Free Practice Questions for CBCN

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Exam Review

Key Facts: CBCN Exam

165

Exam Questions

ONCC 2026 manual (125 scored + 40 pretest)

Session Length

ONCC 2026 manual

24%

Treatment Modalities Weight

ONCC 2026 CBCN test content outline

24%

Nursing Practice Weight

ONCC 2026 CBCN test content outline

$300/$420

Member/Nonmember Fee

ONCC CBCN certification page

78%

2025 First-Time Pass Rate

ONCC 2025 examination statistics

The ONCC CBCN exam has 165 multiple-choice questions (125 scored, 40 pretest) in a 3-hour session at PSI test centers, and the passing standard is a scaled score of 55. Candidates need an active RN license, 24 months of RN experience and 2,000 breast care hours within 48 months, and 10 breast care contact hours within 36 months. The 2026 domains are Care Continuum (19%), Diagnosis and Staging (21%), Treatment Modalities and Considerations (24%), Nursing Practice (24%), and Psychosocial Dimensions of Care (12%). The fee is $300 for ONS/APHON members and $420 for nonmembers.

Sample CBCN Practice Questions

Try these sample questions to review concepts for the CBCN exam. Each question includes a detailed explanation. Start the interactive quiz above for the full 136+ question experience with AI tutoring.

1Which imaging modality is recommended as the primary screening tool for breast cancer in average-risk women aged 40 and older?

A.Breast MRI

B.Breast ultrasound

C.Digital mammography

D.Thermography

Explanation: Digital mammography is the recommended primary screening tool for breast cancer in average-risk women aged 40 and older per guidelines from the American College of Radiology and most major organizations. It can detect calcifications, masses, and architectural distortions before they are palpable. Breast MRI is reserved for high-risk patients, ultrasound is supplemental, and thermography is not recommended as a screening tool.

2A 35-year-old woman with a BRCA1 mutation asks about breast cancer screening. In addition to annual mammography, which supplemental screening is recommended?

A.Annual thermography

B.Annual breast MRI with contrast

C.Biannual breast ultrasound only

D.No additional screening is needed

Explanation: For women with BRCA1/BRCA2 mutations, annual breast MRI with contrast is recommended in addition to annual mammography, typically starting at age 25-30. MRI has higher sensitivity than mammography for detecting cancers in dense breast tissue common in younger high-risk women. Thermography is not a validated screening tool, and ultrasound alone is insufficient for this risk level.

3Which risk assessment model incorporates both genetic and non-genetic risk factors to estimate a woman's lifetime risk of developing breast cancer?

A.Framingham Risk Score

B.Gail Model

C.Tyrer-Cuzick (IBIS) Model

D.CHADS2 Score

Explanation: The Tyrer-Cuzick (IBIS) model is the most comprehensive breast cancer risk assessment tool, incorporating both genetic factors (family history including second-degree relatives, known mutations) and non-genetic factors (reproductive history, BMI, hormone use, benign breast disease). The Gail Model is simpler but does not include paternal family history or second-degree relatives. Framingham and CHADS2 scores are cardiovascular risk tools.

4Which benign breast condition is characterized by bilateral breast pain that worsens before menstruation and is associated with fibrous and cystic changes?

A.Fibroadenoma

B.Fibrocystic changes

C.Phyllodes tumor

D.Intraductal papilloma

Explanation: Fibrocystic changes are the most common benign breast condition, affecting up to 60% of women. They are characterized by bilateral breast pain (mastalgia) that typically worsens in the luteal phase before menstruation. The condition involves fibrous tissue proliferation and cyst formation. Fibroadenomas are painless, firm mobile masses; phyllodes tumors are rare stromal tumors; and intraductal papillomas cause nipple discharge.

5A woman's Gail Model 5-year risk score is 2.5%. What does this indicate about her eligibility for chemoprevention?

A.She is not a candidate for chemoprevention

B.She meets the threshold for discussing chemoprevention with tamoxifen or raloxifene

C.She requires immediate bilateral mastectomy

D.She should begin annual breast MRI screening

Explanation: A 5-year Gail Model risk of 1.67% or greater is the threshold at which chemoprevention should be discussed. With a 2.5% five-year risk, this woman is eligible for chemoprevention with tamoxifen (pre- or postmenopausal) or raloxifene (postmenopausal only), which can reduce breast cancer risk by 30-50%. This risk level alone does not warrant prophylactic mastectomy or MRI screening, which requires a lifetime risk of 20% or greater.

