2026 OCN Oncology Certified Nurse Exam New Latest
Version with All Questions from Actual Exam 100%
Correct Answers and Rationale
OCN® MOST TESTED & MOST DIFFICULT QUESTIONS (1–25)
1. A patient receiving chemotherapy develops fever 101.5°F (38.6°C) with an ANC of 400/mm³. What is
the PRIORITY nursing action?
A. Administer acetaminophen
B. Obtain blood cultures and start IV antibiotics
C. Encourage oral fluids
D. Place patient in neutropenic isolation only
✅ Correct Answer: B
Explanation:
This is febrile neutropenia, an oncologic emergency. Broad-spectrum IV antibiotics must be started
within 1 hour.
2. Which ANC value defines neutropenia?
A. <1500/mm³
B. <1200/mm³
C. <1000/mm³
D. <500/mm³
✅ Correct Answer: A
3. Which symptom MOST suggests tumor lysis syndrome (TLS)?
A. Hypercalcemia
B. Hyperuricemia
,C. Hypokalemia
D. Hypophosphatemia
✅ Correct Answer: B
4. The PRIORITY nursing intervention to prevent TLS is:
A. Restrict fluids
B. Administer diuretics
C. Aggressive IV hydration
D. Give potassium supplements
✅ Correct Answer: C
5. Which malignancy is MOST commonly associated with TLS?
A. Breast cancer
B. Prostate cancer
C. Acute leukemia
D. Colon cancer
✅ Correct Answer: C
6. A patient receiving vesicant chemotherapy reports burning at the IV site. What is the FIRST action?
A. Flush the IV line
B. Remove the IV catheter
C. Stop the infusion
D. Apply warm compress
✅ Correct Answer: C
7. Which drug class carries the HIGHEST risk for extravasation injury?
A. Alkylating agents
B. Antimetabolites
C. Vinca alkaloids
D. Hormonal agents
✅ Correct Answer: C
8. Which symptom indicates possible spinal cord compression?
, A. Headache
B. Back pain with weakness
C. Nausea
D. Fever
✅ Correct Answer: B
9. The PRIORITY treatment for suspected spinal cord compression is:
A. Chemotherapy
B. Radiation therapy
C. High-dose corticosteroids
D. Pain medication only
✅ Correct Answer: C
10. Which laboratory abnormality is MOST concerning for hypercalcemia of malignancy?
A. Calcium 9.5 mg/dL
B. Calcium 10.2 mg/dL
C. Calcium 12.8 mg/dL
D. Calcium 8.0 mg/dL
✅ Correct Answer: C
11. A patient with hypercalcemia may exhibit which symptom?
A. Tetany
B. Muscle cramps
C. Lethargy and confusion
D. Hyperreflexia
✅ Correct Answer: C
12. Which intervention is FIRST-LINE for hypercalcemia of malignancy?
A. Calcium supplements
B. IV fluids
C. Potassium replacement
D. Fluid restriction
✅ Correct Answer: B
Version with All Questions from Actual Exam 100%
Correct Answers and Rationale
OCN® MOST TESTED & MOST DIFFICULT QUESTIONS (1–25)
1. A patient receiving chemotherapy develops fever 101.5°F (38.6°C) with an ANC of 400/mm³. What is
the PRIORITY nursing action?
A. Administer acetaminophen
B. Obtain blood cultures and start IV antibiotics
C. Encourage oral fluids
D. Place patient in neutropenic isolation only
✅ Correct Answer: B
Explanation:
This is febrile neutropenia, an oncologic emergency. Broad-spectrum IV antibiotics must be started
within 1 hour.
2. Which ANC value defines neutropenia?
A. <1500/mm³
B. <1200/mm³
C. <1000/mm³
D. <500/mm³
✅ Correct Answer: A
3. Which symptom MOST suggests tumor lysis syndrome (TLS)?
A. Hypercalcemia
B. Hyperuricemia
,C. Hypokalemia
D. Hypophosphatemia
✅ Correct Answer: B
4. The PRIORITY nursing intervention to prevent TLS is:
A. Restrict fluids
B. Administer diuretics
C. Aggressive IV hydration
D. Give potassium supplements
✅ Correct Answer: C
5. Which malignancy is MOST commonly associated with TLS?
A. Breast cancer
B. Prostate cancer
C. Acute leukemia
D. Colon cancer
✅ Correct Answer: C
6. A patient receiving vesicant chemotherapy reports burning at the IV site. What is the FIRST action?
A. Flush the IV line
B. Remove the IV catheter
C. Stop the infusion
D. Apply warm compress
✅ Correct Answer: C
7. Which drug class carries the HIGHEST risk for extravasation injury?
A. Alkylating agents
B. Antimetabolites
C. Vinca alkaloids
D. Hormonal agents
✅ Correct Answer: C
8. Which symptom indicates possible spinal cord compression?
, A. Headache
B. Back pain with weakness
C. Nausea
D. Fever
✅ Correct Answer: B
9. The PRIORITY treatment for suspected spinal cord compression is:
A. Chemotherapy
B. Radiation therapy
C. High-dose corticosteroids
D. Pain medication only
✅ Correct Answer: C
10. Which laboratory abnormality is MOST concerning for hypercalcemia of malignancy?
A. Calcium 9.5 mg/dL
B. Calcium 10.2 mg/dL
C. Calcium 12.8 mg/dL
D. Calcium 8.0 mg/dL
✅ Correct Answer: C
11. A patient with hypercalcemia may exhibit which symptom?
A. Tetany
B. Muscle cramps
C. Lethargy and confusion
D. Hyperreflexia
✅ Correct Answer: C
12. Which intervention is FIRST-LINE for hypercalcemia of malignancy?
A. Calcium supplements
B. IV fluids
C. Potassium replacement
D. Fluid restriction
✅ Correct Answer: B
