OCN Oncology Certified Nurse Exam — Questions and Answers

Question 1: What is the definitive emergency treatment for malignant cardiac tamponade?

IV atropine
Pericardiocentesis (Correct answer)
Emergent chest surgery
IV corticosteroids

Correct answer: Pericardiocentesis

Pericardiocentesis (needle drainage of the pericardial effusion) is the definitive emergency treatment to relieve tamponade physiology.

Question 2: Which process allows cancer cells to invade surrounding tissues by breaking down the extracellular matrix?

Decreased VEGF production
Upregulation of E-cadherin
Matrix metalloproteinase (MMP) secretion (Correct answer)
Increased cell adhesion

Correct answer: Matrix metalloproteinase (MMP) secretion

Cancer cells secrete matrix metalloproteinases (MMPs) that degrade the basement membrane and extracellular matrix, enabling local invasion and metastasis.

Question 3: Which of the following is the correct definition of brachytherapy?

Systemic radiolabeled antibody therapy
Radioactive source placed inside or near the tumor (Correct answer)
Fractionated external beam radiation
High-energy proton beam delivered externally

Correct answer: Radioactive source placed inside or near the tumor

Brachytherapy involves placing a radioactive source directly inside or adjacent to the tumor, delivering high local doses.

Question 4: Which oncogene is frequently amplified in HER2-positive breast cancer, making it a therapeutic target?

KRAS
BCL-2
ERBB2 (HER2/neu) (Correct answer)
MYC

Correct answer: ERBB2 (HER2/neu)

ERBB2 gene amplification produces excess HER2 protein on the cell surface, driving uncontrolled cell proliferation in HER2-positive breast cancer.

Question 5: Which of the following best describes the action of monoclonal antibodies used in cancer immunotherapy?

Replace deficient white blood cells in the bone marrow
Target specific antigens on cancer cells to trigger immune destruction (Correct answer)
Block all cell division non-selectively
Directly alkylate DNA to halt replication

Correct answer: Target specific antigens on cancer cells to trigger immune destruction

Monoclonal antibodies bind to specific antigens expressed on cancer cells, flagging them for destruction by the immune system.

Question 6: When educating a survivor about sun protection after cancer treatment, the nurse should emphasize:

Use SPF 30+ broad-spectrum sunscreen, wear protective clothing, and avoid peak UV hours (Correct answer)
Avoid all sun exposure permanently indoors
Sunscreen is only needed at the beach
SPF 15 is sufficient for all cancer survivors

Correct answer: Use SPF 30+ broad-spectrum sunscreen, wear protective clothing, and avoid peak UV hours

Many cancer treatments increase photosensitivity; survivors need SPF 30+, protective clothing, and UV avoidance during peak hours (10 AM–4 PM).

Question 7: Tumor heterogeneity refers to which biological characteristic of cancers?

Genetic diversity among cells within the same tumor, leading to varied drug sensitivities (Correct answer)
Identical genetic profiles across primary and metastatic sites
The spread of cancer to multiple organs
Uniform cell populations within a tumor

Correct answer: Genetic diversity among cells within the same tumor, leading to varied drug sensitivities

Tumor heterogeneity means different cells within one tumor have different mutations, making some subpopulations resistant to specific treatments.

Question 8: Which drug class inhibits the mammalian target of rapamycin (mTOR) pathway in cancer treatment?

Erlotinib and gefitinib
Bevacizumab and ramucirumab
Ipilimumab and nivolumab
Everolimus and temsirolimus (Correct answer)

Correct answer: Everolimus and temsirolimus

Everolimus and temsirolimus are mTOR inhibitors used in renal cell carcinoma, neuroendocrine tumors, and certain breast cancers.

Question 9: EGFR inhibitors such as erlotinib are most effective in NSCLC patients who have which characteristic?

KRAS mutation
Activating EGFR mutation (Correct answer)
PD-L1 negative status
ALK rearrangement

Correct answer: Activating EGFR mutation

Activating mutations in the EGFR gene (exons 19 and 21) predict sensitivity to EGFR tyrosine kinase inhibitors in non-small cell lung cancer.

Question 10: What lab value must be assessed before administering methotrexate at high doses?

Serum calcium
Creatinine clearance/renal function (Correct answer)
Liver enzymes only
Complete blood count only

Correct answer: Creatinine clearance/renal function

High-dose methotrexate requires adequate renal clearance to prevent toxic accumulation; creatinine clearance must be assessed before dosing.

Question 11: Which agent is used as antidote or reversal for severe methotrexate toxicity when leucovorin is insufficient?

Mesna
Glucarpidase (carboxypeptidase G2) (Correct answer)
N-acetylcysteine
Dexrazoxane

Correct answer: Glucarpidase (carboxypeptidase G2)

Glucarpidase rapidly converts methotrexate to inactive metabolites in the plasma, used when methotrexate levels remain dangerously high despite leucovorin rescue.

Question 12: What does the term 'nadir' refer to in chemotherapy nursing?

The point of maximum tumor shrinkage
The lowest point of blood cell counts after chemotherapy (Correct answer)
The highest point of nausea after infusion
The peak drug concentration in the blood

Correct answer: The lowest point of blood cell counts after chemotherapy

Nadir is the period of lowest blood counts, typically 7–14 days after chemotherapy, when infection risk is greatest.

Question 13: When caring for a patient with malignant pleural effusion, which intervention provides the most immediate relief of dyspnea?

Applying supplemental oxygen via nasal cannula at 2 L/min
Administering a diuretic such as furosemide
Positioning in high Fowler's and assisting with thoracentesis (Correct answer)
Encouraging incentive spirometry every hour

Correct answer: Positioning in high Fowler's and assisting with thoracentesis

Thoracentesis to drain the effusion provides immediate relief of dyspnea by re-expanding the compressed lung; high Fowler's positioning aids breathing while preparing for the procedure.

Question 14: Which chemotherapy agent class is most commonly associated with secondary leukemia as a long-term complication?

Taxanes
Antimetabolites
Alkylating agents and topoisomerase II inhibitors (Correct answer)
Vinca alkaloids

Correct answer: Alkylating agents and topoisomerase II inhibitors

Alkylating agents and topoisomerase II inhibitors are most strongly linked to treatment-related myelodysplastic syndrome and AML.

Question 15: Which domain represents the largest portion of the OCN exam blueprint?

Health Promotion
Oncology Nursing Practice
Treatment Modalities
Symptom Management (Correct answer)

Correct answer: Symptom Management

Symptom Management consistently represents the largest percentage of questions on the OCN exam blueprint.

Question 16: Which of the following best describes the concept of 'informed consent' in oncology?

Consent is only required for surgical procedures
Family members can always provide consent instead of the patient
The patient receives complete information about diagnosis, treatment options, risks, benefits, and alternatives to make a voluntary decision (Correct answer)
The patient signs a form agreeing to any treatment the physician recommends

Correct answer: The patient receives complete information about diagnosis, treatment options, risks, benefits, and alternatives to make a voluntary decision

Informed consent requires that patients receive full disclosure of their condition, options, risks, benefits, and alternatives and voluntarily agree to the proposed treatment.

Question 17: Which non-pharmacologic intervention is evidence-based for managing cancer-related fatigue?

High-dose vitamin C supplementation
Aerobic exercise (Correct answer)
Strict caloric restriction
Prolonged bed rest

Correct answer: Aerobic exercise

Moderate aerobic exercise is the most evidence-based intervention for cancer-related fatigue, improving energy and quality of life.

Question 18: Which of the following best describes the purpose of the OCN certification?

To grant oncology nursing licensure at the state level
To authorize nurses to prescribe oncology medications
To validate specialized knowledge in oncology nursing practice (Correct answer)
To qualify nurses for hospital administration roles

Correct answer: To validate specialized knowledge in oncology nursing practice

The OCN credential validates that a nurse has demonstrated specialized knowledge and expertise in oncology nursing practice.

Question 19: A patient receiving doxorubicin (an anthracycline) asks why the nurse is monitoring cumulative lifetime dose. The nurse explains this is done to prevent:

Cardiomyopathy (Correct answer)
Hepatotoxicity
Peripheral neuropathy
Renal failure

Correct answer: Cardiomyopathy

Anthracyclines like doxorubicin cause dose-dependent cardiotoxicity; cumulative dose is tracked to reduce the risk of irreversible cardiomyopathy.

Question 20: Oral chemotherapy education should stress which of the following to patients?

Never handle tablets with bare hands and use safe disposal methods (Correct answer)
Crush tablets to improve absorption
Store in the bathroom medicine cabinet for convenience
Share doses with caregivers if they have the same cancer

Correct answer: Never handle tablets with bare hands and use safe disposal methods

Oral chemotherapy is still a hazardous drug requiring gloves for handling and proper disposal to protect the patient and household members.

Question 21: A patient receiving irinotecan develops profuse diarrhea within 24 hours of infusion. This is best managed with:

Metoclopramide
Atropine (Correct answer)
Loperamide
Octreotide

Correct answer: Atropine

Early-onset diarrhea with irinotecan is cholinergic in nature and is treated with atropine.

Question 22: Which chemotherapy class works by intercalating into DNA strands and inhibiting topoisomerase II?

Antimetabolites
Alkylating agents
Vinca alkaloids
Anthracyclines (Correct answer)

Correct answer: Anthracyclines

Anthracyclines such as doxorubicin intercalate into DNA and inhibit topoisomerase II, preventing DNA replication.

