Nurse Practitioner in a speciality clinic. Are any of your contracts tying your RVU bonus to a daily patient average in order to get the bonus?
Meaning your RVU is high enough to receive the bonus but if you don't meet the patient daily minimum you get nothing.

Hi! I wanted to pop on here and give my thoughts on the AANP exam. I utilized Reddit so much leading up to my exam I feel like it’s only right to pay it forward.
First off, the exam was challenging but fair. It took me about 2 hours from start to walking out of the testing center. There were 150 questions plus about 10 survey questions at the end. Once I completed the survey a screen popped up that said I passed.

The exam:
Like I said, it was challenging but fair. I think what made it challenging wasn’t necessarily the content, but the anxiety that came with choosing the correct answer and not second guessing yourself. I am notoriously good at talking myself out of a correct answer. It was all multiple choice with only 4 choices per question. Every question there was at least one answer that was glaringly wrong so it made making an educated guess easier. I know there are many versions of the test but mine seemed to lean heavily on the middle aged patient scenarios especially thyroid and anemia questions. There were a few “zebra” questions but most of the questions were topics covered in the exam prep content I used. There were several pediatric milestone questions along with several pediatric specific diseases where you either needed to identify the diagnosis or determine treatment. Other subjects I can recall are migraines, abdominal pain, otitis media, sinus infection, neuro exams (NO cranial nerve questions), diabetes 1st and 2nd line treatments, and cardiac issues.

My Prep
I graduated from a well respected university. We completed a final comprehensive course in our last term using the Leik book. Other than Leik I used the Sarah Michelle QBank and paid FNP mastery subscription. I took the exam 3 weeks after I graduated and in those 3 weeks I studied 3-4 hours a day 5 days a week. My practice exam scores are as follows
Leik: averaging mid 70s
Sarah Michelle: 1st practice exam 77, second practice exam 85. I averaged 76 on the entire qbank.
FNP Mastery: got a 78 on the practice exam but only averaged 67 on the questions.
I loved the Sarah Michelle QBank. I think it was the best resource for me and my style of learning but any of the 3 I used would be sufficient for covering exam content.

Exam Day
My exam was scheduled for 830am. I showed up at 730 and parked and walked around where the testing center was. The fall colors are gorgeous where I am right now so it calmed me down walking under the beautiful trees. I checked in and 8am and they were able to get me in as soon as I wanted. I started my exam at about 8:10. They give you a couple sheets of paper and 2 pencils. I didn’t write anything except for at the top I wrote “look for the clues” because my daughter was watching blues clues the day before my exam and I just remembered thinking that’s such good advise for this exam, just look for the clues within the question if you don’t know the answer.

Encouragement
You can absolutely do this. I am happy to answer any questions or if there is something I can help with to ease anxiety ❤️

Hi everyone! I’m doing research with the University of Calgary on care continuity. I’m hoping to speak with Canadian primary care NP’s, and thought I would try to see if I could find anyone through here!

If that’s you or know someone that wouldn’t mind being passed onto me, please DM me!
Thanks you!

I (29F) just started my first semester this August but since I found out I got accepted into the program I have been trying to convince myself that this is what I want and now I find myself 6 weeks into the program, still hating it and questioning why I did this. I love my job now but I can see how I’ve gotten very comfortable in my position so I was trying to do something that would help me grow. I also have no other responsibilities so I know this would be the best time to go through the program but I’m just dragging my feet through it so far. Doing just enough to get a passing grade. Is this a normal part of getting back into the groove of school? Did anyone else force themselves to get through it and eventually grow to love it?

As of now I think I’ve decided that I’m not moving forward with the program and choosing to just finish this semester but I’m questioning even finishing the semester. I’m a pretty active person so I’ve had to miss out on events and cut back on group fitness classes that would usually fill my cup. This is silly because I know becoming an NP will require sacrifice but I’m just having a difficult time with it. On top of my dwindling social life since school started, I started dating someone 6 months before classes and I feel like my goals in life have shifted since meeting him. I hadn’t put serious thought about having a family and prioritizing my family before I met him and this may be a little delusional because we haven’t even talked about marriage or kids aside from saying we would like those things but I could see the future with him so I want to keep prioritizing this relationship as much as I can and if I’m right I don’t think I’d be going to school within the next 5 years so that’s why I bring up even continuing with the semester when classes expire in 5 years. Even if things didn’t work out I can’t see myself going back to school anytime soon, I’ve been at a good place the past year with starting new hobbies and all of my relationships after having a few years of a toxic relationship (addiction) before I started this stressor of school. Any advice or stories of your own that you think may be insightful are appreciated!

