AOCNP CERTIFICATION EXAM QUESTIONS
AND CORRECT ANSWERS (VERIFIED
ANSWERS) PLUS RATIONALES 2026/2027 |
ADVANCED ONCOLOGY CERTIFIED NURSE
PRACTITIONER | PASS GUARANTEED
Core Domains:
- Cancer Continuum (Screening, Genetics, Diagnosis, Staging, Survivorship)
- Cancer Treatment and Supportive Care (Systemic Therapy, Radiation, Surgery,
Symptom Management)
- Oncologic Emergencies (TLS, Febrile Neutropenia, Spinal Cord Compression,
Hypercalcemia)
- Psychosocial Issues (Distress Screening, Coping, Caregiver Support)
- Professional Practice and Roles of the APRN (Ethics, Quality Improvement,
Cultural Competence)
Introduction
This comprehensive examination assesses the candidate's mastery of advanced
oncology nursing practice required for the AOCNP certification. It evaluates
knowledge of the cancer continuum, treatment modalities, supportive care,
oncologic emergencies, psychosocial issues, and professional practice. Questions
are presented in multiple-choice and scenario-based formats requiring integration
of knowledge across domains. Emphasis is placed on real-world clinical decision-
making, evidence-based practice, and adherence to ONCC standards. Successful
completion demonstrates readiness for advanced oncology nurse practitioner
certification.
SECTION ONE: QUESTIONS 1–50
Question 1
A 62-year-old patient with stage IIIB non-small cell lung cancer is receiving
pembrolizumab. The patient develops a new-onset cough, dyspnea, and
hypoxemia. What is the most likely diagnosis and appropriate next step?
A. Pneumonia; start empiric antibiotics
B. Pulmonary embolism; order CT angiography
,C. Immune-mediated pneumonitis; hold pembrolizumab and initiate corticosteroids
D. Disease progression; order repeat imaging
C. Immune-mediated pneumonitis; hold pembrolizumab and initiate
corticosteroids
RATIONALE: Immune checkpoint inhibitors like pembrolizumab can cause
immune-related adverse events. Pneumonitis is a potentially life-threatening irAE
characterized by cough, dyspnea, and hypoxemia. The first step is to hold the
immunotherapy and initiate corticosteroids .
Question 2
A patient receiving cisplatin develops acute kidney injury with a creatinine of
2.4 mg/dL (baseline 0.9). Which of the following interventions is most
appropriate for prevention of further nephrotoxicity?
A. Administer furosemide 40 mg IV push
B. Administer IV normal saline at 250 mL/hr
C. Administer sodium bicarbonate IV
D. Administer allopurinol
B. Administer IV normal saline at 250 mL/hr
RATIONALE: Cisplatin-induced nephrotoxicity is dose-limiting and
cumulative. Aggressive IV hydration with normal saline is the cornerstone of
prevention by ensuring adequate urine output and reducing the concentration of
cisplatin in the renal tubules .
Question 3
A 45-year-old female with breast cancer is on tamoxifen. She reports new-
onset hot flashes and vaginal dryness. What is the most appropriate
management?
A. Discontinue tamoxifen
B. Switch to an aromatase inhibitor
C. Offer nonpharmacologic interventions (cooling techniques, lifestyle
modifications)
D. Prescribe venlafaxine
, D. Prescribe venlafaxine
RATIONALE: Tamoxifen commonly causes vasomotor symptoms (hot
flashes) and vaginal dryness. Venlafaxine is a non-hormonal option effective for
managing hot flashes in breast cancer patients. Aromatase inhibitors are not
appropriate for premenopausal women without ovarian suppression .
Question 4
A patient with acute myeloid leukemia (AML) develops tumor lysis syndrome
(TLS) following induction chemotherapy. Which laboratory finding would be
most consistent with TLS?