Question 23: CAR-T cell therapy works by:

Stimulating NK cells with cytokines
Delivering radiation to tumor cells via antibodies
Genetically engineering patient T cells to recognize and kill cancer cells (Correct answer)
Blocking checkpoint proteins on T cells

Correct answer: Genetically engineering patient T cells to recognize and kill cancer cells

CAR-T therapy collects a patient's T cells, engineers them to express chimeric antigen receptors targeting cancer antigens, and reinfuses them.

Question 24: A patient on high-dose corticosteroids for brain metastases should be monitored for which common complication?

Thrombocytopenia
Hyponatremia
Hyperglycemia (Correct answer)
Hypocalcemia

Correct answer: Hyperglycemia

Corticosteroids cause insulin resistance and gluconeogenesis, commonly causing hyperglycemia that requires monitoring and management.

Question 25: A newly diagnosed cancer patient tells the nurse, 'I just can't believe this is happening to me.' The nurse's best therapeutic response is:

'Everything will be fine, many people beat cancer.'
'You need to stay positive to fight this disease.'
'Let me give you the statistics on your survival odds.'
'I understand this must be very difficult and shocking for you right now.' (Correct answer)

Correct answer: 'I understand this must be very difficult and shocking for you right now.'

Acknowledging the patient's emotional state with empathic reflection validates their experience and builds therapeutic trust.

Question 26: A patient has been informed that adjuvant chemotherapy is required after cancer surgery. According to the nurse, adjuvant chemotherapy means:

Regimens given to patients who cannot tolerate aggressive therapies
Immunotherapy used to boost the body's immune system
Drugs given to target minimal disease or micro metastases (Correct answer)
Investigational drugs used in combination with surgery

Correct answer: Drugs given to target minimal disease or micro metastases

Adjuvant chemotherapy is administered after the primary treatment, such as surgery or radiation, to eliminate any remaining cancer cells that may not have been visible or completely removed. Its purpose is to target micrometastases or minimal residual disease. This reduces the risk of cancer recurrence and improves long-term survival rates.

Question 27: A patient receiving bleomycin should be monitored closely for which life-threatening complication?

Renal failure
Pulmonary fibrosis (Correct answer)
Cardiac arrhythmia
Hepatic veno-occlusive disease

Correct answer: Pulmonary fibrosis

Bleomycin can cause pulmonary fibrosis and pneumonitis; cumulative dose limits and pulmonary function monitoring are essential.

Question 28: Peripheral neuropathy induced by paclitaxel typically presents as which symptom pattern?

Unilateral facial numbness
Proximal muscle weakness only
Central chest pain and paresthesia
Stocking-glove distribution numbness and tingling (Correct answer)

Correct answer: Stocking-glove distribution numbness and tingling

Taxane-induced peripheral neuropathy typically causes a symmetric stocking-glove pattern of numbness, tingling, and burning in the extremities.

Question 29: Parents of young patients receiving radiation treatments that affect the central nervous system should be informed about post-radiation somnolence. What time of year does this neurological syndrome typically occur?

Immediately
Within 1 to 2 weeks
Within 5 to 8 weeks (Correct answer)
Within 3 to 6 months

Correct answer: Within 5 to 8 weeks

Post-radiation somnolence syndrome is a well-recognized, transient neurological side effect that can occur after radiation treatments affecting the central nervous system. This syndrome, characterized by increased sleepiness, lethargy, and sometimes irritability, typically manifests within 5 to 8 weeks after the completion of radiation therapy. Parents should be informed about this delayed onset to help them understand and manage their child's symptoms.

Question 30: The nurse is assessing oral mucositis in a chemotherapy patient using the NCI grading scale. Which finding corresponds to Grade 3 mucositis?

Symptomatic but able to eat a modified diet
Asymptomatic with mild erythema
Life-threatening requiring urgent intervention
Severe symptoms preventing adequate oral intake (Correct answer)

Correct answer: Severe symptoms preventing adequate oral intake

NCI Grade 3 mucositis is characterized by severe symptoms that prevent adequate oral intake, requiring enteral or parenteral nutritional support.

Question 31: One of the primary tumors with the most significant frequency of brain metastases is:

Non-Hodgkin's lymphoma
Ovarian cancer
Thyroid cancer
Melanoma (Correct answer)

Correct answer: Melanoma

Melanoma is notoriously aggressive and has a high propensity to metastasize to distant sites, with the brain being one of the most common and challenging locations. Among primary tumors, melanoma is recognized as having one of the highest frequencies of brain metastases, often leading to significant neurological complications. This makes it a critical consideration in the staging and management of melanoma patients.

Question 32: Which cancer screening test detects precancerous lesions and is recommended for cervical cancer prevention?

Colonoscopy only
CA-125 blood test
Papanicolaou (Pap) smear and HPV testing (Correct answer)
Chest CT scan

Correct answer: Papanicolaou (Pap) smear and HPV testing

Pap smear and co-testing with HPV detection identify cervical dysplasia before it progresses to invasive cancer, making cervical cancer highly preventable.

Question 33: A patient receiving whole-brain radiation therapy reports significant fatigue. Which nursing intervention is most appropriate?

Refer immediately to the hematology team for erythropoietin therapy
Teach energy conservation strategies and encourage light activity balanced with rest (Correct answer)
Advise complete bed rest for the entire duration of radiation treatment
Encourage the patient to push through fatigue and maintain a normal activity schedule

Correct answer: Teach energy conservation strategies and encourage light activity balanced with rest

Energy conservation techniques and a balance of activity and rest are the evidence-based first-line approach for managing radiation-induced fatigue without unnecessary deconditioning.

Question 34: A nurse is caring for a patient with cancer-related fatigue. Which recommendation is most evidence-based?

Complete bed rest throughout treatment
Encourage a structured, moderate aerobic exercise program (Correct answer)
Recommend high-dose vitamin C supplementation
Avoid all physical activity until treatment ends

Correct answer: Encourage a structured, moderate aerobic exercise program

Evidence consistently supports moderate aerobic exercise as the most effective intervention for cancer-related fatigue during and after treatment.

Question 35: 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?

Refer the patient to a pain specialist before changing therapy
Add a non-opioid adjuvant like gabapentin only
Initiate strong opioids such as morphine immediately (Step 3)
Add a weak opioid such as tramadol or codeine (Step 2) (Correct answer)

Correct answer: Add a weak opioid such as tramadol or codeine (Step 2)

The WHO three-step analgesic ladder recommends adding a weak opioid (Step 2) when a non-opioid alone provides inadequate pain control before escalating to strong opioids.

Question 36: Advance care planning discussions should occur at which point in the cancer care trajectory?

Only after all curative treatment options fail
Only when the patient asks about it
Only when the patient is admitted to hospice
Early in diagnosis, not only at end of life (Correct answer)

Correct answer: Early in diagnosis, not only at end of life

Evidence supports early advance care planning at diagnosis to allow patients time to reflect on values and make informed decisions without crisis pressure.

Question 37: Spinal cord compression in oncology patients most commonly presents initially with:

Sensory loss only
Bowel and bladder incontinence
Back pain (Correct answer)
Complete paralysis

Correct answer: Back pain

Back pain is the earliest and most common presenting symptom of malignant spinal cord compression, often preceding neurologic deficits.

Question 38: Bevacizumab (Avastin) targets tumor angiogenesis by inhibiting which growth factor?

Vascular endothelial growth factor (VEGF) (Correct answer)
Platelet-derived growth factor (PDGF)
Epidermal growth factor (EGF)
Fibroblast growth factor (FGF)

Correct answer: Vascular endothelial growth factor (VEGF)

Bevacizumab is a monoclonal antibody that binds and neutralizes VEGF, preventing the formation of new blood vessels that tumors need to grow.

Question 39: What is brachytherapy?

Radiation delivered by a machine positioned at a long distance from the patient
Targeted radiopharmaceutical therapy given intravenously
Placement of radioactive sources directly inside or adjacent to the tumor (Correct answer)
A low-dose rate form of external beam radiation

Correct answer: Placement of radioactive sources directly inside or adjacent to the tumor

Brachytherapy involves placing radioactive implants (seeds, wires, or catheters) directly within or next to the tumor to deliver a concentrated local dose.

Question 40: Which intervention is most appropriate when a patient develops chemotherapy extravasation of a vesicant agent?

Discontinue the IV and massage the affected area vigorously
Apply warm compresses and continue the infusion at a slower rate
Stop the infusion immediately, aspirate residual drug, and apply cold compresses for most vesicants (Correct answer)
Flush the IV line with normal saline and apply a warm compress

Correct answer: Stop the infusion immediately, aspirate residual drug, and apply cold compresses for most vesicants

For vesicant extravasation, the infusion must be stopped immediately, residual drug aspirated, the IV removed, and cold compresses applied (except for vinca alkaloids which require warmth).

Question 41: Which scale is most commonly used in clinical practice to assess cancer pain intensity?

Karnofsky Performance Status
Numerical Rating Scale (NRS) 0–10 (Correct answer)
Glasgow Coma Scale
ECOG Performance Status

Correct answer: Numerical Rating Scale (NRS) 0–10

The 0–10 Numerical Rating Scale (NRS) is the most widely used clinical tool to assess pain intensity in cancer patients.

Question 42: The Warburg effect in cancer cells refers to which metabolic phenomenon?

Decreased glucose uptake by cancer cells
Preferential use of fatty acids for energy
Increased oxidative phosphorylation exclusively
Preferential use of aerobic glycolysis even in the presence of oxygen (Correct answer)

Correct answer: Preferential use of aerobic glycolysis even in the presence of oxygen

The Warburg effect describes how cancer cells preferentially use glycolysis (even with oxygen present) to meet their high energy and biosynthetic demands.

