Oncology Nursing Examination Questions and
Verified Answers 2026-2027
Comprehensive Practice Test Bank & Clinical Assessment Guide for Oncology Nursing
Practice
1. A nurse is caring for a client receiving chemotherapy who develops an Absolute
Neutrophil Count (ANC) of 350/mm³. What clinical priority intervention should be
implemented immediately?
A. Administer subcutaneous erythropoietin.
B. Restrict fluid intake to 1 liter per day.
C. Initiate neutropenic precautions and monitor temperature closely.
D. Place the client on contact isolation for viral shedding.
Rationale: An ANC below 500/mm³ indicates severe neutropenia, placing the client at
extremely high risk for life-threatening systemic infection. Neutropenic precautions and
frequent fever checks are essential.
2. A client diagnosed with small cell lung cancer presents with severe facial edema,
distended neck veins, dyspnea, and a feeling of fullness in the head. What oncologic
emergency is indicated?
A. Superior Vena Cava (SVC) Syndrome
B. Spinal Cord Compression
C. Tumor Lysis Syndrome
D. Cardiac Tamponade
Rationale: SVC syndrome occurs when mediastinal tumors obstruct blood flow through the
superior vena cava, causing facial edema, jugular venous distention, and dyspnea.
3. A client receiving intravenous doxorubicin complains of sudden burning pain and
swelling at the peripheral IV insertion site. What immediate action should the oncology
nurse perform?
A. Apply a warm compress and slow the infusion rate.
B. Flush the catheter with 10 mL of normal saline.
C. Stop the infusion immediately and disconnect the IV tubing.
D. Elevate the arm and continue the infusion under close observation.
Rationale: Doxorubicin is a potent vesicant. Pain and swelling signal extravasation, requiring
an immediate stop to the infusion to minimize tissue necrosis.
4. Which diagnostic laboratory finding is characteristic of acute Tumor Lysis Syndrome
(TLS) following initial chemotherapy induction?
, A. Hypokalemia, hypouricemia, and hypercalcemia
B. Hyperkalemia, hyperphosphatemia, hyperuricemia, and hypocalcemia
C. Hyponatremia, hypophosphatemia, and hypercalcemia
D. Hypernatremia, hypokalemia, and hypouricemia
Rationale: TLS causes massive intracellular content release, yielding high serum potassium,
phosphorus, and uric acid. Elevated phosphorus binds serum calcium, causing secondary
hypocalcemia.
5. A client receiving external beam radiation therapy for head and neck cancer develops
painful oral mucosal ulcerations and erythema. How should the nurse document this
finding?
A. Xerostomia
B. Oral Stomatitis / Mucositis
C. Oropharyngeal Dysphagia
D. Oral Candidiasis
Rationale: Radiation injury to rapidly dividing mucosal lining leads to inflammation and painful
ulceration known as oral mucositis or stomatitis.
6. A client with metastatic prostate cancer complains of new progressive lower back
pain, lower extremity weakness, and urinary retention. What oncologic emergency
should be suspected?
A. Hypercalcemia of malignancy
B. Spinal Cord Compression
C. Syndrome of Inappropriate Antidiuretic Hormone
D. Disseminated Intravascular Coagulation
Rationale: Epidural spinal cord compression presents with localized back pain, motor
weakness, and autonomic bowel/bladder dysfunction, requiring emergency neuroimaging and
high-dose steroids.
7. A client with metastatic breast cancer presents with lethargy, confusion, constipation,
polyuria, and a serum calcium level of 13.8 mg/dL. What initial medical management is
indicated?
A. Intravenous hydration with 0.9% Normal Saline and bisphosphonate therapy
B. Intravenous administration of calcium gluconate
C. Fluid restriction to 800 mL per day
D. Oral administration of vitamin D supplements
Rationale: Hypercalcemia of malignancy is treated initially with aggressive IV isotonic saline
hydration to promote renal calcium excretion, combined with bisphosphonates (e.g.,
zoledronic acid).
8. An oncology nurse prepares to administer intravenous vincristine. What route of
administration for vincristine is fatal and strictly contraindicated?
