100+ Free ENP-C Practice Questions

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A 50-year-old male with a history of alcoholism presents with a 2-day history of epigastric pain that radiates to his back. The pain is worse after eating. He also complains of nausea and vomiting. His serum lipase is elevated. What is the most likely diagnosis?

Pancreatitis

Cholecystitis

Peptic ulcer disease

Gastroesophageal reflux disease (GERD)

to track

2026 Statistics

Key Facts: ENP-C Exam

150

Total Questions

AANPCB

135

Scored Questions

AANPCB

3 hrs

Time Limit

AANPCB

500/800

Passing Scaled Score

AANPCB

$350

Non-Member Fee

AANPCB 2026

5 yrs

Certification Validity

AANPCB

ENP-C requires an active FNP-C or FNP-BC certification plus 2,000 hours of recent ED practice or completion of an academic emergency NP program. Once approved, candidates have 120 days to schedule the exam.

Sample ENP-C Practice Questions

Try these sample questions to test your ENP-C exam readiness. Each question includes a detailed explanation. Start the interactive quiz above for the full 100+ question experience with AI tutoring.

1A 45-year-old male presents to the emergency department with a chief complaint of chest pain. He describes the pain as a squeezing sensation that radiates to his left arm. He is diaphoretic and short of breath. What is the most appropriate initial action?

A.Administer nitroglycerin

B.Obtain a 12-lead ECG

C.Draw blood for cardiac enzymes

D.Administer aspirin

Explanation: The most appropriate initial action for a patient with suspected myocardial infarction is to obtain a 12-lead ECG. This will help to determine if the patient is experiencing an ST-elevation myocardial infarction (STEMI), which requires immediate reperfusion therapy. While the other actions are also important, the ECG is the most time-sensitive intervention.

2A 6-year-old child is brought to the emergency department with a 2-day history of fever, cough, and runny nose. The child is alert and playful, with a respiratory rate of 24 breaths/minute and an oxygen saturation of 98% on room air. According to the Emergency Severity Index (ESI), what is the most appropriate triage level for this child?

A.Level 1

B.Level 2

C.Level 3

D.Level 4

Explanation: This child is stable and does not require immediate life-saving interventions. The ESI level is determined by the number of resources the patient is expected to consume. A child with a simple viral illness is likely to require only one or two resources, such as a prescription or a single diagnostic test.

3A 65-year-old female with a history of hypertension presents with a sudden onset of tearing chest pain that radiates to her back. Her blood pressure is 220/120 mmHg in the right arm and 180/100 mmHg in the left arm. A chest X-ray reveals a widened mediastinum. What is the most likely diagnosis?

A.Myocardial infarction

B.Pulmonary embolism

C.Aortic dissection

D.Pericarditis

Explanation: The classic presentation of aortic dissection is the sudden onset of tearing chest pain that radiates to the back. A discrepancy in blood pressure between the arms and a widened mediastinum on chest X-ray are also highly suggestive of this diagnosis.

4A 2-year-old child is brought to the emergency department after ingesting an unknown amount of their grandmother's diltiazem. The child is lethargic, with a heart rate of 50 beats/minute and a blood pressure of 70/40 mmHg. What is the most appropriate initial treatment?

A.Atropine

B.Glucagon

C.Calcium gluconate

D.Naloxone

Explanation: Calcium channel blocker overdose can cause profound bradycardia and hypotension. Calcium gluconate is the first-line treatment, as it directly antagonizes the effects of calcium channel blockers at the cellular level.

5A 16-year-old female presents to the emergency department requesting treatment for a sexually transmitted infection. She asks that her parents not be informed. What is the most appropriate action for the nurse practitioner?

A.Refuse to treat the patient without parental consent.

B.Inform the parents of the patient's request.

C.Treat the patient without parental consent.

D.Contact child protective services.

Explanation: In most states, minors can consent to treatment for sexually transmitted infections without parental notification. The nurse practitioner should respect the patient's confidentiality and provide treatment.

6A 70-year-old male with a history of atrial fibrillation presents with the sudden onset of right-sided weakness and aphasia. His symptoms began 2 hours ago. A non-contrast head CT is negative for hemorrhage. What is the most appropriate next step in management?

A.Administer aspirin

B.Administer intravenous tissue plasminogen activator (tPA)

C.Perform a carotid endarterectomy

D.Observe the patient for 24 hours

Explanation: The patient is presenting with an acute ischemic stroke within the 3- to 4.5-hour window for thrombolytic therapy. A non-contrast head CT has ruled out hemorrhage, so the patient is a candidate for intravenous tPA.

7A 25-year-old female presents with a 1-day history of right lower quadrant abdominal pain, nausea, and vomiting. On physical examination, she has tenderness at McBurney's point. What is the most likely diagnosis?