Question 43: Which route of administration is used for intrathecal chemotherapy?

Intravenous
Into the cerebrospinal fluid space (Correct answer)
Intraperitoneal
Subcutaneous

Correct answer: Into the cerebrospinal fluid space

Intrathecal chemotherapy is injected directly into the cerebrospinal fluid via lumbar puncture or Ommaya reservoir to treat or prevent CNS disease.

Question 44: A patient with small cell lung cancer presents with facial swelling, venous distension of the neck and chest, and dyspnea. This presentation is most consistent with:

Cardiac tamponade
Pulmonary embolism
Tension pneumothorax
Superior vena cava (SVC) syndrome (Correct answer)

Correct answer: Superior vena cava (SVC) syndrome

SVC syndrome is caused by obstruction of the SVC, commonly by mediastinal tumors, leading to facial edema, neck vein distension, and dyspnea.

Question 45: A patient's pain is described as burning and shooting down the leg following spinal metastasis. This type of pain is classified as:

Visceral nociceptive pain
Psychogenic pain
Neuropathic pain (Correct answer)
Somatic nociceptive pain

Correct answer: Neuropathic pain

Burning, shooting, or electric shock-like pain radiating along a nerve distribution is characteristic of neuropathic pain.

Question 46: A patient who completed chest radiation 6 weeks ago presents with fever, dry cough, and dyspnea. Which radiation complication is most likely?

Pericarditis
Radiation esophagitis
Radiation dermatitis
Radiation pneumonitis (Correct answer)

Correct answer: Radiation pneumonitis

Radiation pneumonitis typically occurs 1–3 months after chest irradiation and presents with fever, dry cough, and dyspnea due to inflammatory lung damage.

Question 47: A nurse is preparing to administer rituximab infusion. Which pre-medication is typically given to reduce infusion reactions?

Acetaminophen and diphenhydramine (Correct answer)
Lorazepam and morphine
Epinephrine and hydrocortisone
Ondansetron and dexamethasone only

Correct answer: Acetaminophen and diphenhydramine

Acetaminophen and diphenhydramine are standard pre-medications before rituximab to reduce fever and hypersensitivity infusion reactions.

Question 48: TNM staging for solid tumors classifies cancers based on which three factors?

Tissue grade, Necrosis, and Margin status
Treatment response, Nodular pattern, and Metastasis
Tumor type, Necrosis, and Molecular markers
Tumor size/extent, lymph Node involvement, and Metastasis (Correct answer)

Correct answer: Tumor size/extent, lymph Node involvement, and Metastasis

TNM staging uses primary tumor extent (T), regional lymph node involvement (N), and distant metastasis (M) to classify cancer stage and guide treatment.

Question 49: A patient on a VEGFR tyrosine kinase inhibitor (TKI) develops hypertension. The nurse should recognize this as:

A predictable on-target side effect (Correct answer)
An unrelated comorbidity
An allergic reaction requiring discontinuation
A sign of tumor lysis syndrome

Correct answer: A predictable on-target side effect

Hypertension is a predictable, on-target side effect of VEGFR TKIs because VEGF normally promotes vasodilation.

Question 50: A patient with leukemia develops petechiae, prolonged bleeding from IV sites, and a platelet count of 8,000/mm³. The priority nursing intervention is:

Apply heat to bleeding sites
Implement bleeding precautions and prepare for platelet transfusion (Correct answer)
Administer aspirin for discomfort
Encourage the patient to ambulate to prevent DVT

Correct answer: Implement bleeding precautions and prepare for platelet transfusion

A critically low platelet count with active bleeding requires immediate bleeding precautions and preparation for platelet transfusion.

Question 51: Which type of gene mutation is found in the germline and can be inherited by offspring?

Frameshift mutation only
Silent mutation only
Germline mutation (hereditary) (Correct answer)
Somatic mutation (acquired)

Correct answer: Germline mutation (hereditary)

Germline mutations are present in all cells of the body from birth and can be passed to children, as seen with BRCA1/2 and Lynch syndrome mutations.

Question 52: Which of the following is a sign of increased intracranial pressure (ICP) in a patient with brain metastases?

Hypoglycemia
Peripheral edema
Hypotension and tachycardia
Morning headache, nausea, and papilledema (Correct answer)

Correct answer: Morning headache, nausea, and papilledema

Increased ICP classically presents with morning headache (worse when lying flat), nausea/vomiting, and papilledema on fundoscopic exam.

Question 53: PARP inhibitors such as olaparib are most effective in cancers with defects in which pathway?

RAS/MAPK signaling pathway
VEGF signaling pathway
Homologous recombination repair (BRCA1/2 mutations) (Correct answer)
PI3K/AKT/mTOR pathway

Correct answer: Homologous recombination repair (BRCA1/2 mutations)

PARP inhibitors exploit synthetic lethality in BRCA-mutated cells that cannot repair DNA through homologous recombination, leading to cancer cell death.

Question 54: What is the correct action if extravasation of a vesicant chemotherapy agent is suspected?

Increase the infusion rate to dilute the drug
Stop the infusion immediately and leave the needle in place (Correct answer)
Apply heat to the site to promote absorption
Flush the IV line rapidly with saline

Correct answer: Stop the infusion immediately and leave the needle in place

The infusion must be stopped immediately and the needle left in place so residual drug can be aspirated before further intervention.

Question 55: Hot flashes in breast cancer survivors receiving aromatase inhibitors are best managed initially with which non-pharmacological approach?

Increased caffeine intake
Lifestyle modifications including layered clothing, cool room temperatures, and avoiding triggers (Correct answer)
High-dose estrogen replacement
Sedating antihistamines

Correct answer: Lifestyle modifications including layered clothing, cool room temperatures, and avoiding triggers

Non-pharmacological strategies such as trigger avoidance, cool environments, and layered clothing are recommended first because estrogen is contraindicated in breast cancer.

Question 56: A patient with cancer-related hypercalcemia of malignancy is most likely to present with which set of symptoms?

Diarrhea, muscle cramps, and perioral tingling
Hypertension, peripheral edema, and weight gain
Fatigue, constipation, polyuria, and confusion (Correct answer)
Bradycardia, hypotension, and skin flushing

Correct answer: Fatigue, constipation, polyuria, and confusion

Hypercalcemia classically presents with fatigue, constipation, polyuria/polydipsia, and altered mental status (bones, stones, groans, moans).

Question 57: A proto-oncogene becomes an oncogene through which process?

Loss-of-function mutation in a tumor suppressor
Normal aging-related methylation
Deletion of the gene entirely
Mutation, amplification, or translocation that causes gain-of-function overactivation (Correct answer)

Correct answer: Mutation, amplification, or translocation that causes gain-of-function overactivation

Proto-oncogenes become oncogenes when mutations, amplifications, or chromosomal translocations cause the gene product to become constitutively active.

Question 58: The IOM's Six Aims of Quality Healthcare include all of the items below, with the exception of:

Safe and effective
Patient-centered and timely
Safe and rapid (Correct answer)
Efficient and equitable

Correct answer: Safe and rapid

The Institute of Medicine (IOM), now the National Academy of Medicine, outlined six aims for quality healthcare: safe, effective, patient-centered, timely, efficient, and equitable. The option 'safe and rapid' is incorrect because 'rapid' is not one of the distinct aims. Instead, 'timely' is the correct aim, focusing on reducing harmful delays for both those who receive and those who give care.

Question 59: Which of the following is a key component of a survivorship care plan (SCP)?

Full pathology and surgical operative reports
Insurance billing codes for all treatments received
Summary of cancer treatment received plus a follow-up plan for surveillance and late effects (Correct answer)
A list of all oncology team members and their credentials

Correct answer: Summary of cancer treatment received plus a follow-up plan for surveillance and late effects

A survivorship care plan includes a treatment summary and a forward-looking plan covering surveillance schedules, late effects, and health promotion.

Question 60: Which chemotherapy agent is classified as an alkylating agent?

Doxorubicin
Vincristine
Cyclophosphamide (Correct answer)
Methotrexate

Correct answer: Cyclophosphamide

Cyclophosphamide is an alkylating agent that works by cross-linking DNA strands to prevent cell replication.

Question 61: Which electrolyte abnormality is the most life-threatening complication of tumor lysis syndrome?

Hyperkalemia (Correct answer)
Hyperuricemia
Hypocalcemia
Hyperphosphatemia

Correct answer: Hyperkalemia

Hyperkalemia is the most immediately life-threatening complication of TLS because it can cause fatal cardiac arrhythmias.

Question 62: What is the term for giving chemotherapy before the primary surgical procedure to shrink a tumor?

Neoadjuvant therapy (Correct answer)
Consolidation therapy
Salvage therapy
Adjuvant therapy

Correct answer: Neoadjuvant therapy

Neoadjuvant therapy is given before surgery to reduce tumor size and potentially allow for less extensive surgical resection.

Question 63: What is the nadir in the context of chemotherapy administration?

The first day of a new chemotherapy cycle
The cumulative lifetime dose limit
The peak drug concentration in blood
The point of lowest blood cell counts after chemotherapy (Correct answer)

Correct answer: The point of lowest blood cell counts after chemotherapy

The nadir is the lowest point of blood counts (especially neutrophils) following chemotherapy, typically occurring 7–14 days after treatment.

Question 64: Epithelial-to-mesenchymal transition (EMT) in cancer enables which key behavior?

