ONCOLOGY CERTIFIED NURSE (OCN®) – COMPREHENSIVE
EXAM (ONCC-ALIGNED) - LATEST PRACTICE QUESTIONS
AND 100% VERIFIED CORRECT ANSWERS | COMPLETE EXAM
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Exam Overview:
This 150-question comprehensive assessment reflects the full scope of the Oncology Nursing
Certification Corporation (ONCC) Oncology Certified Nurse (OCN®) examination blueprint. It covers:
Cancer biology & epidemiology (10–15%)
Treatment modalities (chemotherapy, biotherapy, immunotherapy, radiation, surgery, transplant)
(25–30%)
Symptom management & oncologic emergencies (20–25%)
Psychosocial dimensions of care (10–15%)
Palliative & end-of-life care (10–15%)
Professional practice, ethics, survivorship, patient education, safety, and research (10–15%)
Balanced across foundational theory, applied clinical reasoning, real-world case scenarios, regulatory
standards, patient safety, and professional practice.
1. A tumor biopsy reveals poorly differentiated cells with high mitotic activity
and loss of normal tissue architecture. Which characteristic best supports
malignancy?
A. Encapsulation
B. Low nuclear-to-cytoplasmic ratio
C. Limited angiogenesis
D. Anaplasia
Rationale: Anaplasia refers to loss of cellular differentiation and is a
hallmark of malignant tumors.
2. A patient with a BRCA1 mutation is at highest risk for which cancer?
A. Colon
B. Lung
C. Breast and ovarian
, D. Pancreatic
Rationale: BRCA1 mutations significantly increase risk for breast and
ovarian cancers.
3. A chemotherapy agent classified as an alkylating agent works primarily by:
A. Inhibiting topoisomerase I
B. Blocking microtubule formation
C. Cross-linking DNA strands
D. Inhibiting HER2 receptors
Rationale: Alkylating agents damage DNA by cross-linking strands,
preventing replication.
4. A patient receiving cisplatin reports tinnitus. The nurse recognizes this as:
A. Neurotoxicity
B. Ototoxicity
C. Nephrotoxicity
D. Mucositis
Rationale: Cisplatin commonly causes ototoxicity manifested as tinnitus or
hearing loss.
5. A neutropenic patient (ANC 400) develops fever of 38.5°C. The nurse’s
priority action is to:
A. Administer acetaminophen
B. Obtain blood cultures
C. Initiate broad-spectrum IV antibiotics
D. Notify family
Rationale: Febrile neutropenia is an oncologic emergency requiring
immediate empiric antibiotics.
6. Tumor lysis syndrome is most commonly associated with:
A. Breast cancer
, B. Prostate cancer
C. High-grade lymphomas
D. Basal cell carcinoma
Rationale: Rapidly proliferating hematologic malignancies are at highest
risk.
7. A patient receiving external beam radiation develops erythema and dry
desquamation. Appropriate nursing advice includes:
A. Apply petroleum jelly
B. Use perfumed lotion
C. Scrub area daily
D. Use mild soap and avoid sun exposure
Rationale: Gentle skin care reduces radiation dermatitis progression.
8. Trastuzumab is indicated for tumors that overexpress:
A. EGFR
B. VEGF
C. KRAS
D. HER2/neu
Rationale: Trastuzumab targets HER2-positive breast cancers.
9. The primary goal of phase I clinical trials is to determine:
A. Efficacy
B. Comparison to standard therapy
C. Maximum tolerated dose and safety
D. Long-term outcomes
Rationale: Phase I trials assess safety and dosing.
10.A patient with spinal cord compression reports new back pain and leg
weakness. The nurse anticipates:
A. Oral opioids
, B. Immediate corticosteroids and MRI
C. Physical therapy
D. Discharge home
Rationale: Spinal cord compression is an emergency requiring steroids and
imaging.
11.Cachexia in cancer patients is primarily caused by:
A. Dehydration
B. Reduced intake only
C. Inflammatory cytokines altering metabolism
D. Malabsorption
Rationale: Cachexia is driven by systemic inflammation and metabolic
dysregulation.
12.Which lab value is most concerning before chemotherapy?
A. Platelets 180,000
B. WBC 6,000
C. Hemoglobin 12
D. ANC 900
Rationale: ANC below 1,000 increases infection risk.
13.Extravasation of vesicant chemotherapy requires:
A. Immediate flushing
B. Heat application
C. Stopping infusion and aspirating drug
D. Elevating limb only
Rationale: Infusion must stop immediately; drug aspirated per protocol.
