100+ Free CONO Clinical Sciences Practice Questions

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2026 Statistics

Key Facts: CONO Clinical Sciences Exam

200

Total Questions

CONO Examination Handbook

Modified Angoff

Passing Standard

CONO Exam Guidelines

4 Hours

Time Limit

CONO Exam Guidelines

$850

Exam Fee (CAD)

CONO Fee Schedule

Active

2026 Status

CONO Exams

The CONO Ontario Clinical Sciences Examination consists of 200 multiple-choice questions with a 4-hour time limit. It is a mandatory computer-based exam for registration as a Naturopathic Doctor in Ontario, with a passing score determined by the Modified Angoff method.

Sample CONO Clinical Sciences Practice Questions

Try these sample questions to test your CONO Clinical Sciences exam readiness. Each question includes a detailed explanation. Start the interactive quiz above for the full 100+ question experience with AI tutoring.

1A 28-year-old female presents with fatigue and heavy menses. Her laboratory results show a hemoglobin of 102 g/L (reference range: 120-160 g/L), MCV of 72 fL (reference range: 80-100 fL), serum ferritin of 8 ug/L (reference range: 15-150 ug/L), and total iron-binding capacity (TIBC) of 480 ug/dL (reference range: 250-450 ug/dL). Which of the following is the most likely diagnosis?

A.Iron deficiency anemia

B.Anemia of chronic disease

C.Thalassemia minor

D.Sideroblastic anemia

Explanation: Iron deficiency anemia is characterized by microcytic hypochromic anemia with low serum ferritin and elevated TIBC (reflecting increased transferrin levels). Heavy menses is a common etiology of iron depletion in women of reproductive age. Ferritin is the most sensitive and specific marker for diagnosing iron deficiency.

2During a physical examination, a patient is asked to stand with feet close together and eyes open, then close their eyes. The patient stands steadily with eyes open but sways and loses balance immediately upon closing their eyes. What does this positive Romberg's test primarily indicate?

A.Cerebellar ataxia

B.Sensory ataxia from dorsal column dysfunction

C.Vestibular dysfunction only

D.Upper motor neuron lesion

Explanation: A positive Romberg's test occurs when balance is maintained with eyes open but lost with eyes closed, indicating a loss of proprioception (sensory ataxia) mediated by the dorsal columns. This demonstrates that the patient is relying on visual cues to maintain balance due to compromised sensory input. Causes include vitamin B12 deficiency (subacute combined degeneration) and tabes dorsalis.

3A 22-year-old soccer player presents with acute knee pain after twisting their knee during a match. During the physical exam, the practitioner flexes the patient's knee, applies valgus stress, externally rotates the tibia, and gradually extends the knee, which elicits a painful click. Which anatomical structure is most likely injured?

A.Anterior cruciate ligament (ACL)

B.Medial meniscus

C.Lateral collateral ligament (LCL)

D.Patellar tendon

Explanation: The McMurray test described (valgus stress, external rotation, and extension) is designed to evaluate the medial meniscus. A painful click or snap indicates a tear in the posterior horn of the medial meniscus. Meniscal tears are common injuries resulting from rotational force applied to a weight-bearing knee joint.

4A 55-year-old patient with a history of long-standing diabetes mellitus presents with sudden onset diplopia. Examination of the right eye reveals ptosis, a pupil that is dilated and non-reactive to light, and the eye positioned 'down and out'. Which cranial nerve is most likely compromised?

A.Cranial Nerve II (Optic)

B.Cranial Nerve III (Oculomotor)

C.Cranial Nerve IV (Trochlear)

D.Cranial Nerve VI (Abducens)

Explanation: A complete Cranial Nerve III (oculomotor) palsy presents with ptosis (due to levator palpebrae superioris weakness), a dilated pupil (loss of parasympathetic pupilloconstrictor fibers), and a 'down and out' eye position (unopposed action of superior oblique and lateral rectus). In diabetic patients, this is often microvascular in origin, although a dilated pupil can also indicate compressive aneurysm of the posterior communicating artery.