Cancer cells to lose cell junctions and gain migratory and invasive properties (Correct answer)
Increased sensitivity to chemotherapy
Stable tumor growth without spread
Enhanced response to hormone therapy

Correct answer: Cancer cells to lose cell junctions and gain migratory and invasive properties

EMT is a developmental process hijacked by cancer cells to lose epithelial characteristics and gain mesenchymal traits, enabling migration and metastasis.

Question 65: CAR-T cell therapy requires which critical patient preparation step?

Complete fasting for 24 hours
Lymphodepleting chemotherapy before infusion (Correct answer)
Bone marrow biopsy on day of infusion
High-dose steroid premedication only

Correct answer: Lymphodepleting chemotherapy before infusion

Lymphodepleting chemotherapy (conditioning) before CAR-T infusion removes endogenous lymphocytes to create space for the engineered T-cells to expand.

Question 66: Which of the following communication strategies improves medication adherence in cancer outpatients?

Relying on family members to teach the patient
Providing only written materials without verbal explanation
Using teach-back method to confirm patient understanding (Correct answer)
Limiting patient questions to save time

Correct answer: Using teach-back method to confirm patient understanding

The teach-back method — asking patients to explain instructions in their own words — confirms comprehension and significantly improves adherence.

Question 67: Which type of biopsy provides the least invasive tissue diagnosis for accessible superficial tumors?

Incisional biopsy
Open surgical biopsy
Fine needle aspiration (FNA) (Correct answer)
Excisional biopsy

Correct answer: Fine needle aspiration (FNA)

Fine needle aspiration uses a thin needle to withdraw cells from a mass with minimal invasion and no general anesthesia, making it the least invasive biopsy technique.

Question 68: When a patient with cancer develops spinal cord compression, which symptom requires the most urgent nursing assessment?

Nausea and decreased appetite
Fatigue and generalized weakness
Mild low back pain rated 3/10
New onset urinary or bowel incontinence with back pain (Correct answer)

Correct answer: New onset urinary or bowel incontinence with back pain

New bowel or bladder dysfunction combined with back pain signals potential spinal cord compression, an oncologic emergency requiring immediate imaging and intervention to prevent permanent paralysis.

Question 69: Cancer-related fatigue (CRF) differs from normal fatigue in which key way?

CRF resolves after one full night of sleep
CRF is caused only by anemia
CRF is not relieved by rest or sleep (Correct answer)
CRF only occurs during chemotherapy

Correct answer: CRF is not relieved by rest or sleep

Cancer-related fatigue is uniquely persistent and is not relieved by rest, distinguishing it from normal activity-related fatigue.

Question 70: 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 4
Grade 3 (Correct answer)
Grade 2
Grade 1

Correct answer: Grade 3

Moist desquamation is CTCAE Grade 3 radiation dermatitis, requiring wound care and possible treatment interruption.

Question 71: An advance directive (living will) in oncology primarily serves to:

Restrict information sharing with family members
Document the patient's wishes for end-of-life care in case they cannot speak for themselves (Correct answer)
Assign a healthcare power of attorney
Authorize billing for cancer treatments

Correct answer: Document the patient's wishes for end-of-life care in case they cannot speak for themselves

A living will is an advance directive that documents a patient's treatment wishes (e.g., CPR, ventilation) in the event they become incapacitated.

Question 72: Which of the following is a common dose-limiting toxicity of cisplatin?

Hepatotoxicity
Pulmonary fibrosis
Nephrotoxicity (Correct answer)
Cardiotoxicity

Correct answer: Nephrotoxicity

Cisplatin causes significant nephrotoxicity; aggressive hydration and amifostine may be used to minimize renal damage.

Question 73: Which of the following best describes 'breakthrough pain' in cancer patients?

Transient flares of pain that exceed baseline despite stable around-the-clock analgesia (Correct answer)
Pain caused by the analgesic medication itself
Baseline persistent pain requiring around-the-clock medication
Pain that occurs only at night

Correct answer: Transient flares of pain that exceed baseline despite stable around-the-clock analgesia

Breakthrough pain is a transient exacerbation of pain that occurs against a background of otherwise controlled baseline pain.

Question 74: Which type of cancer is most strongly associated with the Philadelphia chromosome (BCR-ABL translocation)?

Multiple myeloma
Hodgkin lymphoma
Acute myeloid leukemia (AML)
Chronic myeloid leukemia (CML) (Correct answer)

Correct answer: Chronic myeloid leukemia (CML)

The Philadelphia chromosome (translocation between chromosomes 9 and 22) creating the BCR-ABL fusion gene is the hallmark of chronic myeloid leukemia.

Question 75: Metastasis occurs through which sequence of events?

Apoptosis → local invasion → circulation
Angiogenesis → extravasation → intravasation
Local invasion → intravasation → circulation → extravasation → colonization (Correct answer)
Colonization → circulation → local invasion

Correct answer: Local invasion → intravasation → circulation → extravasation → colonization

The metastatic cascade involves invasion of local tissue, entry into blood/lymphatics (intravasation), survival in circulation, exit (extravasation), and growth at a distant site.

Question 76: What cumulative dose of doxorubicin is associated with the greatest risk of cardiomyopathy?

450–550 mg/m² (Correct answer)
750 mg/m²
100 mg/m²
200 mg/m²

Correct answer: 450–550 mg/m²

Cardiotoxicity from doxorubicin significantly increases when the cumulative dose exceeds 450–550 mg/m².

Question 77: Which staging system is most commonly used to stage solid tumors in oncology practice?

TNM Classification (Correct answer)
Ann Arbor Classification
FIGO staging
Rai staging

Correct answer: TNM Classification

The TNM (Tumor, Node, Metastasis) classification system is the universally accepted standard for staging most solid tumors and guides treatment planning.

Question 78: Neutropenic fever in a cancer patient is defined as a single oral temperature ≥38.3°C (101°F) or ≥38°C (100.4°F) for 1 hour AND an ANC of:

< 1000 cells/mm³
< 100 cells/mm³
< 1500 cells/mm³
< 500 cells/mm³ (Correct answer)

Correct answer: < 500 cells/mm³

IDSA guidelines define neutropenic fever as fever with an ANC <500 cells/mm³, or <1000 cells/mm³ with expected decline to <500.

Question 79: What is the purpose of using a CVAD (central venous access device) for chemotherapy?

To safely administer vesicants and reduce peripheral vein damage (Correct answer)
To improve oral bioavailability
To allow the patient to go home sooner
To reduce drug costs

Correct answer: To safely administer vesicants and reduce peripheral vein damage

CVADs provide reliable venous access for vesicant infusions, protecting peripheral veins and reducing extravasation risk.

Question 80: Which clinical feature differentiates superior vena cava (SVC) syndrome from other oncologic emergencies?

Facial and upper extremity edema, venous distension of the neck and chest, and dyspnea (Correct answer)
Sudden onset chest pain radiating to the jaw
Severe lower extremity edema and ascites
Bilateral lower extremity weakness with saddle anesthesia

Correct answer: Facial and upper extremity edema, venous distension of the neck and chest, and dyspnea

SVC syndrome presents with facial/arm edema, visible chest and neck vein distension, and dyspnea due to obstruction of venous return from the upper body to the right atrium.

Question 81: Return to work after cancer treatment is supported by which nursing intervention?

Returning to work immediately after the last chemo dose
Advising permanent disability leave for all survivors
Connecting the patient with occupational therapy and informing them of ADA workplace accommodations (Correct answer)
Avoiding any discussion of employment during cancer care

Correct answer: Connecting the patient with occupational therapy and informing them of ADA workplace accommodations

Nurses help survivors return to work by facilitating occupational therapy referrals and educating about ADA rights to reasonable workplace accommodations.

Question 82: Which statement about cancer survivorship is accurate?

Survivorship care begins only after a patient is declared cured
Follow-up visits are only needed to monitor for cancer recurrence
Long-term side effects of treatment are rare and not worth discussing
Survivorship encompasses physical, emotional, social, and financial effects from diagnosis onward (Correct answer)

Correct answer: Survivorship encompasses physical, emotional, social, and financial effects from diagnosis onward

Cancer survivorship begins at diagnosis and encompasses the full spectrum of physical, psychological, social, and financial challenges throughout and beyond treatment.

Question 83: A patient undergoing radiation therapy to the chest asks if they can hug their grandchildren. The correct response is:

'Radiation makes you radioactive so you must avoid all contact.'
'Contact with family is fine only after your last radiation session.'
'You should avoid anyone under 18 for the duration of treatment.'
'External beam radiation does not make you radioactive — you are safe to hug family members.' (Correct answer)

Correct answer: 'External beam radiation does not make you radioactive — you are safe to hug family members.'

External beam radiation does not make patients radioactive; restrictions on contact apply only to patients with implanted or ingested radioactive sources.

Question 84: Which type of radiation therapy delivers a high dose to a small target with steep dose fall-off, minimizing exposure to surrounding tissue?

Brachytherapy
Total body irradiation
Stereotactic radiosurgery (SRS) (Correct answer)
Conventional fractionated radiotherapy

Correct answer: Stereotactic radiosurgery (SRS)

Stereotactic radiosurgery (SRS) delivers high-dose, precise radiation to a small target using multiple beams that converge, sparing surrounding tissue.

Question 85: Radiation-induced skin reactions are graded using which system in oncology practice?

Norton Scale
Braden Scale
NCI Common Terminology Criteria for Adverse Events (CTCAE) (Correct answer)
Fitzpatrick Skin Type Scale

Correct answer: NCI Common Terminology Criteria for Adverse Events (CTCAE)

The NCI CTCAE provides standardized grading of radiation dermatitis from Grade 1 (faint erythema) to Grade 4 (skin necrosis), guiding intervention.

