AOCNP (Advanced Oncology Certified
Nurse Practitioner) 100-Question
Practice Exam Bank: Correct Answers
with Detailed Clinical Rationales for
the 2025/2026 ONCC Blueprint
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 in this scenario?
A) KRAS
B) BRCA1
C) EGFR
D) BCR-ABL
Answer: B) BRCA1
Rationale: BRCA1 and BRCA2 mutations confer a high hereditary risk
for breast and ovarian cancer, especially with early-onset family
history.
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.
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.
4. BRCA1 mutation increases risk primarily for:
A) Thyroid cancer
B) Breast and ovarian cancer
C) Colon cancer
D) Lung cancer
Answer: B) Breast and ovarian cancer
Rationale: BRCA1 and BRCA2 are tumor suppressor genes; pathogenic
mutations confer significantly increased lifetime risks for breast,
ovarian, and other cancers.
5. 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 primary imaging modality to differentiate
cystic from solid breast masses.
6. A 58-year-old patient with newly diagnosed non-small cell lung
cancer asks about the role of PD-L1 testing. The AOCNP explains that
PD-L1 testing primarily guides:
A) Surgical candidacy
B) Radiation dosing
C) Immunotherapy selection
D) Chemotherapy toxicity prediction
Answer: C) Immunotherapy selection
Rationale: PD-L1 expression on tumor cells predicts response to
immune checkpoint inhibitors like pembrolizumab.
7. A patient with a strong family history of breast cancer meeting
criteria for hereditary breast and ovarian cancer syndrome should
undergo:
A) BRCA1/2 testing only
B) Multigene panel testing
C) No genetic testing
D) KRAS testing
Answer: B) Multigene panel testing
Rationale: Multigene panel testing is recommended for patients
meeting criteria for hereditary breast and ovarian cancer syndrome.
, 8. Which cancer screening test is recommended for average-risk
individuals starting at age 45?
A) Colonoscopy
B) Mammogram
C) PSA
D) Low-dose CT chest
Answer: B) Mammogram
Rationale: Average-risk women should begin mammography
screening at age 45.
9. The classic diagnostic triad of gross hematuria, costovertebral pain,
and a palpable flank mass is associated with:
A) Bladder cancer
B) Renal cell carcinoma
C) Prostate cancer
D) Testicular cancer
Answer: B) Renal cell carcinoma
Rationale: This classic triad is seen in only 10% to 20% of patients with
renal cell carcinoma.
10. Sentinel lymph node biopsy is an accurate technique for
determining regional metastasis and staging information for patients
with:
A) Melanoma and breast cancer
B) Lung cancer and colon cancer
C) Prostate cancer and pancreatic cancer
D) Ovarian cancer and cervical cancer
Answer: A) Melanoma and breast cancer
Nurse Practitioner) 100-Question
Practice Exam Bank: Correct Answers
with Detailed Clinical Rationales for
the 2025/2026 ONCC Blueprint
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 in this scenario?
A) KRAS
B) BRCA1
C) EGFR
D) BCR-ABL
Answer: B) BRCA1
Rationale: BRCA1 and BRCA2 mutations confer a high hereditary risk
for breast and ovarian cancer, especially with early-onset family
history.
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.
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.
4. BRCA1 mutation increases risk primarily for:
A) Thyroid cancer
B) Breast and ovarian cancer
C) Colon cancer
D) Lung cancer
Answer: B) Breast and ovarian cancer
Rationale: BRCA1 and BRCA2 are tumor suppressor genes; pathogenic
mutations confer significantly increased lifetime risks for breast,
ovarian, and other cancers.
5. 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 primary imaging modality to differentiate
cystic from solid breast masses.
6. A 58-year-old patient with newly diagnosed non-small cell lung
cancer asks about the role of PD-L1 testing. The AOCNP explains that
PD-L1 testing primarily guides:
A) Surgical candidacy
B) Radiation dosing
C) Immunotherapy selection
D) Chemotherapy toxicity prediction
Answer: C) Immunotherapy selection
Rationale: PD-L1 expression on tumor cells predicts response to
immune checkpoint inhibitors like pembrolizumab.
7. A patient with a strong family history of breast cancer meeting
criteria for hereditary breast and ovarian cancer syndrome should
undergo:
A) BRCA1/2 testing only
B) Multigene panel testing
C) No genetic testing
D) KRAS testing
Answer: B) Multigene panel testing
Rationale: Multigene panel testing is recommended for patients
meeting criteria for hereditary breast and ovarian cancer syndrome.
, 8. Which cancer screening test is recommended for average-risk
individuals starting at age 45?
A) Colonoscopy
B) Mammogram
C) PSA
D) Low-dose CT chest
Answer: B) Mammogram
Rationale: Average-risk women should begin mammography
screening at age 45.
9. The classic diagnostic triad of gross hematuria, costovertebral pain,
and a palpable flank mass is associated with:
A) Bladder cancer
B) Renal cell carcinoma
C) Prostate cancer
D) Testicular cancer
Answer: B) Renal cell carcinoma
Rationale: This classic triad is seen in only 10% to 20% of patients with
renal cell carcinoma.
10. Sentinel lymph node biopsy is an accurate technique for
determining regional metastasis and staging information for patients
with:
A) Melanoma and breast cancer
B) Lung cancer and colon cancer
C) Prostate cancer and pancreatic cancer
D) Ovarian cancer and cervical cancer
Answer: A) Melanoma and breast cancer