14.The best screening for colorectal cancer is:
A. PSA
B. CEA
EXAM (ONCC-ALIGNED) - LATEST PRACTICE QUESTIONS
AND 100% VERIFIED CORRECT ANSWERS | COMPLETE EXAM
PREP TESTBANK | GUARANTEED PASS | INSTANT DOWNLOAD
Exam Overview:
This 150-question comprehensive assessment reflects the full scope of the Oncology Nursing
Certification Corporation (ONCC) Oncology Certified Nurse (OCN®) examination blueprint. It covers:
Cancer biology & epidemiology (10–15%)
Treatment modalities (chemotherapy, biotherapy, immunotherapy, radiation, surgery, transplant)
(25–30%)
Symptom management & oncologic emergencies (20–25%)
Psychosocial dimensions of care (10–15%)
Palliative & end-of-life care (10–15%)
Professional practice, ethics, survivorship, patient education, safety, and research (10–15%)
Balanced across foundational theory, applied clinical reasoning, real-world case scenarios, regulatory
standards, patient safety, and professional practice.
1. A tumor biopsy reveals poorly differentiated cells with high mitotic activity
and loss of normal tissue architecture. Which characteristic best supports
malignancy?
A. Encapsulation
B. Low nuclear-to-cytoplasmic ratio
C. Limited angiogenesis
D. Anaplasia
Rationale: Anaplasia refers to loss of cellular differentiation and is a
hallmark of malignant tumors.
2. A patient with a BRCA1 mutation is at highest risk for which cancer?
A. Colon
B. Lung
C. Breast and ovarian
, D. Pancreatic
Rationale: BRCA1 mutations significantly increase risk for breast and
ovarian cancers.
3. A chemotherapy agent classified as an alkylating agent works primarily by:
A. Inhibiting topoisomerase I
B. Blocking microtubule formation
C. Cross-linking DNA strands
D. Inhibiting HER2 receptors
Rationale: Alkylating agents damage DNA by cross-linking strands,
preventing replication.
4. A patient receiving cisplatin reports tinnitus. The nurse recognizes this as:
A. Neurotoxicity
B. Ototoxicity
C. Nephrotoxicity
D. Mucositis
Rationale: Cisplatin commonly causes ototoxicity manifested as tinnitus or
hearing loss.
5. A neutropenic patient (ANC 400) develops fever of 38.5°C. The nurse’s
priority action is to:
A. Administer acetaminophen
B. Obtain blood cultures
C. Initiate broad-spectrum IV antibiotics
D. Notify family
Rationale: Febrile neutropenia is an oncologic emergency requiring
immediate empiric antibiotics.
6. Tumor lysis syndrome is most commonly associated with:
A. Breast cancer
, B. Prostate cancer
C. High-grade lymphomas
D. Basal cell carcinoma
Rationale: Rapidly proliferating hematologic malignancies are at highest
risk.
7. A patient receiving external beam radiation develops erythema and dry
desquamation. Appropriate nursing advice includes:
A. Apply petroleum jelly
B. Use perfumed lotion
C. Scrub area daily
D. Use mild soap and avoid sun exposure
Rationale: Gentle skin care reduces radiation dermatitis progression.
8. Trastuzumab is indicated for tumors that overexpress:
A. EGFR
B. VEGF
C. KRAS
D. HER2/neu
Rationale: Trastuzumab targets HER2-positive breast cancers.
9. The primary goal of phase I clinical trials is to determine:
A. Efficacy
B. Comparison to standard therapy
C. Maximum tolerated dose and safety
D. Long-term outcomes
Rationale: Phase I trials assess safety and dosing.
10.A patient with spinal cord compression reports new back pain and leg
weakness. The nurse anticipates:
A. Oral opioids
, B. Immediate corticosteroids and MRI
C. Physical therapy
D. Discharge home
Rationale: Spinal cord compression is an emergency requiring steroids and
imaging.
11.Cachexia in cancer patients is primarily caused by:
A. Dehydration
B. Reduced intake only
C. Inflammatory cytokines altering metabolism
D. Malabsorption
Rationale: Cachexia is driven by systemic inflammation and metabolic
dysregulation.
12.Which lab value is most concerning before chemotherapy?
A. Platelets 180,000
B. WBC 6,000
C. Hemoglobin 12
D. ANC 900
Rationale: ANC below 1,000 increases infection risk.
13.Extravasation of vesicant chemotherapy requires:
A. Immediate flushing
B. Heat application
C. Stopping infusion and aspirating drug
D. Elevating limb only
Rationale: Infusion must stop immediately; drug aspirated per protocol.
14.The best screening for colorectal cancer is:
A. PSA
B. CEA
