100+ Free ONP-C Practice Questions

Pass your ONCB Orthopaedic Nurse Practitioner-Certified exam on the first try — instant access, no signup required.

✓ No registration✓ No credit card✓ No hidden fees✓ Start practicing immediately

Not publicly reported Pass Rate

100+ Questions

100% Free

1 / 100

Question 1

Score: 0/0

A 4-year-old girl is brought in with refusal to use the right arm after a caregiver pulled her hand. Elbow is held slightly flexed and pronated; X-ray is normal. What is the diagnosis and treatment?

Nursemaid's elbow (radial head subluxation) — reduce with supination and flexion or hyperpronation maneuver

Distal radius fracture — cast for 3 weeks

Elbow dislocation — urgent reduction under sedation

Pulled shoulder — apply arm sling

to track

Same family resources

Explore More ONCB Orthopaedic Nursing Certifications

Continue into nearby exams from the same family. Each card keeps practice questions, study guides, flashcards, videos, and articles in one place.

ONCB ONC Orthopaedic Nurse Certified

Practice Questions100 questions

2026 Statistics

Key Facts: ONP-C Exam

150

Total Questions

135 scored + 15 pilot

96/135

Passing Raw Score

ONCB exam description

3 hrs

Exam Time

ONCB

39%

Degenerative Disorders

Largest blueprint domain

$375-500

Exam Fee

ONCB 2026

5 years

Certification Valid

Recertification cycle

The ONP-C exam contains 150 questions (135 scored) over 3 hours with a passing raw score of 96. Degenerative disorders dominate at 39% of the blueprint. Eligibility requires a master's or higher NP degree, current RN license, 3 years RN/APRN experience, and 2,000 hours of musculoskeletal NP practice within 3 years. Fees are $375 (member) or $500 (non-member). Certification is valid for 5 years.

Sample ONP-C Practice Questions

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

1During knee examination, you apply anterior tibial force with the knee at 20–30° flexion and feel a soft endpoint. Which test is positive and what does it indicate?

A.Lachman test — anterior cruciate ligament (ACL) injury

B.McMurray test — medial meniscus tear

C.Anterior drawer test — posterior cruciate ligament injury

D.Valgus stress test — medial collateral ligament tear

Explanation: The Lachman test at 20–30° flexion is the most sensitive clinical test for ACL integrity (sensitivity ~85%). A soft endpoint and >3 mm anterior translation indicate ACL disruption. The anterior drawer is performed at 90° and is less sensitive.

2McMurray's test is performed with the patient supine. Which maneuver specifically stresses the medial meniscus?

A.External tibial rotation with valgus force as knee extends

B.Internal tibial rotation with varus force as knee extends

C.Anterior tibial translation at 90° flexion

D.Axial compression with neutral rotation

Explanation: External tibial rotation with valgus force stresses the medial meniscus. A click or pain along the medial joint line is a positive McMurray sign. Internal rotation with varus targets the lateral meniscus.

3A patient reports posterior knee pain and instability when walking downstairs. The posterior drawer test shows 8 mm of posterior tibial translation. Which structure is most likely injured?

A.Posterior cruciate ligament

B.Anterior cruciate ligament

C.Lateral collateral ligament

D.Posterior horn of medial meniscus

Explanation: The posterior drawer test (posterior tibial force at 90° knee flexion) specifically tests PCL integrity. >5 mm translation suggests PCL tear. PCL injuries cause instability descending stairs and posterior knee pain.

4Spurling's test reproduces right arm pain and paresthesias when the neck is laterally flexed toward the right with axial compression. What is the most likely diagnosis?

A.Cervical nerve root compression (radiculopathy)

B.Thoracic outlet syndrome

C.Rotator cuff impingement

D.Cervical facet arthropathy

Explanation: Spurling's (foraminal compression) test narrows the neural foramen ipsilaterally. Reproduction of radicular arm symptoms indicates cervical nerve root compression. Sensitivity ~40–60%, specificity ~92–100%.

5The FABER (Patrick) test reproduces groin pain in a 58-year-old with hip osteoarthritis. Which structures are stressed by this maneuver?

A.Hip joint, sacroiliac joint, and anterior hip musculature

B.Posterior hip capsule and piriformis

C.Medial knee ligaments and pes anserine bursa

D.Lumbar facet joints only

Explanation: FABER (Flexion, ABduction, External Rotation) places the hip in a position that stresses the hip joint anteriorly, the sacroiliac joint, and anterior hip structures. Groin pain suggests hip pathology; buttock pain suggests SI joint involvement.

