Free Advanced Oncology Certified Nurse Practitioner (AOCNP®) certification examination Practice Questions

Sample Practice Questions

Try these 10 sample questions from the Advanced Oncology Certified Nurse Practitioner (AOCNP®) certification examination practice bank. Each includes the answer and explanation. Continue with the interactive practice above to review the full question set.

1. 1An oncology NP counsels a 46-year-old woman without prior breast cancer, high-risk breast lesions, a pathogenic cancer-risk variant, or chest irradiation. Under the USPSTF recommendation, what routine mammography interval should the NP recommend?

   1. A. Every 2 years
   2. B. Every 3 years
   3. C. Every 5 years
   4. D. Every year

   Answer: A

   Explanation: "The USPSTF recommends biennial screening mammography for women aged 40 to 74 years." Biennial means every 2 years. She is within the age range and has none of the exclusions; annual, triennial, and five-year intervals differ from this recommendation.

   Reference: USPSTF Final Recommendation: Breast Cancer Screening — Recommendation Summary; women aged 40 to 74 years

2. 2An NP explains a small first-in-human oncology trial designed to identify tolerable dosing and characterize adverse effects. Which phase best matches these primary aims?

   1. A. Phase 1
   2. B. Phase 2
   3. C. Phase 3
   4. D. Phase 4

   Answer: A

   Explanation: "In a phase 1 clinical trial, researchers figure out whether a new treatment is safe, what its side effects are, whether people can tolerate it, and the highest dose that people can tolerate." These dose and safety aims characterize phase 1. Phase 2 emphasizes preliminary antitumor activity, phase 3 comparative efficacy, and phase 4 postapproval evaluation.

   Reference: National Cancer Institute: How Do Clinical Trials Work? — Phases of clinical trials; phase 1

3. 3Before a first rituximab infusion for non-Hodgkin lymphoma, the NP reviews the warning about circulating malignant cells. What minimum count does the prescribing information identify as conferring greater tumor lysis syndrome risk?

   1. A. 10,000 cells/mm³
   2. B. 20,000 cells/mm³
   3. C. 25,000 cells/mm³
   4. D. 50,000 cells/mm³

   Answer: C

   Explanation: "A high number of circulating malignant cells (greater than or equal to 25,000/mm3) or high tumor burden, confers a greater risk of TLS." The minimum circulating malignant-cell count specified in this warning is 25,000/mm³. Ten and twenty thousand are below that stated count; fifty thousand also meets the warning but is not its minimum specified count. This does not imply that patients below the count have no TLS risk.

   Reference: FDA: Rituximab-pvvr Prescribing Information — Warnings and Precautions — Tumor Lysis Syndrome (TLS)

4. 4A patient has an elevated brief distress-screening score at an oncology visit. What does this result establish?

   1. A. A confirmed diagnosis of generalized anxiety disorder
   2. B. A need for a specific antidepressant prescription
   3. C. A need for a more detailed psychosocial assessment
   4. D. A confirmed diagnosis of major depressive disorder

   Answer: C

   Explanation: "Screening is a rapid method of identifying patients with psychosocial distress" Screening identifies possible need for further assessment. An elevated score alone does not diagnose a specific psychiatric disorder or determine a medication.

   Reference: National Cancer Institute: Adjustment to Cancer—Anxiety and Distress (PDQ®), Health Professional Version — Screening and Assessment

5. 5An oncology NP is adapting treatment discussions for a patient who can communicate personal preferences. Which information should primarily guide the patient-specific approach to cultural and communication needs?

   1. A. Community-level health-belief survey results
   2. B. Family members' account of shared traditions
   3. C. The patient's stated beliefs and communication needs
   4. D. Demographic patterns in cultural reference guides

   Answer: C

   Explanation: "care and services that respond to cultural health beliefs and practices, languages, health literacy, and other communication needs." Direct assessment of this patient’s stated beliefs and needs should guide individualized adaptation. Community surveys, family traditions, and reference guides can provide background, but cannot establish what this individual believes or prefers.

