OCN Cheat Sheet 2026

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

1. A patient undergoing pelvic radiation for cervical cancer reports vaginal dryness and dyspareunia. The nurse should recommend: → Vaginal moisturizers and dilator use as prescribed
2. A patient with bone metastases reports sudden inability to void and new lower extremity weakness. The nurse should suspect: → Spinal cord compression — a medical emergency
3. The IOM's Six Aims of Quality Healthcare include all of the items below, with the exception of: → Safe and rapid
4. What is the nadir in the context of chemotherapy administration? → The point of lowest blood cell counts after chemotherapy
5. Which calculation method is most commonly used to determine chemotherapy dosing? → Body surface area (BSA)
6. Dyspnea in a patient with lung cancer should first be assessed for which reversible cause? → Pleural effusion
7. A patient receiving immunotherapy with pembrolizumab develops a new onset dry cough and dyspnea at rest. The nurse should suspect: → Immune-mediated pneumonitis
8. A survivor completing treatment should receive a survivorship care plan from which care setting? → The treating oncology team at the end of active treatment
9. Which medication is first-line for treating opioid-induced nausea and vomiting? → Prochlorperazine or metoclopramide
10. The OCN certification must be renewed how often? → Every 4 years
11. What is 'equianalgesic dosing' used for in pain management? → Converting between different opioids or routes while maintaining equivalent pain control
12. Which antifungal drug interaction is most important to monitor in patients receiving voriconazole and certain chemotherapy agents? → CYP450 enzyme inhibition increasing chemotherapy drug levels
13. Cytokine release syndrome (CRS) is a potentially life-threatening complication most associated with which therapies? → CAR-T cell therapy and bispecific antibodies
14. Which type of radiation therapy delivers a high dose to a small target with steep dose fall-off, minimizing exposure to surrounding tissue? → Stereotactic radiosurgery (SRS)
15. Which dietary recommendation is evidence-based for cancer survivors to reduce recurrence risk? → Plant-forward diet rich in vegetables, fruits, and whole grains, limiting processed meats
16. Which scale is most commonly used in clinical practice to assess cancer pain intensity? → Numerical Rating Scale (NRS) 0–10
17. Which of the following treatments is recommended for a patient whose liver-metastasizing renal cell carcinoma is surgically incurable? → Temsirolimus
18. A patient has been informed that adjuvant chemotherapy is required after cancer surgery. According to the nurse, adjuvant chemotherapy means: → Drugs given to target minimal disease or micro metastases
19. Lymphedema education for a patient who had axillary lymph node dissection should include which instruction? → Avoid blood pressure cuffs and blood draws on the affected arm
20. Colony-stimulating factors (e.g., filgrastim/G-CSF) are used in oncology patients primarily for which purpose? → To stimulate neutrophil production and reduce febrile neutropenia risk
21. Bevacizumab (Avastin) targets tumor angiogenesis by inhibiting which growth factor? → Vascular endothelial growth factor (VEGF)
22. The nurse is caring for a patient with hypercalcemia of malignancy. Which symptom would the nurse expect to assess? → Confusion, polyuria, constipation, and fatigue
23. Which tumor marker is most specific for monitoring colorectal cancer recurrence? → Carcinoembryonic antigen (CEA)
24. Mucositis is most likely to develop in patients receiving which treatment? → High-dose methotrexate or radiation to the head and neck
25. Which type of cancer is most strongly associated with the Philadelphia chromosome (BCR-ABL translocation)? → Chronic myeloid leukemia (CML)
26. Which of the following is a cell-cycle-specific chemotherapy agent? → Vincristine
27. Which element is essential in a comprehensive cancer survivorship care plan? → Summary of treatment received and schedule of recommended follow-up
28. A patient with cancer-related hypercalcemia of malignancy is most likely to present with which set of symptoms? → Fatigue, constipation, polyuria, and confusion
29. A patient with cancer reports a pain level of 7/10 currently on acetaminophen alone. According to the WHO analgesic ladder, what is the next appropriate step? → Add a weak opioid such as tramadol or codeine (Step 2)
30. A patient receiving external beam radiation develops brisk erythema and moist desquamation. This is classified as what grade of acute skin toxicity per CTCAE? → Grade 3