AOCNP Exam Review 2026 Review
Questions & Terms for Advanced
Oncology Certified Nurse Practitioner
Board Exam Prep (PDF)
SECTION 1: CANCER CONTINUUM – SCREENING,
PREVENTION, GENETICS, DIAGNOSIS, STAGING (~35% OF
EXAM)
Q1. A patient's pathology report shows invasive breast cancer that is estrogen receptor
(ER)-positive, progesterone receptor (PR)-positive, and HER2-negative. What is the most
important next step in treatment planning?
A. Immediate initiation of chemotherapy
B. Referral to medical oncology for consideration of endocrine therapy
C. Immediate bilateral mastectomy
D. Radiation therapy planning
Answer: B
Rationale: ER-positive, HER2-negative breast cancer is typically treated with endocrine
therapy (e.g., tamoxifen or aromatase inhibitors). The NP should explain the significance
of receptor testing and coordinate referrals to the multidisciplinary team.
,Q2. Which finding would MOST strongly suggest a hereditary cancer syndrome rather
than sporadic cancer?
A. Tumor located in the descending colon
B. Diagnosis at age 45 with no family history
C. Diagnosis at age 30 with multiple generations affected
D. Unilateral breast cancer
Answer: C
Rationale: Features suggesting hereditary cancer include early age of onset (e.g., breast
cancer under 50), multiple primary cancers in the same individual, bilateral or multifocal
disease, and multiple generations affected.
Q3. Which gene mutations are associated with hereditary melanoma?
A. BRCA1 and BRCA2
B. APC and MLH1
C. p16/CDKN2A and CDK4
D. TP53 and PTEN
Answer: C
Rationale: p16/CDKN2A and CDK4 are the primary genes associated with hereditary
melanoma. Hereditary melanomas account for approximately 10% of all melanomas and
are inherited in an autosomal dominant pattern.
Q4. According to the ONCC, which of the following is TRUE about the AOCNP exam?
A. Brand-name drug names are used exclusively on the exam
B. Only generic drug names are used on ONCC tests
C. Both generic and brand names are used interchangeably
D. Only drug classes are tested, not specific drug names
Answer: B
Rationale: Only generic drug names are used on ONCC tests.
,Q5. Which cancer screening test is recommended for average-risk individuals beginning
at age 45 according to current guidelines?
A. Colonoscopy
B. Mammography
C. PSA testing
D. Low-dose CT chest
Answer: A
Rationale: Average-risk individuals should begin colorectal cancer screening at age 45.
Q6. A patient with Lynch syndrome asks about colon cancer screening
recommendations. What is the appropriate screening recommendation?
A. Colonoscopy every 5 years starting at age 40
B. Annual colonoscopy starting at age 20-25
C. Fecal occult blood testing annually starting at age 30
D. CT colonography every 3 years starting at age 35
Answer: B
Rationale: For patients with Lynch syndrome, annual colonoscopy is recommended
beginning at age 20-25 (or 5 years before the earliest family diagnosis, whichever comes
first).
Q7. A 48-year-old female with a BRCA1 mutation is considering risk-reducing salpingo-
oophorectomy (RRSO). At what age is RRSO MOST recommended for BRCA1 mutation
carriers?
A. Age 35-40
B. Age 40-45
C. Age 45-50
D. Age 50-55
, Answer: B
Rationale: For BRCA1 mutation carriers, RRSO is recommended between ages 40-45, or
when childbearing is complete. For BRCA2 carriers, the recommendation is ages 45-50.
Q8. A patient with a history of colorectal cancer treated with curative intent is being
seen for surveillance. When is the first surveillance colonoscopy recommended?
A. 3 months post-surgery
B. 6 months post-surgery
C. 1 year post-surgery
D. 3 years post-surgery
Answer: C
Rationale: For patients with colorectal cancer treated with curative intent, the first
surveillance colonoscopy is recommended at 1 year post-surgery, then every 3-5 years
depending on findings.
Q9. A 62-year-old male with a new diagnosis of prostate cancer has a Gleason score of
4+3=7, PSA of 12 ng/mL, and clinical stage T2a. What is the patient's risk category?
A. Low risk
B. Favorable intermediate risk
C. Unfavorable intermediate risk
D. High risk
Answer: C
Rationale: Gleason score 4+3=7 is considered unfavorable intermediate risk (compared
to 3+4=7 which is favorable intermediate).