, A. Intravenous piggyback
B. Intravenous bolus
C. Intrathecal administration
D. Central venous catheter infusion
Rationale: Intrathecal administration of vincristine causes ascending
radiculomyeloencephalopathy and fatal neurotoxicity. Vincristine must only be given
intravenously.
9. A client undergoing chemotherapy has a platelet count of 18,000/mm³. What clinical
sign requires immediate nursing action?
A. Mild fatigue after ambulation
B. Sudden severe headache and altered level of consciousness
C. Fine, diffuse dry skin on the lower extremities
D. Anorexia and nausea
Rationale: Severe thrombocytopenia (<20,000/mm³) poses a critical risk for spontaneous
intracranial hemorrhage. A sudden headache or neurological change is a life-threatening
sign.
10. What monoclonal antibody targets the Human Epidermal Growth Factor Receptor 2
(HER2) in overexpression-positive metastatic breast cancer?
A. Rituximab
B. Trastuzumab
C. Bevacizumab
D. Cetuximab
Rationale: Trastuzumab is a targeted monoclonal antibody that binds specifically to the HER2
protein, inhibiting cell proliferation in HER2-positive breast cancer.
11. A client diagnosed with acute promyelocytic leukemia develops petechiae, mucosal
bleeding, prolonged PT/aPTT, and low fibrinogen. What coagulopathy is occurring?
A. Disseminated Intravascular Coagulation (DIC)
B. Immune Thrombocytopenic Purpura (ITP)
C. Thrombotic Thrombocytopenic Purpura (TTP)
D. Heparin-Induced Thrombocytopenia (HIT)
Rationale: DIC involves microvascular clotting paired with severe factor and platelet
consumption, yielding low fibrinogen, prolonged clotting times, and active bleeding.
12. A client receiving high-dose cyclophosphamide is at heightened risk for hemorrhagic
cystitis. What protective agent is co-administered to neutralize toxic urinary metabolites?
A. Amifostine
B. Mesna
C. Leucovorin
Verified Answers 2026-2027
Comprehensive Practice Test Bank & Clinical Assessment Guide for Oncology Nursing
Practice
1. A nurse is caring for a client receiving chemotherapy who develops an Absolute
Neutrophil Count (ANC) of 350/mm³. What clinical priority intervention should be
implemented immediately?
A. Administer subcutaneous erythropoietin.
B. Restrict fluid intake to 1 liter per day.
C. Initiate neutropenic precautions and monitor temperature closely.
D. Place the client on contact isolation for viral shedding.
Rationale: An ANC below 500/mm³ indicates severe neutropenia, placing the client at
extremely high risk for life-threatening systemic infection. Neutropenic precautions and
frequent fever checks are essential.
2. A client diagnosed with small cell lung cancer presents with severe facial edema,
distended neck veins, dyspnea, and a feeling of fullness in the head. What oncologic
emergency is indicated?
A. Superior Vena Cava (SVC) Syndrome
B. Spinal Cord Compression
C. Tumor Lysis Syndrome
D. Cardiac Tamponade
Rationale: SVC syndrome occurs when mediastinal tumors obstruct blood flow through the
superior vena cava, causing facial edema, jugular venous distention, and dyspnea.
3. A client receiving intravenous doxorubicin complains of sudden burning pain and
swelling at the peripheral IV insertion site. What immediate action should the oncology
nurse perform?
A. Apply a warm compress and slow the infusion rate.
B. Flush the catheter with 10 mL of normal saline.
C. Stop the infusion immediately and disconnect the IV tubing.
D. Elevate the arm and continue the infusion under close observation.
Rationale: Doxorubicin is a potent vesicant. Pain and swelling signal extravasation, requiring
an immediate stop to the infusion to minimize tissue necrosis.
4. Which diagnostic laboratory finding is characteristic of acute Tumor Lysis Syndrome
(TLS) following initial chemotherapy induction?
