Study guide
1.1 About the AOCNP Exam
Advanced Oncology Certified Nurse Practitioner AOCNP
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1 Chapter 1: Introduction & Exam Overview
1.1 About the AOCNP Exam 1.2 How to Use This AOCNP Study Guide
2 Chapter 2: Cancer Continuum - Risk, Prevention & Screening
2.1 Cancer Risk Factors, At-Risk Populations & Health Disparities 2.2 Primary Prevention, Vaccination, Chemoprevention & Risk-Reducing Surgery 2.3 Cancer Screening & Early Detection Guidelines 2.4 Screening for Subsequent & Second Primary Malignancies 2.5 Hereditary Cancer Syndromes & Genetic Counseling
3 Chapter 3: Cancer Continuum - Assessment, Diagnosis & Staging
3.1 Diagnostic Workup, Tissue Biopsy & Biomarker Evaluation 3.2 Pathology Interpretation, Histology & Tumor Grading 3.3 Cancer Staging Systems (TNM) & Prognostication Models 3.4 Performance Status, Frailty & Geriatric Assessment
4 Chapter 4: Cancer Continuum - Planning, Coordination & Survivorship
4.1 Established Guidelines for Care & Categories of Evidence 4.2 Individualized Treatment Planning & Molecular Tumor Boards 4.3 Reproductive Planning & Fertility Preservation 4.4 Patient Navigation & Interprofessional Care Coordination 4.5 Survivorship Care Planning & Late Effects Management 4.6 Post-Treatment Surveillance for Cancer Recurrence
5 Chapter 5: Cancer Treatment - Antineoplastic Pharmacology & Chemotherapy
5.1 Antineoplastic Principles, Dosing & Dose Adjustments 5.2 Cytotoxic Chemotherapy Classes & Adverse Effect Management 5.3 Safe Administration, Handling & Infusion Toxicities 5.4 Oral Antineoplastic Therapy: Adherence, Interactions & Monitoring
6 Chapter 6: Cancer Treatment - Targeted, Immuno & Hormonal Therapies
6.1 Targeted Therapies, Tyrosine Kinase Inhibitors & ADCs 6.2 Cancer Immunotherapy, Checkpoint Inhibitors & CAR T-Cell Therapy 6.3 Endocrine & Hormonal Therapies in Oncology
7 Chapter 7: Cancer Treatment - Radiation, Surgery, Regional & Multimodal Therapy
7.1 Radiation Oncology Principles & Toxicity Management 7.2 Surgical Oncology, Perioperative Care & Reconstruction 7.3 Regional & Localized Therapy Administration 7.4 Multimodal Therapy & Treatment Sequencing 7.5 Complementary, Alternative & Integrative Therapies
8 Chapter 8: Cancer Treatment - Transplantation, Clinical Trials & Response
8.1 Hematopoietic Stem Cell Transplantation (HSCT) & Cell Therapy 8.2 Clinical Trials, Research Protocols & Response Evaluation (RECIST)
9 Chapter 9: Supportive Care - Pain & Controlled Substance Safety
9.1 Cancer Pain Assessment & Comprehensive Analgesic Management 9.2 Controlled Substance Safety & Opioid Stewardship 9.3 Nonpharmacologic & Integrative Symptom Interventions
10 Chapter 10: Supportive Care - Symptom & Comorbidity Management
10.1 Acute, Late & Long-Term Patterns of Treatment-Related Symptoms 10.2 Gastrointestinal Symptom Management (CINV, Mucositis, Diarrhea) 10.3 Hematologic & Neurologic Toxicity Management 10.4 Dermatologic, Metabolic & Fatigue Management 10.5 Cancer-Associated Thrombosis & Anticoagulation 10.6 Comorbid Conditions & Their Interaction With Cancer Treatment 10.7 Palliative Care, Hospice & End-of-Life Management
11 Chapter 11: Oncologic Emergencies
11.1 Superior Vena Cava Syndrome & Structural Emergencies 11.2 Spinal Cord Compression & Neurologic Emergencies 11.3 Metabolic Emergencies: Tumor Lysis Syndrome & Hypercalcemia of Malignancy 11.4 Febrile Neutropenia, Sepsis & Vesicant Extravasation 11.5 Cardiopulmonary & Airway Emergencies 11.6 Hematologic & Endocrine Emergencies: DIC, Leukostasis, Hyperviscosity & SIADH
12 Chapter 12: Psychosocial Issues
12.1 Psychosocial Assessment & Distress Screening in Oncology 12.2 Risk Factors & At-Risk Oncology Populations 12.3 Psychosocial & Emotional Sequelae of Disease and Treatment 12.4 Psychiatric & Psychosocial Comorbidities in Cancer Care 12.5 Caregiver Burden, Support & Community Resources
13 Chapter 13: Professional Practice & Roles of the APRN
13.1 APRN Scope of Practice, Prescriptive Authority & Standards of Care 13.2 Bioethics, Informed Consent & Quality Improvement in Oncology 13.3 Cultural Competence, Implicit Bias & Equitable Oncology Care 13.4 Accreditation Standards & Outcomes of APRN Practice 13.5 Competency Evaluation, Peer Review & Peer Education
1.1 About the AOCNP Exam
Key Takeaways Explain This Topic AI
The AOCNP examination contains 165 multiple-choice questions, of which 125 are scored and 40 are unscored pretest items, administered in a single 3-hour session.