6Neer's impingement sign is elicited by passively forward-flexing the internally rotated arm. Hawkins-Kennedy involves flexing to 90° and internally rotating. Both are positive in this patient. What is the most likely diagnosis?

A.Subacromial impingement syndrome

B.Acromioclavicular joint pathology

C.Superior labral anterior-to-posterior (SLAP) tear

D.Biceps tendinopathy

Explanation: Both Neer and Hawkins-Kennedy tests compress the supraspinatus tendon under the coracoacromial arch, indicating subacromial impingement syndrome. Combined positive tests improve diagnostic accuracy.

7Phalen's test is held for 60 seconds and reproduces numbness and tingling in the thumb, index, and middle fingers. Tinel's sign is positive at the wrist. Which nerve is compressed?

A.Median nerve at the carpal tunnel

B.Ulnar nerve at Guyon's canal

C.Radial nerve at the spiral groove

D.Median nerve at the pronator teres

Explanation: Phalen's (sustained wrist flexion) and Tinel's (percussion over carpal tunnel) both implicate median nerve compression at the carpal tunnel. Numbness in thumb, index, and middle fingers is the classic median nerve distribution.

8A 16-year-old male presents with sudden onset left hip pain and inability to bear weight after playing soccer. Temperature is 38.8°C, ESR 68 mm/hr, CRP 42 mg/L, WBC 13.5 × 10⁹/L. Hip ultrasound shows effusion. What is the most urgent diagnosis to exclude?

A.Septic arthritis

B.Transient synovitis

C.Legg-Calvé-Perthes disease

D.Slipped capital femoral epiphysis

Explanation: Kocher criteria (fever >38.5°C, non-weight-bearing, ESR >40, WBC >12,000) — this patient meets all four, predicting >99% probability of septic arthritis. Urgent aspiration and orthopaedic consultation are required to prevent avascular necrosis.

9A 45-year-old obese woman has bilateral knee pain that is worse with stairs and improved with rest. X-ray shows medial joint space narrowing and osteophytes. BMI 38. Which diagnosis best explains her presentation?

A.Medial compartment knee osteoarthritis

B.Rheumatoid arthritis

C.Pes anserine bursitis

D.Meniscal tear

Explanation: Medial compartment OA is strongly associated with obesity and presents with activity-related medial knee pain, bony enlargement, and radiographic medial joint space narrowing with osteophytes. This is the most common form of knee OA.

10A 55-year-old man has 6 weeks of worsening low back pain with night sweats, 8 kg weight loss, and elevated ESR. MRI shows vertebral endplate destruction at L3–L4 with paraspinal soft tissue mass. What must be ruled out first?

A.Vertebral osteomyelitis or metastatic malignancy

B.Lumbar disk herniation

C.Ankylosing spondylitis

D.Degenerative disk disease

Explanation: Constitutional red flags (night sweats, weight loss) with endplate destruction and paraspinal mass indicate either infectious spondylodiscitis or malignancy until proven otherwise. Biopsy, blood cultures, and oncology/infectious disease workup are mandatory.

About the ONP-C Exam

The ONP-C certification validates advanced practice NP competency in musculoskeletal and orthopaedic care. The exam contains 150 questions (135 scored, 15 pilot items) covering eight content domains: Degenerative Disorders (39%), Orthopaedic Trauma (18%), Sports Injuries (14%), Inflammatory Disorders (8%), Metabolic Bone Disorders (8%), Congenital/Pediatric (6%), Neuromuscular (4%), and Musculoskeletal Tumors (3%). Content spans NP roles: Clinician/Practitioner (63–70%), Educator (10–17%), Consultant (8–14%), Manager (2–7%), and Researcher (2–7%).

Questions

150 scored questions

Time Limit

3 hours

Passing Score

96 correct out of 135 scored questions (~71%)

Exam Fee

$375-500 (Orthopaedic Nurses Certification Board (ONCB))

ONP-C Exam Content Outline

39%

Degenerative Disorders

Knee/hip/shoulder/spine OA, degenerative disc disease, rotator cuff tendinopathy, adhesive capsulitis, meniscal degeneration, cervical/lumbar spondylosis

18%

Orthopaedic Trauma

Fracture principles, open fracture classification, compartment syndrome, peri-operative fracture care, femoral neck fractures, distal radius fractures

14%

Sports Injuries

ACL/PCL/meniscal injuries, rotator cuff tears, ankle sprains, overuse syndromes, concussion management, return-to-play criteria

Inflammatory Disorders

RA diagnosis and biologic/DMARD management, gout/pseudogout crystal arthropathies, ankylosing spondylitis, psoriatic arthritis, PMR/GCA

