ONCOLOGY CERTIFIED NURSE (OCN®) – COMPREHENSIVE
EXAM (ONCC-ALIGNED) - LATEST PRACTICE QUESTIONS AND
100% VERIFIED CORRECT ANSWERS COMPLETE EXAM PREP
TESTBANK GUARANTEED PASS INSTANT DOWNLOAD PDF
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
C. Colonoscopy
D. Chest X-ray
RATIONALE: Colonoscopy detects and removes precancerous lesions.
15. A patient undergoing HSCT is at greatest risk for:
A. Hypercalcemia
B. Graft-versus-host disease
C. Hypoglycemia
D. Polycythemia
RATIONALE: GVHD is a major complication of allogeneic transplant.
16. SIADH in small cell lung cancer leads to:
EXAM (ONCC-ALIGNED) - LATEST PRACTICE QUESTIONS AND
100% VERIFIED CORRECT ANSWERS COMPLETE EXAM PREP
TESTBANK GUARANTEED PASS INSTANT DOWNLOAD PDF
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
C. Colonoscopy
D. Chest X-ray
RATIONALE: Colonoscopy detects and removes precancerous lesions.
15. A patient undergoing HSCT is at greatest risk for:
A. Hypercalcemia
B. Graft-versus-host disease
C. Hypoglycemia
D. Polycythemia
RATIONALE: GVHD is a major complication of allogeneic transplant.
16. SIADH in small cell lung cancer leads to:
