KAPLAN ONCOLOGY NURSING QUESTIONS AND CORRECT ANSWERS (VERIFIED ANSWERS) PLUS RATIONALES 2026 Q&A
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Core Domains
*- Cancer Pathophysiology and Staging*
*- Chemotherapy Administration and Safety*
*- Radiation Therapy Nursing Care*
*- Pain Management and Symptom Control*
*- Palliative and End-of-Life Care*
*- Oncology Emergency Management*
*- Ethics, Legal Compliance, and Professional Standards*
*- Immunotherapy and Targeted Therapy*
*- Psychosocial Support and Patient Education*
*- Infection Prevention and Neutropenic Care*
Introduction
This exam assesses comprehensive knowledge and clinical decision-making skills essential for oncology nursing practice. It evaluates competency
in cancer pathophysiology, treatment modalities, symptom management, emergency interventions, and ethical standards. The assessment
consists of multiple-choice and scenario-based questions designed to test both foundational theory and applied professional knowledge. Emphasis
is placed on real-world clinical application, critical thinking, and evidence-based decision-making to ensure nurses can provide safe, high-quality
care to patients across the cancer continuum.
Section One: Questions 1–100
Question 1
A patient receiving cisplatin chemotherapy reports ringing in the ears. Which assessment should the nurse prioritize?
A. Complete blood count
B. Auditory assessment and hearing test
C. Serum creatinine and BUN
D. Neurological reflex testing
🟢 B. Auditory assessment and hearing test
🔴 RATIONALE: Cisplatin is ototoxic and commonly causes tinnitus and hearing loss. The nurse must prioritize auditory assessment to detect early
signs of ototoxicity. While nephrotoxicity (C) is also a concern with cisplatin, the patient's reported symptom directly indicates ear involvement.
,Question 2
Which nursing intervention is most appropriate for a patient with neutropenia (ANC 450/mm³)?
A. Allow fresh flowers in the room
B. Restrict all visitors regardless of health status
C. Implement strict hand hygiene and neutropenic precautions
D. Administer live vaccines to prevent infection
🟢 C. Implement strict hand hygiene and neutropenic precautions
🔴 RATIONALE: Neutropenic precautions including strict hand hygiene are essential to prevent infection in patients with ANC <500/mm³. Fresh
flowers (A) harbor bacteria and should be avoided. Live vaccines (D) are contraindicated. Visitors with illness should be restricted, not all visitors (B).
Question 3
A patient with advanced ovarian cancer states, "I want to stop chemotherapy and go home for hospice." The family insists treatment continue. What
is the nurse's priority action?
A. Support the family's request to continue treatment
B. Explain that chemotherapy is the only option
C. Advocate for the patient's autonomy and right to refuse treatment
D. Ask the physician to override the patient's decision
🟢 C. Advocate for the patient's autonomy and right to refuse treatment
🔴 RATIONALE: Patient autonomy is a fundamental ethical principle. Competent patients have the right to refuse treatment even if family
disagrees. The nurse must advocate for the patient's wishes and facilitate discussion about hospice care.
Question 4
Which side effect requires immediate intervention in a patient receiving doxorubicin?
A. Alopecia
B. Red-tinged urine
C. Decreased ejection fraction on echocardiogram
D. Nausea
,🟢 C. Decreased ejection fraction on echocardiogram
🔴 RATIONALE: Doxorubicin causes dose-dependent cardiotoxicity that can lead to irreversible heart failure. A decreased ejection fraction indicates
cardiac damage requiring immediate intervention. Alopecia (A) and red urine (B) are expected; nausea (D) is manageable.
Question 5
A patient with cancer-related pain is taking morphine 30 mg PO every 4 hours. The patient reports breakthrough pain. What is the appropriate
nursing action?
A. Increase the scheduled morphine dose
B. Administer a breakthrough dose of immediate-release morphine
C. Switch to fentanyl patch immediately
D. Tell the patient the pain is expected
🟢 B. Administer a breakthrough dose of immediate-release morphine
🔴 RATIONALE: Breakthrough pain is managed with immediate-release opioid doses (typically 10-15% of total daily dose). The scheduled dose
should not be increased without assessment. Fentanyl patch (C) is for chronic pain, not acute breakthrough.
Question 6
Which finding indicates tumor lysis syndrome in a patient receiving chemotherapy for leukemia?