Question 86: Lymphedema education for a patient who had axillary lymph node dissection should include which instruction?

Avoid all physical activity permanently
Avoid blood pressure cuffs and blood draws on the affected arm (Correct answer)
Apply tight compression wraps daily without guidance
Restrict fluid intake to reduce swelling

Correct answer: Avoid blood pressure cuffs and blood draws on the affected arm

BP cuffs and venipuncture on the affected arm increase lymphatic load and infection risk, and should be avoided to prevent or worsen lymphedema.

Question 87: A cancer patient is receiving high-dose methotrexate. What is the primary antidote used to rescue normal cells?

Mesna
Dexrazoxane
Amifostine
Leucovorin (folinic acid) (Correct answer)

Correct answer: Leucovorin (folinic acid)

Leucovorin (folinic acid) rescue bypasses the dihydrofolate reductase blockade caused by methotrexate, protecting normal cells from folate depletion toxicity.

Question 88: Financial toxicity in oncology refers to:

Medications that cause liver damage affecting financial decision-making
The negative financial burden experienced by patients due to cancer treatment costs, affecting well-being and adherence (Correct answer)
Overprescribing of expensive medications
Hospital billing errors that harm patients financially

Correct answer: The negative financial burden experienced by patients due to cancer treatment costs, affecting well-being and adherence

Financial toxicity describes the economic harm caused by cancer treatment costs — including medical bills, lost wages, and out-of-pocket expenses — which can lead to non-adherence and poor outcomes.

Question 89: 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 (Correct answer)
Elimination of all carbohydrates
High-protein meat-only diet
Daily megadose antioxidant supplements

Correct answer: Plant-forward diet rich in vegetables, fruits, and whole grains, limiting processed meats

Major cancer organizations recommend a plant-rich, minimally processed diet that limits red and processed meats to reduce cancer recurrence risk.

Question 90: The nurse is assessing a cancer patient for distress. Which validated tool is recommended by NCCN for this purpose?

Beck Depression Inventory
Hamilton Anxiety Rating Scale
PHQ-9 Depression Scale
Distress Thermometer (Correct answer)

Correct answer: Distress Thermometer

The NCCN Distress Thermometer is a validated, brief (0–10) screening tool recommended for routine distress screening in oncology patients.

Question 91: Which psychosocial issue is most commonly reported by long-term cancer survivors?

Complete return to pre-cancer psychological baseline
Post-traumatic growth only
Indifference about follow-up care
Fear of recurrence (Correct answer)

Correct answer: Fear of recurrence

Fear of cancer recurrence is the most commonly reported psychosocial concern among cancer survivors and can significantly impair quality of life.

Question 92: A hospice nurse is counseling a family on normal signs of dying in the final days. Which finding is expected and should be reassured as normal?

Severe uncontrolled pain requiring emergency intervention
Mottling of the extremities and irregular breathing (Correct answer)
Sudden increase in appetite
High fever above 104°F

Correct answer: Mottling of the extremities and irregular breathing

Mottling (livedo reticularis) of the extremities and irregular (Cheyne-Stokes) breathing are normal physiologic signs of imminent death.

Question 93: Which of the following accurately describes anticipatory nausea and vomiting in chemotherapy patients?

Nausea triggered by delayed serotonin release 5 days after chemotherapy
A conditioned response where nausea occurs before chemotherapy begins, triggered by associated cues (Correct answer)
Vomiting caused by morphine administration
Nausea caused by tumor-produced emetic factors

Correct answer: A conditioned response where nausea occurs before chemotherapy begins, triggered by associated cues

Anticipatory nausea is a classically conditioned response where patients develop nausea before treatment in response to sights, smells, or other cues associated with chemotherapy.

Question 94: The nurse is evaluating a patient with metastatic non-small cell lung cancer. During the assessment, the patient complains of periodic numbness and tingling in their hands and new back discomfort. The BEST thing the nurse can do is:

Explain to the patient that this is a normal side effect of chemotherapy
Communicate the finding to the appropriate provider (Correct answer)
Contact the provider to initiate pain management consult as this is a new issue for this patient
Educate the patient about the signs and symptoms of peripheral neuropathy related to chemotherapy

Correct answer: Communicate the finding to the appropriate provider

New neurological symptoms like numbness, tingling, and new back pain in a patient with metastatic cancer are concerning and require immediate medical evaluation. These symptoms could indicate serious complications such as spinal cord compression due to metastasis or peripheral neuropathy. Prompt communication with the provider ensures timely assessment and intervention, which is crucial for preventing further neurological damage or managing severe pain.

Question 95: Which factor most commonly triggers a cancer survivor's distress around surveillance imaging?

Overconfidence about being cured
Lack of understanding of scan technology
Scanxiety — fear of recurrence around scheduled scans or test results (Correct answer)
Discomfort with lying still in the scanner

Correct answer: Scanxiety — fear of recurrence around scheduled scans or test results

Scanxiety is the well-recognized pattern of heightened anxiety around surveillance imaging that many cancer survivors experience throughout their follow-up.

Question 96: A nurse notes that a patient's absolute neutrophil count (ANC) is 450 cells/mm³. Which classification and action is correct?

Normal range; no special precautions needed
Severe neutropenia (< 500); initiate neutropenic precautions and notify provider (Correct answer)
Critical value; administer packed red blood cells immediately
Mild neutropenia; encourage handwashing only

Correct answer: Severe neutropenia (< 500); initiate neutropenic precautions and notify provider

An ANC below 500 cells/mm³ is severe neutropenia, placing the patient at very high infection risk and requiring immediate neutropenic precautions, provider notification, and possible filgrastim therapy.

Question 97: Which organization provides the primary standards for safe handling of hazardous drugs in oncology nursing?

Joint Commission (TJC)
National Cancer Institute (NCI)
American Cancer Society (ACS)
Oncology Nursing Society (ONS) (Correct answer)

Correct answer: Oncology Nursing Society (ONS)

The Oncology Nursing Society (ONS) publishes evidence-based guidelines for chemotherapy administration and hazardous drug safety.

Question 98: Which statement best reflects the nurse's role in informed consent for cancer treatment?

Informed consent for cancer treatment does not require nursing involvement
The nurse's only role is to give the patient the consent form
The nurse witnesses the signature, reinforces information, and ensures the patient's questions are answered (Correct answer)
The nurse obtains the legal informed consent independently

Correct answer: The nurse witnesses the signature, reinforces information, and ensures the patient's questions are answered

Informed consent is obtained by the physician; the nurse's role is to witness, reinforce information, and act as an advocate ensuring the patient's questions are addressed.

Question 99: Which mechanism explains why cancer cells continue to divide without responding to normal growth-stop signals?

Overproduction of hormones
Increased nutrient intake
Insensitivity to antigrowth signals (dysregulation of tumor suppressor pathways) (Correct answer)
Overactivation of apoptosis

Correct answer: Insensitivity to antigrowth signals (dysregulation of tumor suppressor pathways)

Loss of tumor suppressor gene function (e.g., RB, p53) removes the normal brake on cell division, allowing cancer cells to ignore antigrowth signals.

Question 100: Which immune checkpoint inhibitor targets PD-1?

Ipilimumab
Pembrolizumab (Correct answer)
Atezolizumab
Durvalumab

Correct answer: Pembrolizumab

Pembrolizumab (Keytruda) is a monoclonal antibody that targets the PD-1 receptor on T cells, restoring anti-tumor immunity.

Question 101: Late cardiovascular effects of cancer treatment are most associated with which therapies?

Antiemetics and pain medications
Oral hormone therapy only
Colony-stimulating factors
Anthracyclines, trastuzumab, and chest radiation (Correct answer)

Correct answer: Anthracyclines, trastuzumab, and chest radiation

Anthracyclines and trastuzumab cause cardiomyopathy, while chest radiation causes pericarditis, coronary artery disease, and valvular damage as late effects.

Question 102: Cytokine release syndrome (CRS) is a potentially life-threatening complication most associated with which therapies?

Oral targeted therapy
Alkylating chemotherapy
CAR-T cell therapy and bispecific antibodies (Correct answer)
Hormone therapy

Correct answer: CAR-T cell therapy and bispecific antibodies

CRS is a systemic inflammatory response caused by massive cytokine release when immune cells are activated by CAR-T cell therapy or bispecific antibodies.

Question 103: A patient on long-term opioid therapy for cancer pain reports worsening constipation unresponsive to laxatives. Which agent is specifically FDA-approved for opioid-induced constipation in cancer patients?

Naloxegol or methylnaltrexone (Correct answer)
Lactulose
Polyethylene glycol
Senna with docusate

Correct answer: Naloxegol or methylnaltrexone

Peripherally acting mu-opioid receptor antagonists (PAMORAs) like naloxegol and methylnaltrexone are specifically approved for opioid-induced constipation without reversing central analgesia.

Question 104: Doxorubicin has a cumulative lifetime dose limit primarily because of which toxicity?

Nephrotoxicity
Neurotoxicity
Hepatotoxicity
Cardiomyopathy (Correct answer)

Correct answer: Cardiomyopathy

Doxorubicin accumulates in cardiac tissue and can cause irreversible cardiomyopathy; the total lifetime dose is capped at 450–550 mg/m².

Question 105: Tamoxifen requires conversion by CYP2D6 to its active metabolite endoxifen. What is the nursing implication?

Administer only with antacids
Avoid CYP2D6 inhibitors (e.g., fluoxetine) that reduce tamoxifen efficacy (Correct answer)
Monitor for hypoglycemia regularly
Encourage high-fat diet to improve absorption

Correct answer: Avoid CYP2D6 inhibitors (e.g., fluoxetine) that reduce tamoxifen efficacy

CYP2D6 inhibitors like fluoxetine block conversion of tamoxifen to its active metabolite, potentially reducing therapeutic efficacy in ER+ breast cancer.

