OCC Cheat Sheet 2026

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

1. During assessment of a patient on high-dose corticosteroids as part of a chemotherapy regimen, which finding requires immediate nursing action? → Random blood glucose of 385 mg/dL with polydipsia
2. What is the first procedural step in manufacturing autologous CAR-T cell therapy for a patient? → Perform leukapheresis to collect the patient's T cells
3. Which clinical findings are characteristic of superior vena cava (SVC) syndrome in an oncology patient? → Facial plethora, upper extremity edema, and distended neck veins
4. Atezolizumab differs from pembrolizumab and nivolumab in that it targets which molecule? → PD-L1 on tumor and immune cells
5. Moderate to severe immune-related adverse events (irAEs) from checkpoint inhibitors are primarily managed with: → Holding the checkpoint inhibitor and initiating systemic corticosteroids
6. What is the recommended minimum number of glove layers required when handling hazardous drugs per USP ? → Two pairs of ASTM-tested chemotherapy gloves
7. Hand-foot skin reaction (HFSR) with painful, thickened skin on palms and soles is a characteristic toxicity of which class? → Multikinase inhibitors targeting VEGFR (sorafenib, sunitinib)
8. A patient's chemotherapy cycle requires dose reduction due to a creatinine clearance of 35 mL/min. Which agent most commonly requires renal dose adjustment? → Carboplatin
9. Before starting chemotherapy, which baseline assessment is most critical? → Complete blood count (CBC)
10. What is the primary nursing goal when managing chemotherapy-induced thrombocytopenia with a platelet count of 15,000/mm³? → Prevent hemorrhage through bleeding precautions and fall prevention
11. What is the primary mechanism of action of bevacizumab (Avastin)? → Binds circulating VEGF to prevent tumor angiogenesis
12. Which patient statement about managing chemotherapy-induced constipation indicates a need for further teaching? → I should take an over-the-counter enema if I miss more than one day
13. A patient refuses a recommended chemotherapy regimen after being fully informed of the risks and benefits. What is the nurse's ethical obligation? → Document the refusal and respect the patient's autonomous decision
14. The oncology nurse is reviewing a study that reports a hazard ratio (HR) of 0.65 with a 95% CI of 0.50-0.85 for a new drug versus placebo. What does this mean? → The new drug reduces the risk of the event by 35%, and this is statistically significant
15. Which instruction is MOST important for a patient experiencing chemotherapy-induced alopecia? → Avoid sun exposure to the scalp and use SPF protection
16. A patient asks why they must use a condom during chemotherapy. The nurse's best explanation is: → Chemotherapy agents can be excreted in bodily fluids and may expose the partner
17. What is the correct flushing sequence for a positive pressure implanted port after chemotherapy administration? → Saline → heparin → clamp while maintaining positive pressure
18. The nurse's role in advocating for systemic change in chemotherapy safety policy is BEST supported by which professional organization? → Oncology Nursing Society (ONS)
19. Which class of targeted therapy works by inhibiting the BCR-ABL tyrosine kinase, making it effective in chronic myeloid leukemia (CML)? → Tyrosine kinase inhibitors (TKIs)
20. Which chemotherapeutic drug is associated with hemorrhagic cystitis? → Cyclophosphamide
21. Which finding would MOST concern the oncology nurse when caring for a patient experiencing chemotherapy-induced peripheral neuropathy (CIPN)? → Inability to button a shirt or walk without assistance
22. A nurse researcher is reviewing a meta-analysis on antiemetic efficacy. What does this study design involve? → Statistical pooling of results from multiple independent studies on the same question
23. A patient receiving a continuous 5-FU infusion via ambulatory pump reports that the pump alarmed and the site feels warm. What is the nurse's priority? → Stop the infusion, assess for extravasation, and notify the provider
24. Which vesicant chemotherapy agent requires an antidote (dexrazoxane) if extravasation occurs? → Doxorubicin (anthracycline)
25. Trastuzumab (Herceptin) targets which receptor overexpressed in HER2-positive breast cancer? → HER2/neu (ErbB2)
26. Which step helps minimize exposure risk during oral chemotherapy handling? → Wear gloves and use designated containers
27. A nurse is preparing to access an implanted port. Which action is ESSENTIAL to prevent infection? → Use a non-coring Huber needle with strict aseptic technique
28. A patient receiving cisplatin-based chemotherapy develops a serum creatinine of 2.1 mg/dL. Which intervention is the highest priority? → Hold the next cisplatin dose and notify the oncologist
29. When preparing chemotherapy agents in the pharmacy, which type of biological safety cabinet (BSC) is required? → Class II Type B2 BSC
30. What is the nurse's primary responsibility when a patient refuses chemotherapy? → Respect the patient’s decision and notify the provider