Adult-Gerontology Acute Care

Adult-Gerontologyacutecarenpcertification:Anccandaacn

Two national bodies certify adult-gerontology acute care nurse practitioners, and both credentials are accepted for APRN licensure. The American Nurses Credentialing Center (ANCC) awards the AGACNP-BC, and the American Association of Critical-Care Nurses (AACN) Certification Corporation awards the ACNPC-AG. Both exams are computer-based, entry-level competency exams with 175 multiple-choice questions, 150 of them scored, and both allow 3.5 hours. They differ in how the content is organized, where you test, and how renewal works. This guide covers the content of both.

The Two Exams Side by Side

Anccagacnp-Bcandaacnacnpc-Agcompared

Feature	ANCC AGACNP-BC	AACN ACNPC-AG
Questions	175(150scored 25unscoredpretest) ,	175(150scored 25unscored) ,
Time	35hours .	35hours .
Itemtype	Computer-based selected -response questions ,	Four-option multiple choice in a linear format;
		itemscanbemarked skipped andrevisited , ,
Contentframework	Threedomains:CoreCompetencies Clinical ,	ClinicalJudgmentbybodysystem(about80%)
	Practice ProfessionalRole ,	andProfessionalCaringandEthicalPractice
		(about20%) basedontheAACNSynergyModel ,
Scoring	Scaledscore;350ona0–500scaleisrequiredto	Pass/fail against a criterion-referenced passing
	pass	standard
Testingvendor	Prometrictestcenters	PSItestcenters
Fee	$395nonmember;$295ANAmember;$340	$385nonmember;$275AACNmember
	AANPorGAPNAmember
Renewal	Every5years:continuingeducation(including	Every5years:practicehoursplusCEpoints ,
	pharmacotherapeutics)pluspracticehoursor	practicehoursplusexamandpharmacologyCE ,
	otherprofessionaldevelopmentcategories or ,	orCEpointsplusexam
	reexamination
Retakes	After60daysfromthelasttestdate;nomorethan	PermittedaccordingtotheAACNexamhandbook;
	3 attempts in any 12 -month period	anewapplicationandfeearerequired

Both exams test the same body of knowledge: managing acutely and critically ill adults and older adults across the acute care continuum. Choose the exam by logistics (vendor, fee, renewal pathway) and by which content framework matches how you study; the clinical knowledge required is the same.

The ANCC Test Content Outline

The ANCC exam is built on three domains. Clinical Practice is the largest, so management of acute conditions, diagnostics, procedures, and pharmacology deserve the most study time. The Professional Role domain is larger than many candidates expect: one question in three addresses scope of practice, policy, quality and safety, research, education, or relationships.

Clinical Practice

43%

Standards of care, assessment tools, risk stratification, diagnostics and procedures, interventions, health promotion

Professional Role Scope and standards, policy and advocacy, quality and safety, research, education,

33%

relationships

Core Competencies

24%

Advanced pathophysiology, advanced pharmacology, advanced physical assessment

Domain	ScoredItems	KnowledgeandSkillAreas
I CoreCompetencies .	36(24%)	Knowledge:advancedpathophysiology;advancedpharmacology Skill:advanced .
		physicalassessment
II ClinicalPractice .	65(43%)	Knowledge: standards of care and evidence-based principles; standardized
		assessmenttools;psychosocialfactors includingculturalandspiritual ,
		considerations; cost-effective care; health promotion and disease prevention Skills: .
		riskstratification;diagnostictestingandprocedures;nonpharmacologicand
		pharmacologicinterventions
III ProfessionalRole .	49(33%)	Knowledge:scopeandstandardsofpractice;healthcarepolicyandadvocacy;
		quality and safety improvement processes Skills: research and evidence-based .
		application;patienteducationandhealthliteracy;relationshipdevelopmentwith
		patients families andmultidisciplinaryteams , ,

The AACN Test Plan

The AACN exam organizes about 80% of its content as Clinical Judgment by body system and patient problem, and about 20% as Professional Caring and Ethical Practice. The clinical portion gives the most weight to cardiovascular, respiratory, and multisystem problems (sepsis, shock, multiorgan dysfunction, toxicology), followed by neurology and the remaining systems. The professional portion maps to the Synergy Model nurse competencies.

Cardiovascular · Respiratory · Multisystem · Neurology ·

Advocacy and moral agency · Caring practices · Response to

Hematology, Immunology, and Oncology · Endocrine ·

diversity · Facilitation of learning · Collaboration · Systems

Genitourinary and Renal · Gastrointestinal · Musculoskeletal ·

thinking · Clinical inquiry

Integumentary · Cognitive, Behavioral, and Psychosocial · Factors influencing health status

Section 1 and Section 2 of this guide cover the AACN Clinical Judgment content system by system, and Section 3 covers the Synergy Model competencies. If you are taking the AACN exam, give extra time to cardiovascular, pulmonary, and multisystem topics such as sepsis, shock, and ARDS.

Question Style and Scoring

Most questions are clinical scenarios about hospitalized or emergency patients, often older adults with several comorbidities. They ask for the most likely diagnosis, the most appropriate next step, the best initial therapy, a dose adjustment, the interpretation of a laboratory or hemodynamic result, or the priority action. Professional role questions are also scenario based: a quality project that needs a balancing measure, a patient who lacks decision-making capacity, a billing or scope-of-practice situation, or a conflict within the team. The 25 unscored pretest items are mixed in and cannot be identified, so treat every question as scored. There is no penalty for guessing; answer every item.

Eligibility and Registration

Requirement	Details
Licensure	Acurrent active unencumberedRNlicenseinaUS stateorterritory(orthelegallyrecognized , , . .
	equivalent)
Education	A master's postgraduate certificate or DNP from an accredited adult-gerontology acute care NP , ,
	program
Clinicalhours	ANCC requires a minimum of 500 faculty-supervised clinical hours in the AGACNP role and population
Corecourses	Graduatecoursesinadvancedphysiologyandpathophysiology advancedhealthassessment and , ,
	advancedpharmacology pluscontentinhealthpromotionanddifferentialdiagnosisanddisease ,
	management
Scheduling	Applytothecertifyingbody;afterapproval schedulewithPrometric(ANCC)orPSI(AACN)withinthe ,
	authorizationwindow
Credential	AGACNP-BC(ANCC)orACNPC-AG(AACN);bothareacceptedforAPRNlicensureandalignwiththe
	APRNConsensusModel