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200+ Free ONC Practice Questions

Pass your NAON ONC Orthopaedic Nurse Certified exam on the first try — instant access, no signup required.

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Questions by Category

Onc-Degenerative-Disorders36 questions
Onc-Complications32 questions
Onc-Orthopaedic-Trauma25 questions
Onc-Inflammatory-Disorders19 questions
Onc-Congenital-Pediatric15 questions
Onc-Neuromuscular14 questions
Onc-Activity11 questions
Onc-Musculoskeletal-Tumors11 questions
Onc-Pain-Management9 questions
Onc-Metabolic-Bone-Disorders8 questions
Onc-Psychosocial8 questions
Onc-Self-Care6 questions
Onc-Sports-Injuries5 questions
Onc-Nutrition1 questions
2026 Statistics

Key Facts: ONC Exam

150

Questions (135 scored)

ONCB test plan

3 hours

Exam Time

ONCB

97/135

Passing Score (~72%)

ONCB

~80%

First-Time Pass Rate

ONCB data

$425

Exam Fee (non-member)

ONCB 2026

7,800+

Certified ONC Nurses

ONCB

38%

Degenerative Disorders

Largest domain

5 years

Certification Valid

ONCB policy

The ONC exam has an approximately 80% first-time pass rate. The exam includes 150 questions (135 scored, 15 pilot) with 3 hours to complete. NAON members receive significant exam fee discounts. With 7,800+ certified orthopaedic nurses, the ONC credential demonstrates specialized expertise in musculoskeletal care. ONC-certified nurses work in hospitals, ambulatory surgery centers, specialty clinics, and sports medicine facilities with average salaries exceeding $85,000 annually.

About the ONC Exam

The ONC certification validates expertise in orthopaedic nursing care across 8 musculoskeletal condition domains and nursing tasks. The exam covers degenerative disorders (38%), orthopaedic trauma (19%), sports injuries (11%), metabolic bone disorders (9%), inflammatory disorders (8%), congenital/pediatric conditions (5%), musculoskeletal tumors (5%), and neuromuscular conditions (4%). Nursing tasks include pain management, complications prevention, self-care education, activity/mobility support, nutrition, and psychosocial care.

Questions

150 scored questions

Time Limit

3 hours

Passing Score

97/135 (72%)

Exam Fee

$425 (non-members), $300-340 (members) (ONCB (Orthopaedic Nurses Certification Board))

ONC Exam Content Outline

38%

Degenerative Disorders

Osteoarthritis, rheumatoid arthritis, avascular necrosis, spinal stenosis, degenerative disc disease, total joint replacement (hip, knee, shoulder), revision arthroplasty, joint replacement complications

19%

Orthopaedic Trauma

Fracture classification and healing, open/closed fractures, fracture complications, compartment syndrome, fat embolism syndrome, hip fractures, pelvic fractures, spinal cord injury, casting, traction, external fixation

11%

Sports Injuries

Meniscal injuries, ligament injuries (ACL, PCL, MCL, LCL), shoulder instability, rotator cuff injuries, tendon injuries, cartilage injuries, concussion, return-to-play criteria, injury prevention

9%

Metabolic Bone Disorders

Osteoporosis, osteopenia, osteomalacia, Paget's disease, vertebral compression fractures, bone mineral density, bisphosphonates, calcium and vitamin D metabolism

8%

Inflammatory Disorders

Septic arthritis, osteomyelitis, seronegative spondyloarthropathies (ankylosing spondylitis, psoriatic arthritis), gout, pseudogout, infectious disorders

5%

Congenital/Pediatric

Developmental dysplasia of the hip, clubfoot, adolescent idiopathic scoliosis, spinal deformities, cerebral palsy orthopaedic manifestations, pediatric fractures, physeal injuries

5%

Musculoskeletal Tumors

Benign bone tumors (osteochondroma, osteoid osteoma), malignant bone tumors (osteosarcoma, Ewing sarcoma, chondrosarcoma), metastatic bone disease, soft tissue sarcomas

4%

Neuromuscular

Low back pain, herniated disc, sciatica, cervical radiculopathy, muscular dystrophies, carpal tunnel syndrome, peripheral nerve injuries, complex regional pain syndrome

How to Pass the ONC Exam

What You Need to Know

  • Passing score: 97/135 (72%)
  • Exam length: 150 questions
  • Time limit: 3 hours
  • Exam fee: $425 (non-members), $300-340 (members)

