FLORIDA BOARD OF NURSING ONCOLOGY
NURSE CERTIFICATION EXAM WITH
ACTUAL QUESTIONS AND VERIFIED
ANSWERS, PLUS EXPLAINED
RATIONALES/EXPERT VERIFIED FOR
GUARANTEED 100% PASS 2026/LATEST
UPDATE/INSTANT DOWNLOAD PDF
1. A patient with small-cell lung cancer develops new facial and neck
edema, distended neck veins, dyspnea, and a feeling of chest
pressure. Which complication should the oncology nurse suspect
first?
A. Tumor lysis syndrome
B. Superior vena cava syndrome
C. Disseminated intravascular coagulation
D. Spinal cord compression
Answer: B. Superior vena cava syndrome
Rationale: Superior vena cava syndrome occurs when the superior
vena cava is compressed or obstructed, commonly by a thoracic
malignancy such as lung cancer or lymphoma. Facial and neck
edema, venous distention, dyspnea, cough, and upper-extremity
swelling are characteristic. This can become life-threatening if airway
or cerebral venous congestion develops.
2. A patient receiving chemotherapy has a temperature of 38.5°C
(101.3°F) and an absolute neutrophil count of 400/mm³. Which
action is the nurse's priority?
A. Administer acetaminophen and reassess in 2 hours
B. Encourage oral fluids and place the patient on protective precautions
1
,C. Notify the oncology provider immediately and initiate the febrile-
neutropenia protocol
D. Obtain a stool specimen before contacting the provider
Answer: C. Notify the oncology provider immediately and initiate
the febrile-neutropenia protocol
Rationale: Fever in a severely neutropenic patient is an oncologic
emergency because even minor infections can progress rapidly to
sepsis. Prompt cultures and empiric broad-spectrum antimicrobial
therapy are generally required according to institutional protocol.
Antipyretic administration alone must not delay evaluation and
treatment.
3. A patient with leukemia has a white blood cell count of
180,000/mm³ and develops headache, confusion, dyspnea, and visual
changes. Which complication is most concerning?
A. Hypercalcemia
B. Leukostasis
C. SIADH
D. Tumor lysis syndrome
Answer: B. Leukostasis
Rationale: Leukostasis occurs when extremely elevated circulating
leukocyte levels increase blood viscosity and impair microvascular
perfusion. Neurologic and pulmonary manifestations, including
confusion, headache, visual disturbances, hypoxemia, and dyspnea,
are particularly concerning. It requires urgent medical management.
4. A patient with metastatic prostate cancer reports severe new-
onset back pain, bilateral leg weakness, and difficulty initiating
urination. What should the nurse recognize?
2
,A. Chemotherapy-induced peripheral neuropathy
B. Spinal cord compression
C. Opioid withdrawal
D. Hyperkalemia
Answer: B. Spinal cord compression
Rationale: New severe back pain accompanied by weakness, sensory
changes, or bladder/bowel dysfunction strongly suggests malignant
spinal cord compression. Rapid recognition is critical because
prolonged compression can result in permanent neurologic deficits.
5. A patient with multiple myeloma has nausea, constipation,
confusion, polyuria, and a serum calcium level of 14.8 mg/dL.
Which condition is most likely?
A. Hypocalcemia
B. Hypercalcemia of malignancy
C. Tumor lysis syndrome
D. SIADH
Answer: B. Hypercalcemia of malignancy
Rationale: Hypercalcemia may occur with multiple myeloma and
cancers associated with bone destruction or secretion of parathyroid
hormone-related peptide. Manifestations include weakness,
constipation, nausea, polyuria, dehydration, altered mental status, and
cardiac abnormalities. Severe hypercalcemia requires urgent
treatment.
6. A patient receiving an anthracycline develops progressive
dyspnea, fatigue, peripheral edema, and decreased exercise
tolerance several weeks after treatment. Which adverse effect
should the nurse suspect?
3
, A. Nephrotoxicity
B. Cardiotoxicity
C. Ototoxicity
D. Pulmonary fibrosis
Answer: B. Cardiotoxicity
Rationale: Anthracyclines such as doxorubicin can cause dose-related
myocardial injury and cardiomyopathy. Symptoms of heart failure,
including dyspnea, fatigue, edema, and reduced exercise tolerance,
require prompt evaluation. Baseline and ongoing cardiac assessment
may be incorporated into treatment monitoring.
7. A patient receiving cisplatin has decreasing urine output and an
increasing serum creatinine level. Which toxicity is most likely?
A. Nephrotoxicity
B. Cardiotoxicity
C. Neurotoxicity
D. Mucositis
Answer: A. Nephrotoxicity
Rationale: Cisplatin is strongly associated with renal toxicity.
Oncology nurses monitor renal function, urine output, electrolytes,
and hydration status. Adequate hydration is commonly incorporated
into cisplatin administration protocols to reduce renal injury.
8. A patient receiving chemotherapy develops painful oral
ulcerations that interfere with eating. Which nursing intervention is
most appropriate?