Questions & Terms for Advanced
Oncology Certified Nurse Practitioner
Board Exam Prep (PDF)
SECTION 1: CANCER CONTINUUM – SCREENING,
PREVENTION, GENETICS, DIAGNOSIS, STAGING (~35% OF
EXAM)
Q1. A patient's pathology report shows invasive breast cancer that is estrogen receptor
(ER)-positive, progesterone receptor (PR)-positive, and HER2-negative. What is the most
important next step in treatment planning?
A. Immediate initiation of chemotherapy
B. Referral to medical oncology for consideration of endocrine therapy
C. Immediate bilateral mastectomy
D. Radiation therapy planning
Answer: B
Rationale: ER-positive, HER2-negative breast cancer is typically treated with endocrine
therapy (e.g., tamoxifen or aromatase inhibitors). The NP should explain the significance
of receptor testing and coordinate referrals to the multidisciplinary team.
,Q2. Which finding would MOST strongly suggest a hereditary cancer syndrome rather
than sporadic cancer?
A. Tumor located in the descending colon
B. Diagnosis at age 45 with no family history
C. Diagnosis at age 30 with multiple generations affected
D. Unilateral breast cancer
Answer: C
Rationale: Features suggesting hereditary cancer include early age of onset (e.g., breast
cancer under 50), multiple primary cancers in the same individual, bilateral or multifocal
disease, and multiple generations affected.
Q3. Which gene mutations are associated with hereditary melanoma?
A. BRCA1 and BRCA2
B. APC and MLH1
C. p16/CDKN2A and CDK4
D. TP53 and PTEN
Answer: C
Rationale: p16/CDKN2A and CDK4 are the primary genes associated with hereditary
melanoma. Hereditary melanomas account for approximately 10% of all melanomas and
are inherited in an autosomal dominant pattern.
Q4. According to the ONCC, which of the following is TRUE about the AOCNP exam?
A. Brand-name drug names are used exclusively on the exam
B. Only generic drug names are used on ONCC tests
C. Both generic and brand names are used interchangeably
D. Only drug classes are tested, not specific drug names
Answer: B
Rationale: Only generic drug names are used on ONCC tests.
,Q5. Which cancer screening test is recommended for average-risk individuals beginning
at age 45 according to current guidelines?
A. Colonoscopy
B. Mammography
C. PSA testing
D. Low-dose CT chest
Answer: A
Rationale: Average-risk individuals should begin colorectal cancer screening at age 45.
Q6. A patient with Lynch syndrome asks about colon cancer screening
recommendations. What is the appropriate screening recommendation?
A. Colonoscopy every 5 years starting at age 40
B. Annual colonoscopy starting at age 20-25
C. Fecal occult blood testing annually starting at age 30
D. CT colonography every 3 years starting at age 35
Answer: B
Rationale: For patients with Lynch syndrome, annual colonoscopy is recommended
beginning at age 20-25 (or 5 years before the earliest family diagnosis, whichever comes
first).
Q7. A 48-year-old female with a BRCA1 mutation is considering risk-reducing salpingo-
oophorectomy (RRSO). At what age is RRSO MOST recommended for BRCA1 mutation
carriers?
A. Age 35-40
B. Age 40-45
C. Age 45-50
D. Age 50-55
, Answer: B
Rationale: For BRCA1 mutation carriers, RRSO is recommended between ages 40-45, or
when childbearing is complete. For BRCA2 carriers, the recommendation is ages 45-50.
Q8. A patient with a history of colorectal cancer treated with curative intent is being
seen for surveillance. When is the first surveillance colonoscopy recommended?
A. 3 months post-surgery
B. 6 months post-surgery
C. 1 year post-surgery
D. 3 years post-surgery
Answer: C
Rationale: For patients with colorectal cancer treated with curative intent, the first
surveillance colonoscopy is recommended at 1 year post-surgery, then every 3-5 years
depending on findings.
Q9. A 62-year-old male with a new diagnosis of prostate cancer has a Gleason score of
4+3=7, PSA of 12 ng/mL, and clinical stage T2a. What is the patient's risk category?
A. Low risk
B. Favorable intermediate risk
C. Unfavorable intermediate risk
D. High risk
Answer: C
Rationale: Gleason score 4+3=7 is considered unfavorable intermediate risk (compared
to 3+4=7 which is favorable intermediate).
