NUR 209 ONCOLOGY NURSING EXAM GUIDE 2026
EDITION Q&A
1. A patient with advanced ovarian cancer is receiving cisplatin
chemotherapy. Which nursing intervention is most critical to
prevent the most common dose-limiting toxicity?
A. Administer antiemetics 30 minutes before infusion
B. Ensure aggressive IV hydration before and after treatment
C. Monitor platelet counts every 12 hours
D. Assess for peripheral neuropathy daily
Correct Answer: B
Explanation: Cisplatin is highly nephrotoxic, and aggressive
hydration is the primary preventive measure for renal damage,
which is the dose-limiting toxicity. While antiemetics (A) are
important for nausea, neuropathy (D) is a concern but not dose-
limiting, and platelet monitoring (C) is less critical than renal
protection.
2. A nurse is caring for a patient with neutropenia (ANC 450/mm³)
following chemotherapy. Which action should be prioritized?
A. Implement strict neutropenic precautions and limit visitors
B. Administer granulocyte colony-stimulating factor immediately
C. Teach the patient to avoid raw fruits and vegetables
D. Monitor temperature every 4 hours
Correct Answer: A
Explanation: With an ANC of 450/mm³, the patient is severely
neutropenic and at extreme risk for infection. Strict neutropenic
precautions are the immediate priority to prevent exposure to
, pathogens. While temperature monitoring (D) is important,
prevention is paramount. G-CSF (B) may be ordered but requires a
physician's order, and dietary restrictions (C) are part of
precautions but not the priority intervention.
3. A patient with metastatic breast cancer develops superior vena
cava (SVC) syndrome. Which symptom should the nurse assess for
first?
A. Facial edema and distended neck veins
B. Hemoptysis and chest pain
C. Lower extremity edema
D. Abdominal distension
Correct Answer: A
Explanation: SVC syndrome results from obstruction of the
superior vena cava, causing facial edema, neck vein distension,
and upper extremity swelling due to impaired venous return from
the head and neck. This is a medical emergency requiring
immediate intervention. Hemoptysis (B) suggests lung
involvement, lower extremity edema (C) indicates inferior vena
cava issues, and abdominal distension (D) is not characteristic of
SVC syndrome.
4. Which medication is the antidote for extravasation of vinblastine,
a vesicant chemotherapy agent?
A. Dexrazoxane
B. Hyaluronidase with warm compresses
C. Sodium thiosulfate
, D. Dexamethasone
Correct Answer: B
Explanation: Vinblastine is a vinca alkaloid vesicant, and
hyaluronidase with warm compresses is the specific antidote to
facilitate drug dispersion and absorption. Dexrazoxane (A) is for
anthracycline extravasation, sodium thiosulfate (C) is for cisplatin
extravasation, and dexamethasone (D) is not a specific antidote
for vinblastine.
5. A patient with multiple myeloma presents with hypercalcemia
(calcium 14.2 mg/dL). Which intervention should the nurse
anticipate first?
A. Administer oral bisphosphonates
B. Initiate aggressive IV fluid hydration with normal saline
C. Prepare for hemodialysis
D. Administer calcium gluconate IV
Correct Answer: B
Explanation: Aggressive IV hydration with normal saline is the
first-line treatment for severe hypercalcemia to promote renal
calcium excretion and prevent renal failure. Bisphosphonates (A)
are given but take 24-48 hours to work. Dialysis (C) is reserved for
refractory cases. Calcium gluconate (D) is contraindicated as it
would worsen hypercalcemia.
6. Which Assessment finding indicates tumor lysis syndrome in a
patient with high-grade lymphoma after starting chemotherapy?
A. Hyperkalemia, hyperphosphatemia, hypocalcemia, and
, hyperuricemia
B. Hypokalemia, hypophosphatemia, hypercalcemia, and
hypouricemia
C. Hypernatremia, hypomagnesemia, and hypercalcemia
D. Hypokalemia, hyperphosphatemia, and hypercalcemia
Correct Answer: A
Explanation: Tumor lysis syndrome causes rapid cell breakdown,
releasing intracellular contents: potassium, phosphate, and uric
acid, leading to hyperkalemia, hyperphosphatemia, hyperuricemia,
and secondary hypocalcemia (due to calcium-phosphate
precipitation). Options B, C, and D present incorrect electrolyte
abnormalities.
7. A patient receiving doxorubicin develops reddish-orange urine.
What is the most appropriate nursing response?
A. Notify the physician immediately for potential hematuria
B. Reassure the patient that this is a harmless side effect of the
medication
C. Collect a urine sample for culture and sensitivity
D. Hold the next dose and assess for bleeding
Correct Answer: B
Explanation: Doxorubicin (Adriamycin) causes reddish-orange
discoloration of urine, which is a harmless and expected side
effect. It is not hematuria. The nurse should reassure the patient.
No need to notify the physician (A), collect urine culture (C), or
hold the dose (D) as this is not a sign of toxicity.
