From January 2026, the Family Nurse Practitioner (FNP-C) exam run by the AANP Certification Board, now called NPCB, allows up to 3 attempts per calendar year. You apply to retest online, and the board reviews a re-exam application much like a new one. Each retest application needs at least 15 continuing education hours, and the retake fee matches the first exam: $315, or $240 for AANP members.
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Written and reviewed by the LexPort exam-prep team, led by our Founder & Exam-Prep Lead. LexPort builds certification practice questions — this is exam-preparation material, not medical advice. Last reviewed October 2026.
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Up to 3 attempts per calendar year, starting January 2026. NPCB notes that its other exams currently allow 2 attempts per year.
What do I need to apply for a retest?
A re-exam application submitted online and a minimum of 15 continuing education hours.
How much does the retake cost?
$315 for non-members and $240 for AANP and AAENP members — the same as the initial certification exam.
When will I hear my result?
NPCB emails a score report letter within 3-5 business days after testing, with further details on retesting.
Is there a set waiting period?
NPCB’s FAQ does not state a minimum waiting period between attempts.
Test yourself: 3 FNP practice questions
Tap an answer for instant feedback and the full rationale. The app has 3,000+, timed and scored.
Question 1
A primary care clinic is considering replacing its standard generic asthma inhaler with an expensive new asthma inhaler. A recent randomized superiority trial comparing the two reports a p-value of 0.12 for the primary outcome of reducing severe exacerbations. What is the most appropriate clinical decision based on this appraisal?
▸ Why B is the answer
A p-value of 0.12 is greater than the alpha threshold of 0.05, meaning the study fail to reject the null hypothesis. There is no statistically significant difference in exacerbation rates between the new expensive inhaler and the standard generic one. Option B is correct because, without evidence of superiority, it is most appropriate and cost-effective to maintain the current standard of care. Option A is incorrect because the new inhaler did not demonstrate better control. Option C is incorrect because the trial did not show the new inhaler works better for severe exacerbations, making targeted prescribing unjustified. Option D is incorrect because a lack of difference between two active treatments does not mean both are ineffective; it simply means the new one is not demonstrably better than the established baseline.
🔑 Key takeaway
When a superiority trial yields a non-significant p-value, standard therapy should generally be maintained.
Question 2
A 68-year-old male with advanced COPD asks about adding an inhaled corticosteroid to his daily formoterol-tiotropium regimen. He has a history of recurrent community-acquired pneumonia. Why should the nurse practitioner advise against this addition?
▸ Why C is the answer
In patients with COPD, adding an inhaled corticosteroid is associated with a well-documented increased risk of developing lower respiratory tract infections, which is particularly dangerous for someone with a history of recurrent community-acquired pneumonia. Option C correctly identifies this major adverse effect. Option A is incorrect because hypokalemia is a potential systemic side effect of beta-agonists, not inhaled corticosteroids. Option B is false; corticosteroids do not antagonize long-acting muscarinic antagonists, and the two are frequently used together safely in triple therapy regimens. Option D is incorrect because combining an inhaled corticosteroid with a long-acting beta-agonist does not inherently cause paradoxical bronchospasm.
🔑 Key takeaway
Inhaled corticosteroids increase the risk of pneumonia in patients with chronic obstructive pulmonary disease.
Question 3
A 58-year-old female with COPD reports significant daily breathlessness, scoring a 3 on the mMRC dyspnea scale. She states she has had no exacerbations over the past two years. Which initial pharmacological intervention is most appropriate?
▸ Why D is the answer
This patient has a high symptom burden based on her mMRC score but a low risk of exacerbations, placing her in GOLD Group B. Updated guidelines recommend combination LABA and LAMA therapy as the initial maintenance treatment for highly symptomatic patients to optimize bronchodilation and improve daily functioning. Option A is incorrect because inhaled corticosteroids are not indicated without a history of frequent exacerbations and elevated eosinophils. Option B is insufficient for chronic maintenance in highly symptomatic patients. Option C is reserved for patients with severe chronic bronchitis and a history of frequent exacerbations, which does not fit this clinical picture.
🔑 Key takeaway
Highly symptomatic COPD patients with low exacerbation risk should receive dual LABA and LAMA maintenance therapy.
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