Metabolic Bone Disorders

Osteoporosis (DEXA, T-score criteria), bisphosphonates, vitamin D/calcium, denosumab, teriparatide, Paget's disease, AVN risk factors

Congenital/Pediatric Conditions

Septic hip vs transient synovitis (Kocher criteria), SCFE, LCP disease, idiopathic scoliosis screening and bracing, nursemaid's elbow

Neuromuscular Conditions

Carpal tunnel syndrome, cubital tunnel, cervical myelopathy, CRPS, peripheral nerve injuries, neuropathic pain pharmacotherapy

Musculoskeletal Tumors

Red flags for malignancy, bone metastases imaging patterns, primary bone tumors, biopsy principles, urgent referral criteria

How to Pass the ONP-C Exam

What You Need to Know

Passing score: 96 correct out of 135 scored questions (~71%)
Exam length: 150 questions
Time limit: 3 hours
Exam fee: $375-500

Keys to Passing

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

ONP-C Study Tips from Top Performers

1Master MSK special tests — Lachman, McMurray, Spurling, FABER, Neer, Hawkins-Kennedy, Phalen, Tinel — with sensitivity/specificity context

2Memorize Kocher criteria to distinguish septic hip from transient synovitis in pediatric presentations

3Know the ONCB blueprint percentages: Degenerative 39% is the largest domain — weight your study time accordingly

4Understand fracture surgical indications: femoral neck (Garden classification), distal radius (angulation/shortening thresholds), Jones fracture in athletes

5Review perioperative biologic DMARD management per 2022 ACR/AAHKS guidelines (hold 1 dosing cycle before elective TJA)

6Know bisphosphonate administration rules, MRONJ risk, and atypical femoral fracture pattern for long-term users

7Practice DEXA T-score interpretation (WHO criteria) and osteoporosis treatment selection by CKD stage

8Understand VTE prophylaxis after TJA: duration 10–35 days, dual pharmacologic + mechanical approach

9Know crystal arthropathy differentiation: negatively birefringent needles (gout) vs positively birefringent rhomboids (CPPD)

10Review GCA/PMR distinction — jaw claudication is a red flag requiring immediate high-dose prednisone to prevent blindness

Frequently Asked Questions

What is the ONP-C exam?

The ONP-C (Orthopaedic Nurse Practitioner-Certified) is a specialty NP certification offered by the Orthopaedic Nurses Certification Board (ONCB). It validates advanced practice competency in musculoskeletal and orthopaedic care for nurse practitioners across all NP specialties (FNP, AGNP, PNP) who care for orthopaedic patients.

What are the ONP-C eligibility requirements?

To sit for the ONP-C exam you must: (1) Hold a master's degree or higher in nursing from a US APRN/NP program; (2) Have a current unencumbered RN license; (3) Have 3 years of RN/APRN experience; and (4) Have a minimum 2,000 hours of advanced practice NP work in orthopaedic/musculoskeletal care within the past 3 years. You must currently function as an NP caring for musculoskeletal patients.

How many questions are on the ONP-C exam?

The ONP-C exam contains 150 questions total — 135 scored and 15 unscored pilot items. You have 3 hours to complete the exam. A raw score of 96 correct (out of 135 scored questions) is required to pass.

What is the ONP-C exam blueprint?

The ONP-C blueprint covers eight condition-based domains: Degenerative Disorders (39%), Orthopaedic Trauma (18%), Sports Injuries (14%), Inflammatory Disorders (8%), Metabolic Bone Disorders (8%), Congenital/Pediatric (6%), Neuromuscular (4%), and Musculoskeletal Tumors (3%). Questions also test NP role competencies: Clinician/Practitioner (63–70%), Educator, Consultant, Manager, and Researcher.

What is the ONP-C exam fee?

The ONP-C exam fee is $375 for members of NAON, AANP, NOVA, or CONA. Non-members pay $500. Student and associate memberships do not qualify for the member discount rate.

How long is ONP-C certification valid?

ONP-C certification is valid for 5 years. Recertification is achieved through continuing education or by retaking the exam. Candidates must maintain active NP licensure and practice in orthopaedic/musculoskeletal care during the certification period.

How should I prepare for the ONP-C exam?

Study systematically across all blueprint domains, emphasizing Degenerative Disorders (39%) and Trauma (18%). Use the ONCB candidate handbook and official practice exam. Focus on MSK special tests (Lachman, McMurray, Spurling, FABER, impingement signs), pharmacology (DMARDs, biologics, bisphosphonates), post-operative THA/TKA care, fracture management principles, and pediatric orthopaedic differentials. Plan 10–16 weeks of focused preparation.