AOCNP Advanced Oncology Certified
Nurse Practitioner Practice Exam: Correct
Questions & Detailed Rationales
(2025/2026 Update)
DOMAIN 1: Cancer Continuum (Screening, Prevention, Assessment, Diagnosis,
Survivorship)
**Question 1**
A 45-year-old woman with a family history of early-onset breast cancer requests
genetic testing. Which gene mutation should be prioritized for testing?
- A) KRAS
- B) BRCA1
- C) EGFR
- D) BCR-ABL
**Answer: B) BRCA1**
**Rationale:** BRCA1 and BRCA2 mutations confer high hereditary breast and
ovarian cancer risk, especially with early-onset family history. KRAS, EGFR, and
BCR-ABL are somatic oncogenes, not primary hereditary markers.
---
,**Question 2**
Which lifestyle modification is most strongly associated with a reduced risk of
developing colorectal cancer?
- A) High-dose vitamin E supplementation
- B) Daily consumption of processed red meat
- C) Regular physical activity of ≥150 minutes per week
- D) Exclusive use of fruit juice for hydration
**Answer: C) Regular physical activity of ≥150 minutes per week**
**Rationale:** Regular moderate-intensity physical activity lowers colorectal
cancer risk by improving bowel motility and reducing insulin resistance. Processed
red meat increases risk; vitamin E and fruit juice have no proven benefit.
---
**Question 3**
Which of the following is the most appropriate screening test for hepatocellular
carcinoma (HCC) in a cirrhotic patient?
- A) Serum AFP alone annually
- B) Abdominal ultrasound every 6 months ± AFP
- C) Colonoscopy every 10 years
- D) Low-dose CT chest annually
**Answer: B) Abdominal ultrasound every 6 months ± AFP**
,**Rationale:** Semiannual ultrasound, with or without AFP, is recommended for
HCC surveillance in cirrhosis. AFP alone lacks sensitivity. Colonoscopy screens for
colorectal cancer, not HCC.
---
**Question 4**
A 45-year-old woman with BRCA1 mutation asks about breast cancer risk
reduction. Which intervention has the strongest evidence for risk reduction?
- A) Annual mammography starting at age 30
- B) Prophylactic bilateral salpingo-oophorectomy
- C) Tamoxifen 20 mg daily for 5 years
- D) Monthly breast self-exams
**Answer: C) Tamoxifen 20 mg daily for 5 years**
**Rationale:** Tamoxifen reduces breast cancer incidence by approximately 50%
in high-risk women. Prophylactic oophorectomy reduces ovarian cancer risk but
has less effect on breast cancer than tamoxifen.
---
**Question 5**
Which cancer screening test is recommended for average-risk adults beginning at
age 45?
- A) Colonoscopy every 10 years
, - B) PSA blood test annually
- C) Low-dose chest CT annually
- D) Pap smear every 3 years
**Answer: A) Colonoscopy every 10 years**
**Rationale:** Colonoscopy beginning at age 45 is USPSTF Grade A for colorectal
cancer screening. PSA is shared decision-making starting at age 55. Low-dose CT is
for lung cancer in high-risk smokers.
---
**Question 6**
A bilateral diagnostic mammogram is recommended for breast cancer workup
and staging. If needed, which test can help distinguish a cystic mass from a solid
mass?
- A) Breast MRI
- B) Ultrasound
- C) PET scan
- D) Bone scan
**Answer: B) Ultrasound**
**Rationale:** Ultrasound is the imaging modality of choice to differentiate cystic
from solid breast masses. MRI, PET, and bone scans are used for different clinical
indications in breast cancer evaluation.
Nurse Practitioner Practice Exam: Correct
Questions & Detailed Rationales
(2025/2026 Update)
DOMAIN 1: Cancer Continuum (Screening, Prevention, Assessment, Diagnosis,
Survivorship)
**Question 1**
A 45-year-old woman with a family history of early-onset breast cancer requests
genetic testing. Which gene mutation should be prioritized for testing?
- A) KRAS
- B) BRCA1
- C) EGFR
- D) BCR-ABL
**Answer: B) BRCA1**
**Rationale:** BRCA1 and BRCA2 mutations confer high hereditary breast and
ovarian cancer risk, especially with early-onset family history. KRAS, EGFR, and
BCR-ABL are somatic oncogenes, not primary hereditary markers.
---
,**Question 2**
Which lifestyle modification is most strongly associated with a reduced risk of
developing colorectal cancer?
- A) High-dose vitamin E supplementation
- B) Daily consumption of processed red meat
- C) Regular physical activity of ≥150 minutes per week
- D) Exclusive use of fruit juice for hydration
**Answer: C) Regular physical activity of ≥150 minutes per week**
**Rationale:** Regular moderate-intensity physical activity lowers colorectal
cancer risk by improving bowel motility and reducing insulin resistance. Processed
red meat increases risk; vitamin E and fruit juice have no proven benefit.
---
**Question 3**
Which of the following is the most appropriate screening test for hepatocellular
carcinoma (HCC) in a cirrhotic patient?
- A) Serum AFP alone annually
- B) Abdominal ultrasound every 6 months ± AFP
- C) Colonoscopy every 10 years
- D) Low-dose CT chest annually
**Answer: B) Abdominal ultrasound every 6 months ± AFP**
,**Rationale:** Semiannual ultrasound, with or without AFP, is recommended for
HCC surveillance in cirrhosis. AFP alone lacks sensitivity. Colonoscopy screens for
colorectal cancer, not HCC.
---
**Question 4**
A 45-year-old woman with BRCA1 mutation asks about breast cancer risk
reduction. Which intervention has the strongest evidence for risk reduction?
- A) Annual mammography starting at age 30
- B) Prophylactic bilateral salpingo-oophorectomy
- C) Tamoxifen 20 mg daily for 5 years
- D) Monthly breast self-exams
**Answer: C) Tamoxifen 20 mg daily for 5 years**
**Rationale:** Tamoxifen reduces breast cancer incidence by approximately 50%
in high-risk women. Prophylactic oophorectomy reduces ovarian cancer risk but
has less effect on breast cancer than tamoxifen.
---
**Question 5**
Which cancer screening test is recommended for average-risk adults beginning at
age 45?
- A) Colonoscopy every 10 years
, - B) PSA blood test annually
- C) Low-dose chest CT annually
- D) Pap smear every 3 years
**Answer: A) Colonoscopy every 10 years**
**Rationale:** Colonoscopy beginning at age 45 is USPSTF Grade A for colorectal
cancer screening. PSA is shared decision-making starting at age 55. Low-dose CT is
for lung cancer in high-risk smokers.
---
**Question 6**
A bilateral diagnostic mammogram is recommended for breast cancer workup
and staging. If needed, which test can help distinguish a cystic mass from a solid
mass?
- A) Breast MRI
- B) Ultrasound
- C) PET scan
- D) Bone scan
**Answer: B) Ultrasound**
**Rationale:** Ultrasound is the imaging modality of choice to differentiate cystic
from solid breast masses. MRI, PET, and bone scans are used for different clinical
indications in breast cancer evaluation.