A. Hyperkalemia, hyperphosphatemia, hypocalcemia, hyperuricemia
B. Hypokalemia, hypophosphatemia, hypercalcemia
C. Hypernatremia, hypouricemia, hypermagnesemia
D. Hypocalcemia, hypouricemia, hyperkalemia
🟢 A. Hyperkalemia, hyperphosphatemia, hypocalcemia, hyperuricemia
🔴 RATIONALE: Tumor lysis syndrome causes release of intracellular contents leading to hyperkalemia, hyperphosphatemia, hypocalcemia (from
calcium-phosphate precipitation), and hyperuricemia. This is a medical emergency requiring aggressive hydration and rasburicase/allopurinol.
Question 7
A patient receiving brachytherapy for cervical cancer asks about safety. What instruction is correct?
, A. Visitors can stay unlimited time in the room
B. Pregnant visitors are allowed with distance
C. The nurse should limit time in the room and use lead shielding
D. The patient should not use the bathroom
🟢 C. The nurse should limit time in the room and use lead shielding
🔴 RATIONALE: Brachytherapy involves radioactive implants. Staff should follow ALARA principles: minimize time, maximize distance, use
shielding. Pregnant visitors and children should not visit (B). Visitors are time-limited (A). Bathroom use is permitted with special precautions (D).
Question 8
Which medication is the antidote for extravasation of vesicant chemotherapy?
A. Vitamin K
B. Dexrazoxane for anthracyclines
C. Naloxone
D. Flumazenil
🟢 B. Dexrazoxane for anthracyclines
🔴 RATIONALE: Dexrazoxane is the specific antidote for anthracycline (e.g., doxorubicin) extravasation. Vitamin K reverses warfarin (A). Naloxone
reverses opioids (C). Flumazenil reverses benzodiazepines (D).
Question 9
A patient with lung cancer presents with facial swelling, distended neck veins, and dyspnea. What is the priority nursing intervention?
A. Administer oxygen and prepare for emergency intervention
B. Give oral antihistamines
C. Place patient in supine position
D. Obtain routine vital signs
🟢 A. Administer oxygen and prepare for emergency intervention
🔴 RATIONALE: These are signs of superior vena cava (SVC) syndrome, an oncologic emergency requiring immediate oxygen, corticosteroids, and
possibly radiation/stenting. Supine position (C) worsens symptoms. Antihistamines (B) are ineffective.
| INSTANT DOWNLOAD PDF
Core Domains
*- Cancer Pathophysiology and Staging*
*- Chemotherapy Administration and Safety*
*- Radiation Therapy Nursing Care*
*- Pain Management and Symptom Control*
*- Palliative and End-of-Life Care*
*- Oncology Emergency Management*
*- Ethics, Legal Compliance, and Professional Standards*
*- Immunotherapy and Targeted Therapy*
*- Psychosocial Support and Patient Education*
*- Infection Prevention and Neutropenic Care*
Introduction
This exam assesses comprehensive knowledge and clinical decision-making skills essential for oncology nursing practice. It evaluates competency
in cancer pathophysiology, treatment modalities, symptom management, emergency interventions, and ethical standards. The assessment
consists of multiple-choice and scenario-based questions designed to test both foundational theory and applied professional knowledge. Emphasis
is placed on real-world clinical application, critical thinking, and evidence-based decision-making to ensure nurses can provide safe, high-quality
care to patients across the cancer continuum.
Section One: Questions 1–100
Question 1
A patient receiving cisplatin chemotherapy reports ringing in the ears. Which assessment should the nurse prioritize?
A. Complete blood count
B. Auditory assessment and hearing test
C. Serum creatinine and BUN
D. Neurological reflex testing
🟢 B. Auditory assessment and hearing test
🔴 RATIONALE: Cisplatin is ototoxic and commonly causes tinnitus and hearing loss. The nurse must prioritize auditory assessment to detect early
signs of ototoxicity. While nephrotoxicity (C) is also a concern with cisplatin, the patient's reported symptom directly indicates ear involvement.
,Question 2
Which nursing intervention is most appropriate for a patient with neutropenia (ANC 450/mm³)?
A. Allow fresh flowers in the room
B. Restrict all visitors regardless of health status
C. Implement strict hand hygiene and neutropenic precautions
D. Administer live vaccines to prevent infection
🟢 C. Implement strict hand hygiene and neutropenic precautions
🔴 RATIONALE: Neutropenic precautions including strict hand hygiene are essential to prevent infection in patients with ANC <500/mm³. Fresh
flowers (A) harbor bacteria and should be avoided. Live vaccines (D) are contraindicated. Visitors with illness should be restricted, not all visitors (B).
