200+ Free AOCNP Practice Questions

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2026 Statistics

Key Facts: AOCNP Exam

165

Questions

ONCC test plan

3 hours

Exam Time

ONCC

79%

2025 Initial Pass Rate

ONCC (254 of 322)

$300 / $420

Member / Nonmember Fee

ONCC 2026 manual

45%

Treatment Domain

Largest section

4 years

Certification Valid

ONCC policy

The AOCNP exam had a 79% initial-candidate pass rate in 2025. It consists of 165 multiple-choice questions over 3 hours and uses the current outline based on ONCC's role delineation study completed in 2022. The largest content area is Cancer Treatment and Supportive Care (45%).

Sample AOCNP Practice Questions

Try these sample questions to test your AOCNP exam readiness. Each question includes a detailed explanation. Start the interactive quiz above for the full 200+ question experience with AI tutoring.

1A 55-year-old male patient with a 30 pack-year smoking history asks about lung cancer screening. According to USPSTF guidelines, which screening recommendation is most appropriate?

A.Annual chest X-ray beginning at age 50

B.Annual low-dose CT (LDCT) for adults aged 50-80 with 20+ pack-year history

C.Annual sputum cytology and chest X-ray

D.Screening not recommended for any smoking history

Explanation: The USPSTF recommends annual screening for lung cancer with low-dose computed tomography (LDCT) in adults aged 50-80 who have a 20 pack-year smoking history and currently smoke or have quit within the past 15 years. Chest X-ray and sputum cytology are not recommended for lung cancer screening.

2A 45-year-old woman with a family history of breast cancer (mother diagnosed at age 42) asks about BRCA testing. What is the most appropriate initial action?

A.Order BRCA1/2 genetic testing immediately

B.Refer to genetic counseling for risk assessment

C.Recommend prophylactic mastectomy

D.Begin annual breast MRI at age 50

Explanation: Genetic counseling is the appropriate first step for patients with a family history suggestive of hereditary breast cancer. The genetic counselor will assess risk, discuss testing options, implications of results, and family planning considerations. Testing should not be ordered without informed consent and counseling.

3Which screening combination is recommended for average-risk adults aged 45-75 for colorectal cancer prevention?

A.Fecal occult blood testing every 5 years

B.Colonoscopy every 10 years OR FIT annually

C.CT colonography every 3 years

D.Flexible sigmoidoscopy every 5 years with annual FIT

Explanation: Multiple screening strategies are recommended for colorectal cancer: colonoscopy every 10 years, annual FIT (fecal immunochemical test), CT colonography every 5 years, or flexible sigmoidoscopy every 5 years (with or without annual FIT). The best test is the one that gets done.

4A 38-year-old woman presents with BRCA1 mutation. Which risk-reducing strategy has the strongest evidence for improving survival?

A.Tamoxifen chemoprevention

B.Risk-reducing bilateral salpingo-oophorectomy (RRSO)

C.Enhanced surveillance with breast MRI

D.Aromatase inhibitors

Explanation: Risk-reducing bilateral salpingo-oophorectomy (RRSO) in BRCA1/2 mutation carriers significantly reduces ovarian cancer risk and is associated with improved overall survival. It is recommended between ages 35-40 for BRCA1 and 40-45 for BRCA2, after completion of childbearing.

5Human papillomavirus (HPV) vaccination is recommended for cancer prevention in which population?

A.All females ages 9-26 only

B.All males and females ages 9-45

C.Only those with abnormal Pap smears

D.Adults over 50 with multiple partners

Explanation: HPV vaccination is recommended for all males and females ages 9-45 for prevention of HPV-related cancers including cervical, anal, oropharyngeal, vulvar, vaginal, and penile cancers. Catch-up vaccination is recommended for all persons through age 26, and shared decision-making for ages 27-45.

6A 50-year-old male with ulcerative colitis for 15 years asks about colon cancer surveillance. What is the recommended screening interval?

A.Every 10 years like average-risk patients

B.Every 1-2 years with random biopsies

C.Only if symptoms develop

D.Every 5 years beginning at age 50

Explanation: Patients with long-standing ulcerative colitis (≥8 years for pancolitis, ≥12-15 years for left-sided colitis) should undergo surveillance colonoscopy every 1-2 years with extensive random biopsies to detect dysplasia. This high-risk population has significantly increased colorectal cancer risk.

7Which factor is considered a high-risk criterion for Lynch syndrome (hereditary nonpolyposis colorectal cancer)?

A.First-degree relative with breast cancer at age 60

B.Colorectal cancer diagnosed before age 50 in two first-degree relatives

C.One second-degree relative with endometrial cancer

D.Personal history of 5-10 adenomatous polyps

Explanation: Lynch syndrome (HNPCC) Amsterdam II criteria include: 3+ relatives with Lynch-associated cancer (colorectal, endometrial, ovarian, gastric, etc.), 2+ successive generations affected, 1+ diagnosed before age 50, and exclusion of FAP. Early-onset colorectal cancer in multiple relatives is highly suggestive.

8A patient asks about aspirin for colorectal cancer prevention. Which statement is most accurate?

A.Aspirin is FDA-approved for colorectal cancer prevention in all adults

B.USPSTF recommends low-dose aspirin for CRC prevention in select high-risk adults aged 50-59

C.Aspirin has no effect on colorectal cancer risk

D.Only high-dose aspirin (325mg daily) shows chemopreventive benefit

Explanation: The USPSTF recommends initiating low-dose aspirin for primary prevention of cardiovascular disease and colorectal cancer in adults aged 50-59 with ≥10% 10-year CVD risk, who are not at increased bleeding risk, and have a life expectancy of ≥10 years. Decision should be individualized.