ONCC sets the passing standard at a scaled score of 55 on a 25-to-75 scale, and the same standard applies to every ONCC examination.
Eligibility has two pathways, both measured within the prior 5 years: an oncology-concentration NP degree plus 500 supervised adult oncology NP hours, or an adult/adult-gerontology/family/women's-health NP degree plus 1,000 adult oncology NP practice hours, and either pathway also requires one graduate-level oncology course of at least 2 credits or 30 contact hours of oncology continuing education.
The blueprint, based on a 2022 role delineation study, weights Cancer Continuum 28%, Cancer Treatment and Supportive Care 45%, Oncologic Emergencies 12%, Psychosocial Issues 10%, and Professional Practice and Roles of the APRN 5%.
Certification lasts 4 years and is renewed through the ILNA, whose learning plan is generated from the candidate's own test or assessment results report and mirrors the current test content outline.
Last updated: August 2026
About the Advanced Oncology Certified Nurse Practitioner (AOCNP) Exam
The Advanced Oncology Certified Nurse Practitioner (AOCNP®) credential is the specialty board certification for Advanced Practice Registered Nurses (APRNs) who practice as nurse practitioners in adult oncology . It is granted by the Oncology Nursing Certification Corporation (ONCC) , and it is one of five ONCC programs accredited by the National Commission for Certifying Agencies (NCCA) . The examination validates the clinical judgment required to manage patients across the entire cancer continuum — risk assessment and screening, diagnosis and staging, systemic and local therapy, supportive care, oncologic emergencies, psychosocial care, and end-of-life care.
1. Candidate Eligibility: Two Pathways
ONCC publishes two eligibility pathways. Every requirement must be met at the time of application and at the time of examination . All practice hours and oncology-specific education must fall within the 5 years (60 months) prior to application .
- Requirement Pathway 1 Pathway 2
- Licensure Current, active, unencumbered RN license in the US, its territories, or Canada Same
Graduate education Graduate degree from an accredited NP program with a concentration in oncology Graduate degree from an accredited NP program with a concentration in adult primary or acute care, adult-gerontology across the lifespan, family, or women's health
Oncology practice 500 hours of supervised clinical practice as an adult oncology NP, obtained within and/or following the graduate program 1,000 hours of practice as an adult oncology NP, obtained within and/or following the graduate program
Oncology-specific education One graduate-level oncology course of at least 2 credits OR 30 contact hours of oncology nursing continuing education Same
Exam trap: The contact-hour requirement is 30 hours , not 10, and the lookback window is 5 years , not 3. Contact hours must be provided or formally approved by an accredited provider of nursing continuing professional development (NCPD) — ONCC accepts hours awarded by ANCC, ACCME, or ACPE.
2. Exam Specifications
ONCC contracts test delivery to PSI ; authorization-to-test (ATT) messages arrive from no-reply@psiexams.com . The ATT is valid for 90 days , and the test must be scheduled and taken before it expires or all test fees are forfeited.
