultural Care covers patient rights, consent, confidentiality and duty to warn, the ANA psychiatric-mental health nursing scope and standards, cultural and spiritual care, equity and inclusion, involuntary treatment and capacity, and advocacy for accommodations and leave. Questions are also classified by body system, drug class and age group, from infant to frail elderly.
What the AANPCB Exam Covers
| Domain | Scored Questions | Share |
|---|---|---|
| Assess | 45 | 33% |
| Diagnose | 28 | 21% |
| Plan | 35 | 26% |
| Evaluate | 27 | 20% |
The AANPCB outline follows the steps of a patient encounter and adds a second dimension for age: infants and children 6%, pre-adolescents 8%, adolescents 16%, adults 50% and older adults 20%. Questions draw on scientific foundations, pharmacology (including pharmacogenetic testing and complementary therapies), nonpharmacologic therapies such as ECT and rTMS, individual, group and family psychotherapies, assessment and diagnosis, care practices (risk assessment, safety planning, harm reduction, crisis management, least restrictive interventions, trauma-informed care, cultural humility and social determinants of health) and the professional role (evidence-based practice, ethics and law, scope and standards, boundaries, telehealth, quality improvement and billing). AANPCB updates its blueprint periodically, so check the PMHNP Candidate Handbook for the version in effect on your test date.
How the Exams Are Scored
Both exams are criterion-referenced: you are measured against a fixed passing standard set by expert panels, not against other candidates. Pretest questions do not count, and you cannot tell which questions they are, so treat every question as scored. There is no penalty for a wrong answer, so answer every question. ANCC reports a scaled score with 350 needed to pass. AANPCB gives a preliminary pass or fail result as soon as you finish, and the official result is released afterward in your online profile.
What Kinds of Questions to Expect
- Clinical cases that ask for the most likely diagnosis, the best initial medication, the next step when a medication fails, or the monitoring a drug requires
- Psychopharmacology questions on receptors, CYP450 interactions, drug levels, adverse-effect syndromes and special populations such as children, pregnant patients and older adults
- Therapeutic communication questions that quote a patient and ask for the best PMHNP response
- Screening scores, mental status findings, lab panels and medication lists to interpret
- Suicide and violence risk, agitation and other emergencies that ask for the priority action and the right level of care
- Psychotherapy and theory questions that describe a technique, a family pattern or a developmental stage
- Ethics, legal and cultural questions on capacity, consent, confidentiality, involuntary treatment, duty to protect, accommodations and culturally responsive care
- Single-best-answer multiple-choice questions; both certifying bodies describe their exams as multiple choice
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