6Which breast biopsy technique uses a hollow needle to remove a cylinder of tissue and is the preferred method for tissue diagnosis of a palpable mass?

A.Fine needle aspiration (FNA)

B.Core needle biopsy

C.Excisional biopsy

D.Punch biopsy

Explanation: Core needle biopsy uses a large hollow needle to remove cylinders of tissue, providing histological architecture for definitive diagnosis including receptor status testing. It is the preferred initial biopsy method for most breast lesions because it is less invasive than excisional biopsy, provides more tissue than FNA, and allows biomarker testing (ER/PR/HER2). FNA provides cytology only and cannot distinguish invasive from in situ disease.

7A breast cancer specimen is reported as ER-positive, PR-positive, and HER2-negative. Which treatment approach is MOST appropriate for this tumor profile?

A.Trastuzumab-based targeted therapy

B.Endocrine (hormonal) therapy

C.Triple-drug chemotherapy only

D.No systemic therapy needed

Explanation: ER-positive, PR-positive, HER2-negative breast cancer (luminal A subtype) responds to endocrine therapy such as tamoxifen (premenopausal) or aromatase inhibitors (postmenopausal). Hormonal therapy is the cornerstone of treatment for hormone receptor-positive disease. Trastuzumab targets HER2-positive tumors. Chemotherapy may be added based on genomic assays (e.g., Oncotype DX) and staging, but endocrine therapy is always included for HR-positive disease.

8What does a HER2/neu 3+ result on immunohistochemistry (IHC) indicate?

A.HER2 is negative; no targeted therapy needed

B.HER2 is equivocal; FISH testing required

C.HER2 is positive; patient is a candidate for HER2-targeted therapy

D.The test is invalid and must be repeated

Explanation: A HER2/neu IHC score of 3+ indicates HER2 overexpression and the tumor is considered HER2-positive. This makes the patient a candidate for HER2-targeted therapies such as trastuzumab (Herceptin), pertuzumab, and ado-trastuzumab emtansine (T-DM1). A score of 0 or 1+ is negative, and 2+ is equivocal requiring confirmatory FISH (fluorescence in situ hybridization) testing to determine gene amplification status.

9In the TNM staging system for breast cancer, what does T2 indicate?

A.Tumor is 2 cm or less in greatest dimension

B.Tumor is more than 2 cm but not more than 5 cm

C.Tumor is more than 5 cm

D.Tumor involves the chest wall or skin

Explanation: In the AJCC TNM staging system for breast cancer, T2 indicates a tumor that is more than 2 cm but not more than 5 cm in greatest dimension. T1 is 2 cm or less, T3 is more than 5 cm, and T4 involves extension to the chest wall or skin (including inflammatory breast cancer). Accurate T staging is essential for treatment planning and prognosis determination.

10Which genomic assay is used to determine the benefit of adjuvant chemotherapy in early-stage, ER-positive, HER2-negative breast cancer?

A.BRCA1/BRCA2 genetic test

B.Oncotype DX Recurrence Score

C.CA 27-29 tumor marker

D.HER2 FISH test

Explanation: Oncotype DX is a 21-gene genomic assay that generates a Recurrence Score (0-100) to predict the benefit of adding chemotherapy to endocrine therapy in early-stage, ER-positive, HER2-negative, node-negative (or limited node-positive) breast cancer. A low score (<26 for women 50+, <16 for women under 50) suggests chemotherapy provides minimal benefit. BRCA testing assesses hereditary risk, CA 27-29 monitors metastatic disease, and FISH confirms HER2 status.

About the CBCN Exam

The CBCN certification validates specialized knowledge in breast care nursing across the continuum from screening through survivorship. Administered by ONCC, it covers risk assessment, diagnosis, treatment modalities, symptom management, and professional practice for RNs dedicated to breast cancer care.

Exam sponsor: ONCC. The requirements and fees below concern the certification or admission exam, separate from our free practice resources.

