Adult-Gerontology Clinical Nurse Specialist Practice Test

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The ANCC Adult-Gerontology Clinical Nurse Specialist exam assesses the knowledge and skills that registered nurses must have in the adult-gerontology specialty.

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AGCNS Exam Eligibility

To be eligible for this exam, you must hold a current RN license in the US (or another country’s legally recognized equivalent). You must also meet the following requirements:

  • You must hold a master’s degree, post-graduate certificate, or Doctor of Nursing Practice (DNP)
  • You must have completed three separate graduate-level APRN Core courses

AGCNS Exam Outline

The ANCC Adult-Gerontology CNS exam contains 175 multiple-choice questions, 25 of which are unscored, and you will be given a time limit of 3.5 hours.

The exam is split into three content domains, which are designed to cover the various competencies and points of knowledge that a registered nurse in the adult-gerontology specialty should possess.

I. Assessment and Diagnosis (41 scored questions)

The questions in this domain assess your knowledge and skills pertaining to various assessments, theories, and diagnoses.

  • Diagnostic testing
  • Environmental determinants of health
  • Normal age-related changes
  • Abuse and neglect
  • Individual determinants of health
  • Nursing theories
  • Pathophysiology across the lifespan
  • Differential diagnoses
  • Comprehensive assessments
  • Problem-focused assessments
  • Ethical healthcare practice

II. Planning and Implementation (64 scored questions)

The questions in this domain assess your knowledge and skills pertaining to various interventions, roles, and initiatives.

  • Pharmacotherapeutics
  • Substance use disorders
  • Family and caregiver roles
  • Polypharmacy
  • Palliative and end-of-life care
  • Care transition and coordination
  • Change management
  • Educational initiatives
  • Adult learning theories
  • Information technology
  • Pharmacologic interventions
  • Nursing and healthcare advocacy
  • Non-pharmacologic interventions
  • Coordination of nursing and healthcare resources
  • Health promotion
  • Evidence-based practice process
  • Complementary and alternative therapies
  • Patient, family, and caregiver education, coaching, and advocacy

III. Evaluation (45 scored questions)

The questions in this domain assess your knowledge and skills pertaining to various outcomes, responses to interventions, and improvements.

  • Scope and standards of healthcare practice
  • Patient outcomes
  • System outcomes
  • Research methodology and statistical analysis
  • Quality and process improvement
  • Regulatory compliance
  • Healthcare business and finance
  • Patient response to interventions
  • Family and caregiver response to interventions
  • Care plan modification
  • Organization and systems leadership
  • Developing and collaborating with interdisciplinary team members

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AGCNS Exam Registration

Registering for and scheduling your Adult-Gerontology CNS exam can be done online. The cost of the examination is $395 for all candidates who are not ANCC members. Active ANCC members will only have to pay $295 to register for the exam.

Once you have registered, you will receive information on how to schedule your examination appointment.

Test Day

You should arrive at the testing center about 30 minutes before the exam is scheduled to begin to leave you with extra time to complete the check-in process. When you arrive, you will be asked to provide two forms of identification, one of which must contain your photo and signature. If your ID is invalid, you will not be permitted to take the examination.

Personal items are not allowed in the testing area, so you will be asked to leave them in a secured locker before the exam begins.

Once the check-in process is complete, you will be led to your testing station and given a short tutorial on the testing system before beginning your exam.

How the AGCNS Exam is Scored

The scores for the ANCC Adult-Gerontology CNS exam are calculated using a criterion-based scoring system. This means that a panel of ANCC subject-matter experts has evaluated the questions and determined a passing score. The passing score is set using the modified-Angoff method, which means that your score is based solely on your performance, without any input from the performance of other test-takers.

Your score is reported on a scale of 1 to 500, and you must get a score of at least 350 to pass the exam.

You will be able to see your preliminary scores as soon as you complete the exam, and your final score report will be made available via your ANCC account.

Retaking the AGCNS Exam

If you fail the exam, you may retake it after a 60-day waiting period. After the waiting period, you must resubmit an application and the retest fee of $270.

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How many questions are on the Adult-Gerontology CNS exam?


There are 175 multiple-choice questions on the exam.


How long is the Adult-Gerontology CNS exam?


The time limit for the exam is 3.5 hours.


What is the passing score for the Adult-Gerontology CNS exam?


To pass the exam, you must achieve a scaled score of at least 350.


How much does the Adult-Gerontology CNS exam cost?


The examination fee is $295 for ANCC members and $395 for non-members.

By Kate Nockunas

Kate has been Mometrix’s Nursing and Medical Editor for over four years. She has a bachelor’s degree in Communications from Vanderbilt University, a bachelor’s degree in Nursing from Marymount University, and a master’s degree in Education from Johns Hopkins. Kate is a critical care registered nurse who still works occasionally in the ICU and PACU.


by Mometrix Test Preparation | This Page Last Updated: January 2, 2024