Question 106: Which corticosteroid is most commonly used as part of antiemetic regimens for highly emetogenic chemotherapy?

Dexamethasone (Correct answer)
Hydrocortisone
Methylprednisolone
Prednisone

Correct answer: Dexamethasone

Dexamethasone is the preferred corticosteroid in CINV regimens due to its potency, long half-life, and synergistic antiemetic effect with 5-HT3 antagonists.

Question 107: The nurse is creating a care strategy for the multiple myeloma patient. Which priority intervention is included by the nurse in the care plan?

Coughing and deep breathing
Providing frequent oral care
Encouraging fluids (Correct answer)
Monitoring red blood cell count

Correct answer: Encouraging fluids

Multiple myeloma often leads to complications such as hypercalcemia, kidney dysfunction, and increased risk of infection. Encouraging fluids is a priority intervention because it helps prevent kidney damage by flushing out excess calcium and protein byproducts. Adequate hydration is crucial for maintaining overall organ function and reducing the risk of these serious complications.

Question 108: A patient is prescribed ondansetron for chemotherapy-induced nausea. The nurse should monitor for which cardiac side effect?

Atrial fibrillation
Bradycardia
Hypertension
QT prolongation (Correct answer)

Correct answer: QT prolongation

Ondansetron (a 5-HT3 antagonist) can cause QT interval prolongation, increasing the risk of serious dysrhythmias such as torsades de pointes.

Question 109: Sexual health concerns in cancer survivors should be addressed using which approach?

Only address sexual health at the last visit
PLISSIT model (Permission, Limited Information, Specific Suggestions, Intensive Therapy) (Correct answer)
Refer all sexual concerns to psychiatry without discussion
Avoid the topic unless the patient raises it first

Correct answer: PLISSIT model (Permission, Limited Information, Specific Suggestions, Intensive Therapy)

The PLISSIT model provides a structured framework for progressively addressing sexual health concerns in cancer survivors within nursing practice.

Question 110: Before administering paclitaxel, the nurse should premedicate with which agents to prevent hypersensitivity reactions?

Corticosteroids, diphenhydramine, and an H2 blocker (Correct answer)
Acetaminophen and ibuprofen
Metoclopramide and dexamethasone
Ondansetron and lorazepam

Correct answer: Corticosteroids, diphenhydramine, and an H2 blocker

Paclitaxel's Cremophor EL solvent causes hypersensitivity reactions; premedication with a steroid, antihistamine, and H2 blocker is required.

Question 111: Which of the following best prevents tumor lysis syndrome in high-risk patients starting chemotherapy?

Allopurinol or rasburicase plus aggressive IV hydration (Correct answer)
Immediate plasmapheresis
Prophylactic potassium supplementation
Restricting IV fluids to prevent fluid overload

Correct answer: Allopurinol or rasburicase plus aggressive IV hydration

Allopurinol (or rasburicase for very high-risk cases) combined with aggressive IV hydration is the standard prophylaxis for TLS in high-risk patients.

Question 112: When teaching a patient about neutropenic precautions at home, which instruction is most important?

Take prophylactic antibiotics without physician guidance
Avoid raw fruits, vegetables, and crowds; report fever promptly (Correct answer)
Restrict fluid intake to 1 liter per day
Avoid all physical activity

Correct answer: Avoid raw fruits, vegetables, and crowds; report fever promptly

Neutropenic patients must avoid infection sources (raw produce, crowds) and report fever immediately, as infection can become life-threatening rapidly.

Question 113: Which route of administration bypasses the blood-brain barrier most effectively for CNS tumors?

Oral
Intravenous
Intrathecal (Correct answer)
Subcutaneous

Correct answer: Intrathecal

Intrathecal administration delivers chemotherapy directly into the cerebrospinal fluid, bypassing the blood-brain barrier.

Question 114: What is the primary mechanism of action of taxanes such as paclitaxel?

Blocking folate metabolism
Inhibiting topoisomerase II
DNA cross-linking
Stabilizing microtubules to prevent mitosis (Correct answer)

Correct answer: Stabilizing microtubules to prevent mitosis

Taxanes like paclitaxel stabilize microtubules, preventing their disassembly and thus blocking cell division.

Question 115: Chemotherapy combined with adjuvant radiation therapy is the proper course of treatment to reduce tumor size and improve blockage; that is the root cause of the syndrome. Treatment options for a pleural effusion might include chest tube insertion and thoracentesis. Superior vena cava syndrome cannot be effectively treated with packed red blood cell transfusions.

Apply soothing ointments to the lips for dryness and cracking
None of these answer choices
Use a soft, nylon toothbrush when brushing teeth.
Rinse the mouth several times per day with a baking soda and warm water solution
Moisten foods with sauces, gravies and other liquids
All of these choices (Correct answer)

Correct answer: All of these choices

The listed interventions are all crucial for managing common oral side effects experienced by oncology patients, such as mucositis, dry mouth, and chapped lips, which can exacerbate discomfort and impact nutrition. Using a soft toothbrush prevents gum irritation, moistening foods aids swallowing, applying ointments soothes dry lips, and baking soda rinses maintain oral hygiene and reduce inflammation. Implementing "All of these choices" provides comprehensive supportive care to improve patient comfort and oral health during treatment.

Question 116: A patient receiving cisplatin needs prehydration primarily to prevent which toxicity?

Nephrotoxicity (Correct answer)
Cardiotoxicity
Pulmonary toxicity
Hepatotoxicity

Correct answer: Nephrotoxicity

Cisplatin is highly nephrotoxic, and aggressive IV hydration before and after administration is required to protect renal function.

Question 117: A patient with advanced cancer has a DNR order. They develop a bowel obstruction and severe pain. What is the nurse's priority action?

Withhold all medications since resuscitation is not desired
Contact surgery to reverse the obstruction despite the DNR
Notify the family and await further orders before acting
Focus on aggressive symptom management and comfort measures (Correct answer)

Correct answer: Focus on aggressive symptom management and comfort measures

A DNR order applies only to cardiopulmonary resuscitation; all other treatments, especially aggressive pain and symptom management, remain appropriate and are the priority in palliative care.

Question 118: Which calculation method is most commonly used to determine chemotherapy dosing?

Actual body weight only
Ideal body weight only
Age-based dosing tables
Body surface area (BSA) (Correct answer)

Correct answer: Body surface area (BSA)

Chemotherapy doses are most commonly calculated using body surface area (m²) to standardize dosing across patient sizes.

Question 119: A patient is prescribed bevacizumab. The nurse knows this drug targets which molecular pathway?

EGFR tyrosine kinase
HER2/neu receptor
BCR-ABL tyrosine kinase
Vascular endothelial growth factor (VEGF) (Correct answer)

Correct answer: Vascular endothelial growth factor (VEGF)

Bevacizumab is a monoclonal antibody that targets VEGF, inhibiting tumor angiogenesis.

Question 120: Tumor lysis syndrome (TLS) is most likely to occur in which cancer type?

Hormone-sensitive breast cancer
Slow-growing solid tumors
Highly proliferative tumors such as Burkitt lymphoma or ALL (Correct answer)
Well-differentiated thyroid cancer

Correct answer: Highly proliferative tumors such as Burkitt lymphoma or ALL

TLS most commonly occurs with highly proliferative hematologic malignancies like Burkitt lymphoma or ALL due to rapid cell lysis releasing intracellular contents.

Question 121: Bisphosphonates such as zoledronic acid are used in oncology to treat which complications?

Lymphedema
Liver metastases
Bone metastases, hypercalcemia of malignancy, and osteoporosis prevention (Correct answer)
Brain metastases

Correct answer: Bone metastases, hypercalcemia of malignancy, and osteoporosis prevention

Zoledronic acid inhibits osteoclast activity to reduce skeletal-related events from bone metastases and treat hypercalcemia of malignancy.

Question 122: Which chemotherapy drug requires leucovorin rescue to prevent life-threatening toxicity?

High-dose methotrexate (Correct answer)
Paclitaxel
Gemcitabine
Doxorubicin

Correct answer: High-dose methotrexate

Leucovorin (folinic acid) rescue is used after high-dose methotrexate to protect normal cells from folate depletion toxicity.

Question 123: Tumor grade refers to which pathological characteristic?

The presence of distant metastases
The number of lymph nodes involved
How differentiated (similar to normal tissue) the cancer cells appear under microscopy (Correct answer)
The physical size of the tumor

Correct answer: How differentiated (similar to normal tissue) the cancer cells appear under microscopy

Tumor grade reflects the degree of cellular differentiation: low grade (well differentiated) cells look like normal cells, while high grade (poorly differentiated) cells are more abnormal and aggressive.

Question 124: Colony-stimulating factors (e.g., filgrastim/G-CSF) are used in oncology patients primarily for which purpose?

To prevent anemia from chemotherapy
To increase platelet counts
To reduce nausea from radiation
To stimulate neutrophil production and reduce febrile neutropenia risk (Correct answer)

Correct answer: To stimulate neutrophil production and reduce febrile neutropenia risk

G-CSF agents like filgrastim stimulate the bone marrow to produce neutrophils, reducing the depth and duration of chemotherapy-induced neutropenia.

Question 125: Aromatase inhibitors (e.g., anastrozole, letrozole) are used in postmenopausal breast cancer patients to achieve which effect?