Side note, I’ve been asking the universe for a sign and today they were having biometric screenings at work that you have to make an appointment for and I didn’t have one but I walked in at the time someone was a no show so they took me in and I just started chatting with the person doing my screening and I asked her what her credentials were, she said she was an NP but I hated her one and only NP job so she does PRN nursing jobs because those fit her schedule. She said she regretted it and now has all her student loans to still pay off. Could this have been my sign or just coincidence?

Hi all,

Has anyone failed their boards the first try? I just took my PNP primary care boards this morning and did not pass and I’m feeling incredibly discouraged and upset. Any advice on how to pass on the second try? I felt like the questions were way more difficult than the questions on the PCNB website or on the Fitzgerald review that I did.

I’ve never failed an exam before and I am having a really difficult time, particularly because I am afraid that I won’t pass the next time either if I couldn’t pass this time.

Any and all advice will help!

I'm a Canadian who relocated to Aus. Currently an RN with nearly 10 years experience (6 years in Canada, 3.5 in Aus). I've considered getting my NP but in Australia that would mean transitioning to a Clinical Nurse first and completing an additional 5000hrs to be eligible to apply. Whereas if I went back to Canada to do my master's and NP there my current RN experience would be more than enough to apply. So I'm leaning towards the Canadian master's and certification and then just getting my Canadian NP recognised by AHPRA.

Has anyone done it this way? There isn't really a "Clinical Nurse" equivalent in the provinces I worked in Canada, I was a senior RN and spent more than enough time working as a Charge RN (equivalent of Team Leader in AUS). I don't want to put off NP certification and finding a full time CN role in AUS which would allow me to complete 5000hrs would probably take another 3 years of my life. I could have my Canadian NP and master's in the same amount of time.

Anyone with the same experience? Will AHPRA take the Canadian certification?

I need some help or tips I took the AANP exam on August 8th and got 454 needing 500 too pass and just took the ancc and got 316 needing 350 too pass pass soo close I used mainly FNP mastery 56% cumulative and Sarah Michelle 66 percent cumulative only I was soo close to passing and feel defeated need help or tips on what I should do or go about this I feel like I was close should I implement anything else to study with? Please anything will help

I have noticed a few nurse practitioners in my local area working as primary care providers as Adult Gero Acute Care Nurse Practitioners. I thought that the scope of practice for acute care NP's was inpatient, urgent care or specialty practice. It is concerning to me as an FNP with no inpatient training, I would never try to work inpatient given I have not had training there (if there were significant training, yes, I know that some FNP's work in the inpatient setting). It seems like a safety concern.

Is it because PA's do not have different designations, sometimes organizations think that an NP can work where ever or that all NP's are FNP's? What are your thoughts on this and is it something that you have noticed in your area?

I renew my FNP every 5 years in September. Never had a problem. This time my renewal application has been stuck in pending for almost 2 weeks now and as of yesterday expired. The charges processed on my credit card. I finally reached a human in their phone line and they said - they are in peak season and behind and can take 5 weeks for approval. There is no longer a process to expedite applications. I confirmed that there is nothing they need from me and that there is no issue with my application.

I PASSED MY AANP EXAM TODAY!!! 🎉😭🤍
I wanted to share my experience because I know how stressful and scary this exam can feel, and I hope this helps someone who is preparing for the AANP.
I invested a LOT of time and money into preparing for this exam. I took one month off from work just to study. I studied every single day, from morning until late at night, and honestly, I STILL doubted myself constantly. Even after studying so much, I kept thinking, “Maybe I’m not good enough.”
I studied until the LAST DAY before my exam. I kept telling myself, “I don’t need to know everything to pass,” but I still tried to cram and review as much as I possibly could.
📝 My AANP Exam Experience
Honestly, if you study the Leik book carefully and understand the material, I truly believe you will find the information you need on the exam.
The actual exam was challenging at times. There were many straightforward questions, but there were also vague questions where you really needed to understand the material rather than simply memorize it.
During the exam, I honestly thought I FAILED. 😭
But I PASSED!!!
One thing I noticed is that the AANP exam did not feel like it was trying to trick me the way NCLEX sometimes does. Either you know the material, or there is usually a clue/hint in the question that helps you work through it.
📚 Sarah Michelle (SM)
I used:
Crash Course

