KAPLAN ONCOLOGY NURSING EXAM QUESTIONS AND CORRECT ANSWERS (VERIFIED ANSWERS) PLUS RATIONALES
2026 Q&A | INSTANT DOWNLOAD PDF
Core Domains
*- Cancer Pathophysiology and Carcinogenesis*
*- Chemotherapy and Systemic Therapies*
*- Radiation Therapy and Precautions*
*- Oncologic Emergencies*
*- Symptom Management and Side Effects*
*- Pain Management and Palliative Care*
*- Psychosocial and Spiritual Support*
*- Ethics, Legal Compliance, and Professional Standards*
*- Nutrition and Fluid Management in Cancer Care*
*- Infection Prevention and Neutropenic Care*
Introduction
This comprehensive assessment evaluates critical knowledge and clinical decision-making skills essential for oncology nursing practice. The exam
covers cancer pathophysiology, treatment modalities, symptom management, oncologic emergencies, and professional standards. All 100
questions use multiple-choice format with scenario-based clinical situations that emphasize real-world application. Candidates will demonstrate
competency in chemotherapy safety, radiation precautions, infection control, pain management, ethical decision-making, and patient education.
The assessment mirrors actual certification exam structure, preparing nursing professionals for high-stakes testing and clinical practice in
oncology settings.
Section One: Questions 1–100
Question 1
A patient with stage III breast cancer is receiving doxorubicin chemotherapy. During the infusion, the patient reports burning at the IV site. What is
the nurse's FIRST action?
A. Slow the infusion rate and continue monitoring
B. Administer prescribed antidote through the IV
C. Stop the infusion immediately and disconnect the IV
D. Apply warm compress to the affected area
🟢 Correct answer: C
,🔴 RATIONALE: Burning at the IV site during doxorubicin infusion indicates extravasation, a serious complication. The nurse must stop the
infusion immediately to prevent further tissue damage. Doxorubicin is a vesicant that can cause severe tissue necrosis if it leaks into surrounding
tissue. Continuing the infusion or slowing the rate would worsen the injury.
Question 2
Which laboratory value is MOST critical for the nurse to assess before administering cisplatin?
A. Hemoglobin 11.2 g/dL
B. Serum creatinine 1.8 mg/dL
C. Platelet count 150,000/mm³
D. WBC count 5,200/mm³
🟢 Correct answer: B
🔴 RATIONALE: Cisplatin is highly nephrotoxic and requires adequate renal function for safe administration. A serum creatinine of 1.8 mg/dL
indicates impaired kidney function, which increases the risk of severe nephrotoxicity. The nurse must notify the provider before administering
cisplatin when creatinine is elevated. Hemoglobin, platelets, and WBC are less critical for cisplatin safety.
Question 3
A patient with neutropenia (WBC 1,800/mm³, neutrophils 8%) is admitted. Which intervention is MOST important for infection prevention?
A. Administer prophylactic antibiotics
B. Restrict all fresh fruits and vegetables
C. Implement strict hand hygiene for everyone entering the room
D. Place the patient in a negative-pressure room
🟢 Correct answer: C
🔴 RATIONALE: Hand hygiene is the single most effective method for preventing infection in neutropenic patients. While dietary restrictions and
antibiotic prophylaxis may be appropriate, they are secondary to hand hygiene. Negative-pressure rooms are used for airborne infections, not
neutropenia. Strict hand hygiene by all healthcare providers, visitors, and the patient themselves significantly reduces infection risk.
Question 4
Which symptom should the nurse prioritize as a potential oncologic emergency in a patient with multiple myeloma?
,A. Fatigue and weakness
B. Serum calcium 12.8 mg/dL
C. Mild back pain
D. Decreased appetite
🟢 Correct answer: B
🔴 RATIONALE: Hypercalcemia (serum calcium >10.5 mg/dL) is a life-threatening oncologic emergency common in multiple myeloma. A calcium
level of 12.8 mg/dL requires immediate intervention including IV fluids, bisphosphonates, and monitoring for cardiac abnormalities. Fatigue, back
pain, and decreased appetite are expected symptoms but not emergencies.
Question 5
A patient receiving external beam radiation to the chest asks about skin care. Which instruction is MOST appropriate?
