The ONC exam is based on an analysis of the practice of orthopaedic registered nurses across the United States. From that analysis, test specifications (test blueprint or content outline) are constructed to identify the percentage of questions that will cover each area of practice (musculoskeletal health condition) and each nursing task.
The ONC examination contains 150 questions. Of these, 135 are scored; the remaining 15 questions are pilot items, and the candidate’s performance on those questions will not be reflected in the exam score. A raw score (number of questions answered correctly) of 97 is needed to pass the examination.
Individual candidate examination results are maintained within the secure data base hosted by Meazure Learning, ONCB’s test vendor. They are reported securely to the ONCB so certification documents can be provided to new credential holders. ONCB does not report this information to outside agencies or individuals, and only uses pass-fail distinctions for future examination marketing.
Successful ONC exam candidates earn certification for a five-year term.
These specifications include the number of examination questions in each content area, and can be used to guide your examination preparation.
Please note that questions related to operative orthopaedics will appear in all areas of the exam as relevant to the disorder.
Degenerative Disorders (51 questions)
Orthopaedic Trauma (26 questions)
Sports Injuries (15 questions)
Metabolic Bone Disorders (12 questions)
Inflammatory Disorders (11 questions)
Congenital/Pediatric (7 questions)
Musculoskeletal Tumors (7 questions)
Neuromuscular (6 questions)
Self-Care – Teach self-care to achieve maximum functional capacity. (22-32 questions)
Pain – Select appropriate pain management strategies for patients’ altered comfort. (35-45 questions)
Complications – Select appropriate measures to prevent, minimize, or alleviate complications. (31-41 questions)
Activity – Identify activity and positioning parameters, and assistive devices, for musculoskeletal conditions. (15-25 questions)
Nutrition – Identify strategies to promote optimal hydration and nutrition. (3-9 questions)
Psychosocial – Select appropriate emotional support strategies in relation to specific musculoskeletal problems. (3-9 questions)