ONCC credentials for registered nurses · read in ONCC documents November 14, 2026
Oncology nursing certification exams and who awards them
The OCN® and the four other credentials in the table below are all awarded by ONCC, the Oncology Nursing Certification Corporation, which sets the eligibility rules, writes the tests and runs renewal. The Oncology Nursing Society (ONS) is a separate professional society; it does not award the OCN. This site starts with the OCN: its facts, its 2026 outline and ten topic pages with practice questions. The other ONCC exams are listed with checked facts now and get question sets as the site grows.
Read November 14, 2026 in the board's 2026 Certification Test Registration Manual, its 2025 examination statistics and its 2025 annual report. Rows marked coming carry facts only; their question sets follow. Fees are the 2026 schedule.
Who each credential is written for:
OCN®, open now: the broadest of the five, written for adult oncology RNs. The OCN exam guide covers eligibility, fees, the 2026 outline and renewal, and links the ten topic pages.
TCTCN™: the transplant and cellular therapy credential, formerly BMTCN (Blood and Marrow Transplant Certified Nurse), for nurses on blood and marrow transplant and cellular therapy units.
CPHON®: the pediatric credential, for nurses whose practice hours are in pediatric hematology and oncology.
CBCN®: breast care nursing, from diagnosis and staging through treatment and survivorship.
ROCN™: radiation oncology nursing, a new exam in 2026 and not yet accredited. ONCC has published no pass rate or holder count for it yet; its launch dates are in the ROCN table below.
All four specialty exams follow the OCN pattern: an RN license, recent RN experience and the same practice-hour minimum, counted in the specialty, plus continuing education in the field.
ROCN™, the newest exam of the five, as the board described it on November 14, 2026.
Fact
Value
Source · read
Status
Registration open, with 90-day testing windows; ONCC ran the first tests as a beta, February 2 – March 31, 2026ONCC posts no test-date calendar; check the ROCN page (read Nov 14, 2026)
ONCC decides who is eligible, scores the test and renews the credential.
PSI runs the test centers; after ONCC approves an application, PSI emails your Authorization to Test, and the testing window starts.
ONS and APHON are member societies; their members get the lower fee.
Your state board of nursing holds the RN license that every ONCC exam requires.
OCN topic pages, sorted into the six content areas
The weight after each area is the board's figure from the 2026 OCN Test Content Outline. A topic page carries the weight of the area it sits in; there is no separate weight for the topic itself.
Domain IV · Symptom Management and Supportive Care25%
06Neutropenia and myelosuppressionAbsolute neutrophil count, neutropenic precautions, febrile neutropenia and the first hour of sepsis, growth factors, bleeding precautions, anemia and transfusion.
07Symptom management and supportive careNausea and vomiting, bowel changes, mucositis, neuropathy, fatigue, skin and hair changes, lymphedema and ostomies, nutrition and weight loss, pain, and complementary therapies.
Domain III · Treatment Modalities20%
03Chemotherapy, targeted therapy and immunotherapyDrug classes and how they work, checkpoint inhibitors, CAR T cells and bispecific antibodies, hormonal agents, oral therapy and adherence teaching, intrathecal and intravesical therapy, and recognizing immune-related toxicity.
04Safe chemotherapy administration and handlingOrder checks and independent double checks, dose and body surface area, hazardous drug handling and spills, protective equipment, infusion reactions, and first steps when a vesicant leaks.
05Radiation, surgery and transplantSurgical and procedural care, radiation principles and safety (time, distance, shielding; sealed and unsealed sources), common site effects, and an overview of autologous and allogeneic transplant.
Domain V · Oncologic Emergencies16%
08Oncologic emergencies: structural and treatment-relatedSuperior vena cava syndrome, spinal cord compression, cardiac tamponade, raised intracranial pressure, obstructions and pneumonitis, with a map of all sixteen Domain V emergencies.
09Tumor lysis syndrome and metabolic emergenciesTumor lysis syndrome, SIADH, hypercalcemia of malignancy, DIC and venous thromboembolism: who is at risk, the labs, and what the nurse does first.
Domain II · Oncology Nursing Practice15%
02Cancer biology, staging and practice standardsCarcinogenesis and immunology, genetic versus genomic testing, TNM staging and grading, performance status scales, clinical trial basics, ethics, advocacy and compassion fatigue.
Domain I · Care Continuum14%
01Care continuum: prevention, screening and survivorshipRisk factors, screening and prevention, navigation, survivorship care plans and late effects, advance care planning, and end-of-life and hospice care at the level the OCN exam tests.
Domain VI · Psychosocial Dimensions of Care10%
10Psychosocial care in oncologyDistress screening, coping, body image, sexuality and fertility, learning needs, cultural and spiritual care, caregiver strain, crises, and the cost of cancer care.
Board and society
ONCC awards the credential; ONS is the society
"ONS certification" can point to any of three things, and only the first is a board certification:
ONCC: the board exams
The OCN and its sister credentials. The board awards them after a proctored computer exam, taken at a PSI test center; each one is renewed every 4 years.