Assessment

125 scored + 40 pretest

Time Limit

3 hours (includes a 15-minute tutorial and post-test survey)

Passing Score

Scaled score of 55 (scale 25 to 75)

Exam / Certification Fees

$300 ONS members / $420 non-members

Exam sponsor website

Reported exam pass rate: 2025: 78% first-time, 75% overall (ONCC). This describes exam candidates, not OpenExamPrep users or results from using our resources. Exam sponsor website

Fees, eligibility, and exam policies can change. Confirm them with the exam sponsor before applying or paying.

Official sources

Our practice resources: topics covered

We aim to reflect publicly available exam outlines and topic information in our study resources. Coverage, format, and difficulty may differ from the actual exam, and we cannot guarantee that every detail is accurate or current. Confirm exam requirements, fees, and policies with the official exam sponsor.

19%

Care Continuum

Breast health and screening, clinical breast exam, special populations, risk assessment and genetics, patient navigation, and surveillance and survivorship

21%

Diagnosis and Staging

Carcinogenesis, diagnostic imaging and biopsy, pathology and prognostic features, ER/PR/HER2 biomarkers, genomic testing, and clinical and pathologic staging

24%

Treatment Modalities and Considerations

Breast and axillary surgery, reconstruction, radiation, systemic therapy, triple-negative and HER2-positive disease, IBC, Paget disease, phyllodes tumor, angiosarcoma, and special populations

24%

Nursing Practice

Surgical, medical, and radiation symptom management, integrative care, rehabilitation, oncologic emergencies, professional practice, clinical trials, and self-care

12%

Psychosocial Dimensions of Care

Culture, spirituality, identity and disparities, family and caregiver dynamics, body image, reproductive and sexual health, distress, and social determinants of health

Preparing for the CBCN Exam

What You Need to Know

Passing score: Scaled score of 55 (scale 25 to 75)
Assessment: 125 scored + 40 pretest
Time limit: 3 hours (includes a 15-minute tutorial and post-test survey)
Exam / certification fees: $300 ONS members / $420 non-members Official sources

Using Our Practice Resources

Work through all 136 available questions
Review every answer and explanation
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CBCN: Suggested Study Strategy

1Treatment Modalities and Nursing Practice are each 24% of the CBCN exam, so together they make up nearly half of the scored items

2Do not skip the 12% Psychosocial domain: culture, family dynamics, body image, sexual health, and distress are all tested

3Master ER/PR/HER2 interpretation, AJCC prognostic staging, and when genomic assays change chemotherapy decisions

4Know the emergencies named in the outline: anaphylaxis, extravasation, hypercalcemia, pleural effusion, sepsis, spinal cord compression, and thromboembolism

5ONCC uses generic drug names only, so study medications by generic name and key toxicities

Frequently Asked Questions

How many questions are on the CBCN exam?

The CBCN exam has 165 multiple-choice questions: 125 are scored and 40 are unscored pretest items that are not identified. The 3-hour session at a PSI test center includes a 15-minute computer tutorial and a post-test survey, with no scheduled breaks.

What are the CBCN eligibility requirements?

CBCN candidates need a current, unencumbered RN license in the U.S., its territories, or Canada; at least 24 months of RN experience and 2,000 hours of breast care nursing practice within the past 48 months; and at least 10 accredited breast care contact hours within the past 36 months.

How much does the CBCN exam cost?

The CBCN test fee is $300 for ONS or APHON members and $420 for nonmembers. Candidates can add ONCC DoubleTake for $100 at the initial application, which covers a second attempt within 180 days if they do not pass.

What content domains does the CBCN exam cover?

The 2026 CBCN test content outline has five domains: Care Continuum (19%), Diagnosis and Staging (21%), Treatment Modalities and Considerations (24%), Nursing Practice (24%), and Psychosocial Dimensions of Care (12%). Multiply each weight by 125 to estimate scored items.

What is the CBCN passing score and pass rate?

ONCC sets the passing standard at a scaled score of 55 on a 25-to-75 scale, and candidates see an official pass/fail result before leaving the test center. In 2025, 78% of first-time CBCN candidates and 75% of all candidates passed.

How long is CBCN certification valid and how is it renewed?

CBCN certification is valid for 4 years. Renewal requires an active RN license, 12 months of RN experience within 36 months, and 1,000 hours of breast care practice within 30 months, plus professional development points or a passing retest.

Free Practice Questions for CBCN

CBCN Certified Breast Care Nurse