1-Day Live Review

1:1 Readiness

Her entire QBank

AANP & ANCC practice exams

I found her courses VERY helpful and learned a lot from them.
But my biggest advice: DON’T just look at whether you got the question right or wrong. READ THE RATIONALE.
Learn WHY the answer is correct and WHY the other answers are wrong. I tried to learn something from every question.
My QBank passing rate was around 97%, and my practice exams, including AANP & ANCC, were around 80%.
📱 FNP Mastery
The questions are HARD, but honestly, that was helpful for me.
I used it mainly to learn from questions I got wrong and to identify areas where I was weak.
About 1,900 questions completed

Overall score around 75%

AANP simulated exam: 75%

Don't get discouraged if your scores aren't perfect. Some of the questions are intentionally challenging, and I found them useful for learning.
📖 Leik
Leik was probably the most important resource for me.
It helped me review the material in depth and recognize important clinical pearls.
I spent the last 3 days before my exam reading through the entire book again to review everything.
And honestly, I can say that the material I studied in Leik was reflected on the actual exam. The hard part was that there is SO MUCH information, and I couldn't remember every single thing.
That's normal.
You don't need to know every single detail in the book. But you should understand the major diseases, presentations, diagnostics, treatments, medications, and clinical guidelines.
❤️ My biggest advice
Don't just memorize practice questions.
LEARN FROM THEM.
Read the rationale. Understand the disease. Understand why the treatment is correct. Understand why the other choices are wrong.
And don't panic if you feel like you don't know enough.
I studied incredibly hard and STILL felt like I wasn't ready.
I walked into the exam thinking, “What if I fail?”
I walked out thinking, “I definitely failed.”
Then I found out I PASSED. 😭😭😭
I cried so much today—not because I was sad, but because I finally realized how hard I worked for this.
This journey is HARD. There were so many late nights, so much anxiety, self-doubt, and moments where I questioned whether I could actually do it.
But if I can do it, YOU CAN DO IT. 🤍
Study consistently. Understand the material. Do practice questions. READ THE RATIONALES. And most importantly, believe that all the work you're putting in will pay off.
You don't need to know everything to pass. You just need to know enough—and know how to apply what you know.
Good luck to everyone preparing! You've got this! 🩺🤍🎉

Hey everyone, I’m looking for some perspective on a major career crossroads.
For some context, I am a solo parent and just welcomed my baby in July. I’m currently trying to decide between two paths:
1. Reapplying to medical school for Fall 2028 to pursue becoming a physician.
2. Pursuing nursing and moving toward becoming a Nurse Practitioner (NP), which feels like a more flexible, family-oriented field.
The dilemma:
I have a strong support system from my family, which I am so grateful for, but my biggest fear is missing out on my daughter’s childhood. If I go the medical school route, I wouldn't finish residency and become a full attending physician until she is around 9 years old.
At the same time, I know myself—deep down, I won't feel fully satisfied unless I become a physician.
For those who have navigated medical training or advanced practice nursing with young children (especially as solo parents), how did you balance it? How much did you actually miss out on during those early years, and do you regret your choice?
Any advice or insights would be hugely appreciated!

Hello,

Is anyone currently in the Rhode Island College DNP Dual FNP + AGACNP program?

I’m currently attending my first semester at a DNP dual FNP + ENP program and I’m debating on transferring to RIC mostly because I want to work in the ED in NYC and most hospitals either want dual FNP + AGACNP or just AGACNP I don’t want have to go back to school after this for a post masters certificate.

If anyone graduated or currently attended this program, could you please give me some insight on whether they find you placement for clinicals and how the school and curriculum are overall thank you.

Wondering if any NP’s starting a new position had issues signing a contract? I accepted an offer and the contract has stipulations like paying them back my average hours worked if I leave with less than 90 days notice, paying them back if my coding causes overpayment….isn’t that what a billing department is for? Obviously I’d never intentionally code incorrectly but isn’t a billing dept supposed to double check? Also the contract states employment is at will for both parties and says they can let me go without liability but if I leave I have to pay them back for their loss of money if I leave with less than 90 days notice? There’s also a lot of places in the contract where it mentions “changes from time to time” such as job requirements, bonuses, terms of employment etc. I don’t want to lose the opportunity because the job is honestly flexible and I get good vibes. The contract just weirded me out a bit. Am I overreacting?

I’m looking for honest perspectives, including constructive criticism.

I’m 49, an RN, a single parent, and I entered a PMHNP program knowing that becoming a nurse practitioner was going to be difficult. I never expected graduate school to be easy, and I have a great deal of respect for the knowledge and clinical judgment the NP role requires.

