Oncology Nursing Practice Exam
COMPLETE 120 REAL EXAM
QUESTIONS AND CORRECT VERIFIED
ANSWERS/ ALREADY GRADED A+|
(MOST RECENT!!)
1. A patient receiving cisplatin reports tinnitus and a feeling
of fullness in the ears. What is the priority nursing action?
A. Administer prescribed acetaminophen
B. Assess blood urea nitrogen (BUN) and creatinine
C. Notify the healthcare provider immediately
D. Reassure the patient it is a temporary side effect
Answer: C. Notify the healthcare provider immediately
Rationale: Tinnitus and ear fullness are early signs of ototoxicity,
a dose-limiting side effect of cisplatin. The HCP must be notified
immediately to consider discontinuing the drug to prevent
permanent hearing loss. Options A and B are relevant but not the
priority; option D is incorrect as the damage can be permanent.
2. A patient with neutropenia has a temperature of 101.2°F
(38.4°C). Which intervention should the nurse implement
first?
A. Obtain blood cultures
B. Administer prescribed antibiotic
,C. Initiate a neutropenic precaution sign
D. Give acetaminophen for fever
Answer: B. Administer prescribed antibiotic
Rationale: In febrile neutropenia (ANC <500 and fever >38.3°C),
antibiotics are the priority to prevent septic shock and death.
Cultures should be obtained rapidly, ideally within 15 minutes, but
antibiotics should be given within 1 hour of fever recognition.
Delaying antibiotics increases mortality.
3. A patient is receiving doxorubicin (Adriamycin). Which
assessment finding is most concerning for the nurse?
A. Red-orange urine
B. ST-segment depression on ECG
C. Nausea and vomiting
D. Alopecia
Answer: B. ST-segment depression on ECG
Rationale: Doxorubicin causes dose-related cumulative
cardiotoxicity (cardiomyopathy and heart failure). ST depression
may indicate myocardial damage. Red-orange urine is a harmless,
expected finding. Nausea and alopecia are bothersome but not
life-threatening.
4. A patient with breast cancer is receiving tamoxifen. Which
side effect should the nurse teach the patient to report
immediately?
A. Hot flashes
B. Vaginal discharge
C. Unilateral leg pain and swelling
D. Fatigue
,Answer: C. Unilateral leg pain and swelling
Rationale: Tamoxifen increases the risk of deep vein thrombosis
(DVT) and pulmonary embolism. Unilateral leg pain, swelling, or
warmth suggests DVT and requires immediate evaluation. Hot
flashes and vaginal discharge are common but not emergent.
5. Which lab value is the most critical to check before
administering methotrexate?
A. Platelet count
B. Serum creatinine
C. Hemoglobin
D. White blood cell count
Answer: B. Serum creatinine
Rationale: Methotrexate is excreted renally. Impaired renal
function leads to toxic accumulation, causing severe
myelosuppression, mucositis, and renal failure. The dose must be
adjusted or held based on creatinine clearance.
6. A patient undergoing external beam radiation for lung
cancer reports odynophagia (painful swallowing). What is the
most appropriate intervention?
A. Encourage spicy foods to stimulate appetite
B. Provide viscous lidocaine solution before meals
C. Recommend cold, bland liquids and soft foods
D. Place the patient on NPO status
Answer: C. Recommend cold, bland liquids and soft foods
Rationale: Radiation esophagitis causes painful swallowing. Cold,
bland, soft foods (e.g., pudding, smoothies) minimize irritation.
Viscous lidocaine is sometimes used but can impair the gag reflex
and is not first-line. Spicy foods worsen pain.
, 7. A patient with leukemia has a platelet count of 12,000/µL.
Which finding requires immediate nursing intervention?
A. Petechiae on lower extremities
B. Blood pressure of 160/90 mmHg
C. Headache and decreased level of consciousness
D. Hemoglobin of 8.0 g/dL
Answer: C. Headache and decreased level of consciousness
Rationale: With severe thrombocytopenia, a headache and
altered mental status may indicate intracranial hemorrhage, a life-
threatening emergency. Petechiae are expected. Hypertension
should be controlled, but CNS bleed is the immediate priority.
8. The nurse is administering vincristine intravenously. What
is the most important safety measure?
A. Use a central line only
B. Ensure the IV is in a large vein and infusing freely before
administration
C. Pre-medicate with an antiemetic
D. Protect the IV site from light
Answer: B. Ensure the IV is in a large vein and infusing freely
before administration
Rationale: Vincristine is a vesicant. Extravasation causes severe
tissue necrosis. It must be given through a freely flowing IV into a
large vein. While central lines are preferred, it can be given
peripherally with careful monitoring. Pre-medication is not
routinely required.
9. A patient receiving rituximab (Rituxan) develops fever,
chills, and hypotension during the first infusion. Which action
should the nurse take?