A. Apply alcohol-based lotions to keep skin dry
B. Use hot water for washing to remove radiation marks
C. Wear loose, soft clothing and avoid Direct sunlight
D. Scrub the radiation area gently to remove marks
🟢 Correct answer: C
🔴 RATIONALE: Radiation therapy causes skin sensitivity and increases risk of burning. Patients should wear loose, soft clothing to avoid friction
and avoid direct sunlight to prevent additional skin damage. Alcohol-based lotions, hot water, and scrubbing can worsen skin irritation and damage
the treated area.
Question 6
Which medication is the nurse EXPECTED to administer for tumor lysis syndrome prevention?
A. Allopurinol
B. Furosemide
C. Morphine
D. Lorazepame
🟢 Correct answer: A
, 🔴 RATIONALE: Allopurinol is a xanthine oxidase inhibitor that reduces uric acid production and prevents tumor lysis syndrome, which occurs
when cancer cells break down rapidly during chemotherapy. Furosemide may be used for fluid management but doesn't prevent TLS. Morphine and
lorazepam are for pain and anxiety, not TLS prevention.
Question 7
A patient with advanced lung cancer states, "I want to stop treatment and go home." The family insists on continuing aggressive treatment. What is
the nurse's BEST initial action?
A. Support the family's decision to continue treatment
B. Explain that the patient must follow medical recommendations
C. Facilitate a discussion between the patient and family about goals of care
D. Notify the healthcare provider of the family's disagreement
🟢 Correct answer: C
🔴 RATIONALE: The patient's autonomy and right to refuse treatment must be respected. The nurse's role is to facilitate communication between
the patient and family to understand differing perspectives and reach consensus on goals of care. Supporting the family over the patient violates
patient autonomy. The provider should be involved, but communication facilitation is the priority.
Question 8
Which finding indicates successful pain management in a patient receiving morphine for cancer pain?
A. Pain score reduced from 8 to 4 within 2 hours
B. Patient reports pain score of 2 and can sleep
C. Patient requests additional pain medication every 3 hours
D. Respiratory rate decreases from 18 to 12 breaths/min
🟢 correct answer: B
🔴 RATIONALE: Successful pain management means the patient reports adequate pain relief (score of 2 or less) and can perform normal activities
like sleeping. A reduction from 8 to 4 indicates incomplete relief. Requesting medication every 3 hours suggests inadequate pain control. A
respiratory rate of 12 is acceptable but doesn't indicate pain management success.
2026 Q&A | INSTANT DOWNLOAD PDF
Core Domains
*- Cancer Pathophysiology and Carcinogenesis*
*- Chemotherapy and Systemic Therapies*
*- Radiation Therapy and Precautions*
*- Oncologic Emergencies*
*- Symptom Management and Side Effects*
*- Pain Management and Palliative Care*
*- Psychosocial and Spiritual Support*
*- Ethics, Legal Compliance, and Professional Standards*
*- Nutrition and Fluid Management in Cancer Care*
*- Infection Prevention and Neutropenic Care*
Introduction
This comprehensive assessment evaluates critical knowledge and clinical decision-making skills essential for oncology nursing practice. The exam
covers cancer pathophysiology, treatment modalities, symptom management, oncologic emergencies, and professional standards. All 100
questions use multiple-choice format with scenario-based clinical situations that emphasize real-world application. Candidates will demonstrate
competency in chemotherapy safety, radiation precautions, infection control, pain management, ethical decision-making, and patient education.
The assessment mirrors actual certification exam structure, preparing nursing professionals for high-stakes testing and clinical practice in
oncology settings.
Section One: Questions 1–100
Question 1
A patient with stage III breast cancer is receiving doxorubicin chemotherapy. During the infusion, the patient reports burning at the IV site. What is
the nurse's FIRST action?
A. Slow the infusion rate and continue monitoring
B. Administer prescribed antidote through the IV
C. Stop the infusion immediately and disconnect the IV
D. Apply warm compress to the affected area
🟢 Correct answer: C
,🔴 RATIONALE: Burning at the IV site during doxorubicin infusion indicates extravasation, a serious complication. The nurse must stop the
infusion immediately to prevent further tissue damage. Doxorubicin is a vesicant that can cause severe tissue necrosis if it leaks into surrounding
tissue. Continuing the infusion or slowing the rate would worsen the injury.
Question 2
Which laboratory value is MOST critical for the nurse to assess before administering cisplatin?
