Boards/confidence - help!!

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Specializes in Emergency/med surg.

hello - I just graduated from a reputable MSN/FNP program. I am attempting to study for my AANP and its not going well - I feel SO stupid. like beyond new grad RN stupid. I am honestly just so overwhelmed with all the content.

I have been a nurse for 5 years now between med-surg and now in an ER- I feel fairly confident and competent most days - I can anticipate most of my patients/needs/orders/labs/imaging/meds - (yes I know primary care and ED are two different animals) and then I go to study and I read some things and am like holy crap -- why didn't I know this stuff before?? I am so embarrased that I do not even talk about being an NP with anyone- because I cannot even picture myself in the role. I just feel like if and when I even pass my boards -- get a job (ha, thats another issue) I am going to struggle - and assume all my patients have something horribly wrong with them (ED mentality) order a slew of tests they dont need -- or worse I will miss something huge and they will die on account of my incompetence. I felt this way when as I was studying for my NCLEX post BSN - I was anxious/depressed about it but then ended up passing in 75 questions under an hour -- I just don't forsee the same outcome for AANP - I have looked into some reviews but they are so expensive and not even held in person (COVID ugh) which is hard to focus - a lot of people in my program have passed and do the program prepped them well.

those who went RN-NP- did you feel the same way? Appreciate any and all thought and insights please! Thank you!!

I definitely felt like “why didn’t I know this stuff!” When I first started studying for FNP boards! Just keep studying and I feel like I’m a brand new nurse again too! But this is why I wanted this career change! So that I could provide healthcare in a new role and start all over again.

I think I can provide you with some advice. After nine weeks of intense studying, I received a preliminary pass on the AANP exam last week. Like you, I feared that I would be one of the few people to receive a fail (which is approximately 20% of test takers). However, now that I have been through the process of studying and actually sitting for the exam, I realize that the AANP exam is not overly difficult for the well-prepared person. It is certainly a comprehensive exam, so you cannot skip studying body systems/content that you find more challenging to learn and still expect to do okay (for me, that would have been musculoskeletal and nearly all of pediatrics). Nevertheless, a person who makes studying a priority and uses the right tools should expect to get a passing score. I was able to complete my test and review all of my answers with plenty of time left on the clock.

1. Create a study plan - I found this advice online and knew it would be important for me to follow. I can become rather aimless if I do not have concrete goals that I am trying to achieve. At the same time, I knew that I would never adhere to a plan that was too specific. My study plan involved determining the number of weeks I wanted to study (8-9 weeks) and the number of hours I would study per week (30 hours). I also set a test date so that I would not be tempted to draw out the process. I completed a live online review course offered by Fitzgerald, and not all of the content is covered during those ~17 hours, so I knew that I wanted to get through the remainder of the content at least once during the first 1-2 weeks. Besides making goals about how quickly I would finish reviewing my other main resource (Leik's FNP Certification Intensive Review, 3rd edition), I did not include much else in my study plan. I did document how many hours I studied each day and totaled them at the end of the week so that I could hold myself accountable. And to be honest, I did not reach my goal of 30 hours/week each week, but I believe I studied many more hours by having a goal than I would have had I not created one. All in all, I studied ~215 hours for this exam. 

2. Pay attention to any information that two or more resources seem to emphasize -- you'll probably see it on the exam.

3. If you have trouble remembering certain content (e.g., types of anemia, cardiac murmurs), make a note card on that content because you can carry your note cards with you wherever you go and review them when you have downtime. I purchased some 4x6 notecards for this purpose and am glad that I did. Repeatedly seeing the information helped me memorize it.

4. Remember that you're not simply trying to pass an exam -- you're trying to acquire as much knowledge as possible so that when you enter clinical practice, you will be able to meet the needs of your patients. Maybe it's just me, but keeping this in mind made studying kind of enjoyable.

5. Take practice exams. In addition to the practice exams that came with my Fitzgerald review course and the questions in the back of the Leik book, I purchased 5 exams from Exam Edge, 1 from PSI, and 1 from APEA. I began taking these practice tests about midway through my studying to gauge how prepared I was for the AANP exam. The PSI exam was the most expensive, but like others have said, it is most similar to the actual exam, so I am glad that I purchased it. However, the website states that your score on the exam is not indicative of how you will do on the test day, so I wanted to take at least one predictor exam offered by APEA. My scores on these two tests were 81% and 82%, respectively. I considered taking another PSI exam the day before my test date but decided not to because I knew that a bad score would wipe out my confidence.

6. Do not try to cram at the end. Cramming will not work for this exam because you will not really know the content. I probably studied 2-3 hours the day prior to my test date, and I really think anything more than that would have been pointless. It is more important that you focus on your mental wellbeing and getting ample rest.

7. Look at the exam blueprint. Currently, only 3% of the exam covers prenatal care but 21% is geriatrics. It is obviously more important to prioritize studying geriatric care than prenatal if your study time is limited.

8. Remember that the purpose of the test is to determine whether you have the knowledge and skills needed to be an entry-level provider. Can you recognize danger signs? Do you know when it is necessary to refer? What are the first-line pharmacotherapies for common primary care conditions? What populations are at highest risk for particular diseases?

Hope this helps.

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