EDITION Q&A
1. A patient with advanced ovarian cancer is receiving cisplatin
chemotherapy. Which nursing intervention is most critical to
prevent the most common dose-limiting toxicity?
A. Administer antiemetics 30 minutes before infusion
B. Ensure aggressive IV hydration before and after treatment
C. Monitor platelet counts every 12 hours
D. Assess for peripheral neuropathy daily
Correct Answer: B
Explanation: Cisplatin is highly nephrotoxic, and aggressive
hydration is the primary preventive measure for renal damage,
which is the dose-limiting toxicity. While antiemetics (A) are
important for nausea, neuropathy (D) is a concern but not dose-
limiting, and platelet monitoring (C) is less critical than renal
protection.
2. A nurse is caring for a patient with neutropenia (ANC 450/mm³)
following chemotherapy. Which action should be prioritized?
A. Implement strict neutropenic precautions and limit visitors
B. Administer granulocyte colony-stimulating factor immediately
C. Teach the patient to avoid raw fruits and vegetables
D. Monitor temperature every 4 hours
Correct Answer: A
Explanation: With an ANC of 450/mm³, the patient is severely
neutropenic and at extreme risk for infection. Strict neutropenic
precautions are the immediate priority to prevent exposure to
, pathogens. While temperature monitoring (D) is important,
prevention is paramount. G-CSF (B) may be ordered but requires a
physician's order, and dietary restrictions (C) are part of
precautions but not the priority intervention.
3. A patient with metastatic breast cancer develops superior vena
cava (SVC) syndrome. Which symptom should the nurse assess for
first?
A. Facial edema and distended neck veins
B. Hemoptysis and chest pain
C. Lower extremity edema
D. Abdominal distension
Correct Answer: A
Explanation: SVC syndrome results from obstruction of the
superior vena cava, causing facial edema, neck vein distension,
and upper extremity swelling due to impaired venous return from
the head and neck. This is a medical emergency requiring
immediate intervention. Hemoptysis (B) suggests lung
involvement, lower extremity edema (C) indicates inferior vena
cava issues, and abdominal distension (D) is not characteristic of
SVC syndrome.
4. Which medication is the antidote for extravasation of vinblastine,
a vesicant chemotherapy agent?
A. Dexrazoxane
B. Hyaluronidase with warm compresses
C. Sodium thiosulfate
, D. Dexamethasone
Correct Answer: B
Explanation: Vinblastine is a vinca alkaloid vesicant, and
hyaluronidase with warm compresses is the specific antidote to
facilitate drug dispersion and absorption. Dexrazoxane (A) is for
anthracycline extravasation, sodium thiosulfate (C) is for cisplatin
extravasation, and dexamethasone (D) is not a specific antidote
for vinblastine.
5. A patient with multiple myeloma presents with hypercalcemia
(calcium 14.2 mg/dL). Which intervention should the nurse
anticipate first?
A. Administer oral bisphosphonates
B. Initiate aggressive IV fluid hydration with normal saline
C. Prepare for hemodialysis
D. Administer calcium gluconate IV
Correct Answer: B
Explanation: Aggressive IV hydration with normal saline is the
first-line treatment for severe hypercalcemia to promote renal
calcium excretion and prevent renal failure. Bisphosphonates (A)
are given but take 24-48 hours to work. Dialysis (C) is reserved for
refractory cases. Calcium gluconate (D) is contraindicated as it
would worsen hypercalcemia.
6. Which Assessment finding indicates tumor lysis syndrome in a
patient with high-grade lymphoma after starting chemotherapy?
A. Hyperkalemia, hyperphosphatemia, hypocalcemia, and
, hyperuricemia
B. Hypokalemia, hypophosphatemia, hypercalcemia, and
hypouricemia
C. Hypernatremia, hypomagnesemia, and hypercalcemia
D. Hypokalemia, hyperphosphatemia, and hypercalcemia
Correct Answer: A
Explanation: Tumor lysis syndrome causes rapid cell breakdown,
releasing intracellular contents: potassium, phosphate, and uric
acid, leading to hyperkalemia, hyperphosphatemia, hyperuricemia,
and secondary hypocalcemia (due to calcium-phosphate
precipitation). Options B, C, and D present incorrect electrolyte
abnormalities.
7. A patient receiving doxorubicin develops reddish-orange urine.
What is the most appropriate nursing response?
A. Notify the physician immediately for potential hematuria
B. Reassure the patient that this is a harmless side effect of the
medication
C. Collect a urine sample for culture and sensitivity
D. Hold the next dose and assess for bleeding
Correct Answer: B
Explanation: Doxorubicin (Adriamycin) causes reddish-orange
discoloration of urine, which is a harmless and expected side
effect. It is not hematuria. The nurse should reassure the patient.
No need to notify the physician (A), collect urine culture (C), or
hold the dose (D) as this is not a sign of toxicity.
