AG-ACNP High-Yield Topics: What to Know Cold

High-yield means two things: the systems the blueprint weights most, and the first decisions that come up in them.

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AG-ACNP libraryEvery board topic by body system, each with a verified cheat sheet.Open the library 10 free board-style questionsAnswer, then see why each option is right or wrong.Try them

In 30 seconds

1On AACN, cardiovascular, multisystem and respiratory are 40% of the exam together. On ANCC, the professional role alone is 33%.
2Below: 15 topics with one must-know fact each, from our verified fact sheets, with the source for each.
3Each topic opens its free cheat sheet. The library has 328 topics in all.

Cardiovascular (15% of AACN)

STEMI: Every patient with suspected ACS gets a 12-lead ECG within 10 minutes of first medical contact. The ECG, not the troponin, triggers reperfusion in STEMI.
Acute Decompensated Heart Failure: Treat significant fluid overload promptly with an IV loop diuretic: a total IV dose of 2.5 times the home oral dose diureses more than a 1-times dose; bolus and continuous infusion work equally.
Atrial Fibrillation: For stable rapid AF give a beta-blocker or diltiazem/verapamil (only if LVEF > 40%); aim for a resting rate under 100–110 bpm, guided by symptoms.

Shock, sepsis and multisystem (14% of AACN)

Sepsis & Septic Shock: Give IV antimicrobials immediately, ideally within 1 hour of recognition, for possible septic shock and for probable or definite sepsis; draw blood cultures first when this causes no meaningful delay.

Pulmonary (11% of AACN)

Acute Respiratory Distress Syndrome (ARDS): Ventilate every ARDS patient with low tidal volumes, starting at 6 mL/kg predicted body weight (range 4–8), and keep plateau pressure at or below 30 cmH₂O; this lowers mortality.
Pulmonary Embolism: Start anticoagulation as soon as PE is strongly suspected if bleeding risk is low. Do not wait for the CT.

Neurology (8% of AACN)

Acute Ischemic Stroke: Reperfusion windows run from last known well, not from discovery; a patient who wakes with deficits was last known well at bedtime.
Increased Intracranial Pressure & Herniation: Cerebral perfusion pressure = MAP − ICP. Below about 50 mmHg the brain becomes ischemic; keep CPP at least 60 mmHg in severe TBI.

Hematology, endocrine and renal

Heparin-Induced Thrombocytopenia (HIT): With an intermediate or high 4Ts score, stop every heparin source immediately (infusions, prophylactic doses, line flushes and LMWH) before test results return.
Diabetic Ketoacidosis (DKA): If K⁺ is < 3.5 mmol/L, hold insulin and give potassium until K⁺ > 3.5.
Hyperkalemia: With ECG changes give IV calcium gluconate; it stabilizes the myocardium within minutes, lasts only 20–30 minutes and lowers no potassium.
Hyponatremia: Chronic or unknown-duration hyponatremia: target a 4–8 mEq/L rise per 24 h, and never exceed 8 mEq/L in the first 24 h.

Professional role (33% of ANCC)

Informed Consent & Decision-Making Capacity: A patient has decision-making capacity when able to understand the information, appreciate how it applies to the patient’s own situation, reason about the options, and communicate a clear choice.
Research Statistics for Clinicians: PPV and NPV depend on prevalence: as prevalence falls, PPV falls and NPV rises. Sensitivity and specificity do not.

Psychosocial and cognitive

Delirium: CAM-ICU is positive with an acute change or fluctuating mental status plus inattention, plus either an altered level of consciousness (any RASS other than 0) or disorganized thinking.

Quick check · no scrolling back

Hyperkalemia with ECG changes: what does IV calcium do?

Sources

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 are the highest-weighted AG-ACNP topics?

On AACN, cardiovascular (15%), multisystem (14%) and respiratory (11%). On ANCC, the professional role is 33% of scored questions.