A. Recommend an alcohol-containing mouthwash
B. Encourage frequent oral care with a bland, nonirritating rinse
4
NURSE CERTIFICATION EXAM WITH
ACTUAL QUESTIONS AND VERIFIED
ANSWERS, PLUS EXPLAINED
RATIONALES/EXPERT VERIFIED FOR
GUARANTEED 100% PASS 2026/LATEST
UPDATE/INSTANT DOWNLOAD PDF
1. A patient with small-cell lung cancer develops new facial and neck
edema, distended neck veins, dyspnea, and a feeling of chest
pressure. Which complication should the oncology nurse suspect
first?
A. Tumor lysis syndrome
B. Superior vena cava syndrome
C. Disseminated intravascular coagulation
D. Spinal cord compression
Answer: B. Superior vena cava syndrome
Rationale: Superior vena cava syndrome occurs when the superior
vena cava is compressed or obstructed, commonly by a thoracic
malignancy such as lung cancer or lymphoma. Facial and neck
edema, venous distention, dyspnea, cough, and upper-extremity
swelling are characteristic. This can become life-threatening if airway
or cerebral venous congestion develops.
2. A patient receiving chemotherapy has a temperature of 38.5°C
(101.3°F) and an absolute neutrophil count of 400/mm³. Which
action is the nurse's priority?
A. Administer acetaminophen and reassess in 2 hours
B. Encourage oral fluids and place the patient on protective precautions
1
,C. Notify the oncology provider immediately and initiate the febrile-
neutropenia protocol
D. Obtain a stool specimen before contacting the provider
Answer: C. Notify the oncology provider immediately and initiate
the febrile-neutropenia protocol
Rationale: Fever in a severely neutropenic patient is an oncologic
emergency because even minor infections can progress rapidly to
sepsis. Prompt cultures and empiric broad-spectrum antimicrobial
therapy are generally required according to institutional protocol.
Antipyretic administration alone must not delay evaluation and
treatment.
3. A patient with leukemia has a white blood cell count of
180,000/mm³ and develops headache, confusion, dyspnea, and visual
changes. Which complication is most concerning?
A. Hypercalcemia
B. Leukostasis
C. SIADH
D. Tumor lysis syndrome
Answer: B. Leukostasis
Rationale: Leukostasis occurs when extremely elevated circulating
leukocyte levels increase blood viscosity and impair microvascular
perfusion. Neurologic and pulmonary manifestations, including
confusion, headache, visual disturbances, hypoxemia, and dyspnea,
are particularly concerning. It requires urgent medical management.
4. A patient with metastatic prostate cancer reports severe new-
onset back pain, bilateral leg weakness, and difficulty initiating
urination. What should the nurse recognize?
2
,A. Chemotherapy-induced peripheral neuropathy
B. Spinal cord compression
C. Opioid withdrawal
D. Hyperkalemia
Answer: B. Spinal cord compression
Rationale: New severe back pain accompanied by weakness, sensory
changes, or bladder/bowel dysfunction strongly suggests malignant
spinal cord compression. Rapid recognition is critical because
prolonged compression can result in permanent neurologic deficits.
5. A patient with multiple myeloma has nausea, constipation,
confusion, polyuria, and a serum calcium level of 14.8 mg/dL.
Which condition is most likely?
A. Hypocalcemia
B. Hypercalcemia of malignancy
C. Tumor lysis syndrome
D. SIADH
Answer: B. Hypercalcemia of malignancy
Rationale: Hypercalcemia may occur with multiple myeloma and
cancers associated with bone destruction or secretion of parathyroid
hormone-related peptide. Manifestations include weakness,
constipation, nausea, polyuria, dehydration, altered mental status, and
cardiac abnormalities. Severe hypercalcemia requires urgent
treatment.
6. A patient receiving an anthracycline develops progressive
dyspnea, fatigue, peripheral edema, and decreased exercise
tolerance several weeks after treatment. Which adverse effect
should the nurse suspect?
3
, A. Nephrotoxicity
B. Cardiotoxicity
C. Ototoxicity
D. Pulmonary fibrosis
Answer: B. Cardiotoxicity
Rationale: Anthracyclines such as doxorubicin can cause dose-related
myocardial injury and cardiomyopathy. Symptoms of heart failure,
including dyspnea, fatigue, edema, and reduced exercise tolerance,
require prompt evaluation. Baseline and ongoing cardiac assessment
may be incorporated into treatment monitoring.
7. A patient receiving cisplatin has decreasing urine output and an
increasing serum creatinine level. Which toxicity is most likely?
A. Nephrotoxicity
B. Cardiotoxicity
C. Neurotoxicity
D. Mucositis
Answer: A. Nephrotoxicity
Rationale: Cisplatin is strongly associated with renal toxicity.
Oncology nurses monitor renal function, urine output, electrolytes,
and hydration status. Adequate hydration is commonly incorporated
into cisplatin administration protocols to reduce renal injury.
8. A patient receiving chemotherapy develops painful oral
ulcerations that interfere with eating. Which nursing intervention is
most appropriate?
A. Recommend an alcohol-containing mouthwash
B. Encourage frequent oral care with a bland, nonirritating rinse
4