A.Ovarian torsion

B.Ectopic pregnancy

C.Appendicitis

D.Diverticulitis

Explanation: The classic presentation of appendicitis is periumbilical pain that migrates to the right lower quadrant, nausea, vomiting, and tenderness at McBurney's point.

8A 5-year-old child is brought to the emergency department with a 3-day history of a barking cough and inspiratory stridor. The child is afebrile and has a steeple sign on neck X-ray. What is the most likely diagnosis?

A.Epiglottitis

B.Bacterial tracheitis

C.Croup

D.Foreign body aspiration

Explanation: Croup, or laryngotracheobronchitis, is a viral infection that causes inflammation of the upper airway. The classic presentation is a barking cough and inspiratory stridor. The steeple sign on neck X-ray is pathognomonic for croup.

9A 30-year-old female with a history of type 1 diabetes presents with nausea, vomiting, and abdominal pain. Her blood glucose is 450 mg/dL, and her arterial blood gas shows a pH of 7.25, a pCO2 of 25 mmHg, and a bicarbonate of 10 mEq/L. What is the most likely diagnosis?

A.Hyperosmolar hyperglycemic state (HHS)

B.Diabetic ketoacidosis (DKA)

C.Hypoglycemia

D.Lactic acidosis

Explanation: The patient is presenting with the classic signs and symptoms of DKA, including hyperglycemia, metabolic acidosis with an anion gap, and ketonemia. The anion gap is calculated as follows: (Na+) - [(Cl-) + (HCO3-)] = (140) - [(100) + (10)] = 30. A normal anion gap is 8-12 mEq/L.

10A 45-year-old male presents with a painful, swollen, and red great toe. He denies any recent trauma. Aspiration of the joint reveals needle-shaped, negatively birefringent crystals. What is the most likely diagnosis?

A.Septic arthritis

B.Gout

C.Pseudogout

D.Rheumatoid arthritis

Explanation: The classic presentation of gout is the sudden onset of a monoarticular arthritis, most commonly affecting the great toe (podagra). The diagnosis is confirmed by the presence of needle-shaped, negatively birefringent monosodium urate crystals in the synovial fluid.

About the ENP-C Exam

The Emergency Nurse Practitioner Certification (ENP-C) is awarded by the American Academy of Nurse Practitioners Certification Board (AANPCB). It is a competency-based credential for certified Family Nurse Practitioners who have additional specialty education and practice in emergency care. The exam contains 150 multiple-choice questions (135 scored, 15 pretest) delivered at Prometric testing centers.

Questions

150 scored questions

Time Limit

3 hours

Passing Score

Scaled 500/800

Exam Fee

$350 (AANPCB)

ENP-C Exam Content Outline

45%

Medical Screening

Triage, focused history and physical, point-of-care testing, ECG interpretation, imaging selection, and risk stratification across emergency presentations.

33%

Medical Management

Pharmacologic and procedural management of urgent and emergent conditions, including resuscitation, sedation, pain control, and stabilization.

12%

Patient Disposition

Discharge planning, admission criteria, transfer protocols (EMTALA), follow-up coordination, and patient education in the ED setting.

10%

Professional, Legal, and Ethical Issues

Scope of practice, EMTALA, informed consent, end-of-life care, mandatory reporting, and emergency department ethics.

How to Pass the ENP-C Exam

What You Need to Know

Passing score: Scaled 500/800
Exam length: 150 questions
Time limit: 3 hours
Exam fee: $350

Keys to Passing

Complete 500+ practice questions
Score 80%+ consistently before scheduling
Focus on highest-weighted sections
Use our AI tutor for tough concepts

ENP-C Study Tips from Top Performers

1Master high-acuity presentations: STEMI, sepsis, stroke, anaphylaxis, status epilepticus

2Know procedural sedation drugs and reversal agents cold

3Drill ECG interpretation: STEMI mimics, blocks, and dysrhythmias

4Review EMTALA requirements and transfer documentation

5Practice pediatric emergency management — appears throughout the exam

Frequently Asked Questions

How many questions are on the ENP-C exam?

The AANPCB ENP-C exam contains 150 multiple-choice questions: 135 scored items and 15 unscored pretest items. All items are single best-answer.

What is the time limit for the ENP-C exam?

Candidates have 3 hours (180 minutes) to complete the ENP-C exam at a Prometric test center.

What is the passing score for the ENP-C exam?

AANPCB uses a scaled scoring model. Candidates must achieve a scaled score of 500 out of 800 (cut equivalent of approximately 70%) to pass.

How much does the ENP-C exam cost?

The non-member application fee is $350. ANA, AAENP, and ENA members receive discounts ($200-$280 depending on association).

What are the ENP-C eligibility requirements?

Candidates must hold an active FNP-C or FNP-BC certification, plus either (1) completion of an academic emergency NP program, (2) an emergency NP fellowship, or (3) 2,000 hours of recent ED practice with 100 hours of emergency CE.