Question 3
A patient with advanced ovarian cancer states, "I want to stop chemotherapy and go home for hospice." The family insists treatment continue. What
is the nurse's priority action?
A. Support the family's request to continue treatment
B. Explain that chemotherapy is the only option
C. Advocate for the patient's autonomy and right to refuse treatment
D. Ask the physician to override the patient's decision
🟢 C. Advocate for the patient's autonomy and right to refuse treatment
🔴 RATIONALE: Patient autonomy is a fundamental ethical principle. Competent patients have the right to refuse treatment even if family
disagrees. The nurse must advocate for the patient's wishes and facilitate discussion about hospice care.
Question 4
Which side effect requires immediate intervention in a patient receiving doxorubicin?
A. Alopecia
B. Red-tinged urine
C. Decreased ejection fraction on echocardiogram
D. Nausea
,🟢 C. Decreased ejection fraction on echocardiogram
🔴 RATIONALE: Doxorubicin causes dose-dependent cardiotoxicity that can lead to irreversible heart failure. A decreased ejection fraction indicates
cardiac damage requiring immediate intervention. Alopecia (A) and red urine (B) are expected; nausea (D) is manageable.
Question 5
A patient with cancer-related pain is taking morphine 30 mg PO every 4 hours. The patient reports breakthrough pain. What is the appropriate
nursing action?
A. Increase the scheduled morphine dose
B. Administer a breakthrough dose of immediate-release morphine
C. Switch to fentanyl patch immediately
D. Tell the patient the pain is expected
🟢 B. Administer a breakthrough dose of immediate-release morphine
🔴 RATIONALE: Breakthrough pain is managed with immediate-release opioid doses (typically 10-15% of total daily dose). The scheduled dose
should not be increased without assessment. Fentanyl patch (C) is for chronic pain, not acute breakthrough.
Question 6
Which finding indicates tumor lysis syndrome in a patient receiving chemotherapy for leukemia?
A. Hyperkalemia, hyperphosphatemia, hypocalcemia, hyperuricemia
B. Hypokalemia, hypophosphatemia, hypercalcemia
C. Hypernatremia, hypouricemia, hypermagnesemia
D. Hypocalcemia, hypouricemia, hyperkalemia
🟢 A. Hyperkalemia, hyperphosphatemia, hypocalcemia, hyperuricemia
🔴 RATIONALE: Tumor lysis syndrome causes release of intracellular contents leading to hyperkalemia, hyperphosphatemia, hypocalcemia (from
calcium-phosphate precipitation), and hyperuricemia. This is a medical emergency requiring aggressive hydration and rasburicase/allopurinol.
Question 7
A patient receiving brachytherapy for cervical cancer asks about safety. What instruction is correct?
, A. Visitors can stay unlimited time in the room
B. Pregnant visitors are allowed with distance
C. The nurse should limit time in the room and use lead shielding
D. The patient should not use the bathroom
🟢 C. The nurse should limit time in the room and use lead shielding
🔴 RATIONALE: Brachytherapy involves radioactive implants. Staff should follow ALARA principles: minimize time, maximize distance, use
shielding. Pregnant visitors and children should not visit (B). Visitors are time-limited (A). Bathroom use is permitted with special precautions (D).
Question 8
Which medication is the antidote for extravasation of vesicant chemotherapy?
A. Vitamin K
B. Dexrazoxane for anthracyclines
C. Naloxone
D. Flumazenil
🟢 B. Dexrazoxane for anthracyclines
🔴 RATIONALE: Dexrazoxane is the specific antidote for anthracycline (e.g., doxorubicin) extravasation. Vitamin K reverses warfarin (A). Naloxone
reverses opioids (C). Flumazenil reverses benzodiazepines (D).
Question 9
A patient with lung cancer presents with facial swelling, distended neck veins, and dyspnea. What is the priority nursing intervention?
A. Administer oxygen and prepare for emergency intervention
B. Give oral antihistamines
C. Place patient in supine position
D. Obtain routine vital signs
🟢 A. Administer oxygen and prepare for emergency intervention
🔴 RATIONALE: These are signs of superior vena cava (SVC) syndrome, an oncologic emergency requiring immediate oxygen, corticosteroids, and
possibly radiation/stenting. Supine position (C) worsens symptoms. Antihistamines (B) are ineffective.