   Reference: HHS: National Standards for Culturally and Linguistically Appropriate Services — Principal Standard

6. 6A 58-year-old woman has dense breasts and an otherwise negative screening mammogram. She asks whether adding screening ultrasonography has a proven favorable balance of benefits and harms. What should the NP say about the USPSTF assessment?

   1. A. It establishes a moderate net benefit.
   2. B. It finds the evidence insufficient to assess the balance.
   3. C. It finds the harms outweigh the benefits.
   4. D. It establishes a substantial net benefit.

   Answer: B

   Explanation: "The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of supplemental screening for breast cancer using breast ultrasonography or magnetic resonance imaging (MRI) in women identified to have dense breasts on an otherwise negative screening mammogram." The stated situation matches the insufficient-evidence conclusion. This is not a demonstrated large benefit, moderate benefit, or unfavorable balance.

   Reference: USPSTF Final Recommendation: Breast Cancer Screening — Recommendation Summary; women with dense breasts

7. 7An eligible patient entering a randomized cancer trial asks how the treatment arm will be assigned. Which mechanism should the NP describe?

   1. A. Selection by the treating clinician's preference
   2. B. Allocation by chance under the study design
   3. C. Selection by the patient's preferred treatment
   4. D. Allocation by the order of clinic arrival

   Answer: B

   Explanation: "Clinical trial randomization is the process of assigning people by chance to groups that receive different interventions or drugs in later phase trials." Chance assignment is randomization. Clinician preference, patient choice, and arrival order are systematic selection methods rather than random allocation.

   Reference: National Cancer Institute: How Do Clinical Trials Work? — Randomization and bias in clinical trials

8. 8An oncology NP prescribes allopurinol before cytotoxic treatment to reduce tumor-lysis-associated uric acid production. Which enzyme does this preventive treatment inhibit?

   1. A. Dihydrofolate reductase
   2. B. Acetylcholinesterase
   3. C. Carbonic anhydrase
   4. D. Xanthine oxidase

   Answer: D

   Explanation: "It is an inhibitor of xanthine oxidase, the enzyme responsible for the conversion of hypoxanthine to xanthine and of xanthine to uric acid, the end product of purine metabolism in humans." Allopurinol prevents formation of uric acid by blocking xanthine oxidase; it does not act through the other listed enzymes.

   Reference: DailyMed: Allopurinol Tablets Prescribing Information — Clinical Pharmacology, §12.1

9. 9For general adult oncology distress screening with the Distress Thermometer, what is the lowest score NCI identifies as prompting discussion about resources or referral?

   1. A. 6
   2. B. 8
   3. C. 2
   4. D. 4

   Answer: D

   Explanation: "A DT score of 4 or higher should prompt discussion with a member of the oncology team to determine the resource(s) or referral(s) that will best address the patient’s needs." The general adult threshold is 4. Higher scores also warrant discussion, but are not the lowest threshold; this question does not use the exploratory adolescent/young-adult cutoff.

   Reference: National Cancer Institute: Adjustment to Cancer—Anxiety and Distress (PDQ®), Health Professional Version — The Distress Thermometer

10. 10A patient with limited English proficiency needs language assistance for an oncology visit. Under the National CLAS Standards, how should that assistance be financed for the patient?

    1. A. Full out-of-pocket payment for the service
    2. B. A fixed copayment charged for the service
    3. C. Percentage coinsurance charged for the service
    4. D. No charge to the patient for the service

    Answer: D

    Explanation: "Offer language assistance to individuals who have limited English proficiency and/or other communication needs, at no cost to them" specifies that the individual is not charged for language assistance. Full payment, a copayment, and coinsurance are genuine financing arrangements, but each conflicts with the stated CLAS standard.

    Reference: HHS: National Standards for Culturally and Linguistically Appropriate Services — Communication and Language Assistance