9A 30-year-old female smoker inquires about cervical cancer screening. When should cervical cancer screening begin?

A.Age 21 with cytology (Pap test) regardless of sexual history

B.Age 18 if sexually active

C.Age 25 with HPV testing

D.Within 3 years of first sexual activity

Explanation: Cervical cancer screening should begin at age 21 with cytology (Pap test) regardless of sexual history or HPV vaccination status. Screening before age 21 is not recommended due to low cancer incidence and high likelihood of transient HPV infections and associated harms from over-treatment.

10A woman with BRCA2 mutation at age 42 is considering risk-reducing bilateral mastectomy. What is the most appropriate counseling regarding benefits?

A.Guarantees 100% prevention of breast cancer

B.Reduces breast cancer risk by approximately 90% but does not eliminate all risk

C.Only recommended if MRI shows abnormalities

D.No proven benefit over enhanced surveillance

Explanation: Risk-reducing bilateral mastectomy reduces breast cancer risk by approximately 90% in BRCA mutation carriers but does not completely eliminate risk due to residual breast tissue. It is one of several risk management options that should be discussed including enhanced surveillance and risk-reducing medications.

About the AOCNP Exam

The AOCNP certification is for advanced practice registered nurses specializing in adult oncology. The exam tests knowledge across five domains: Cancer Continuum (28%), Cancer Treatment and Supportive Care (45%), Oncologic Emergencies (12%), Psychosocial Issues (10%), and Professional Practice (5%). Applicants must meet one of two ONCC pathways: an oncology-focused NP graduate pathway with 500 supervised adult-oncology NP hours, or an accepted population-focus NP pathway with 1,000 adult-oncology NP practice hours; both also require specified oncology education.

Questions

165 scored questions

Time Limit

3 hours

Passing Score

Scaled score of 55 (scale 25–75)

Exam Fee

$300 ONS/APHON member / $420 non-member (Oncology Nursing Certification Corporation (ONCC))

AOCNP Exam Content Outline

28%

Cancer Continuum

Screening and prevention, assessment and diagnosis, cancer staging, genetic counseling, and plan of care development

45%

Cancer Treatment and Supportive Care

Clinical trials, systemic therapy (chemotherapy, immunotherapy, targeted therapy), radiation therapy, surgical interventions, BMT/stem cell transplant, symptom management, and response assessment

12%

Oncologic Emergencies

Etiology, assessment, and interventions for SVC syndrome, spinal cord compression, tumor lysis syndrome, hypercalcemia, and neutropenic fever

10%

Psychosocial Issues

Psychosocial assessment tools, risk factors, sequelae of disease/treatment, comorbidities, caregiver support, survivorship, end-of-life care, and community resources

Professional Practice

Cultural competence, legal/regulatory issues, accreditation standards, ethics, APRN scope of practice, outcomes evaluation, quality improvement, and peer education

How to Pass the AOCNP Exam

What You Need to Know

Passing score: Scaled score of 55 (scale 25–75)
Exam length: 165 questions
Time limit: 3 hours
Exam fee: $300 ONS/APHON member / $420 non-member

Keys to Passing

Work through all 200 available questions
Review every answer and explanation
Track weak areas and revisit them
Use our AI tutor for tough concepts

AOCNP Study Tips from Top Performers

1Focus on the largest domain: Cancer Treatment and Supportive Care (45%)

2Know chemotherapy agents by generic names - ONCC only uses generic names

3Master oncologic emergency recognition and management protocols

4Understand clinical trial phases and patient eligibility criteria

5Review symptom management for common treatment side effects

6Study palliative care and end-of-life considerations

7Know APRN scope of practice regulations and prescribing laws

8Practice interpreting lab values in the context of oncology care

Frequently Asked Questions

What is the AOCNP exam format?

The AOCNP exam consists of 165 multiple-choice questions administered over 3 hours. Of those, 125 are scored and 40 are unscored pretest items. ONCC's current 2026 registration manual says the test content outline is based on a role delineation study completed in 2022.

What are the eligibility requirements for AOCNP?

Applicants need a current, active, unencumbered RN license and must meet one ONCC pathway. Pathway 1 uses an oncology-focused NP graduate degree plus 500 supervised adult-oncology NP hours; Pathway 2 uses an accepted population-focus NP graduate degree plus 1,000 adult-oncology NP practice hours. Both pathways also require a graduate oncology course of at least 2 credits or 30 oncology nursing CE hours within the 5-year lookback window.

What is the AOCNP pass rate?

ONCC's 2025 statistics report a 79% pass rate for initial AOCNP candidates: 254 passed of 322 who tested.

How long is AOCNP certification valid?

AOCNP certification is valid for 4 years. Renewal can be achieved through the Certification Renewal by Synergy (CRS) program, which requires professional development activities (points), practice hours, and an unrestricted license, OR by retaking and passing the examination.

What content is covered on the AOCNP exam?

The AOCNP exam covers five domains: Cancer Continuum (28%) - screening, diagnosis, staging, and planning; Cancer Treatment and Supportive Care (45%) - chemotherapy, immunotherapy, radiation, surgery, symptom management; Oncologic Emergencies (12%) - SVC syndrome, tumor lysis, neutropenic fever; Psychosocial Issues (10%) - mental health, caregiver support, survivorship; Professional Practice (5%) - ethics, legal, quality improvement.

How should I prepare for the AOCNP exam?

Preparation should include: 1) Reviewing the ONCC Test Content Outline and Role Delineation Study, 2) Using practice questions to identify knowledge gaps, 3) Studying oncology pharmacology (generic names only), 4) Reviewing oncologic emergency protocols, 5) Understanding APRN scope and legal issues in oncology, and 6) Completing at least 200+ practice questions with detailed rationales.