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Questions reflect both multiple-choice and scenario/performance-style prompts aligned to Orthopaedic Nurses Certification objectives.

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Frequently Asked Questions

What is the Orthopaedic Nurses Certification (ONC) Exam and who administers it?

The Orthopaedic Nurses Certification (ONC) exam is a standardized credential offered by the Orthopaedic Nurses Certification Board (ONCB) that validates nurses' specialized knowledge and expertise in orthopaedic care. This certification demonstrates professional competency in areas such as trauma, surgical procedures, patient education, and rehabilitation. The ONCB is the governing body responsible for developing, administering, and maintaining the standards of this certification.

What are the eligibility requirements for the ONC exam?

To be eligible, you must hold a current, unrestricted RN license in the US (or equivalent for international applicants), have at least 2 years of experience as an RN, and complete a minimum of 1,000 hours of orthopedic nursing practice within the past 3 years. This experience can include areas like adult care, pediatrics, emergency room, or administration related to orthopedics.

What topics are covered on the ONC exam?

The exam is based on the ONC Detailed Content Outline and covers major areas of orthopaedic nursing practice, including:

  • Musculoskeletal Trauma
  • Sports Medicine, Amputations, and Wound Care
  • Elective Orthopaedic Surgery
  • Spine and Neuromuscular Disorders
  • Medical Conditions and Metabolic Bone Diseases
  • Pediatric Orthopaedics
  • Rehabilitation, Therapeutics, and Professional Issues

How is the ONC exam structured?

The ONC exam is a computer-based, multiple-choice test.

  • Total Questions: 150 items.
  • Scored Questions: 135 questions are scored.
  • Unscored Questions: 15 questions are unscored (used as pilot items for future exams).
  • Time Limit: Candidates are allotted 3 hours to complete the exam.

How do I apply for the ONC Exam?

Applications are submitted through the ONCB official website. Candidates create an account, complete the online application, upload verification documents, and pay the examination fee. Testing is offered year-round via PSI testing centers or live remote proctoring.

How do I recertify as an Orthopaedic Certified Nurse (ONC)?

There are two primary pathways for recertification:

  • Re-examination: Retake and pass the ONC exam before your certification expires.
  • Practice and Education: Verify 1,000 hours of practice in orthopaedic nursing during the previous five years AND complete 75 contact hours of continuing education (at least 50 hours must be in clinical orthopaedics).

How should I prepare for the ONC Exam?

Preparation involves reviewing the ONCB test blueprint, studying recommended textbooks (such as Core Curriculum for Orthopaedic Nursing), using Prephow ONC practice tests, and participating in study groups or review courses. Consistent review of clinical cases also strengthens exam readiness.

What is the difference between the ONC Exam and other nursing certifications?

The ONC certification is specialized and specifically focuses on orthopaedic nursing practice, whereas general nursing certifications like the RN licensure exam or certifications in other specialties (e.g., critical care, medical-surgical) have broader scopes. The ONC is designed for nurses who have developed expertise in orthopaedic care settings and want to validate this specialized knowledge. This specialization makes the ONC particularly valuable for nurses working in orthopaedic units, surgical centers, rehabilitation facilities, and trauma departments.