ONS: membership and a course
ONS membership. Members of ONS, or of APHON (the Association of Pediatric Hematology/Oncology Nurses), pay $300 per exam instead of $420. Membership by itself certifies nothing.
The ONS/ONCC Chemotherapy Immunotherapy Certificate. An online ONS course that ends with a post-test. ONS describes the certificate on its course page as something that "is neither a professional certification nor licensure" (ons.org, read November 14, 2026). Whether a unit wants it before you give chemotherapy is a decision for the employer, apart from certification.
So a nurse can hold the chemotherapy certificate without the OCN, or the OCN without the certificate. A comparison page for the two is planned.
5 OCN questions drawn from five separate topics
Worked 0 of 5, with 0 right
Care continuum
A survivor treated for lymphoma with an alkylating-agent regimen 6 years ago asks about long-term cancer risks. Which second malignancy should the nurse describe?
Show the answer without choosingThe case for and against each choice
Alkylating agents damage marrow stem cells, and therapy-related myelodysplasia or AML typically appears 5 to 10 years later, so survivors have periodic blood counts.
Liver cancer follows hepatitis, cirrhosis, or toxin exposure, not alkylator therapy.
Myeloma is not a characteristic second cancer after alkylating agents.
Neither CLL nor hairy cell leukemia is a typical treatment-related cancer; both arise on their own.
Biology & staging
A breast tumor's Nottingham histologic grade is calculated from which features?
Show the answer without choosingThe case for and against each choice
Size, nodes, and metastasis are TNM staging, not grade.
Receptor status guides therapy and prognostic staging but is not part of histologic grade.
Nottingham grading scores tubule formation, nuclear pleomorphism, and mitotic count from 1 to 3 each; the total sets grade 1, 2, or 3.
Ki-67 reflects proliferation and margins describe the surgery; neither defines Nottingham grade.
Systemic therapy
Five days after CAR T-cell infusion, a patient whose fever has resolved now has trouble naming objects and new, sloppy handwriting. What is the nurse's priority action?
Show the answer without choosingThe case for and against each choice
Neurotoxicity can worsen within hours; waiting for a routine check delays treatment.
Tocilizumab was ordered for CRS; with fever gone and new language and writing changes, the first step is recognizing and escalating the neurologic change.
Calling new language and writing changes fatigue lets neurotoxicity progress toward seizures or cerebral edema.
Word-finding trouble and handwriting change are early signs of neurotoxicity, which can start as CRS settles; prompt ICE scoring and escalation follow.
Symptoms
A patient with advanced cancer has persistent hiccups interfering with sleep and meals. Which first-line pharmacologic option is appropriate?
Show the answer without choosingThe case for and against each choice
Baclofen is a common first choice, and chlorpromazine is FDA-approved for intractable hiccups; both act on the central reflex arc.
Both block serotonin to prevent nausea; neither acts on the hiccup reflex.
Corticosteroids are a known cause of hiccups in patients with cancer, so a recently started steroid is a suspect to review, not a treatment.
Antihistamines can sedate, but they do not act on the hiccup reflex and are not used to treat persistent hiccups.
Psychosocial
A patient is convinced everyone notices her thinning hair, although it is barely visible, and she has stopped leaving home. Which intervention is most appropriate?
Show the answer without choosingThe case for and against each choice
Staying home reinforces avoidance and isolation.
A wig may help some patients, but hiding the change feeds the belief that it must be concealed.
Reassurance dismisses her experience and does not change the belief driving the avoidance.
Distress and avoidance out of proportion to a barely visible change point to body image disturbance, which responds to cognitive behavioral therapy.
Where the figures come from
Every number in the tables points to the document it was read in, with the page and the date: the 2026 test registration manual, the 2025 OCN Test Content Outline and the 2026 one, the Certification Renewal Manual (2026), the yearly examination statistics and the annual report. Pass rates are first-time rates with their year, never a blend with repeat candidates. When two of the board's documents disagree, the table follows the manual and says so. The full method is on About.
No. ONS is a membership society; the OCN is awarded by ONCC after a proctored exam. The ONS/ONCC Chemotherapy Immunotherapy Certificate is a course certificate, and ONS's own course page says it is not a professional certification.
Which ONCC certification fits an adult oncology RN?
For adult oncology it is the OCN, once you have 2,000 hours of adult oncology practice in the last 48 months and 24 months as an RN in the last 48. Nurses whose hours are in pediatric hematology and oncology, transplant and cellular therapy, breast care or radiation oncology have a specialty exam with the same hour minimum in that field.
What happened to the BMTCN?
The board renamed it. The transplant credential is now the TCTCN™ (formerly BMTCN, Blood and Marrow Transplant Certified Nurse), and ONCC has given the test under the new name since January 2026. Current BMTCN holders were moved over with the same expiry date.
Can I still earn the CPON?
Not as a new candidate. The CPON is kept for renewal by current holders only; the pediatric hematology and oncology exam given today is the CPHON®.
Do ONS members pay less for the OCN?
Yes. ONS and APHON members pay $300, against $420 for everyone else. Renewal by points is cheaper for members too, $340 instead of $460.