How to Become a Family Nurse Practitioner (FNP)

Family nurse practitioners (FNPs) are advanced practice registered nurses (APRNs) who work with individuals and entire families to support patient health through health evaluations, diagnoses, treatment, and health education. FNPs are just one of several types of nurse practitioner; other nurse practitioner specializations include adult care, adult-gerontology acute care, and pediatric primary care.

Overview: How to Become an FNP

To become an FNP, one must generally complete the following steps:

• Acquire and maintain an active license as a registered nurse (RN)
• Enroll in and complete a master of science in nursing (MSN), post-MSN certificate, or doctor of nursing practice (DNP) program with a specialization in family nurse practitioner
• Take a certification exam administered by the American Nurses Credentialing Center (ANCC) or the American Academy of Nurse Practitioners Certification Board (AANPCB)
• Apply for licensure as an advanced practice registered nurse (APRN) in one’s state of residence

Become a Licensed Registered Nurse

To become an RN, students must complete a bachelor of science in nursing (BSN), an associate degree in nursing, or a diploma in nursing from an accredited nursing program. Students must then pass the RN licensure exam (known as the NCLEX-RN) administered by the National Council of State Boards of Nursing. After completing their nursing education and passing the NCLEX-RN, individuals can then apply for RN licensure through their state’s board of nursing.

Complete an Accredited FNP Program

After acquiring and maintaining an active RN license in their state of residence, prospective FNPs must complete a master of science in nursing (MSN) program with a specialization in family nurse practitioner. To qualify for certification as an FNP, one must enroll in a program that has been accredited by the Commission on Collegiate Nursing Education (CCNE) or the Accreditation Commission for Education in Nursing (ACEN). FNP programs are available on campus, as well as online and in hybrid formats.

FNP programs are typically quite rigorous, and involve coursework in both advanced nursing topics and family medical care. Common courses for FNP programs include advanced health assessment, advanced pharmacology, and primary health care for the family. Whether they are on-campus or online, all accredited FNP programs require students to complete a certain number of clinical hours under the supervision of a preceptor (a medical professional who serves as a mentor).

Types of Family Nurse Practitioner Degree Programs

Several pathways exist for registered nurses who wish to become FNPs. The pathway one chooses depends on the level of education one has already obtained. Below are the four primary types of FNP programs currently available:

• BSN to MSN programs are for individuals who have already earned a BSN from a CCNE or ACEN-accredited program, and are comprised exclusively of masters-level courses.

• Bachelor’s to MSN programs enable RNs who hold a bachelor’s degree in a non-nursing field to earn their MSN without earning a second baccalaureate degree. This type of program is mainly comprised of masters-level classes, but may also include a few undergraduate-level bridge courses that help students transition to graduate coursework.

• RN to MSN programs are generally for RNs who have earned an associate degree in nursing (ADN) or a diploma in nursing from an accredited program, and who would like to earn their BSN and MSN together through one concentrated program. While some RN to MSN programs only accept applicants who hold an ADN, other programs accept both nursing diploma and ADN recipients. RN to MSN programs are comprised of both undergraduate and masters-level courses. For individuals choosing between an RN to MSN program and earning their BSN and MSN separately, an RN to MSN track may save time, as it allows students to take fewer classes to earn their two degrees.

• Post-MSN certificates are suitable for registered nurses who have already earned their MSN in a different specialization, and who would like to gain training and certification as an FNP.

• BSN to DNP programs are for individuals who hold a BSN, and who wish to earn their DNP without first earning an MSN through a separate program. These programs typically require students to complete a set of master’s-level courses covering the fundamentals of advanced practice nursing before they progress to doctorate-level courses.

• Post-MSN Doctor of Nursing Practice (DNP) programs are for individuals who have earned an MSN and would like to further advance their careers and potentially work towards a leadership role in nursing. Unlike post-MSN certificates, DNPs typically involve both masters-level and doctorate-level coursework. DNP programs also generally emphasize training students in health policy and influencing healthcare organizations through research, advocacy, and education.

For more information on the programs described above, including their admission requirements, typical curricula, and length of study, please see our online BSN to MSN, online Bachelor’s to MSN, online RN to MSN, and online post-MSN certificate pages. (On OnlineFNPPrograms.com, we do not currently have information on online DNP programs.)

Coursework for FNP Programs

Typical coursework for online FNP programs may include but are not limited to the following:

• Advanced Health Assessment: The essential skills for examining patients, taking medical histories, and gathering essential biological, cultural, psychological, and genetic information from patients. How to interpret different kinds of medical information in order to form an accurate and comprehensive understanding of patient health.

• Primary Health Care for the Family: The principles and practices central to caring for individuals across their lifespan. How to educate patients about certain health conditions and help them manage these conditions through medical treatment and lifestyle changes. This course often includes mandatory clinical hours through which students gain hands-on experience with patient health assessments, evaluations, diagnoses, interventions, and patient monitoring.

• Advanced Physiology and Pathophysiology: Human development across the lifespan and how human physiology changes at the molecular, cellular, tissue, organ, and organ systems levels. How certain health conditions impact the human body’s organ systems; different diseases and their relationship to genetics and environment.

