Orthopaedic Nurses Certification (ONC) Exam

The Orthopaedic
Nurses Certification Exam is a computer-administered exam that is three hours in
length, and includes 150 multiple-choice questions. Of the 150 questions, only
135 will count toward your score.

In order to be eligible for this exam, one must hold a valid RN license in the U.S. or its
territories. If completed nursing education in a country outside of the U.S.,
the examinee must have the credentials in that country to practice first-level
nursing, which must equivalent to RN licensure in the U.S. Additionally, a full
two years’ experience as an RN and at least 1,000 hours as an RN in orthopedic
practice, within the last three years are required.

Individuals with conditions that meet the Americans with Disabilities Act
will have accommodations for them. A request for such accommodations must be made in writing.

All test
centers are wheelchair accessible. Some testing accommodations include small
group setting, extended testing time, hand-held magnifier, seat cushion, and
large print test materials.


What are the categories and tasks covered on this exam?

  • Degenerative Disorders – 42 questions
  • Orthopaedic Trauma – 28 questions
  • Sports Injuries – 26 questions
  • Inflammatory Disorders – 10 questions
  • Metabolic Bone Disorders – 12 questions
  • Pediatric/Congenital – 6 questions
  • Musculoskeletal Tumors – 5 questions
  • Neuromuscular – 6 questions

There are several tasks that will be addressed in the questions of the above categories. These tasks include:

Self-care. With self-care, patients will be taught how to care for themselves so they can function at maximum capacity.

Pain. The proper management strategies will be implemented for patients to find comfort.

Complications. The procedures that help prevent or reduce complications.

Activity. Determine exercise, positioning, and assistive devices needed for conditions related to the musculoskeletal system.

Nutrition. Distinguish the most effective nutrition and hydration practices.

Psychosocial. Choose strategies that offer emotional support for patients experiencing musculoskeletal issues.

What is the most convenient way to register for the exam?

Once you have submitted your application and have been approved, you have 90 days in which to schedule and take the exam.

You can schedule your exam online, using a VISA, MasterCard, American Express, or Discover to make the payment.

What is the cost of the exam?

If registering via an online application, the cost is $290-$405. If you register using a paper application, the exam fee is $315-$430.

What are the testing dates and locations?

Testing is offered year-round, Monday-Saturday, by appointment. This excludes the holidays New Year’s Day, Martin Luther King, Jr. Day, Memorial Day, U.S. Independence Day, Labor Day, Thanksgiving, and Christmas.

The exam is offered at various sites throughout the United States. Locate the site closest to you.

What should I do the day of the exam?

At the latest, report to the testing center at the time of your appointment. If you over 15 minutes late, you may be prohibited from taking the exam.

Be sure to bring two valid forms of ID (not photocopied or expired). One must include your name, signature, and photo. The other must at least have your name and signature. Neither of these forms of identification can be temporary.

Acceptable forms of ID include passport, passport card, driver’s license, national identification, and military identification card.

Personal items such as a cell phone, calculator, handbag, briefcase, food, water bottle, study materials, and tablets are prohibited from the testing area. The testing center will provide pencils and scratch paper.

Can I take a break during the exam?

You may take a break during the exam, but the time used for your break will count against the time you have to complete the exam. This means you will have less than the scheduled amount of time for the exam.

What happens after I take the exam?

Once you have completed the exam, you will receive notification of whether you passed or failed the exam. If you pass the exam, three weeks after taking the exam, you will receive your certificate and a pin. Your certification will be valid for five years.

How many questions do I have to get correct in order to pass the exam?


What happens if I don’t pass the exam?

You can re-take the exam. It is up to you to find out the greatest number of times you can take this exam, as well as any waiting period associated with taking the exam several times.

How Can I Prepare for the ONC Exam?

That’s a great question.  We’ve broken down the answer into three parts.

  1. Do yourself a favor and study.  Do not walk in unprepared. We have recommended prep materials below, but that only helps if you actually try.  Plus, studying is actually proven to be the best antidote to test anxiety.
  2. Take care of yourself.  Make sure you’re eating well, exercising, and sleeping.  All of these things are scientifically linked to brain performance.  If you take care of your body, you’ll be helping your grades.
  3. Get a study guide or set of flashcards.  Some people study better a certain way. Find your study strengths and make the most of them.  We’ve tried to make it easy for you by tracking down the best study guide and flashcard set for your exam.  Below you’ll see links to both!

Study Guide



Last Updated: November 9, 2023