A. Hemoglobin 11.2 g/dL
B. Serum creatinine 1.8 mg/dL
C. Platelet count 150,000/mm³
D. WBC count 5,200/mm³
🟢 Correct answer: B
🔴 RATIONALE: Cisplatin is highly nephrotoxic and requires adequate renal function for safe administration. A serum creatinine of 1.8 mg/dL
indicates impaired kidney function, which increases the risk of severe nephrotoxicity. The nurse must notify the provider before administering
cisplatin when creatinine is elevated. Hemoglobin, platelets, and WBC are less critical for cisplatin safety.
Question 3
A patient with neutropenia (WBC 1,800/mm³, neutrophils 8%) is admitted. Which intervention is MOST important for infection prevention?
A. Administer prophylactic antibiotics
B. Restrict all fresh fruits and vegetables
C. Implement strict hand hygiene for everyone entering the room
D. Place the patient in a negative-pressure room
🟢 Correct answer: C
🔴 RATIONALE: Hand hygiene is the single most effective method for preventing infection in neutropenic patients. While dietary restrictions and
antibiotic prophylaxis may be appropriate, they are secondary to hand hygiene. Negative-pressure rooms are used for airborne infections, not
neutropenia. Strict hand hygiene by all healthcare providers, visitors, and the patient themselves significantly reduces infection risk.
Question 4
Which symptom should the nurse prioritize as a potential oncologic emergency in a patient with multiple myeloma?
,A. Fatigue and weakness
B. Serum calcium 12.8 mg/dL
C. Mild back pain
D. Decreased appetite
🟢 Correct answer: B
🔴 RATIONALE: Hypercalcemia (serum calcium >10.5 mg/dL) is a life-threatening oncologic emergency common in multiple myeloma. A calcium
level of 12.8 mg/dL requires immediate intervention including IV fluids, bisphosphonates, and monitoring for cardiac abnormalities. Fatigue, back
pain, and decreased appetite are expected symptoms but not emergencies.
Question 5
A patient receiving external beam radiation to the chest asks about skin care. Which instruction is MOST appropriate?
A. Apply alcohol-based lotions to keep skin dry
B. Use hot water for washing to remove radiation marks
C. Wear loose, soft clothing and avoid Direct sunlight
D. Scrub the radiation area gently to remove marks
🟢 Correct answer: C
🔴 RATIONALE: Radiation therapy causes skin sensitivity and increases risk of burning. Patients should wear loose, soft clothing to avoid friction
and avoid direct sunlight to prevent additional skin damage. Alcohol-based lotions, hot water, and scrubbing can worsen skin irritation and damage
the treated area.
Question 6
Which medication is the nurse EXPECTED to administer for tumor lysis syndrome prevention?
A. Allopurinol
B. Furosemide
C. Morphine
D. Lorazepame
🟢 Correct answer: A
, 🔴 RATIONALE: Allopurinol is a xanthine oxidase inhibitor that reduces uric acid production and prevents tumor lysis syndrome, which occurs
when cancer cells break down rapidly during chemotherapy. Furosemide may be used for fluid management but doesn't prevent TLS. Morphine and
lorazepam are for pain and anxiety, not TLS prevention.
Question 7
A patient with advanced lung cancer states, "I want to stop treatment and go home." The family insists on continuing aggressive treatment. What is
the nurse's BEST initial action?
A. Support the family's decision to continue treatment
B. Explain that the patient must follow medical recommendations
C. Facilitate a discussion between the patient and family about goals of care
D. Notify the healthcare provider of the family's disagreement
🟢 Correct answer: C
🔴 RATIONALE: The patient's autonomy and right to refuse treatment must be respected. The nurse's role is to facilitate communication between
the patient and family to understand differing perspectives and reach consensus on goals of care. Supporting the family over the patient violates
patient autonomy. The provider should be involved, but communication facilitation is the priority.
Question 8
Which finding indicates successful pain management in a patient receiving morphine for cancer pain?
A. Pain score reduced from 8 to 4 within 2 hours
B. Patient reports pain score of 2 and can sleep
C. Patient requests additional pain medication every 3 hours
D. Respiratory rate decreases from 18 to 12 breaths/min
🟢 correct answer: B
🔴 RATIONALE: Successful pain management means the patient reports adequate pain relief (score of 2 or less) and can perform normal activities
like sleeping. A reduction from 8 to 4 indicates incomplete relief. Requesting medication every 3 hours suggests inadequate pain control. A
respiratory rate of 12 is acceptable but doesn't indicate pain management success.
