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Medical Coding · CHONC

AAPC Hematology/Oncology (CHONC) Examination Practice Test

CHONC practice covers hematologic disorders, blood and marrow findings, and cancer diagnosis and treatment concepts that affect medical coding. Questions in the available bank sample topics such as anemia, sickle cell complications, lymphoma, breast tumor markers, chemotherapy, radiation therapy, and therapeutic phlebotomy. These concepts help connect clinical documentation with the services and conditions represented in a hematology or oncology record.

Exam overview

Exam providerAAPC
Exam codeCHONC
CategoryMedical Coding

About the AAPC Hematology/Oncology (CHONC) Examination Exam

Hematology and oncology coding work depends on recognizing how laboratory findings, pathology, and treatment details describe a patient’s condition and care. Practice scenarios may ask you to distinguish a low reticulocyte count from increased red-cell production, identify the significance of estrogen or HER2 receptor findings, or recognize acute chest syndrome in a patient with sickle cell disease. Other questions address Hodgkin lymphoma pathology, lymph-node biopsy terminology, anticoagulation monitoring, and the purpose of phlebotomy in polycythemia vera. Treatment questions call for understanding the difference between external-beam radiation and radioactive materials, as well as safe handling of uncertainty about an oral chemotherapy dose. Use clinical context and the wording of reports to identify the condition, relevant finding, or treatment concept being tested before selecting an answer.

Sample Practice Questions

Review a selection from this exam's published US Practice Tests practice bank.

Question 1

Which laboratory test is most directly used to monitor the effect of warfarin therapy?

  1. AInternational normalized ratio
  2. BSerum ferritin
  3. CAbsolute neutrophil count
  4. DReticulocyte count
Show answerCorrect answer: A

The prothrombin time, commonly reported as the international normalized ratio (INR), is used to monitor warfarin anticoagulation.

Question 2

A patient with breast cancer is scheduled to receive trastuzumab. Which tumor feature is most relevant to the use of this medication?

  1. AOverexpression or amplification of HER2
  2. BLoss of all estrogen receptors
  3. CA deficiency of clotting factor IX
  4. DIncreased production of erythropoietin
Show answerCorrect answer: A

Trastuzumab is a monoclonal antibody directed against HER2 and is used for appropriately selected HER2-positive cancers.

Question 3

Which statement best describes Hodgkin lymphoma pathology?

  1. AIt is defined by Reed–Sternberg cells in the appropriate clinical and pathologic context
  2. BIt is defined by circulating blasts with the Philadelphia chromosome in every case
  3. CIt is a plasma-cell malignancy characterized by Bence Jones proteins in every case
  4. DIt is a myeloid cancer diagnosed solely by a low platelet count
Show answerCorrect answer: A

Classical Hodgkin lymphoma is characterized by Reed–Sternberg cells in an appropriate tissue and immunophenotypic context. The other options describe features associated with different hematologic disorders or are not diagnostic definitions.

Question 4

A patient with sickle cell disease develops sudden severe chest pain, fever, cough, and a new pulmonary infiltrate on imaging. Which complication should be suspected?

  1. AAcute chest syndrome
  2. BSplenic sequestration
  3. CAplastic crisis
  4. DIron overload
Show answerCorrect answer: A

Acute chest syndrome is characterized by a new pulmonary infiltrate accompanied by symptoms such as chest pain, fever, cough, or hypoxia in a person with sickle cell disease. It is a serious complication requiring prompt evaluation.

Question 5

A pathology report describes a breast tumor as estrogen-receptor positive. Which treatment approach may be considered because of this finding?

  1. AHormone-blocking therapy, such as an estrogen-receptor modulator
  2. BIron chelation therapy
  3. CVitamin K replacement
  4. DAntifungal therapy
Show answerCorrect answer: A

Estrogen-receptor-positive breast cancers may respond to endocrine treatments that block estrogen signaling or reduce estrogen production. The specific treatment depends on the patient's clinical circumstances and treatment plan.

Question 6

A patient undergoing external-beam radiation therapy asks whether the treatment makes them radioactive. Which response is generally accurate for external-beam treatment?

  1. AThe patient does not become radioactive from the external beam itself.
  2. BThe patient must avoid all contact with others for several weeks.
  3. CThe patient will emit radiation only while asleep.
  4. DThe patient becomes radioactive whenever the treated skin is red.
Show answerCorrect answer: A

External-beam radiation delivers radiation from a machine to a targeted area; it does not leave the patient radioactive after a treatment session. Safety precautions can differ for some internal radiation treatments, so instructions should follow the specific therapy plan.

Question 7

A patient with polycythemia vera undergoes therapeutic phlebotomy. What is the main treatment goal of this procedure?

  1. AReduce the red cell mass and hematocrit
  2. BIncrease the platelet count
  3. CReplace missing clotting factors
  4. DStimulate antibody production
Show answerCorrect answer: A

Therapeutic phlebotomy removes whole blood and thereby lowers red cell mass and hematocrit. In polycythemia vera, controlling hematocrit helps reduce complications associated with increased blood viscosity.

How to use this practice test

The free practice page draws up to 20 random questions from its 50-question CHONC bank for each session. Submit your answers to see results after the session, then revisit missed items by identifying the clinical clue—such as a laboratory result, pathology marker, or treatment method—that supports the correct concept.

Preparation tips

  • Compare reticulocyte counts with the clinical context to distinguish reduced red-cell production from a marrow response to anemia.
  • Review how estrogen- and HER2-receptor findings can guide breast cancer treatment decisions, including endocrine therapy and trastuzumab use.
  • Practice recognizing hematologic emergencies and disease features, including acute chest syndrome in sickle cell disease and the defining pathology of Hodgkin lymphoma.
  • Distinguish external-beam radiation from treatments involving radioactive sources, and review why external-beam treatment does not make a patient radioactive.
  • For medication scenarios, identify the documented drug and treatment context; do not assume a missed oral chemotherapy dose should be doubled.
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