• Biostatistics and Research for Healthcare Providers: The research methods that health care providers use to evaluate patient health. How to manage and analyze different types of quantitative (ex. statistical) data alongside qualitative information (ex. social, ethnographic, psychological research findings). How to use statistical concepts to understand medical research findings.

• Advanced Pharmacology: Different types of medicines and their use to treat various types of chronic and acute health conditions. Advanced concepts such as drug metabolism, drug-dose relationships, pharmacokinetics (how drugs move through the body) and pharmacodynamics (how certain medicines act on the human body).

• Health Care Ethics: Ethical principles in the medical workplace and how to apply them in a professional setting. Ethical issues and dilemmas that occur in medicine and how to handle them.

• Health Systems and Policy: How the health care system is organized, and how health policies affect this system. Crucial issues in health care policy, such as health care affordability and accessibility, patient rights, health care quality, and employee protection in the medical workplace.

• Crisis Health Care for the Family: How to provide health care and support for family members experiencing an emotional or physical crisis. Managing the psychological, physical, social, and ethical issues surrounding family crises. Key topics covered include proper bedside manner, compassionate yet professional care, and collaboration with other members of a healthcare team to support families and individuals experiencing hardship.

• Advanced Practice Nursing: Professional Concepts: The analytical, leadership, and educational skills required to be an advanced practice registered nurse (APRN). How to educate individuals and larger groups about topics in healthcare, and interpret research and clinical evidence. How to guide a team of healthcare providers (such as registered nurses, medical assistants, physician assistants, etc.) to adequately care for and support patients.

Obtain Certification Through the ANCC or the AANPCB

After completing an accredited MSN-FNP program, FNP candidates must typically take a certification exam provided by either the American Nurses Credentialing Center (ANCC) or the American Academy of Nurse Practitioners Certification Board (AANPCB). Both the ANCC and the AANPCB have examinations that are specific to family nurse practitioners, and both organizations have certain eligibility requirements that candidates must meet in order to take the exam.

To become FNP Board Certified (FNP-BC) by the ANCC

The ANCC’s Family NP examination has 200 questions that have been divided into three categories: Foundations for Advanced Practice, Professional Practice, and Independent Practice. Within these larger categories, candidates are tested on concepts such as developmental physiology, pathogenesis, pharmacotherapeutics, and advanced health/physical assessments across the lifespan. To qualify for this exam, individuals must:

• Have earned and maintained an active RN license in a state or territory of the United States, or hold an equivalent credential from another country
• Hold a master’s, doctoral, or post-graduate degree from a graduate nursing program that has been accredited by CCNE or ACEN
• Complete at least 500 hours of clinical practice under the supervision of a faculty member or preceptor
• Complete graduate-level coursework in advanced pharmacology, advanced health assessment, advanced physiology/pathophysiology, differential diagnoses, and health promotion and maintenance.

To become Nurse Practitioner – Certified (NP-C) by the AANPCB

The AANPCB’s Family Nurse Practitioner (FNP) examination is comprised of 150 questions, and “tests clinical knowledge in family/individual across the life span of prenatal, pediatric, adolescent, adult, elderly, and frail elderly primary care.” To qualify for this exam, individuals must:

• Have graduated from or will soon graduate from an accredited master’s degree, post-graduate certificate, or doctoral degree nursing program with a concentration in Adult, Family, or Adult-Gerontology Primary Care Nurse Practitioner (proof of enrollment and/or graduation is required in the form of transcript records).
• Complete a minimum of 500 clinical hours under faculty supervision
• Complete the following courses: advanced physical assessment, advanced pharmacology, and advanced pathophysiology
• Hold an active license as an RN in the United States or a Province/Territory of Canada

Once a prospective FNP has taken and passed either the ANCC’s or the AANPCB’s FNP certification examination, he or she is generally ready to apply for licensure as an FNP in his or her state of residence.

Apply for FNP/APRN State Licensure

After receiving certification from the ANCC or the AANPCB as a family nurse practitioner, FNP candidates must apply for a state license in advanced practice registered nursing. In general, APRN state licensure requirements include completing an accredited graduate program in nursing (MSN, DNP, or post-graduate certificate), gaining board certification through the ANCC or AANPCB, passing a background check, and completing a certain number of clinical hours. To apply for licensure as a nurse practitioner, one must submit the relevant application materials, proof of education and/or certification, and a fee to their state’s board of nursing.

While licensure requirements are similar across states, some states do have specific requirements that are different from those of other states. For example, both Florida and Texas require that NP licensure candidates earn a graduate degree in nursing from an accredited institution and obtain national certification through an accredited organization such as the ANCC or AANPCB. New York and California, however, may require national certification only in certain circumstances.

In California, individuals seeking NP licensure are required to either complete an accredited graduate nursing program in-state, or gain national certification through an organization that meets California’s Code of Regulations. Similarly, New York requires NP candidates to either complete a graduate nursing program that has been approved by the state or earn certification from a national certifying body. Please note that board certification through the ANCC or AANPCB requires the completion of an accredited graduate nursing program.

Due to these state-specific variations in licensure requirements, prospective FNPs should check with their state’s board of nursing before enrolling in an MSN program to ensure that the degree they earn will meet the necessary requirements for licensure in their state of residence. After obtaining licensure, FNPs must typically maintain their license by taking board-approved continuing education courses in advanced practice nursing.