, A. Hypokalemia, hypouricemia, and hypercalcemia
B. Hyperkalemia, hyperphosphatemia, hyperuricemia, and hypocalcemia
C. Hyponatremia, hypophosphatemia, and hypercalcemia
D. Hypernatremia, hypokalemia, and hypouricemia
Rationale: TLS causes massive intracellular content release, yielding high serum potassium,
phosphorus, and uric acid. Elevated phosphorus binds serum calcium, causing secondary
hypocalcemia.
5. A client receiving external beam radiation therapy for head and neck cancer develops
painful oral mucosal ulcerations and erythema. How should the nurse document this
finding?
A. Xerostomia
B. Oral Stomatitis / Mucositis
C. Oropharyngeal Dysphagia
D. Oral Candidiasis
Rationale: Radiation injury to rapidly dividing mucosal lining leads to inflammation and painful
ulceration known as oral mucositis or stomatitis.
6. A client with metastatic prostate cancer complains of new progressive lower back
pain, lower extremity weakness, and urinary retention. What oncologic emergency
should be suspected?
A. Hypercalcemia of malignancy
B. Spinal Cord Compression
C. Syndrome of Inappropriate Antidiuretic Hormone
D. Disseminated Intravascular Coagulation
Rationale: Epidural spinal cord compression presents with localized back pain, motor
weakness, and autonomic bowel/bladder dysfunction, requiring emergency neuroimaging and
high-dose steroids.
7. A client with metastatic breast cancer presents with lethargy, confusion, constipation,
polyuria, and a serum calcium level of 13.8 mg/dL. What initial medical management is
indicated?
A. Intravenous hydration with 0.9% Normal Saline and bisphosphonate therapy
B. Intravenous administration of calcium gluconate
C. Fluid restriction to 800 mL per day
D. Oral administration of vitamin D supplements
Rationale: Hypercalcemia of malignancy is treated initially with aggressive IV isotonic saline
hydration to promote renal calcium excretion, combined with bisphosphonates (e.g.,
zoledronic acid).
8. An oncology nurse prepares to administer intravenous vincristine. What route of
administration for vincristine is fatal and strictly contraindicated?
, A. Intravenous piggyback
B. Intravenous bolus
C. Intrathecal administration
D. Central venous catheter infusion
Rationale: Intrathecal administration of vincristine causes ascending
radiculomyeloencephalopathy and fatal neurotoxicity. Vincristine must only be given
intravenously.
9. A client undergoing chemotherapy has a platelet count of 18,000/mm³. What clinical
sign requires immediate nursing action?
A. Mild fatigue after ambulation
B. Sudden severe headache and altered level of consciousness
C. Fine, diffuse dry skin on the lower extremities
D. Anorexia and nausea
Rationale: Severe thrombocytopenia (<20,000/mm³) poses a critical risk for spontaneous
intracranial hemorrhage. A sudden headache or neurological change is a life-threatening
sign.
10. What monoclonal antibody targets the Human Epidermal Growth Factor Receptor 2
(HER2) in overexpression-positive metastatic breast cancer?
A. Rituximab
B. Trastuzumab
C. Bevacizumab
D. Cetuximab
Rationale: Trastuzumab is a targeted monoclonal antibody that binds specifically to the HER2
protein, inhibiting cell proliferation in HER2-positive breast cancer.
11. A client diagnosed with acute promyelocytic leukemia develops petechiae, mucosal
bleeding, prolonged PT/aPTT, and low fibrinogen. What coagulopathy is occurring?
A. Disseminated Intravascular Coagulation (DIC)
B. Immune Thrombocytopenic Purpura (ITP)
C. Thrombotic Thrombocytopenic Purpura (TTP)
D. Heparin-Induced Thrombocytopenia (HIT)
Rationale: DIC involves microvascular clotting paired with severe factor and platelet
consumption, yielding low fibrinogen, prolonged clotting times, and active bleeding.
12. A client receiving high-dose cyclophosphamide is at heightened risk for hemorrhagic
cystitis. What protective agent is co-administered to neutralize toxic urinary metabolites?
A. Amifostine
B. Mesna
C. Leucovorin