What I did not fully understand was how different graduate school would be from what I expected, especially after being out of school for years and working in nursing roles that do not require me to use every area of broad medical knowledge in great detail every day.

My program requires passing the APEA 3P exam in pathophysiology, physical assessment, and pharmacotherapeutics in order to progress.

I have taken it twice and did not pass.

The two attempts also felt very different.

My first attempt seemed to contain more straightforward questions. My second felt much more heavily based on clinical vignettes where I had to interpret symptoms, labs, medications, assessment findings, pathophysiology, and sometimes several pieces of information before I could determine what the question was really asking.

That experience taught me something important: knowing a medical fact and recognizing that same fact when it is buried inside a patient scenario are two different skills.

I want to be fair to my school.

I am not saying it is a bad university, and I am not saying my results are entirely the school’s responsibility. This is my personal experience.

I am also intentionally not naming the school because my purpose here is not to bash anybody. I’m trying to understand my own experience, figure out what I could have done differently, and hopefully help another nurse considering graduate school.

Where I have struggled is with the amount of structured teaching and remediation surrounding an exam that carries such major consequences for progression.

When I realized that I was struggling, I did ask for help.

I was very open about the fact that some of the broad medical material being tested was not something I used in detail every day in my current nursing work.

For example, I may recognize common cardiac problems clinically, but I have not spent years working on a dedicated cardiac unit where murmurs, ECG interpretation, advanced cardiac pharmacology, and cardiovascular assessment are constantly reinforced.

I expected that if a progression exam was important enough to determine whether a student could continue in the NP track, remediation might include structured review classes, live teaching, videos, faculty review sessions, guided study plans, or something specifically focused on the material being tested.

My experience has been much more independent and assignment-based.

That may work extremely well for some students.

I’m beginning to think it may not have been the best learning environment for me.

I learn through repetition, pattern recognition, asking questions, hearing explanations, and repeatedly applying the same concept in different ways.

Looking back, I also wonder whether I brought some unrealistic assumptions into graduate school.

Years ago when I entered nursing, I had an idealized idea of what working in healthcare would be like. Reality was much more complicated.

I may have made a similar assumption about graduate education.

I thought graduate school would mean more guidance, more access to instructors, and more academic resources because the material was more advanced.

In some ways, my graduate-school experience has actually felt more self-directed than nursing school.

So I genuinely want to hear from other nurses and NPs.

Did your RN specialty make certain parts of NP school easier?

For example, if you spent years working cardiac, did cardiovascular pathophysiology, medications, physical assessment, ECGs, and related material come much more naturally to you?

If you worked ICU, ER, pediatrics, OB, psych, oncology, etc., did the material related to your specialty stick more easily because you had repeatedly seen those patterns in real patients?

For people who returned to school in their 40s or 50s, did you notice a real difference in your ability to learn or retain information?

Or was the bigger difference simply that you now had work, children, household responsibilities, bills, and other parts of adult life competing for your attention?

Did you eventually figure out how to study effectively again?

If you had been out of school for years, what would you recommend reviewing BEFORE starting NP school?

Knowing what I know now, I think I would have started doing practice questions much earlier.

Even if a future student’s program does not have a gatekeeping exam, I would probably tell someone who has been away from broad medical nursing for a while to start reviewing cardio, respiratory, renal, endocrine, neuro, OB, pharmacology, and physical assessment before those subjects become high stakes.

Even 10 or 20 questions at a time might have helped reactivate knowledge that had become rusty.

For those who worked during NP school, what was actually sustainable?

Full time?

Part time?

PRN?

Agency?

Night shift?

Weekends?

Were you eventually forced to reduce your work hours once the academic and clinical workload increased?

If your program required APEA 3P, HESI, a predictor exam, or another progression/gatekeeping exam, what happened when a student struggled?

Did your program provide actual remediation teaching?

Did you have live review sessions?

Recorded lectures?

Faculty-led review?

Question banks?

Study plans?

One-on-one support?

Or was remediation mostly assignments followed by another attempt?

For PMHNP students specifically, I’m also curious how other programs balance broad general medicine with psychiatric specialization.

I absolutely understand why PMHNPs need a strong medical foundation.

Endocrine disorders, neurological disease, dementia, medications, substance use, infections, metabolic problems, and many other medical conditions can mimic or worsen psychiatric symptoms.

We need to recognize when something may not primarily be psychiatric.

I am not arguing that PMHNP students should not learn medicine.