A. Hypokalemia, hypophosphatemia, hypocalcemia
B. Hyperkalemia, hyperphosphatemia, hypocalcemia
C. Hyperkalemia, hypophosphatemia, hypercalcemia
D. Hypokalemia, hyperphosphatemia, hypercalcemia
B. Hyperkalemia, hyperphosphatemia, hypocalcemia
RATIONALE: Tumor lysis syndrome is characterized by rapid release of
intracellular contents: hyperkalemia, hyperphosphatemia, hypocalcemia (due to
calcium phosphate precipitation), and hyperuricemia. This can lead to acute kidney
injury .
Question 5
Which of the following is a "targeted therapy" that acts by inhibiting the
BCR-ABL tyrosine kinase?
A. Rituximab
B. Imatinib (Gleevec)
C. Trastuzumab (Herceptin)
D. Bevacizumab (Avastin)
B. Imatinib (Gleevec)
RATIONALE: Imatinib is a tyrosine kinase inhibitor that targets the BCR-
ABL fusion protein in chronic myeloid leukemia (CML). Rituximab is a
, monoclonal antibody targeting CD20; trastuzumab targets HER2; bevacizumab
targets VEGF .
Question 6
A patient on oxaliplatin therapy reports cold-induced tingling and paresthesia
in the hands and feet. This is most consistent with which type of toxicity?
A. Acute laryngeal toxicity
B. Peripheral sensory neuropathy
C. Central neurotoxicity
D. Myelosuppression
B. Peripheral sensory neuropathy
RATIONALE: Oxaliplatin causes a characteristic peripheral sensory
neuropathy, often exacerbated by cold exposure. Patients may experience
paresthesia, dysesthesia, and cold sensitivity in the hands, feet, and perioral area .
Question 7
A 52-year-old female with no family history of breast cancer asks about breast
cancer screening. According to current guidelines, which of the following is
the recommended screening approach?
A. Annual mammography starting at age 40
B. Mammography every 2 years starting at age 50
C. Annual mammography starting at age 45 with option to begin at 40
D. Clinical breast examination only until age 50
C. Annual mammography starting at age 45 with option to begin at 40
RATIONALE: Current NCCN and USPSTF guidelines recommend average-
risk women begin screening mammography at age 45 with the option to start at age
40, transitioning to biennial screening at age 55. Shared decision-making at age 40-
44 is emphasized .
AND CORRECT ANSWERS (VERIFIED
ANSWERS) PLUS RATIONALES 2026/2027 |
ADVANCED ONCOLOGY CERTIFIED NURSE
PRACTITIONER | PASS GUARANTEED
Core Domains:
- Cancer Continuum (Screening, Genetics, Diagnosis, Staging, Survivorship)
- Cancer Treatment and Supportive Care (Systemic Therapy, Radiation, Surgery,
Symptom Management)
- Oncologic Emergencies (TLS, Febrile Neutropenia, Spinal Cord Compression,
Hypercalcemia)
- Psychosocial Issues (Distress Screening, Coping, Caregiver Support)
- Professional Practice and Roles of the APRN (Ethics, Quality Improvement,
Cultural Competence)
Introduction
This comprehensive examination assesses the candidate's mastery of advanced
oncology nursing practice required for the AOCNP certification. It evaluates
knowledge of the cancer continuum, treatment modalities, supportive care,
oncologic emergencies, psychosocial issues, and professional practice. Questions
are presented in multiple-choice and scenario-based formats requiring integration
of knowledge across domains. Emphasis is placed on real-world clinical decision-
making, evidence-based practice, and adherence to ONCC standards. Successful
completion demonstrates readiness for advanced oncology nurse practitioner
certification.
SECTION ONE: QUESTIONS 1–50
Question 1
A 62-year-old patient with stage IIIB non-small cell lung cancer is receiving
pembrolizumab. The patient develops a new-onset cough, dyspnea, and
hypoxemia. What is the most likely diagnosis and appropriate next step?
A. Pneumonia; start empiric antibiotics
B. Pulmonary embolism; order CT angiography
,C. Immune-mediated pneumonitis; hold pembrolizumab and initiate corticosteroids
D. Disease progression; order repeat imaging
C. Immune-mediated pneumonitis; hold pembrolizumab and initiate
corticosteroids
RATIONALE: Immune checkpoint inhibitors like pembrolizumab can cause
immune-related adverse events. Pneumonitis is a potentially life-threatening irAE
characterized by cough, dyspnea, and hypoxemia. The first step is to hold the
immunotherapy and initiate corticosteroids .
