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- 1ANCC: core competencies 24%, clinical practice 43%, professional role 33% (outline effective March 17, 2025).
- 2AACN: clinical judgment 80% by body system, led by cardiovascular 15%, multisystem 14% and respiratory 11%; professional caring and ethical practice 20%.
- 3Each topic below links to its free cheat sheet in the AG-ACNP library.
ANCC AGACNP-BC: three domains
ANCC’s Test Content Outline gives the number of scored questions in each domain (out of 150).
| Domain | Questions | Share | What it covers |
|---|---|---|---|
| Core Competencies | 36 | 24% | Advanced pathophysiology; Advanced pharmacology; Advanced physical assessment |
| Clinical Practice | 65 | 43% | Standards of care and evidence-based principles; Advanced standardized assessment tools; Psychosocial factors (emotional, cultural, spiritual, social determinants); Cost-effective care; Health promotion and disease prevention; Risk stratification; Diagnostic testing and procedures; Nonpharmacologic and pharmacologic treatments and procedures |
| Professional Role | 49 | 33% | Scope and standards of practice; Health care policy and advocacy; Quality and safety improvement; Research and evidence-based practice; Patient education and health literacy; Relationship development with patients, families and teams |
ANCC also writes questions across body systems, drug classes and age groups (adolescent, young adult, adult, older adult and frail elderly), as secondary classifications. So a professional-role question still sits in a clinical situation: a capacity question about a patient refusing dialysis, or a prescribing question at discharge.
A patient with acute kidney injury and fluid overload refuses dialysis. The patient explains the risks, including death, how they apply to the patient’s own situation, and why the burden is unacceptable. The family wants dialysis started. The nurse practitioner should:
AACN ACNPC-AG: body systems plus professional practice
AACN’s test plan applies to exams taken on and after January 10, 2022. Percentages are as AACN publishes them.
| Clinical judgment | Share | Study it in |
|---|---|---|
| Cardiovascular | 15% | Cardiovascular |
| Respiratory | 11% | Pulmonary |
| Multisystem | 14% | Shock, Sepsis & Multisystem |
| Neurology | 8% | Neurology |
| Hematology / Immunology / Oncology | 6% | Hematology, Oncology & Immunology |
| Endocrine | 5% | Endocrine |
| Renal / Genitourinary | 5% | Renal, Fluids, Electrolytes & Acid-Base |
| Factors influencing health status | 5% | Gerontology, Palliative Care & Prevention |
| Gastrointestinal | 3% | Gastrointestinal & Hepatic |
| Musculoskeletal | 3% | Musculoskeletal, Skin & HEENT |
| Psychosocial / Behavioral / Cognitive Health | 3% | Psychosocial, Behavioral & Cognitive |
| Integumentary | 1% | Musculoskeletal, Skin & HEENT |
| Professional caring & ethical practice | Share |
|---|---|
| Advocacy / Moral Agency | 3% |
| Caring Practices | 3% |
| Response to Diversity | 3% |
| Facilitation of Learning | 1% |
| Collaboration | 3% |
| Systems Thinking | 3% |
| Clinical Inquiry | 3% |
Where the weight sits, topic by topic
The biggest AACN systems map to library domains you can study straight away:
- Cardiovascular (15%): STEMI, Acute Decompensated Heart Failure, Atrial Fibrillation.
- Multisystem (14%): Sepsis & Septic Shock, Shock: Classification & Hemodynamics, Vasopressors & Inotropes.
- Respiratory (11%): Acute Respiratory Distress Syndrome (ARDS), Acute Respiratory Failure, Pulmonary Embolism.
- Neurology (8%): Acute Ischemic Stroke, Increased Intracranial Pressure & Herniation, Status Epilepticus.
For ANCC, the 33% role domain is its own library subject: Professional Role, with topics such as APRN Consensus Model & AGACNP Scope, Prescriptive Authority & Controlled Substances, Billing, Coding & Reimbursement and Research Statistics for Clinicians.
A patient with pneumonia has a MAP of 58 mmHg and a lactate of 4.1 mmol/L after 30 mL/kg of balanced crystalloid. Only a peripheral IV is in place. The nurse practitioner should:
Quick check · no scrolling back
On the AACN ACNPC-AG exam, which system carries the largest share?
Sources
- ANCC, Adult-Gerontology Acute Care NP certification (AGACNP-BC), checked November 6, 2026
- ANCC, AGACNP Test Content Outline, effective March 17, 2025
- ANCC, General Testing and Renewal Handbook (scoring)
- AACN, ACNPC-AG certification page, checked November 6, 2026
- AACN, ACNPC-AG Exam Handbook, July 2026 (test plan for exams on and after January 10, 2022)
AGACNP-BC is a credential of the American Nurses Credentialing Center (ANCC). ACNPC-AG is a credential of AACN Certification Corporation. NurseSavvy is not affiliated with or endorsed by ANCC, AACN or any prep company named here.
Common questions
What is on the ANCC AGACNP-BC exam?
Three domains: Core Competencies 24% (36 questions), Clinical Practice 43% (65 questions), Professional Role 33% (49 questions), per the outline effective March 17, 2025.
What is on the AACN ACNPC-AG exam?
Clinical judgment is 80%, by body system: cardiovascular 15%, multisystem 14%, respiratory 11% and smaller shares for the rest. Professional caring and ethical practice is 20%.