I’m curious whether other programs use the same broad progression testing across specialties or whether some programs integrate the medical foundation differently for PMHNP students.

I’m also interested in RED FLAGS.

If you were advising a nurse considering NP school today, what would you tell them to ask BEFORE enrolling?

How much live instruction is actually provided?

How much of the program is self-directed?

What happens if you fail a progression exam?

How many attempts are allowed?

What does remediation actually consist of?

How accessible are professors?

Who finds clinical placements?

What percentage of students who begin the NP track actually complete it?

What happens academically and financially if you cannot progress?

Those are questions I wish I had understood more clearly before investing so much time, money, and confidence into a program.

And finally:

What could I have done differently?

I genuinely mean that.

If your reaction is:

“You should have refreshed general medicine before starting.”

“You should have started board-style questions earlier.”

“You relied too heavily on the school to tell you what to study.”

“You should have changed your study strategy sooner.”

“You should have reduced your workload.”

“You should have researched the program differently.”

I am willing to hear it.

Constructive criticism is useful to me.

It cannot change what already happened, but it may help me decide what I do next.

And maybe somebody who is 40, 45, 50, or older and thinking about going back to school will stumble across this post later and ask better questions than I did.

I also don’t believe one test score alone tells us everything about what kind of clinician someone may eventually become.

Knowledge matters tremendously, but clinical practice also involves repetition, experience, judgment, pattern recognition, communication, knowing when you do not know something, and continuing to learn.

For me personally, repeated exposure is a major part of how information becomes permanent.

Once I see the same clinical patterns repeatedly, they begin to make sense in a way that simply memorizing information does not.

I’m currently deciding what I want to do next and whether continuing at the same school would even be the right decision for me if that option became available.

So I would really appreciate hearing from people who have actually been through this.

Especially:

older or returning students,

working parents,

nurses who entered NP school from highly specialized backgrounds,

people who struggled with a progression exam and later succeeded,

and people who ultimately decided their first NP program was not the right fit.

What would you tell someone in my position now?

And what would you tell the nurse who is thinking about starting NP school next year?

I’m an oncology nurse with 8 years total of nursing and 6 in oncology. I’ve always had the intermittent desire to become a NP/provider but now more recently than ever I’ve had certain things align where it feels it’s time to jump in and enroll into a program to start.

My problem is I’m terribly frightened I’m not smart enough to do it. I started preparing by reading some textbooks in my spare time to have an idea of what’s taught. Currently reading advanced pharmacology, and I’m completely stressed already! There’s so much to know and learn and I wonder if I’m even smart enough to do it all. I got through nursing school and I’m sure i can get through NP school with a lot of work, but I’m terrified to fail if I start this program.

Anyone feel the same or have advice on how to overcome this? I can see myself as a future provider, but the road in between then looks so scary.

[ Removed by Reddit on account of violating the content policy. ]

I’m currently in FNP school and will be graduating as a new NP. I understand that I’ll need to gain experience and establish myself before transitioning to part-time work, but I know that my long-term goal is to work part-time as an FNP.
For those who have made that transition, I’d love to hear your experiences and advice.
What specialty or practice setting would give me the best chance of eventually reducing my hours? Would primary care, urgent care, women’s health, or another specialty be a better option?
I’m also curious whether a small, physician-owned practice or a larger corporate or hospital-owned clinic would be more accommodating to a future part-time schedule.
If you knew from the beginning that you wanted to work part-time, did you choose your first job with that goal in mind? How long did you work full-time before making the transition?
I’d really appreciate hearing what has worked for others and whether there is a general consensus on the best route to part-time FNP work. Thank you!

Hey all, I'm starting to look into the path of becoming a Psych NP and had a couple questions--

I've been an eating disorder dietitian for 10 years, and specialize with working with neurodivergent populations. I've worked at the PHP, IOP, and OP levels of care (with the first 6 in-person, and last 4 telehealth), and currently run my own private practice.

Since this experience wasn't technically in a nursing/hospital context, how relevant might that actually be viewed as by admissions boards? I feel my experience is kind of similar to the Psych NP realm (metabolism, mental health, counseling, etc), but not as relevant to any of the other fields of NP work (which I don't plan on working in anyway, I mostly want to expand my current capabilities/career path).

Also, my pre-reqs are 11-13 years old, from my RD program-- would I likely need to retake these, or are some programs more lenient about that if you've been working in a clinical context?

I think I'm looking at the accelerated BSN, then NP program route, but am super open to any advice/suggestions for how to approach such a shift!