AOCNP Cheat Sheet 2026

The 30 highest-yield AOCNP facts, distilled from real exam questions. Print it, save it as a PDF, or study it here — free, no sign-up.

1. Which obesity-related mechanism most directly increases the risk of postmenopausal breast cancer? → Conversion of androgens to estrogens in adipose tissue via aromatase
2. The USPSTF recommends against which cancer screening test due to insufficient evidence of benefit in average-risk asymptomatic adults? → Annual CA-125 for ovarian cancer screening in average-risk women
3. A 55-year-old woman with a family history of Lynch syndrome undergoes genetic counseling. Which cancers are primarily associated with Lynch syndrome? → Colorectal and endometrial cancer
4. Radiation pneumonitis typically presents within which timeframe after thoracic radiation? → 1–6 months after completion of radiation
5. Radiation-induced fatigue is best managed with which evidence-based intervention during active treatment? → Moderate aerobic exercise (walking program)
6. The International Prognostic Index (IPI) for aggressive non-Hodgkin lymphoma includes which of the following five adverse factors? → Age >60, elevated LDH, ECOG PS ≥2, Stage III–IV, >1 extranodal site
7. Fertility preservation counseling is a standard of care recommendation that should be offered: → To all patients of reproductive age BEFORE initiation of potentially gonadotoxic therapy
8. Which biomarker must be tested before initiating trastuzumab (Herceptin) therapy for breast cancer? → HER2 overexpression or gene amplification
9. Radiation-induced mucositis in the oral cavity is best managed with: → Frequent saline rinses, pain assessment, and nutritional support
10. Irinotecan causes severe delayed diarrhea through which mechanism? → Active SN-38 metabolite inhibiting topoisomerase I in intestinal epithelium
11. Which cancer type is most commonly associated with disseminated intravascular coagulation (DIC) in adults? → Acute promyelocytic leukemia (APL)
12. Secondary prevention in oncology differs from primary prevention in that secondary prevention focuses on: → Detecting cancer early in asymptomatic individuals
13. Lynch syndrome increases lifetime risk of which cancer most significantly? → Colorectal cancer
14. Which class of immunotherapy works by blocking the PD-1/PD-L1 checkpoint pathway to restore anti-tumor T-cell activity? → Checkpoint inhibitors
15. A patient on long-acting opioids reports breakthrough pain. The appropriate breakthrough dose is approximately: → 10–15% of the total daily opioid dose
16. Which lab value change in the immediate postoperative period after major cancer surgery most warrants notification of the surgical team? → Serum lactate >2 mmol/L with tachycardia and hypotension
17. Which grading system is used by oncology nurses to assess and document radiation-induced side effects including mucositis and dermatitis? → CTCAE (Common Terminology Criteria for Adverse Events)
18. Cardiotoxicity monitoring in cancer survivors who received anthracyclines includes which primary surveillance modality? → Echocardiogram or MUGA scan to assess left ventricular ejection fraction (LVEF)
19. What is the primary mechanism by which ionizing radiation kills cancer cells? → Inducing DNA double-strand breaks leading to apoptosis or mitotic catastrophe
20. Which biologic agent works by depleting CD20-positive B cells and is used in certain lymphomas? → Rituximab
21. Opioid rotation is indicated when a patient experiences: → Inadequate analgesia or intolerable side effects despite dose optimization
22. The BRCA1/2 mutation confers the highest lifetime risk for which two cancers? → Breast and ovarian cancer
23. Which of the following is a CTLA-4 checkpoint inhibitor used in the treatment of melanoma? → Ipilimumab
24. VEGF inhibitor bevacizumab carries which unique risk compared to cytotoxic chemotherapy? → Arterial thromboembolic events, wound healing impairment, and GI perforation
25. Which electrolyte abnormality most immediately threatens cardiac function in tumor lysis syndrome? → Hyperkalemia
26. Radiation-induced xerostomia (dry mouth) is most effectively prevented by which technique when treating head and neck cancers? → Intensity-modulated radiation therapy (IMRT) with parotid gland sparing
27. Capecitabine (Xeloda) is an oral prodrug of which chemotherapy agent? → 5-Fluorouracil (5-FU)
28. Annual mammography screening for breast cancer is recommended by ACS starting at which age for average-risk women? → 45 years
29. A Pap smear result of ASC-H (atypical squamous cells, cannot exclude HSIL) in a 35-year-old woman should prompt which next step? → Referral for colposcopy
30. The CRAB criteria are used to define symptomatic multiple myeloma requiring treatment. What do the letters C-R-A-B represent? → Hypercalcemia, Renal insufficiency, Anemia, Bone lesions