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Nursing students have regularly experienced high levels of clinical testing anxiety. Previous research, conducted in face-to-face nursing programs, revealed high-stakes clinical testing, particularly the Objective Structured Clinical Examination (OSCE), was consistently rated as the most anxiety producing component within nursing education. A gap in the literature was present regarding the feelings, attitudes, and beliefs of online education advanced practice nursing students related to perceived anxiety during the OSCE process. Additionally, past researchers recommended studying anxiety management strategies related to the OSCE. This basic qualitative study was designed to answer the following research question: How do advanced practice nursing students describe their experience of anxiety related to OSCE high-stakes testing in an online education program? Boud and Walker's experiential learning theory served as the theoretical framework. Through purposive sampling, eleven students enrolled in an online advanced practice program at an academic health sciences center in the Southwestern United States participated in the study. Semi structured interviews were conducted and data was analyzed using the constant comparative method. Four themes emerged and included (a) personal experience of anxiety, (b) factors contributing to anxiety, (c) student-led strategies to minimize anxiety, and (d) faculty-directed strategies to decrease anxiety. Decreasing anxiety in students during high-stakes clinical testing is one of many methods to assist in improving overall learning and transfer of skills into clinical practice. Nursing faculty must recognize the experience of anxiety in high-stakes clinical testing is unique to each student, and students need guidance in understanding and managing their anxiety in a meaningful way. Future research on this topic can provide added insight for nursing faculty and nursing programs in designing the OSCE to decrease anxiety while simultaneously preparing students to manage and cope with their own anxiety. [The dissertation citations contained here are published with the permission of ProQuest LLC. Further reproduction is prohibited without permission. Copies of dissertations may be obtained by Telephone (800) 1-800-521-0600. Web page: http://www.proquest.com/en-US/products/dissertations/individuals.shtml.]