ONS ONCC CHEMO RENEWAL
UPDATED 2026 QUESTIONS WITH 100%
CORRECT SOLUTIONS AND
RATIONALES
Question 1
Which of the following is a unique side effect that occurs with the agent
oxaliplatin?
A) Hand-foot syndrome
B) Cold sensory neuropathy
C) Cardiotoxicity
D) Pulmonary fibrosis
Correct Answer: B) Cold sensory neuropathy
Rationale: Cold sensory neuropathy is a unique and characteristic side effect of
oxaliplatin. Symptoms include transient paresthesia, dysesthesia, and hypoesthesia
in the hands, feet, perioral area, or throat, as well as jaw spasm, abnormal tongue
sensation, dysarthria, eye pain, and a feeling of chest pressure. These symptoms
are triggered or worsened by exposure to cold temperatures.
---
Question 2
What are effective treatments for chemotherapy-induced peripheral neuropathy?
,A) Acetaminophen and rest
B) Duloxetine, gabapentin, and opioid combinations
C) NSAIDs alone
D) Muscle relaxants only
Correct Answer: B) Duloxetine, gabapentin, and opioid combinations
Rationale: According to ONS PEP resources, effective treatments for peripheral
neuropathy include duloxetine, gabapentin, and opioid combinations. These
medications target different pain mechanisms associated with nerve damage from
chemotherapy.
---
Question 3
_____ can cause inflammation, pain, and burning but rarely cause tissue necrosis
comparable to a vesicant (unless a large amount or a very high concentration is
extravasated).
A) Irritants
B) Vesicants
C) Antimetabolites
D) Alkylating agents
Correct Answer: A) Irritants
Rationale: Irritants can cause inflammation, pain, and burning at the injection site
but typically do not cause the severe tissue necrosis associated with vesicants.
,However, if a large volume or very high concentration of an irritant is
extravasated, tissue damage can still occur.
---
Question 4
A nurse is preparing to administer chemotherapy to a client with an ANC of
400/mm³. Which action should the nurse take first?
A) Administer the chemotherapy as prescribed
B) Place the client on fluid restriction
C) Notify the provider before administration
D) Encourage visitors to wear masks only
Correct Answer: C) Notify the provider before administration
Rationale: An ANC below 500/mm³ indicates severe neutropenia and increased
infection risk. Chemotherapy may need to be delayed. The nurse should notify the
provider before proceeding with administration.
---
Question 5
Which patient statement indicates understanding of oral chemotherapy teaching?
A) “I should crush the medication if I cannot swallow it.”
B) “I will wear gloves when handling the pills.”
C) “I can store the medication in the bathroom.”
D) “I should double the dose if I miss one.”
, Correct Answer: B) “I will wear gloves when handling the pills.”
Rationale: Oral chemotherapy agents are hazardous drugs and should be handled
carefully. Patients should be taught to wear gloves when handling pills and to
avoid crushing or splitting them unless specifically instructed.
---
Question 6
A client receiving vesicant chemotherapy reports burning at the IV site. What is
the nurse's priority action?
A) Slow the infusion
B) Stop the infusion immediately
C) Flush the line with saline
D) Apply a warm blanket
Correct Answer: B) Stop the infusion immediately
Rationale: Burning may indicate extravasation. The infusion must be stopped
immediately to prevent further tissue damage. The provider should then be notified
and the appropriate extravasation protocol initiated.
---
Question 7
Which laboratory value is most concerning before chemotherapy administration?
UPDATED 2026 QUESTIONS WITH 100%
CORRECT SOLUTIONS AND
RATIONALES
Question 1
Which of the following is a unique side effect that occurs with the agent
oxaliplatin?
A) Hand-foot syndrome
B) Cold sensory neuropathy
C) Cardiotoxicity
D) Pulmonary fibrosis
Correct Answer: B) Cold sensory neuropathy
Rationale: Cold sensory neuropathy is a unique and characteristic side effect of
oxaliplatin. Symptoms include transient paresthesia, dysesthesia, and hypoesthesia
in the hands, feet, perioral area, or throat, as well as jaw spasm, abnormal tongue
sensation, dysarthria, eye pain, and a feeling of chest pressure. These symptoms
are triggered or worsened by exposure to cold temperatures.
---
Question 2
What are effective treatments for chemotherapy-induced peripheral neuropathy?
,A) Acetaminophen and rest
B) Duloxetine, gabapentin, and opioid combinations
C) NSAIDs alone
D) Muscle relaxants only
Correct Answer: B) Duloxetine, gabapentin, and opioid combinations
Rationale: According to ONS PEP resources, effective treatments for peripheral
neuropathy include duloxetine, gabapentin, and opioid combinations. These
medications target different pain mechanisms associated with nerve damage from
chemotherapy.
---
Question 3
_____ can cause inflammation, pain, and burning but rarely cause tissue necrosis
comparable to a vesicant (unless a large amount or a very high concentration is
extravasated).
A) Irritants
B) Vesicants
C) Antimetabolites
D) Alkylating agents
Correct Answer: A) Irritants
Rationale: Irritants can cause inflammation, pain, and burning at the injection site
but typically do not cause the severe tissue necrosis associated with vesicants.
,However, if a large volume or very high concentration of an irritant is
extravasated, tissue damage can still occur.
---
Question 4
A nurse is preparing to administer chemotherapy to a client with an ANC of
400/mm³. Which action should the nurse take first?
A) Administer the chemotherapy as prescribed
B) Place the client on fluid restriction
C) Notify the provider before administration
D) Encourage visitors to wear masks only
Correct Answer: C) Notify the provider before administration
Rationale: An ANC below 500/mm³ indicates severe neutropenia and increased
infection risk. Chemotherapy may need to be delayed. The nurse should notify the
provider before proceeding with administration.
---
Question 5
Which patient statement indicates understanding of oral chemotherapy teaching?
A) “I should crush the medication if I cannot swallow it.”
B) “I will wear gloves when handling the pills.”
C) “I can store the medication in the bathroom.”
D) “I should double the dose if I miss one.”
, Correct Answer: B) “I will wear gloves when handling the pills.”
Rationale: Oral chemotherapy agents are hazardous drugs and should be handled
carefully. Patients should be taught to wear gloves when handling pills and to
avoid crushing or splitting them unless specifically instructed.
---
Question 6
A client receiving vesicant chemotherapy reports burning at the IV site. What is
the nurse's priority action?
A) Slow the infusion
B) Stop the infusion immediately
C) Flush the line with saline
D) Apply a warm blanket
Correct Answer: B) Stop the infusion immediately
Rationale: Burning may indicate extravasation. The infusion must be stopped
immediately to prevent further tissue damage. The provider should then be notified
and the appropriate extravasation protocol initiated.
---
Question 7
Which laboratory value is most concerning before chemotherapy administration?