Keys to Passing

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

ONC Study Tips from Top Performers

1Focus on total joint arthroplasty nursing care - this is the highest-weighted content area
2Master hip precautions for posterior approach THA: no flexion >90°, no adduction, no internal rotation
3Know the 5 Ps of compartment syndrome: Pain, Pallor, Pulselessness, Paresthesia, Paralysis (pain is earliest sign)
4Understand VTE prophylaxis: mechanical (SCDs) + chemical (anticoagulants) + early mobilization
5Study fracture healing phases: inflammatory, reparative (soft callus → hard callus), remodeling
6Learn the Gustilo-Anderson classification for open fractures (Grade I, II, IIIA, IIIB, IIIC)
7Know fat embolism syndrome classic triad: respiratory distress, neurological changes, petechial rash
8Master osteoporosis medications: bisphosphonates (alendronate), denosumab, teriparatide - know administration and side effects
9Study common orthopaedic emergencies: compartment syndrome, fat embolism, neurovascular compromise, cauda equina
10Understand pediatric orthopaedic conditions: DDH (Pavlik harness), clubfoot (Ponseti method), scoliosis (Adams test)
11Learn assistive device progression: walker → crutches → cane → independent (safest to least restrictive)
12Know wound care for joint replacement: assess for infection signs, delayed healing, wound drainage

Frequently Asked Questions

What is the ONC certification?

The ONC (Orthopaedic Nurse Certified) is a specialty certification offered by the Orthopaedic Nurses Certification Board (ONCB) for registered nurses specializing in orthopaedic nursing. It validates expertise in musculoskeletal conditions, orthopaedic surgery care, trauma management, and rehabilitation. The certification is accredited by the Accreditation Board for Specialty Nursing Certification (ABSNC).

What are the eligibility requirements for the ONC exam?

To be eligible for the ONC exam, you must: 1) Hold a current, unrestricted RN license in the US or Canada, 2) Have at least 2 years (24 months) of experience as an RN, 3) Have a minimum of 1,000 hours of orthopaedic nursing practice within the past 3 years. Orthopaedic practice includes direct patient care, education, research, or administration in orthopaedic nursing.

How many questions are on the ONC exam?

The ONC exam consists of 150 multiple-choice questions. Of these, 135 are scored questions and 15 are pilot (unscored) questions used for future exam development. You have 3 hours to complete the exam. The exam is administered via computer at Prometric testing centers.

What is the passing score for the ONC exam?

The passing score for the ONC exam is 97 correct answers out of 135 scored questions (approximately 72%). You will receive preliminary pass/fail results immediately after completing the exam, with official results mailed within 2-3 weeks.

How much does the ONC exam cost?

The ONC exam fee is $425 for non-members. NAON (National Association of Orthopaedic Nurses) members receive discounted rates: $300 for professional members and $340 for affiliate members. Membership pays for itself with the exam discount plus additional member benefits including journal subscriptions and educational resources.

What topics are covered on the ONC exam?

The ONC exam covers 8 musculoskeletal condition domains: Degenerative Disorders (38%), Orthopaedic Trauma (19%), Sports Injuries (11%), Metabolic Bone Disorders (9%), Inflammatory Disorders (8%), Congenital/Pediatric (5%), Musculoskeletal Tumors (5%), and Neuromuscular (4%). Cross-cutting nursing tasks include pain management, complications prevention, self-care education, activity/mobility support, nutrition, and psychosocial care.

How should I prepare for the ONC exam?

Effective preparation includes: 1) Reviewing the ONCB Test Content Outline and Test References, 2) Studying core orthopaedic nursing texts (Core Curriculum for Orthopaedic Nursing), 3) Completing at least 1,500-2,000 practice questions, 4) Focusing on high-yield topics: joint replacement care, fracture management, complications (compartment syndrome, DVT, fat embolism), and orthopaedic emergencies. Use our AI tutor to master difficult concepts and rationales.

How long is the ONC certification valid?

The ONC certification is valid for 5 years. Recertification can be achieved by either: 1) Retaking and passing the ONC exam, OR 2) Completing 75 contact hours of orthopaedic nursing continuing education plus 1,000 practice hours in orthopaedic nursing during the 5-year period. The ONCB also accepts academic credit, presentations, publications, and preceptorship for contact hours.

What is the average salary for an ONC-certified nurse?

ONC-certified nurses typically earn 5-10% more than non-certified orthopaedic nurses. According to industry data, orthopaedic nurses with ONC certification average $85,000-$95,000 annually, with variations based on location, experience, and practice setting. Many institutions offer certification bonuses and higher pay scales for certified nurses.