- Parameter Specification
- Certifying body Oncology Nursing Certification Corporation (ONCC)
- Test delivery vendor PSI (computer-based testing)
- Total items 165 multiple-choice questions , each with a stem and four answer options; only one is correct
- Scored items 125
- Pretest (unscored) items 40 , indistinguishable from scored items
- Time limit 3 hours (180 minutes) ; breaks do not stop the session timer
- Score scale Scaled score, minimum 25 , maximum 75
- Passing standard Scaled score of 55 (criterion-referenced; identical across all ONCC exams)
Results Unofficial pass/fail appears on screen before leaving the test center; an emailed results report gives performance by subject area
- Test fee $300 ONS/APHON member · $420 non-member
- DoubleTake option Optional $100 retake add-on that must be purchased at the time of initial application
- Credential validity 4 years
Exam trap: The scored/pretest split is 125 / 40 , not 140 / 25. ONCC's own instruction for estimating domain item counts is to multiply the domain percentage by 125 .
3. The Official ONCC AOCNP Test Content Outline
The blueprint derives from a role delineation study of advanced oncology nursing practice completed in 2022 . Every major subject area appears on every form of the test at its assigned percentage, although not every sub-area appears on every form.
- Domain Official title Weight Approx. scored items (% × 125)
- I Cancer Continuum 28% ~35
- II Cancer Treatment and Supportive Care 45% ~56
- III Oncologic Emergencies 12% ~15
- IV Psychosocial Issues 10% ~13
- V Professional Practice and Roles of the APRN 5% ~6
Domain I — Cancer Continuum covers screening and prevention (at-risk populations, screening and early detection, screening for subsequent malignancies, hereditary cancer risk assessment); assessment and diagnosis (diagnostic tests and results, patient assessment, staging guidelines, individualized treatment planning, reproductive planning); and plan of care across the continuum (established guidelines, patient navigation, survivorship, surveillance for recurrence, interprofessional care, end-of-life care).
Domain II — Cancer Treatment and Supportive Care covers clinical trials; systemic therapy; localized therapy; surgery; radiation; blood and marrow transplantation; multimodal therapy; complementary and integrative therapies; the etiology, incidence, and patterns of treatment-related symptoms; response to therapy; palliative care; pharmacologic and nonpharmacologic symptom management; the interrelationship of disease, treatment, and comorbid conditions; and controlled substance safety.
Domain III — Oncologic Emergencies is written around three lenses applied to every emergency: etiology/risk factors/prevention, assessment strategies, and interventions.
Domain IV — Psychosocial Issues covers assessment instruments, risk factors and at-risk populations, psychosocial and emotional sequelae, psychiatric and psychosocial comorbidities, and community resources. Note that the official domain title is Psychosocial Issues — end-of-life care sits in Domain I and palliative care in Domain II.
Domain V — Professional Practice and Roles of the APRN covers cultural competence and implicit bias, legal/regulatory requirements, accreditation standards, ethical/legal issues, advanced practice standards of care, outcomes of APRN interventions, quality improvement, competency evaluation, and peer education.
4. Scoring, Retesting, and International Testing
Criterion-referenced scoring. Candidates are measured against a fixed standard of minimum competency, not against one another. Every computer-based test is scored twice as part of routine quality assurance; hand scoring is not available for CBT candidates.
Retesting. A candidate who fails may reapply immediately after the current ATT expires, but may not take the same examination more than once during a 90-day test eligibility period . After a third failure, the candidate must wait one year if all three failures occurred within a three-year period; if the three failures spanned more than three years, the candidate may reapply immediately after ATT expiration under the same 90-day rule.
Testing outside the US. International administration is offered in a limited annual window with an additional international testing fee and an earlier application deadline; candidates licensed outside the US, its territories, or Canada must have their license evaluated for US equivalency first.
5. Renewal and the ILNA
ONCC certification is valid for 4 years , and renewal runs on the Individual Learning Needs Assessment (ILNA) method:
The learning plan is generated from your own results. For the first renewal after testing, ONCC builds the ILNA from your test results report . For later cycles, you take the ONCC Assessment , and its results report generates the plan. The subject areas and their weighting mirror the current AOCNP Test Content Outline — the ILNA is not derived from any external nursing conceptual model.
Earn points where the ILNA says you need them. Points come from nursing continuing education, CME, continuing pharmacy education, academic coursework, publications, and presentations, recorded in ONCC's LearningBuilder system.
Skipping the assessment costs points. A candidate eligible to take the assessment who declines it may still renew, but must submit 100 points that exactly match the subject areas and weighting of the current test content outline .
Renewal by testing. Retaking and passing the AOCNP examination remains an accepted renewal route.