199+ Free OCN Practice Questions

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Question 1

Score: 0/0

Which statement best demonstrates cultural sensitivity in nursing care?

Insisting patients follow Western medical practices

Assessing individual beliefs and preferences without making assumptions

Treating all patients exactly the same regardless of background

Refusing to care for patients with different cultural beliefs

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ArticleOCN Exam Guide 2026: FREE ONCC Oncology Nurse Playbook32 min read

2026 Statistics

Key Facts: OCN Exam

165

Total Questions

2026 ONCC Test Registration Manual

145 + 20

Scored + Pretest

2026 ONCC Test Registration Manual

Test Session

ONCC OCN Exam Page

Passing Scaled Score

ONCC Test Scores and More

65%

2025 Initial Pass Rate

2025 ONCC Examination Statistics

$300/$420

Member / Nonmember Fee

ONCC OCN Exam Page

The OCN exam has 165 multiple-choice questions over a 3-hour PSI test session. The 2026 ONCC manual identifies 145 scored items and 20 pretest items, a scaled passing score of 55, a 90-day ATT window, $300 member and $420 nonmember fees, and six blueprint domains. Certification is valid for 4 years.

Sample OCN Practice Questions

Try these sample questions to test your OCN exam readiness. Each question includes a detailed explanation. Start the interactive quiz above for the full 199+ question experience with AI tutoring.

1A nurse is educating a patient about lifestyle modifications to reduce cancer risk. Which modifiable risk factor has the strongest evidence for cancer prevention?

A.Increasing daily calcium intake

B.Tobacco cessation

C.Drinking green tea daily

D.Taking daily multivitamins

Explanation: Tobacco use is the leading preventable cause of cancer and cancer deaths. Tobacco cessation has the strongest evidence base for reducing cancer risk, as smoking is linked to at least 12 types of cancer. While other lifestyle factors like diet and exercise are important, tobacco cessation provides the single greatest impact on cancer prevention.

2Which screening recommendation is appropriate for average-risk adults according to current guidelines?

A.Colonoscopy every 5 years beginning at age 40

B.Annual mammography beginning at age 45 for women

C.Annual chest X-ray for lung cancer screening in all adults over 50

D.Annual CA-125 testing for ovarian cancer beginning at age 35

Explanation: Current breast cancer screening guidelines recommend annual or biennial mammography beginning at age 40-45 for average-risk women. Colonoscopy is recommended every 10 years (not 5) beginning at age 45. Chest X-ray is not recommended for lung cancer screening; low-dose CT is recommended for high-risk individuals. CA-125 testing is not recommended for ovarian cancer screening in average-risk women.

3A patient with a family history of Lynch syndrome asks about cancer prevention. Which recommendation is most appropriate for this hereditary cancer syndrome?

A.Annual colonoscopy beginning at age 20-25

B.Prophylactic colectomy at age 18

C.Annual fecal occult blood testing beginning at age 50

D.Sigmoidoscopy every 5 years beginning at age 40

Explanation: Lynch syndrome (hereditary non-polyposis colorectal cancer) carries a significantly increased risk of colorectal cancer. Guidelines recommend annual colonoscopy beginning at age 20-25 (or 2-5 years earlier than the youngest case in the family). Standard screening beginning at age 50 is insufficient for this high-risk population.

4A cancer survivor expresses concern about developing a second primary cancer. Which nursing response demonstrates understanding of survivorship care?

A.The risk of second cancers is so low you should not worry about it

B.We will focus on your current treatment and address that later

C.Survivorship care includes surveillance for recurrence and screening for new primaries based on your treatment history

D.Second cancers only occur in patients with genetic mutations

Explanation: Cancer survivors have an increased risk of second primary cancers due to shared risk factors, genetic predisposition, and treatment-related effects (such as radiation and certain chemotherapies). Comprehensive survivorship care includes surveillance for recurrence, monitoring for late effects, and appropriate screening for new primary cancers based on individual risk factors and treatment history.

5Which intervention is most appropriate for a terminally ill patient experiencing existential distress?

A.Increasing the dose of morphine

B.Consulting the palliative care team for psychosocial support and life review

C.Recommending inpatient psychiatric admission

D.Suggesting the patient focus only on physical comfort

Explanation: Existential distress involves concerns about meaning, purpose, and legacy near the end of life. The palliative care team provides comprehensive support including psychosocial interventions, spiritual care, and life review therapy. While physical comfort is important, existential suffering requires specialized psychosocial and spiritual interventions rather than just increased analgesia.

6A patient in hospice care develops terminal restlessness. What is the priority nursing intervention?

A.Administer scheduled haloperidol for agitation

B.Reposition the patient and ensure a calm, quiet environment

C.Initiate intravenous fluids for hydration

D.Transfer the patient to the intensive care unit

Explanation: Terminal restlessness (terminal agitation) requires a comprehensive assessment to identify reversible causes such as pain, urinary retention, or hypoxia. Non-pharmacologic interventions including environmental modifications, family presence, and repositioning are first-line. Medications may be needed but non-pharmacologic measures should be initiated first.

7Which statement best describes the role of a nurse navigator in cancer care?

A.Performing all chemotherapy administration for patients

B.Coordinating care across the continuum and removing barriers to treatment

C.Serving as the primary oncologist for newly diagnosed patients

D.Managing the financial operations of the oncology clinic

Explanation: Nurse navigators play a crucial role in care coordination, helping patients traverse the complex healthcare system. They provide education, coordinate appointments, facilitate communication among care team members, and help remove barriers to care such as transportation or financial concerns. They do not replace physicians or perform all treatments.

8A patient asks about the difference between benign and malignant tumors. Which response is most accurate?