COMPLETE 120 REAL EXAM
QUESTIONS AND CORRECT VERIFIED
ANSWERS/ ALREADY GRADED A+|
(MOST RECENT!!)
1. A patient receiving cisplatin reports tinnitus and a feeling
of fullness in the ears. What is the priority nursing action?
A. Administer prescribed acetaminophen
B. Assess blood urea nitrogen (BUN) and creatinine
C. Notify the healthcare provider immediately
D. Reassure the patient it is a temporary side effect
Answer: C. Notify the healthcare provider immediately
Rationale: Tinnitus and ear fullness are early signs of ototoxicity,
a dose-limiting side effect of cisplatin. The HCP must be notified
immediately to consider discontinuing the drug to prevent
permanent hearing loss. Options A and B are relevant but not the
priority; option D is incorrect as the damage can be permanent.
2. A patient with neutropenia has a temperature of 101.2°F
(38.4°C). Which intervention should the nurse implement
first?
A. Obtain blood cultures
B. Administer prescribed antibiotic
,C. Initiate a neutropenic precaution sign
D. Give acetaminophen for fever
Answer: B. Administer prescribed antibiotic
Rationale: In febrile neutropenia (ANC <500 and fever >38.3°C),
antibiotics are the priority to prevent septic shock and death.
Cultures should be obtained rapidly, ideally within 15 minutes, but
antibiotics should be given within 1 hour of fever recognition.
Delaying antibiotics increases mortality.
3. A patient is receiving doxorubicin (Adriamycin). Which
assessment finding is most concerning for the nurse?
A. Red-orange urine
B. ST-segment depression on ECG
C. Nausea and vomiting
D. Alopecia
Answer: B. ST-segment depression on ECG
Rationale: Doxorubicin causes dose-related cumulative
cardiotoxicity (cardiomyopathy and heart failure). ST depression
may indicate myocardial damage. Red-orange urine is a harmless,
expected finding. Nausea and alopecia are bothersome but not
life-threatening.
4. A patient with breast cancer is receiving tamoxifen. Which
side effect should the nurse teach the patient to report
immediately?
A. Hot flashes
B. Vaginal discharge
C. Unilateral leg pain and swelling
D. Fatigue
,Answer: C. Unilateral leg pain and swelling
Rationale: Tamoxifen increases the risk of deep vein thrombosis
(DVT) and pulmonary embolism. Unilateral leg pain, swelling, or
warmth suggests DVT and requires immediate evaluation. Hot
flashes and vaginal discharge are common but not emergent.
5. Which lab value is the most critical to check before
administering methotrexate?
A. Platelet count
B. Serum creatinine
C. Hemoglobin
D. White blood cell count
Answer: B. Serum creatinine
Rationale: Methotrexate is excreted renally. Impaired renal
function leads to toxic accumulation, causing severe
myelosuppression, mucositis, and renal failure. The dose must be
adjusted or held based on creatinine clearance.
6. A patient undergoing external beam radiation for lung
cancer reports odynophagia (painful swallowing). What is the
most appropriate intervention?
A. Encourage spicy foods to stimulate appetite
B. Provide viscous lidocaine solution before meals
C. Recommend cold, bland liquids and soft foods
D. Place the patient on NPO status
Answer: C. Recommend cold, bland liquids and soft foods
Rationale: Radiation esophagitis causes painful swallowing. Cold,
bland, soft foods (e.g., pudding, smoothies) minimize irritation.
Viscous lidocaine is sometimes used but can impair the gag reflex
and is not first-line. Spicy foods worsen pain.
, 7. A patient with leukemia has a platelet count of 12,000/µL.
Which finding requires immediate nursing intervention?
A. Petechiae on lower extremities
B. Blood pressure of 160/90 mmHg
C. Headache and decreased level of consciousness
D. Hemoglobin of 8.0 g/dL
Answer: C. Headache and decreased level of consciousness
Rationale: With severe thrombocytopenia, a headache and
altered mental status may indicate intracranial hemorrhage, a life-
threatening emergency. Petechiae are expected. Hypertension
should be controlled, but CNS bleed is the immediate priority.
8. The nurse is administering vincristine intravenously. What
is the most important safety measure?
A. Use a central line only
B. Ensure the IV is in a large vein and infusing freely before
administration
C. Pre-medicate with an antiemetic
D. Protect the IV site from light
Answer: B. Ensure the IV is in a large vein and infusing freely
before administration
Rationale: Vincristine is a vesicant. Extravasation causes severe
tissue necrosis. It must be given through a freely flowing IV into a
large vein. While central lines are preferred, it can be given
peripherally with careful monitoring. Pre-medication is not
routinely required.
9. A patient receiving rituximab (Rituxan) develops fever,
chills, and hypotension during the first infusion. Which action
should the nurse take?
