Emergency Nurse Practitioner (ENP)

The ENP certification examination is a competency-based examination for certified Family Nurse Practitioners with specialty education and practice in emergency care.

How many questions are on the examination?

There are 150 questions on each examination. A candidate's score is based solely on the 135 scored questions. Of the 150 questions, 15 are pretest questions.
Pretest questions are used on the examinations to obtain statistical information for determining how well they perform prior to vetting them for use on the scored portion of the examination. The pretest questions cannot be distinguished from those that are scored. A test-taker’s score on pretest questions does not affect a candidate's final score.

2023 ENP EXAMINATION BLUEPRINT

DOMAIN I - *Domains*	% of ENP exam	# of scored items (135 items)	# of pretest items (15 items)
01 - Medical Screening	16%	21	2
02 - Medical Decision Making/ Differential Diagnosis	24%	33	4
03 - Patient Management	36%	48	6
04 - Transitions of Care	16%	22	2
05 -Professional Practices	8%	11	1
TOTAL	100%	135	15

PATIENT CONDITIONS/TYPE

DOMAIN II - *Patient Conditions*	% of ENP exam	# of scored items (135 items)
Thoracic-Respiratory Disorders	10%	14
Cardiovascular Disorders	11%	15
Cutaneous Disorders	6%	7
Abdominal & Gastrointestinal Disorders	13%	17
Musculoskeletal Disorders (Non-traumatic)	7%	10
Renal/Genitourinary Disorders	7%	9
Neurological Disorders	6%	8
Ear, Eye, Nose, Oral/Dental & Throat Disorders	8%	11
Traumatic Disorders	8%	11
Psychobehavioral Disorders	6%	8
Obstetrics and Gynecology	5%	7
Environmental and Toxicological Disorders	3%	4
Systemic Infections and Hematologic and Immune System Disorders	5%	7
Endocrine, Metabolic, and Nutritional Disorders	5%	7
TOTAL	100%	135

DOMAINS AND TASKS

DOMAIN 01 - Medical Screening

Perform a focused history and physical exam based on chief complaint
Establish patient acuity level to determine need for rapid intervention

DOMAIN 02 - Medical Decision Making/ Differential Diagnosis

Identify differential diagnoses based on the greatest likelihood of occurrence
Prioritize differential diagnoses, considering risk of morbidity or mortality
Evaluate diagnostic studies based on the differential diagnoses

DOMAIN 03 - Patient Management

Rapidly intervene to resuscitate/stabilize patient
Prescribe appropriate pharmacologic agents
Initiate non-pharmacologic therapeutic interventions
Perform diagnostic and therapeutic procedures/skills
Consult with other healthcare providers to optimize patient management
Re-evaluate for changes in patient condition
Prioritize and manage multiple patients of varying acuity simultaneously

DOMAIN 04 - Transitions of Care

Determine appropriate and timely patient disposition including admission, discharge, observation, or transfer as appropriate
Formulate a specific disposition plan with appropriate resource utilization
Engage patient and/or caregiver to effectively coordinate transitions of care

DOMAIN 05 - Professional Practices

Integrate diverse, equitable, and inclusive practices into patient management
Manage unique needs of vulnerable populations
Demonstrate knowledge of EMTALA regulations
Adhere to professional, ethical, quality, safety, and regulatory/legal standards in emergency care

ENP Knowledge Areas

Anatomy, physiology, and pathophysiology
Medical screening examination
Focused health history and physical
Differential diagnosis/Medical decision making
Diagnostic studies (e.g., EKG, radiology, body fluid)
Diagnostic/therapeutic procedures
Pharmacological therapies
Integrative therapies
Consultation and collaboration
Patient and family education and counseling
Resource utilization
Documentation (e.g., coding, billing)
Professional, ethical, quality, and regulatory/legal issues
Pre-hospital and EMS
Health equity
Vulnerable populations
Principles of epidemiology, population health, and social determinants of health
Safety and harm reduction
Disaster and mass casualty management
Resuscitation and stabilization
Prioritization
Disposition
Forensics

ENP Procedures

Airway Techniques

Intubation
Mechanical ventilation
Airway adjuncts
Non-invasive ventilatory management
Surgical airway
Ventilatory monitoring

Resuscitation

Cardiopulmonary resuscitation
Arterial catheter insertion
Neonatal resuscitation
Central venous access
Pediatric resuscitation
Intraosseous infusion
Post-resuscitative care
Defibrillation
Blood, fluid, and component therapy

Anesthesia and Acute Pain Management

Local anesthesia
Procedural sedation and analgesia
Regional nerve block

Abdominal and Gastrointestinal Diagnostic and Therapeutic Procedures

Anoscopy
Gastrostomy tube replacement
Excision of thrombosed hemorrhoid
Paracentesis
Esophageal/gastric balloon tamponade (e.g., Minnesota/Blakemore/Linton tube)

Cardiovascular and Thoracic

Cardiac pacing
Pericardiocentesis
Cardioversion
Thoracentesis
ECG interpretation
Needle/Tube thoracostomy

Cutaneous

Escharotomy
Trephination, subungual
Incision and drainage
Wound closure techniques

Head, Ear, Eye, Nose, and Throat

Control of epistaxis
Tonometry
Drainage of peritonsillar abscess
Tooth stabilization
Laryngoscopy
Corneal foreign body removal
Lateral canthotomy
Drainage of hematoma (auricular, septal)
Slit lamp examination

Musculoskeletal

Arthrocentesis
Fracture/Dislocation reduction techniques
Compartment pressure measurement
Spine immobilization techniques
Fracture/Dislocation immobilization techniques
Fasciotomy

Nervous System

Lumbar puncture

Obstetrics and Gynecology

Pelvic examination
Sexual assault examination
Precipitous delivery (including complications)
Bartholin cyst incision and drainage
Perimortem c-section

Psychobehavioral

Violent patient management/Restraint
Psychiatric screening examination/medical stabilization

Renal and Urogenital

Suprapubic catheter
Testicular detorsion

Other Diagnostic and Therapeutic Procedures

Foreign body removal
Point of care ultrasound
Collection and handling of forensic material
Interpretation of diagnostic imaging (e.g., ultrasound, MRI, CT, radiographs)