Same length, same clock, different weight: ANCC tests the role far more, AACN tests the body systems.
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In 30 seconds
- 1Both AG-ACNP boards are 175 multiple-choice questions (150 scored) in 3.5 hours, and both certifications last 5 years.
- 2ANCC AGACNP-BC puts 33% of scored questions on the professional role. AACN ACNPC-AG puts 80% on clinical judgment by body system.
- 3Pick the blueprint that fits how you study, then confirm your state board and employer accept the credential you choose.
The two exams side by side
Every number below was read on the ANCC or AACN page on November 6, 2026. Links are in the sources at the end.
| ANCC AGACNP-BC | AACN ACNPC-AG | |
|---|---|---|
| Questions | 175 (150 scored, 25 pretest) | 175 (150 scored, 25 unscored) |
| Time | 3.5 hours | 3.5 hours |
| Blueprint | Core competencies 24%, clinical practice 43%, professional role 33% | Clinical judgment 80% (by body system), professional caring and ethical practice 20% |
| To pass | Scaled score of 350 or higher (maximum 500) | 101 of the 150 scored questions correct |
| Exam fee | $395; $295 ANA member; $340 AANP member | $385; $275 AACN member |
| First-time pass rate | 80% in 2025 (2,580 tested) | 74.23% in 2025 (1,199 tested) |
| Retest | After 60 days; up to 3 times in 12 months | Up to 4 attempts in a rolling 12 months; retest $320 ($215 member) |
| Clinical hours to sit | At least 500 faculty-supervised hours | At least 500 supervised hours, all in direct care of acutely ill adult-gerontology patients |
| Credential lasts | 5 years | 5 years |
The real difference is the blueprint
ANCC’s outline has three domains. Core competencies (24%) are advanced pathophysiology, pharmacology and physical assessment. Clinical practice (43%) is standards of care, risk stratification, diagnostics and treatment. Professional role (33%, 49 of the 150 scored questions) is scope, policy, quality and safety, research, patient education and relationships.
AACN weights the body systems instead. Cardiovascular alone is 15%, respiratory 11% and multisystem problems such as shock and sepsis 14%. Professional caring and ethical practice is 20%. The full breakdown is in what’s on each AG-ACNP exam.
So the practical question is where your study time goes. A student who is strong at the bedside but has never studied billing, research statistics or prescribing law has more to learn for ANCC. A student who knows the role well but is shaky on cardiac and pulmonary care has more to learn for AACN.
Try one of each
The first question is the kind both exams weight heavily. The second is a professional-role question, a third of ANCC.
A patient arrives at a hospital without a cath lab 2 hours after chest pain began. The ECG shows ST elevation in V1–V4. Transfer for PCI would take about 150 minutes from first contact. The patient has no bleeding risk factors. The best reperfusion plan is:
In a trial, 12% of patients on placebo and 8% of patients on a new drug died within a year. The number needed to treat to prevent one death is:
How to decide
- Check what you need it for. Boards of nursing use national certification as a requirement for APRN licensure, so confirm with your state board, and with any employer you are applying to, that they accept the credential you plan to take.
- Match the blueprint to your gaps. Weak on the role: the AACN weighting puts less on it. Weak on the systems: ANCC spreads the clinical questions across a smaller share.
- Check eligibility early. Both need at least 500 clinical hours. AACN wants every hour in direct care of acutely ill adult-gerontology patients in the U.S.; ANCC asks for three separate courses in advanced pathophysiology, health assessment and pharmacology.
- Don’t pick by pass rate alone. The two rates come from different groups of test takers. Why the rates differ.
Quick check · no scrolling back
Which exam puts about a third of its scored questions on the professional role?
Whichever you pick, the content overlaps: both cover the same acute care adult-gerontology patients. The free AG-ACNP library has 328 topics organized by body system plus the Professional Role domain, each with a verified cheat sheet.
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)
- ANCC 2025 certification data (first-time takers)
- AACN exam statistics and cut scores
- ANCC scores and retest policy
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 the difference between the ANCC and AACN AG-ACNP exams?
Both are 175 multiple-choice questions (150 scored) in 3.5 hours. ANCC AGACNP-BC puts 33% of scored questions on the professional role; AACN ACNPC-AG puts 80% on clinical judgment by body system and 20% on professional caring and ethical practice.
Which AG-ACNP exam has the higher pass rate?
For first-time takers, ANCC reported 80% for 2025 and AACN reported 74.23% for 2025. The groups who take each exam differ, so the rates do not show which exam is easier.
How much do the AG-ACNP exams cost?
ANCC: $395, or $295 for ANA members. AACN: $385, or $275 for AACN members (checked 2026-11-06).