A.Benign tumors are always small and malignant tumors are always large

B.Benign tumors lack the ability to invade surrounding tissues and metastasize

C.Benign tumors grow rapidly while malignant tumors grow slowly

D.Benign tumors are always painful and malignant tumors are painless

Explanation: The key distinguishing feature of malignant tumors is their ability to invade surrounding tissues and metastasize to distant sites. Benign tumors are typically well-circumscribed and do not metastasize. Neither size, growth rate, nor pain are reliable distinguishing characteristics between benign and malignant tumors.

9Which cellular process is primarily responsible for the development of drug resistance in cancer chemotherapy?

A.Apoptosis

B.Mutation of target genes and overexpression of drug efflux pumps

C.Cellular senescence

D.DNA methylation only

Explanation: Cancer drug resistance develops through multiple mechanisms including mutations in target genes, overexpression of drug efflux pumps (such as P-glycoprotein), activation of alternative survival pathways, and enhanced DNA repair mechanisms. These cellular adaptations allow cancer cells to survive despite chemotherapy exposure.

10A patient with colon cancer is staged as T3N1M0. What does this staging indicate?

A.Tumor invades through the muscularis propria, 1-3 regional lymph nodes involved, no distant metastasis

B.Tumor is confined to mucosa, no lymph node involvement, distant metastasis present

C.Tumor invades adjacent structures, more than 6 lymph nodes involved, no distant metastasis

D.Carcinoma in situ, micrometastases to lymph nodes, distant metastasis present

Explanation: In TNM staging, T3 indicates tumor invasion through the muscularis propria into pericolorectal tissues. N1 indicates metastasis in 1-3 regional lymph nodes. M0 indicates no distant metastasis. This would be Stage III colon cancer. Understanding TNM staging is essential for treatment planning and prognosis.

About the OCN Exam

The OCN certification validates adult oncology nursing knowledge across the current ONCC six-domain blueprint: Care Continuum, Oncology Nursing Practice, Treatment Modalities, Symptom Management and Supportive Care, Oncologic Emergencies, and Psychosocial Dimensions of Care.

Questions

165 scored questions

Time Limit

3 hours

Passing Score

Scaled score 55 on the ONCC 25-75 scale

Exam Fee

$300 ONS/APHON members / $420 nonmembers (Oncology Nursing Certification Corporation (ONCC))

OCN Exam Content Outline

14%

Care Continuum

Health promotion, prevention, screening, navigation, palliative care, advance care planning, epidemiology, survivorship, rehabilitation, recurrence concerns, end-of-life care, hospice, bereavement, and comfort measures.

15%

Oncology Nursing Practice

Cancer biology, immunology, clinical trials, genomic and genetic testing, site-specific cancer considerations, staging, performance status, scope, standards, safe handling, documentation, advocacy, ethics, and self-care.

20%

Treatment Modalities

Surgery, procedures, blood and marrow transplant, radiation therapy, systemic therapy, localized therapy, targeted therapy, oral therapy, treatment sequencing, monitoring, and patient teaching.

25%

Symptom Management and Supportive Care

Anatomical and surgical alterations, vascular access devices, pharmacologic and integrative interventions, system-based symptom patterns, nutrition, pain management, and supportive-care evaluation.

16%

Oncologic Emergencies

DIC, SIADH, sepsis, tumor lysis syndrome, hypersensitivity, anaphylaxis, hypercalcemia, cardiac tamponade, spinal cord compression, superior vena cava syndrome, increased intracranial pressure, obstructions, pneumonitis, extravasations, immune-related adverse events, CRS, ICANS, and venous thromboembolism.

10%

Psychosocial Dimensions of Care

Cultural, spiritual, religious, emotional, social, family, sexuality, gender, caregiver, crisis, body image, learning-barrier, support, and financial concerns in adult oncology care.

How to Pass the OCN Exam

What You Need to Know

Passing score: Scaled score 55 on the ONCC 25-75 scale
Exam length: 165 questions
Time limit: 3 hours
Exam fee: $300 ONS/APHON members / $420 nonmembers

Keys to Passing

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

OCN Study Tips from Top Performers

1Focus on the highest-weighted content areas first — they represent the most exam questions

2Complete at least 200 practice questions and review explanations for every missed item

3Study in focused 1-2 hour blocks with active recall and spaced repetition

4Review clinical guidelines and evidence-based practice standards relevant to this credential

5Take at least two full-length timed practice exams before your scheduled test date

Frequently Asked Questions

How many questions are on the OCN exam?

The OCN exam has 165 multiple-choice questions in a 3-hour test session. ONCC states that 145 questions count toward the score and 20 are pretest questions.

What score do I need to pass the OCN exam?

ONCC uses scaled scoring from 25 to 75. A scaled score of 55 is the passing score for ONCC certification tests, including OCN.

What are the 2026 OCN exam domains?

The 2026 OCN blueprint has six domains: Care Continuum 14%, Oncology Nursing Practice 15%, Treatment Modalities 20%, Symptom Management and Supportive Care 25%, Oncologic Emergencies 16%, and Psychosocial Dimensions of Care 10%.

What are the OCN eligibility requirements?

Candidates need an active unencumbered RN license, at least 2 years of RN experience, 2,000 adult oncology nursing practice hours within the prior 4 years, and 10 oncology contact hours or an oncology elective within the prior 3 years.

How much does the OCN exam cost?

The 2026 ONCC OCN exam fee is $300 for ONS/APHON members and $420 for nonmembers. Optional DoubleTake and international testing fees may apply if eligible.

What is the OCN pass rate?

ONCC 2025 examination statistics list a 65% initial OCN pass rate and a 61% total OCN pass rate across all candidate statuses.