Increase progesterone levels
Suppress ovarian estrogen production
Block estrogen at the receptor directly
Block conversion of androgens to estrogen in peripheral tissues (Correct answer)

Correct answer: Block conversion of androgens to estrogen in peripheral tissues

Aromatase inhibitors block the aromatase enzyme that converts androgens to estrogens in peripheral tissues, the main estrogen source in postmenopausal women.

Question 126: A patient with known lung cancer develops distant heart sounds, jugular venous distension, and hypotension. The nurse suspects:

Heart failure exacerbation
Myocardial infarction
Pulmonary embolism
Cardiac tamponade (Correct answer)

Correct answer: Cardiac tamponade

Beck's triad (muffled heart sounds, JVD, hypotension) is classic for cardiac tamponade, which can result from malignant pericardial effusion.

Question 127: Disseminated intravascular coagulation (DIC) in cancer is most commonly associated with which malignancy?

Multiple myeloma
Acute promyelocytic leukemia (APL) (Correct answer)
Breast cancer
Chronic lymphocytic leukemia

Correct answer: Acute promyelocytic leukemia (APL)

APL (AML-M3) is classically associated with DIC due to release of procoagulant granules from malignant promyelocytes.

Question 128: Immune-related adverse events (irAEs) from checkpoint inhibitors most commonly affect which organ systems?

Brain exclusively
Heart and kidneys only
Bone marrow only
Skin, GI tract, liver, and endocrine glands (Correct answer)

Correct answer: Skin, GI tract, liver, and endocrine glands

Checkpoint inhibitors cause autoimmune-like reactions most frequently in skin (rash), gut (colitis), liver (hepatitis), and endocrine organs (thyroiditis).

Question 129: Which of the following chemotherapy drugs is administered to treat the spread of prostate cancer?

Cyclophosphamide (Cytoxan)
Mitoxantrone (Novantrone) (Correct answer)
Doxorubicin (Adriamycin)
5-Fluorouracil (5FU)

Correct answer: Mitoxantrone (Novantrone)

Mitoxantrone (Novantrone) is an anthracenedione antineoplastic agent commonly used in the treatment of hormone-refractory metastatic prostate cancer. It works by interfering with DNA synthesis and repair, thereby inhibiting the growth of cancer cells. The other listed drugs are typically used for different types of cancer.

Question 130: A patient's caregiver asks about the purpose of a 'nadir' blood count check after chemotherapy. The nurse's best explanation is:

It measures tumor marker levels to assess treatment response
It checks for drug resistance to predict the next cycle dose
It determines when the patient can resume a normal diet
It identifies the point of lowest bone marrow function to monitor for infection and bleeding risk (Correct answer)

Correct answer: It identifies the point of lowest bone marrow function to monitor for infection and bleeding risk

The nadir is the lowest point of blood cell counts after chemotherapy (typically 7–14 days), representing the period of greatest vulnerability to infection and bleeding complications.

Question 131: A nurse notes blood return is absent from a patient's port during chemotherapy infusion. What is the priority action?

Stop the infusion and assess for extravasation or port malfunction (Correct answer)
Continue infusion if no patient complaints
Flush aggressively with normal saline
Increase the infusion rate to clear the port

Correct answer: Stop the infusion and assess for extravasation or port malfunction

Loss of blood return may indicate port malfunction or tip migration; the infusion must be stopped immediately and the access assessed before continuing.

Question 132: A neutropenic patient with fever should receive empiric broad-spectrum antibiotics within:

4 hours of presentation
6 hours of presentation
24 hours of presentation
1 hour of presentation (Correct answer)

Correct answer: 1 hour of presentation

Current guidelines recommend initiating empiric IV antibiotics within 1 hour of presentation in febrile neutropenia to reduce morbidity and mortality.

Question 133: A patient with breast cancer is prescribed tamoxifen. The nurse should instruct the patient to report which serious adverse effect immediately?

Hair thinning
Mild hot flashes
Leg pain and swelling (Correct answer)
Mild vaginal dryness

Correct answer: Leg pain and swelling

Tamoxifen increases the risk of thromboembolic events; leg pain and swelling may indicate deep vein thrombosis requiring urgent evaluation.

Question 134: Which of the following is frequently affected when Hodgkin's lymphoma is diagnosed?

Goin
Back
Neck (Correct answer)
Chest

Correct answer: Neck

Hodgkin's lymphoma is a cancer that originates in the lymphatic system, and its most common initial presentation is painless swelling of lymph nodes. The lymph nodes in the neck (cervical region) are frequently the first to be affected and noticed by patients. This characteristic presentation in the neck is a key diagnostic indicator for Hodgkin's lymphoma.

Question 135: The immune system recognizes cancer cells through a process called immune surveillance. Which cells are the primary cancer-killing effectors?

B lymphocytes exclusively
Platelets and red blood cells
Cytotoxic T lymphocytes (CD8+ T cells) and natural killer (NK) cells (Correct answer)
Eosinophils and basophils

Correct answer: Cytotoxic T lymphocytes (CD8+ T cells) and natural killer (NK) cells

CD8+ cytotoxic T cells and NK cells are the primary immune effectors that recognize and destroy cancer cells expressing tumor-associated antigens.

Question 136: Which chemotherapy agent is classified as a vesicant and requires careful monitoring for extravasation?

Cyclophosphamide
Fluorouracil
Vincristine (Correct answer)
Methotrexate

Correct answer: Vincristine

Vincristine is a vesicant that can cause severe tissue necrosis if it extravasates from the vein.

Question 137: A patient with non-Hodgkin lymphoma is receiving rituximab. Which pre-infusion assessment finding should cause the nurse to withhold the drug and notify the provider?

Serum creatinine of 0.9 mg/dL
Temperature of 37.8°C (100°F) with suspected active infection (Correct answer)
Heart rate of 82 beats per minute
Blood pressure of 118/76 mmHg

Correct answer: Temperature of 37.8°C (100°F) with suspected active infection

Rituximab can cause fatal infusion reactions and reactivation of infections; active infection warrants holding the drug and consulting the oncologist before proceeding.

Question 138: Which hallmark of cancer involves the tumor's ability to grow its own blood supply?

Sustained angiogenesis (Correct answer)
Self-sufficiency in growth signals
Limitless replicative potential
Evading apoptosis

Correct answer: Sustained angiogenesis

Sustained angiogenesis is a hallmark of cancer in which tumors secrete VEGF and other factors to grow new blood vessels that supply nutrients and oxygen.

Question 139: A nurse is caring for a patient with a low-dose rate (LDR) cervical brachytherapy implant. Which safety precaution is most important?

Instruct visitors to stand at the foot of the bed as far as possible
Limit time near the patient and keep distance; pregnant visitors and children should not visit (Correct answer)
Double-glove and wear an N95 mask when entering the room
Ensure the patient wears lead shielding at all times

Correct answer: Limit time near the patient and keep distance; pregnant visitors and children should not visit

Radiation safety for LDR brachytherapy requires limiting time and maximizing distance from the radioactive source; pregnant women and children are especially restricted to protect them from radiation exposure.

Question 140: Which personal protective equipment (PPE) is required when handling hazardous chemotherapy drugs?

Single gloves only
Double gloves, gown, and eye protection (Correct answer)
Surgical mask and gown only
N95 mask and gloves

Correct answer: Double gloves, gown, and eye protection

NIOSH and ONS guidelines require double chemotherapy-rated gloves, a protective gown, and eye/face protection when handling hazardous drugs.

Question 141: Trastuzumab (Herceptin) is indicated for cancers that overexpress which receptor?

HER2 (human epidermal growth factor receptor 2) (Correct answer)
Androgen receptor (AR)
Estrogen receptor (ER)
Progesterone receptor (PR)

Correct answer: HER2 (human epidermal growth factor receptor 2)

Trastuzumab is a monoclonal antibody that targets HER2-overexpressing cancers, most commonly HER2+ breast and gastric cancers.

Question 142: A patient with a five-month prognosis is unsure about accessing the Medicare Hospice Benefit due to mounting financial worries. The nurse is aware that part of the advantage is offering:

Respite care lasting more than seven days
Admission in a clinical trial
Transportation for radiation treatments
Durable medical equipment (Correct answer)

Correct answer: Durable medical equipment

The Medicare Hospice Benefit provides comprehensive care for terminally ill patients, aiming to enhance comfort and quality of life. A significant advantage of this benefit is the coverage of durable medical equipment (DME), such as hospital beds, wheelchairs, and oxygen equipment. This provision helps alleviate financial burdens for families and ensures the patient has necessary items for comfort and safety at home.

Question 143: Which non-pharmacological intervention has the strongest evidence for reducing cancer-related fatigue?

High-dose vitamins
Massage therapy alone
Moderate aerobic exercise (Correct answer)
Complete bed rest

Correct answer: Moderate aerobic exercise

Multiple systematic reviews show that moderate aerobic exercise is the most evidence-based non-pharmacological intervention for cancer-related fatigue.

Question 144: Adaptive or particular immunity is demonstrated by:

An inflammatory response
A cell-mediated response (Correct answer)
Large lymphocyte production
Acute-phase protein production

Correct answer: A cell-mediated response

Adaptive immunity, also known as acquired or specific immunity, is characterized by its ability to recognize specific pathogens and mount a targeted, memory-based response. A cell-mediated response, primarily involving T-lymphocytes, is a hallmark of this system, directly attacking infected cells or coordinating other immune cells. This differs from innate immunity, which includes non-specific responses like acute-phase protein production and inflammation.

Question 145: Immune checkpoint inhibitors such as nivolumab work by blocking which protein to restore T-cell function?

