AOCNP Study Guide Practice Test QUESTIONS AND 100% VERIFIED
ANSWERS| A+ GRADE Q&A | INSTANT DOWNLOAD PDF
An oncology NP evaluates a patient with metastatic colon cancer receiving
bevacizumab who develops proteinuria (3+ protein on dipstick). Next steps should
include: A. Continue bevacizumab with increased monitoring B. 24-hour urine collection
for protein quantification C. Immediate nephrology consultation D. Discontinue
bevacizumab permanently
Correct Answer: B Rationale: Proteinuria with bevacizumab requires quantification
with 24-hour urine collection or urine protein/creatinine ratio. Bevacizumab should be
held if proteinuria ≥2 grams/24 hours and discontinued if nephrotic syndrome
develops. The dipstick finding needs quantification before making treatment
decisions.
,A patient with chronic myeloid leukemia receiving dasatinib develops new-onset
dyspnea and cough. Chest imaging shows bilateral pleural effusions. This most likely
represents: Disease progression requiring treatment change B. Dasatinib-induced
pulmonary toxicity C. Opportunistic infection requiring antibiotics D. Cardiac toxicity
from tyrosine kinase inhibitor
Correct Answer: B Rationale: Dasatinib can cause pleural effusions in up to 35% of
patients, typically developing within the first year of treatment. This is a known class effect
of dasatinib distinct from other tyrosine kinase inhibitors. Management may require
dose reduction, diuretics, or drug discontinuation depending on severity.
An oncology NP counsels a patient about fertility after cancer treatment. Which
treatment is most likely to cause permanent infertility in young women? A.
Doxorubicin-based chemotherapy B. Pelvic radiation therapy C. Tamoxifen for 5
years D. Trastuzumab for 1 year
Correct Answer: B Rationale: Pelvic radiation therapy causes the highest risk of
permanent infertility in young women due to direct ovarian damage and uterine effects.
The risk is dose-dependent and almost certain with therapeutic doses.
Chemotherapy may cause temporary or permanent infertility, but pelvic radiation has the
highest risk.
,A patient with metastatic pancreatic cancer receiving palliative chemotherapy asks
about prognosis. The patient states "I need to know how much time I have to arrange my
affairs." The most appropriate response is: A. "Most patients with your condition live
about 6 months" B. "Let's focus on your quality of life rather than time remaining"
C. "It's hard to predict exactly, but let's talk about what's important to you and how to use
your time well" D. "You should ask your oncologist about prognosis"
Correct Answer: C Rationale: When patients specifically request prognostic information
for practical planning, acknowledge the uncertainty while focusing on helping them use
their time meaningfully. This approach provides honest communication without false
precision and supports the patient's goals for planning while maintaining hope.
An oncology NP assesses a patient with superior vena cava syndrome. The most
appropriate immediate management includes: A. Emergency radiation therapy B.
Thrombolytic therapy for presumed clot C. High-dose corticosteroids and supportive
care D. Immediate surgical intervention
Correct Answer: C Rationale: Superior vena cava syndrome requires immediate
supportive care with high-dose corticosteroids to reduce inflammation and swelling,
along with supportive measures (head elevation, oxygen). Emergency radiation may be
needed, but initial management focuses on symptom relief and stabilization.
, 4/8/26, 5:22 PM AOCNP Study Guide Practice Test QUESTIONS AND 100% VERIFIED ANSWERS| A+ GRADE Q&A | INSTANT DOWNLOAD PDF …
A 45-year-old Ashkenazi Jewish woman with a strong maternal family history of breast
and ovarian cancer undergoes genetic testing. Her results show a BRCA1 pathogenic
variant. When counseling her about ovarian cancer risk reduction, the oncology NP
should recommend:
A. Annual transvaginal ultrasound and CA-125 screening beginning at age 30
B. Risk-reducing bilateral salpingo-oophorectomy by age 35-40 or upon completion of
childbearing
C. Oral contraceptive use for at least 10 years to reduce ovarian cancer risk
D. MRI screening every 6 months alternating with ultrasound examination
Correct Answer: B Rationale: BRCA1 mutation carriers have a 40-60% lifetime risk of
ovarian cancer. Risk-reducing bilateral salpingo-oophorectomy by age 35-40 reduces
ovarian cancer risk by 85-90% and also decreases breast cancer risk.
Screening with ultrasound and CA-125 has poor sensitivity for early ovarian cancer
detection. While oral contraceptives do reduce ovarian cancer risk, surgical
prevention is more effective for high-risk individuals.
During a tumor board presentation, the pathologist reports that a lung adenocarcinoma
specimen shows PD-L1 expression in 65% of tumor cells using the 22C3 assay. This
finding most directly impacts:
A. Eligibility for adjuvant chemotherapy protocols
B. Selection of first-line immunotherapy versus chemotherapy
C. Prognosis and overall survival expectations
D. Need for additional molecular testing for targeted therapy
Correct Answer: B Rationale: PD-L1 expression ≥50% using the 22C3 assay is a
predictive biomarker for response to pembrolizumab monotherapy as first-line
treatment for metastatic NSCLC. At 65% expression, this patient would be eligible for
pembrolizumab alone rather than combination chemotherapy. PD-L1 expression doesn't
determine adjuvant therapy eligibility or prognosis directly, though it may influence
treatment selection.