5A 45-year-old male presents with dyspnea on exertion and fatigue. On auscultation, a low-pitched, rumbling diastolic murmur is heard at the apex of the heart, preceded by an opening snap. The patient has a history of untreated streptococcal pharyngitis in childhood. What is the most likely diagnosis?

A.Aortic stenosis

B.Mitral regurgitation

C.Mitral stenosis

D.Aortic regurgitation

Explanation: A low-pitched diastolic rumbling murmur heard at the apex, preceded by an opening snap, is pathognomonic for mitral stenosis. Rheumatic fever resulting from childhood streptococcal infection is the leading cause of mitral valve stenosis. The murmur is best heard in the left lateral decubitus position with the bell of the stethoscope.

6A 35-year-old office worker presents with pain and paresthesia in the palmar aspect of the thumb, index, and middle fingers, which worsens at night. The practitioner performs a physical test by having the patient hold their wrists in complete flexion for 60 seconds. This maneuver reproduces the patient's symptoms. What is this test called and what condition does it assess?

A.Tinel's sign; Cubital tunnel syndrome

B.Phalen's maneuver; Carpal tunnel syndrome

C.Finkelstein's test; De Quervain's tenosynovitis

D.Adson's test; Thoracic outlet syndrome

Explanation: Phalen's maneuver involves holding the wrists in maximal flexion for 60 seconds to compress the median nerve within the carpal tunnel. Reproduction of tingling or pain in the median nerve distribution (thumb, index, middle, and radial half of ring finger) indicates a positive test for carpal tunnel syndrome. This condition is caused by compression of the median nerve as it travels under the flexor retinaculum.

7A 34-year-old female presents with fatigue, unexplained weight gain, and dry skin. A thyroid panel is ordered. The results reveal a TSH of 9.2 mIU/L (reference range: 0.4-4.0 mIU/L) and a free T4 of 0.6 ng/dL (reference range: 0.8-1.8 ng/dL). How should these laboratory findings be interpreted?

A.Primary hypothyroidism

B.Subclinical hypothyroidism

C.Secondary hypothyroidism

D.Non-thyroidal illness syndrome

Explanation: Primary hypothyroidism is defined by an elevated TSH and a decreased free thyroid hormone level (free T4). In this condition, the thyroid gland itself fails to produce sufficient hormone, causing the pituitary gland to secrete high amounts of TSH to compensate. Hashimoto's thyroiditis is the primary cause, which can be confirmed by testing for anti-TPO antibodies.

8A 48-year-old male with a history of alcohol abuse presents with abdominal pain and yellowing of the skin. Laboratory investigation reveals elevated liver enzymes: AST is 240 U/L (reference range: 10-40 U/L) and ALT is 110 U/L (reference range: 7-56 U/L). What is the significance of the AST to ALT ratio in this clinical presentation?

A.An AST:ALT ratio of approximately 2:1 is highly suggestive of alcoholic liver disease.

B.An AST:ALT ratio of less than 1:1 indicates acute toxic hepatitis.

C.The ratio is non-specific and only indicates non-alcoholic fatty liver disease.

D.An elevated AST with a lower ALT confirms biliary tract obstruction.

Explanation: An AST to ALT ratio of 2:1 or greater is characteristic of alcoholic liver injury. This occurs because alcohol clearance depletes pyridoxal 5'-phosphate (vitamin B6), which is a required cofactor for ALT synthesis, thereby suppressing ALT elevation relative to AST. In contrast, most other forms of acute parenchymal liver injury (like viral hepatitis) result in an AST:ALT ratio of less than 1.

9A 50-year-old male presents with severe low back pain after lifting a heavy box. He reports numbness in his groin area and difficulty initiating urination. What is the most appropriate next step in the clinical management of this patient?

A.Prescribe physical therapy and a trial of non-steroidal anti-inflammatory drugs.

B.Refer the patient to the emergency department immediately for suspected cauda equina syndrome.

C.Perform a lumbar spinal manipulation to reduce nerve root compression.

D.Order an outpatient lumbar X-ray and schedule a follow-up in two weeks.

Explanation: Groin numbness (saddle anesthesia) and urinary retention or incontinence are red-flag symptoms indicating cauda equina syndrome. This is a medical emergency caused by massive compression of the lumbosacral nerve roots, requiring immediate neurosurgical evaluation and decompression to prevent permanent neurological deficits. Delaying treatment can lead to permanent bladder, bowel, and sexual dysfunction.

