Oncology Certified Nurse Exam

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Oncology Certified Nurse (OCN)


The Oncology Nursing Certification Corporation (ONCC) was established in 1984 by the membership organization Oncology Nursing Society (ONS) for the purpose of certifying oncology nursing specialists against agreed-upon standards of competency. Only oncology nurses who pass the Oncology Certified Nurse (OCN) examination are authorized to use the OCN credential. Through the processes of certification and recertification, employers, patients and caregivers can be assured that the OCN adheres to the Professional Standards of Oncology Nursing Practice set forth by the ONS and American Nurses’ Association (ANA).[1] The first OCN exam was given in 1986 to 1,607 nurses with a pass rate of 86%. In the next two decades, the OCN gained full accreditation by both the American Board of Nursing Specialties and the National Commission for Certifying Agencies.[2] By March of 2015, ONCC had certified over 30,000 OCNs.[3] Access to testing was limited until very recently. In 2015, the ONCC began providing year-round exam availability through Pearson VUE testing centers nationwide.[4]

Function of the Test

OCN Study Guide

Oncology nurses provide care and counseling to cancer patients and, often, their families, assist in cancer therapy, administer medication, and maintain patient medical records. They are most often employed in the oncology department of a general hospital, or in a specialized cancer treatment center. To become an OCN, an individual must hold a degree or certificate in nursing, have passed the NCLEX-RN national registered nursing examination, and have completed 1,000 hours additional on-the-job RN training.[5] Only currently licensed registered nurses in the US or Canada are eligible to take the exam.[6] Nationwide demand for oncology nursing specialists is growing at a rate faster than most other types of jobs. The average salary for an oncology nurse in 2014 was $65,470 per year ($31.48 per hour).[7]

Test Administration

OCN Flashcards

The exam is offered 11 months out of the year across the US and Canada, and during the month of November at various international sites. There is no deadline for US or Canadian registrants. The cost to take the exam is $286 for ONS or APHON (Association of Pediatric Hematology/Oncology Nurses) members. Applicants who are aged 65 and over receive a 25% discount.[8] First-time candidates can apply online on the ONCC Web site, except those whose employers are paying examination fees in advance.[9] The application fee includes a $100 non-refundable processing fee.[10] Special accommodations for candidates with disabilities covered under the Americans with Disabilities Act (ADA) are available on request by submitting a “Special Accommodations Request Form” within 5 days of applying for the exam. Specific accommodations must be recommended and signed by a physician, psychiatrist or clinical psychologist. Additional documentation may be requested to assist ONCC in meeting candidates’ needs for special accommodations.[11] Candidates who do not pass the exam on their first or second attempt are eligible to reapply immediately to take the exam any time after the end of their existing 90-day testing window. After three attempts, there is a mandatory waiting period of one year before a candidate may retake the exam, unless the failed attempts were spaced over a period of 3 years (one per year). Only one attempt may be made within a given 90-day testing window.[12]

Test Format

Sections of the OCN Test
OCN Test Subject Areas Percent
Health Promotion, Screening, and Early Detection 6%
Scientific Basis for Practice 9%
Treatment Modalities 16%
Symptom Management 22%
Psychosocial Dimensions of Care 8%
Oncologic Emergencies 12%
Survivorship 8%
Palliative and End-of-Life Care 11%
Professional Performance 8%
Total 100%

Test Structure

The OCN Test is made up out of nine major topics: Health Promotion, Screening, and Early Detection; Scientific Basis for Practice; Treatment Modalities; Symptom Management; Psychosocial Dimensions of Care; Oncologic Emergencies; Survivorship; Palliative and End-of-Life Care; and Professional Performance. There are 145 multiple choice questions. There are also an additional 20 pretest questions that will not count towards the final score.[13]

Test Environment

Testing for the OCN test takes place at Pearson VUE testing centers. Test-takers are expected to arrive fifteen minutes to half an hour before the exam is scheduled to begin. At least two forms of identification are required for admission, one of which must be a government issued, photo identification containing a signature. Personal items, includig electronics, bags, wallets, and study materials are not allowed into the testing room.[14]

Sample Questions

More free OCN practice test questions.


Several different examination forms are used for each version of the exam, all drawing from a pool of questions apportioned according to a standard examination blueprint. A process called “equating” is used to convert raw exam scores into scaled scores which take the relative difficulty of each exam form into account so that candidates have an equal advantage regardless of the particular form they are given.[15] Each of the nine content areas of the exam is assigned a different weight when computing the overall score. The overall “cut score” that determines the total score needed to pass the exam is determined for each exam form by a panel of experts in all aspects of oncology nursing in consultation with experts in testing procedures and scoring. Because the exam forms vary in difficulty, the passing score for each exam form is unique and actual numeric scores cannot be compared across forms. For this reason, only the pass/fail status is given to candidates who complete the exam.[16] A scaled score of 55 or above is required to pass the OCN exam. The raw score needed to achieve a scaled score of 55 varies among different exam forms.[17] Score reports are provided to candidates at the testing center when they complete the exam. The score report shows the candidate’s pass/fail status as well as performance on each subject area. The actual scores are not provided on the score report.[18] Historically, between 70% and 80% of candidates pass the exam.[19] In 2014, 3,675 nurses sat for the OCN exam, about ¾ of them for the first time. The pass rate for first-time test takers was 75%. Overall, the pass rate was 72%, with those taking the exam for recertification achieving the highest pass rate, with a lower pass rate for those retaking the exam because they did not pass their first attempt.[20]

Recent/Future Developments

To encourage more employers to promote and support certification for oncology nurses, the ONCC began and employer discount pilot program in 2015 which offers employers incentives for paying for exam fees upfront (rather than as an educational reimbursement). This program will be extended to more employers in 2016 if the pilot proves successful.[21]


  1. ^ Oncology Nursing as a Specialty May 23, 2015
  2. ^ About ONCC May 23, 2015
  3. ^ ONCC Pilot Testing Employer Discounts May 23, 2015
  4. ^ About ONCC May 23, 2015
  5. ^ Oncology Nursing Careers & Salary Outlook May 23, 2015
  6. ^ 2015 Oncology Certified Nurse (OCN) Test Candidate Handbook May 23, 2015
  7. ^ Oncology Nursing Careers & Salary Outlook May 23, 2015
  8. ^ 2015 Test Dates, Application Deadlines, and Fees May 23, 2015
  9. ^ 2015 Oncology Certified Nurse (OCN) Test Candidate Handbook May 23, 2015
  10. ^ Frequently Asked Questions May 23, 2015
  11. ^ Oncology Nursing Certification Corporation Special Accommodations Request Form May 23, 2015
  12. ^ Frequently Asked Questions May 23, 2015
  13. ^ OCN Blueprint 05 May 2015
  14. ^ Candidate Handbook 05 May 2015
  15. ^ Testing and Renewal May 23, 2015
  16. ^ Questions and Answers About Your OCN Examination Scores May 23, 2015
  17. ^ Frequently Asked Questions May 23, 2015
  18. ^ Testing and Renewal May 23, 2015
  19. ^ Testing and Renewal May 23, 2015
  20. ^ Oncology Nursing Certification Corporation 2014 Examination Statistics May 23, 2015
  21. ^ ONCC Pilot Testing Employer Discounts May 23, 2015

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