… 4/37
ANSWERS| A+ GRADE Q&A | INSTANT DOWNLOAD PDF
An oncology NP evaluates a patient with metastatic colon cancer receiving
bevacizumab who develops proteinuria (3+ protein on dipstick). Next steps should
include: A. Continue bevacizumab with increased monitoring B. 24-hour urine collection
for protein quantification C. Immediate nephrology consultation D. Discontinue
bevacizumab permanently
Correct Answer: B Rationale: Proteinuria with bevacizumab requires quantification
with 24-hour urine collection or urine protein/creatinine ratio. Bevacizumab should be
held if proteinuria ≥2 grams/24 hours and discontinued if nephrotic syndrome
develops. The dipstick finding needs quantification before making treatment
decisions.
,A patient with chronic myeloid leukemia receiving dasatinib develops new-onset
dyspnea and cough. Chest imaging shows bilateral pleural effusions. This most likely
represents: Disease progression requiring treatment change B. Dasatinib-induced
pulmonary toxicity C. Opportunistic infection requiring antibiotics D. Cardiac toxicity
from tyrosine kinase inhibitor
Correct Answer: B Rationale: Dasatinib can cause pleural effusions in up to 35% of
patients, typically developing within the first year of treatment. This is a known class effect
of dasatinib distinct from other tyrosine kinase inhibitors. Management may require
dose reduction, diuretics, or drug discontinuation depending on severity.
An oncology NP counsels a patient about fertility after cancer treatment. Which
treatment is most likely to cause permanent infertility in young women? A.
Doxorubicin-based chemotherapy B. Pelvic radiation therapy C. Tamoxifen for 5
years D. Trastuzumab for 1 year
Correct Answer: B Rationale: Pelvic radiation therapy causes the highest risk of
permanent infertility in young women due to direct ovarian damage and uterine effects.
The risk is dose-dependent and almost certain with therapeutic doses.
Chemotherapy may cause temporary or permanent infertility, but pelvic radiation has the
highest risk.
,A patient with metastatic pancreatic cancer receiving palliative chemotherapy asks
about prognosis. The patient states "I need to know how much time I have to arrange my
affairs." The most appropriate response is: A. "Most patients with your condition live
about 6 months" B. "Let's focus on your quality of life rather than time remaining"
C. "It's hard to predict exactly, but let's talk about what's important to you and how to use
your time well" D. "You should ask your oncologist about prognosis"
Correct Answer: C Rationale: When patients specifically request prognostic information
for practical planning, acknowledge the uncertainty while focusing on helping them use
their time meaningfully. This approach provides honest communication without false
precision and supports the patient's goals for planning while maintaining hope.
An oncology NP assesses a patient with superior vena cava syndrome. The most
appropriate immediate management includes: A. Emergency radiation therapy B.
Thrombolytic therapy for presumed clot C. High-dose corticosteroids and supportive
care D. Immediate surgical intervention
Correct Answer: C Rationale: Superior vena cava syndrome requires immediate
supportive care with high-dose corticosteroids to reduce inflammation and swelling,
along with supportive measures (head elevation, oxygen). Emergency radiation may be
needed, but initial management focuses on symptom relief and stabilization.
, 4/8/26, 5:22 PM AOCNP Study Guide Practice Test QUESTIONS AND 100% VERIFIED ANSWERS| A+ GRADE Q&A | INSTANT DOWNLOAD PDF …
A 45-year-old Ashkenazi Jewish woman with a strong maternal family history of breast
and ovarian cancer undergoes genetic testing. Her results show a BRCA1 pathogenic
variant. When counseling her about ovarian cancer risk reduction, the oncology NP
should recommend:
A. Annual transvaginal ultrasound and CA-125 screening beginning at age 30
B. Risk-reducing bilateral salpingo-oophorectomy by age 35-40 or upon completion of
childbearing
C. Oral contraceptive use for at least 10 years to reduce ovarian cancer risk
D. MRI screening every 6 months alternating with ultrasound examination
Correct Answer: B Rationale: BRCA1 mutation carriers have a 40-60% lifetime risk of
ovarian cancer. Risk-reducing bilateral salpingo-oophorectomy by age 35-40 reduces
ovarian cancer risk by 85-90% and also decreases breast cancer risk.
Screening with ultrasound and CA-125 has poor sensitivity for early ovarian cancer
detection. While oral contraceptives do reduce ovarian cancer risk, surgical
prevention is more effective for high-risk individuals.
During a tumor board presentation, the pathologist reports that a lung adenocarcinoma
specimen shows PD-L1 expression in 65% of tumor cells using the 22C3 assay. This
finding most directly impacts:
A. Eligibility for adjuvant chemotherapy protocols
B. Selection of first-line immunotherapy versus chemotherapy
C. Prognosis and overall survival expectations
D. Need for additional molecular testing for targeted therapy
Correct Answer: B Rationale: PD-L1 expression ≥50% using the 22C3 assay is a
predictive biomarker for response to pembrolizumab monotherapy as first-line
treatment for metastatic NSCLC. At 65% expression, this patient would be eligible for
pembrolizumab alone rather than combination chemotherapy. PD-L1 expression doesn't
determine adjuvant therapy eligibility or prognosis directly, though it may influence
treatment selection.
… 4/37