10A diagnostic screening test for a certain disease has a sensitivity of 95% and a specificity of 80%. If this test is applied to a population, how should these parameters be clinically interpreted?

A.95% of individuals who do not have the disease will test negative.

B.95% of individuals who have the disease will test positive.

C.80% of individuals who test positive actually have the disease.

D.20% of the individuals tested will receive a false-negative result.

Explanation: Sensitivity is the probability that a diagnostic test will be positive when the disease is present (true positive rate). Therefore, a sensitivity of 95% means that 95% of diseased individuals will test positive, leaving a 5% false-negative rate. Specificity, on the other hand, measures the test's ability to correctly identify those without the disease (true negative rate).

About the CONO Clinical Sciences Exam

The Ontario Clinical Sciences Examination is a professional entry-to-practice assessment administered by the College of Naturopaths of Ontario (CONO). It evaluates a candidate's clinical readiness, diagnostic reasoning, and therapeutic knowledge in naturopathic modalities before they can be registered as a Naturopathic Doctor (ND) in Ontario. The exam is structured based on a blueprint comprising Assessment & Diagnosis (30-34%) and Modalities (55-59%), with other professional competencies accounting for the remainder. Candidates face 200 multiple-choice questions delivered over a single 4-hour session. The exam uses a mix of case-based clinical scenarios and independent questions.

Assessment

200 multiple-choice questions (computer-based)

Time Limit

4 hours

Passing Score

Modified Angoff

Exam Fee

$850.00 CAD (College of Naturopaths of Ontario (CONO))

CONO Clinical Sciences Exam Content Outline

30-34%

Assessment & Diagnosis

History taking, physical examination, diagnostic imaging and laboratory testing, clinical interpretation, and evidence-informed practice.

55-59%

Modalities

Botanical medicine, clinical nutrition, homeopathy, physical medicine (hydrotherapy, manipulation), counseling and health psychology, acupuncture, and traditional Chinese medicine.

7-15%

Other Competencies

Risk management, patient safety, interprofessional collaboration, and Ontario jurisprudence and professional standards.

How to Pass the CONO Clinical Sciences Exam

What You Need to Know

Passing score: Modified Angoff
Assessment: 200 multiple-choice questions (computer-based)
Time limit: 4 hours
Exam fee: $850.00 CAD

Keys to Passing

Complete 500+ practice questions
Score 80%+ consistently before scheduling
Focus on highest-weighted sections
Use our AI tutor for tough concepts

CONO Clinical Sciences Study Tips from Top Performers

1Focus heavily on Modalities, which constitutes the largest portion (55-59%) of the exam, especially botanical medicine safety and herb-drug-nutrient interactions.

2Understand the Regulated Health Professions Act (RHPA) and the Naturopathic Act, 2007, particularly the controlled acts authorized to NDs in Ontario.

3Be prepared for case-based clinical scenarios where you must analyze physical exam findings, lab results, and diagnostic imaging to make a clinical decision.

4Review pediatric and geriatric dosing adjustments and safety profiles for botanical prescriptions.

5Ensure you are familiar with mandatory reporting requirements in Ontario, such as child protection, abuse, and reportable communicable diseases.

Frequently Asked Questions

Who must take the Ontario Clinical Sciences Examination?

Any applicant seeking registration as a Naturopathic Doctor in Ontario must pass this exam, unless they qualify for registration under labor mobility rules from another regulated Canadian province.

What is the format of the exam?

The exam is a 4-hour computer-based test comprising 200 multiple-choice questions. It includes a combination of case-based scenarios and independent, stand-alone questions.

How is the passing score determined?

Rather than a fixed percentage, the passing score is determined for each exam sitting using the Modified Angoff method. This process relies on a panel of experts who evaluate the difficulty of each question relative to entry-level competence.

Can I take the exam online?

Yes, CONO offers the exam via third-party proctored platforms, allowing candidates to take the exam at a licensed testing center or through an online proctoring service from home.

100+ Free CONO Clinical Sciences Practice Questions

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