Question 2
A patient receiving cisplatin develops acute kidney injury with a creatinine of
2.4 mg/dL (baseline 0.9). Which of the following interventions is most
appropriate for prevention of further nephrotoxicity?
A. Administer furosemide 40 mg IV push
B. Administer IV normal saline at 250 mL/hr
C. Administer sodium bicarbonate IV
D. Administer allopurinol
B. Administer IV normal saline at 250 mL/hr
RATIONALE: Cisplatin-induced nephrotoxicity is dose-limiting and
cumulative. Aggressive IV hydration with normal saline is the cornerstone of
prevention by ensuring adequate urine output and reducing the concentration of
cisplatin in the renal tubules .
Question 3
A 45-year-old female with breast cancer is on tamoxifen. She reports new-
onset hot flashes and vaginal dryness. What is the most appropriate
management?
A. Discontinue tamoxifen
B. Switch to an aromatase inhibitor
C. Offer nonpharmacologic interventions (cooling techniques, lifestyle
modifications)
D. Prescribe venlafaxine
, D. Prescribe venlafaxine
RATIONALE: Tamoxifen commonly causes vasomotor symptoms (hot
flashes) and vaginal dryness. Venlafaxine is a non-hormonal option effective for
managing hot flashes in breast cancer patients. Aromatase inhibitors are not
appropriate for premenopausal women without ovarian suppression .
Question 4
A patient with acute myeloid leukemia (AML) develops tumor lysis syndrome
(TLS) following induction chemotherapy. Which laboratory finding would be
most consistent with TLS?
A. Hypokalemia, hypophosphatemia, hypocalcemia
B. Hyperkalemia, hyperphosphatemia, hypocalcemia
C. Hyperkalemia, hypophosphatemia, hypercalcemia
D. Hypokalemia, hyperphosphatemia, hypercalcemia
B. Hyperkalemia, hyperphosphatemia, hypocalcemia
RATIONALE: Tumor lysis syndrome is characterized by rapid release of
intracellular contents: hyperkalemia, hyperphosphatemia, hypocalcemia (due to
calcium phosphate precipitation), and hyperuricemia. This can lead to acute kidney
injury .
Question 5
Which of the following is a "targeted therapy" that acts by inhibiting the
BCR-ABL tyrosine kinase?
A. Rituximab
B. Imatinib (Gleevec)
C. Trastuzumab (Herceptin)
D. Bevacizumab (Avastin)
B. Imatinib (Gleevec)
RATIONALE: Imatinib is a tyrosine kinase inhibitor that targets the BCR-
ABL fusion protein in chronic myeloid leukemia (CML). Rituximab is a
, monoclonal antibody targeting CD20; trastuzumab targets HER2; bevacizumab
targets VEGF .
Question 6
A patient on oxaliplatin therapy reports cold-induced tingling and paresthesia
in the hands and feet. This is most consistent with which type of toxicity?
A. Acute laryngeal toxicity
B. Peripheral sensory neuropathy
C. Central neurotoxicity
D. Myelosuppression
B. Peripheral sensory neuropathy
RATIONALE: Oxaliplatin causes a characteristic peripheral sensory
neuropathy, often exacerbated by cold exposure. Patients may experience
paresthesia, dysesthesia, and cold sensitivity in the hands, feet, and perioral area .
Question 7
A 52-year-old female with no family history of breast cancer asks about breast
cancer screening. According to current guidelines, which of the following is
the recommended screening approach?
A. Annual mammography starting at age 40
B. Mammography every 2 years starting at age 50
C. Annual mammography starting at age 45 with option to begin at 40
D. Clinical breast examination only until age 50
C. Annual mammography starting at age 45 with option to begin at 40
RATIONALE: Current NCCN and USPSTF guidelines recommend average-
risk women begin screening mammography at age 45 with the option to start at age
40, transitioning to biennial screening at age 55. Shared decision-making at age 40-
44 is emphasized .