PD-1 (programmed death-1) (Correct answer)
CTLA-4 only
HER2
LAG-3 only

Correct answer: PD-1 (programmed death-1)

Nivolumab is an anti-PD-1 antibody that blocks the PD-1 checkpoint, preventing tumor cells from suppressing T-cell immune responses.

Question 146: A patient with newly diagnosed cancer refuses to discuss prognosis with the physician, saying 'Just tell my wife everything.' How should the nurse respond?

Immediately share all information with the spouse
Respect the patient's expressed preference to have the spouse receive information, and document this preference (Correct answer)
Insist the patient hear the information directly
Override the patient's wishes because the prognosis affects treatment decisions

Correct answer: Respect the patient's expressed preference to have the spouse receive information, and document this preference

Patient autonomy includes the right to delegate information-sharing; the nurse should honor and document this preference while ensuring the designated person is properly informed.

Question 147: A survivor completing treatment should receive a survivorship care plan from which care setting?

The treating oncology team at the end of active treatment (Correct answer)
Only if the patient requests it in writing
The emergency department
Only from primary care after 5 years

Correct answer: The treating oncology team at the end of active treatment

The Commission on Cancer requires that oncology programs provide a comprehensive survivorship care plan to patients completing active treatment.

Question 148: Hormonal therapy with tamoxifen is most appropriate for which breast cancer receptor profile?

Estrogen receptor-positive (Correct answer)
PR-negative, ER-negative
HER2-positive, ER-negative
Triple-negative

Correct answer: Estrogen receptor-positive

Tamoxifen is a selective estrogen receptor modulator (SERM) used in estrogen receptor-positive breast cancers.

Question 149: Which laboratory finding is NOT consistent with tumor lysis syndrome?

Hyperkalemia
Hyperphosphatemia
Hyperuricemia
Hypercalcemia (Correct answer)

Correct answer: Hypercalcemia

TLS causes hypocalcemia (not hypercalcemia) because phosphate released from lysed cells binds calcium, lowering serum levels.

Question 150: A patient with cancer reports a new severe headache rated 10/10 that began suddenly. The nurse's priority action is to:

Document and reassess at the next scheduled assessment
Notify the provider immediately — this may indicate CNS metastasis or hemorrhage (Correct answer)
Administer PRN acetaminophen and reassess in 1 hour
Apply a cool cloth and dim the lights

Correct answer: Notify the provider immediately — this may indicate CNS metastasis or hemorrhage

A sudden severe 'thunderclap' headache in a cancer patient is a red-flag symptom warranting immediate provider notification to rule out CNS emergency.

Question 151: Targeted therapy with imatinib (Gleevec) works by inhibiting which specific molecular target?

VEGF receptor
HER2 receptor
BCR-ABL tyrosine kinase (Correct answer)
EGFR receptor

Correct answer: BCR-ABL tyrosine kinase

Imatinib is a tyrosine kinase inhibitor that specifically targets the BCR-ABL fusion protein, which drives CML cell proliferation.

Question 152: A 60-year-old male patient is admitted to the oncology unit with a new diagnosis of small cell carcinoma of the right lung and a cough as his main complaints. The syndrome of the superior vena cava is identified. Which medical procedures would you anticipate being prescribed for this patient?

Transfusion of two units of packed red blood cells
Surgical consultant to place a chest tube
Thoracentesis under local anesthesia
Chemotherapy with adjuvant radiation therapy (Correct answer)

Correct answer: Chemotherapy with adjuvant radiation therapy

For a patient diagnosed with small cell carcinoma of the right lung presenting with superior vena cava (SVC) syndrome, the most appropriate medical procedure is chemotherapy with adjuvant radiation therapy. Small cell lung cancer is highly sensitive to both modalities, and this combined approach aims to rapidly reduce the tumor size, thereby alleviating the compression on the superior vena cava and improving the patient's symptoms.

Question 153: Which of the following is a cell-cycle-specific chemotherapy agent?

Carmustine
Cisplatin
Vincristine (Correct answer)
Cyclophosphamide

Correct answer: Vincristine

Vincristine is cell-cycle-specific, acting in the M phase by binding to tubulin and preventing spindle formation.

Question 154: Which element is essential in a comprehensive cancer survivorship care plan?

List of dietary supplements to take
Contact information of insurance provider only
Only future treatment plans
Summary of treatment received and schedule of recommended follow-up (Correct answer)

Correct answer: Summary of treatment received and schedule of recommended follow-up

A survivorship care plan must include a treatment summary and follow-up schedule so the patient and primary care provider can manage long-term and late effects.

Question 155: Dyspnea in a patient with lung cancer should first be assessed for which reversible cause?

Anxiety disorder only
Terminal decline only
Tumor spread only
Pleural effusion (Correct answer)

Correct answer: Pleural effusion

Pleural effusion is a common, treatable cause of dyspnea in lung cancer patients and should be assessed and drained if present.

Question 156: Which cancer type has a strong etiological link to Helicobacter pylori infection?

Gastric (stomach) adenocarcinoma (Correct answer)
Liver cancer
Colon cancer
Pancreatic cancer

Correct answer: Gastric (stomach) adenocarcinoma

H. pylori infection causes chronic gastric inflammation that over decades can progress to intestinal metaplasia, dysplasia, and gastric adenocarcinoma.

Question 157: A patient undergoing radiation therapy to the chest develops a dry, desquamating skin reaction at the treatment site. What is the most appropriate nursing intervention?

Apply an alcohol-based antiseptic to prevent infection
Apply petroleum-based ointment and cover with a dry dressing
Gently cleanse with mild soap and water and apply a recommended moisturizer (Correct answer)
Rub the area vigorously to remove dead skin cells

Correct answer: Gently cleanse with mild soap and water and apply a recommended moisturizer

Gentle cleansing with mild soap and water followed by a radiation-approved moisturizer minimizes irritation and supports skin integrity during radiation-induced dermatitis.

Question 158: Which antifungal drug interaction is most important to monitor in patients receiving voriconazole and certain chemotherapy agents?

Increased antibiotic resistance
Reduced antiemetic efficacy
CYP450 enzyme inhibition increasing chemotherapy drug levels (Correct answer)
Decreased steroid effectiveness

Correct answer: CYP450 enzyme inhibition increasing chemotherapy drug levels

Voriconazole inhibits CYP450 enzymes and can dramatically increase plasma levels of chemotherapy drugs metabolized by the same pathway, causing toxicity.

Question 159: For cancer pain management, the WHO analgesic ladder recommends starting with which class for mild pain?

Adjuvant medications only
Epidural analgesia
Non-opioid analgesics (e.g., acetaminophen, NSAIDs) (Correct answer)
Strong opioids immediately

Correct answer: Non-opioid analgesics (e.g., acetaminophen, NSAIDs)

The WHO analgesic ladder begins with non-opioid analgesics for mild pain (Step 1) and escalates to opioids only as pain severity increases.

Question 160: Which treatment is the immediate priority for a patient with confirmed malignant spinal cord compression?

Chemotherapy
Radiation therapy
High-dose corticosteroids (dexamethasone) (Correct answer)
Surgical decompression

Correct answer: High-dose corticosteroids (dexamethasone)

High-dose dexamethasone is given immediately to reduce spinal cord edema while definitive treatment (radiation or surgery) is arranged.

Question 161: Which laboratory finding most strongly indicates tumor lysis syndrome (TLS) in a newly treated leukemia patient?

Decreased serum potassium and elevated calcium
Elevated serum potassium, phosphate, and uric acid with decreased calcium (Correct answer)
Elevated serum sodium
Elevated serum albumin and decreased BUN

Correct answer: Elevated serum potassium, phosphate, and uric acid with decreased calcium

TLS is characterized by hyperkalemia, hyperphosphatemia, hyperuricemia, and hypocalcemia due to rapid cell destruction releasing intracellular contents.

Question 162: Which chemotherapy agent is associated with hemorrhagic cystitis as a major side effect?

Cyclophosphamide (Correct answer)
Irinotecan
Vinorelbine
Cisplatin

Correct answer: Cyclophosphamide

Cyclophosphamide's metabolite acrolein irritates the bladder lining, causing hemorrhagic cystitis; mesna and hydration are used for prevention.

Question 163: When educating a patient about neutropenia precautions, which food should the nurse instruct the patient to avoid?

Cooked chicken breast
Raw sushi (Correct answer)
Pasteurized yogurt
Canned vegetables

Correct answer: Raw sushi

Raw or undercooked seafood poses a high risk of bacterial contamination and should be avoided by neutropenic patients who cannot mount an adequate immune response.

Question 164: Lynch syndrome (hereditary non-polyposis colorectal cancer) is caused by mutations in which genes?

Mismatch repair genes (MLH1, MSH2, MSH6, PMS2) (Correct answer)
APC and PTEN
BRCA1 and BRCA2
RB1 and TP53

Correct answer: Mismatch repair genes (MLH1, MSH2, MSH6, PMS2)

Lynch syndrome is caused by germline mutations in DNA mismatch repair genes, leading to microsatellite instability and increased risk of colorectal, endometrial, and other cancers.

OCN Oncology Certified Nurse Exam

The OCN (Oncology Certified Nurse) exam is administered by the Oncology Nursing Certification Corporation (ONCC) and validates expert knowledge in oncology nursing practice. The exam covers cancer biology, treatment modalities including chemotherapy and radiation, symptom management, palliative care, oncologic emergencies, patient education, psychosocial care, and pharmacology. Candidates must hold a current RN license and meet clinical practice requirements in oncology nursing.

165

Questions

180 min

Time Limit

70%

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