Advanced OCN (Oncology Certified Nurse)
Multiple Choice Questions (MCQs) with
Answers and Explanations for Professional
Certification Exams
1. A patient receiving induction chemotherapy for acute myeloid leukemia develops a
temperature of 38.5°C and an absolute neutrophil count of 300 cells/mm³. What is the
priority nursing action?
A. Administer acetaminophen and reassess in 4 hours
B. Obtain a sputum culture only
C. Initiate the neutropenic fever protocol and administer broad-spectrum antibiotics
promptly
D. Delay treatment until blood culture results are available
Explanation: Febrile neutropenia constitutes an oncologic emergency. Prompt initiation of
empiric broad-spectrum antibiotics after obtaining cultures reduces morbidity and mortality
associated with overwhelming infection.
2. A patient undergoing cisplatin therapy reports tinnitus and diminished hearing acuity.
Which toxicity should the nurse suspect?
A. Cardiotoxicity
B. Pulmonary fibrosis
C. Peripheral vascular toxicity
D. Ototoxicity
Explanation: Cisplatin is associated with dose-dependent ototoxicity, characterized by tinnitus
and hearing impairment, requiring prompt evaluation and possible treatment modification.
3. Which laboratory value places a patient receiving chemotherapy at the greatest risk for
spontaneous bleeding?
A. Hemoglobin of 10.2 g/dL
B. White blood cell count of 3,000/mm³
, C. Absolute neutrophil count of 1,200/mm³
D. Platelet count of 15,000/mm³
Explanation: Severe thrombocytopenia significantly increases the risk of spontaneous
hemorrhage and warrants bleeding precautions and possible platelet transfusion.
4. A patient receiving doxorubicin therapy is most at risk for developing:
A. Nephrotoxicity
B. Neurotoxicity
C. Hepatic encephalopathy
D. Cardiomyopathy
Explanation: Doxorubicin is associated with cumulative dose-dependent cardiotoxicity, which
may lead to irreversible cardiomyopathy and heart failure.
5. During administration of vesicant chemotherapy through a peripheral IV, the patient
reports burning and pain at the site. What should the nurse do first?
A. Flush the IV line with saline
B. Remove the catheter immediately without aspiration
C. Continue the infusion at a slower rate
D. Stop the infusion and assess for extravasation
Explanation: Pain and burning may indicate extravasation. Immediate cessation of the infusion
minimizes tissue injury and allows appropriate management.
6. A patient with syndrome of inappropriate antidiuretic hormone secretion secondary to
small-cell lung cancer would most likely exhibit:
A. Hypernatremia
B. Hypercalcemia
C. Hyponatremia
D. Hyperkalemia
Multiple Choice Questions (MCQs) with
Answers and Explanations for Professional
Certification Exams
1. A patient receiving induction chemotherapy for acute myeloid leukemia develops a
temperature of 38.5°C and an absolute neutrophil count of 300 cells/mm³. What is the
priority nursing action?
A. Administer acetaminophen and reassess in 4 hours
B. Obtain a sputum culture only
C. Initiate the neutropenic fever protocol and administer broad-spectrum antibiotics
promptly
D. Delay treatment until blood culture results are available
Explanation: Febrile neutropenia constitutes an oncologic emergency. Prompt initiation of
empiric broad-spectrum antibiotics after obtaining cultures reduces morbidity and mortality
associated with overwhelming infection.
2. A patient undergoing cisplatin therapy reports tinnitus and diminished hearing acuity.
Which toxicity should the nurse suspect?
A. Cardiotoxicity
B. Pulmonary fibrosis
C. Peripheral vascular toxicity
D. Ototoxicity
Explanation: Cisplatin is associated with dose-dependent ototoxicity, characterized by tinnitus
and hearing impairment, requiring prompt evaluation and possible treatment modification.
3. Which laboratory value places a patient receiving chemotherapy at the greatest risk for
spontaneous bleeding?
A. Hemoglobin of 10.2 g/dL
B. White blood cell count of 3,000/mm³
, C. Absolute neutrophil count of 1,200/mm³
D. Platelet count of 15,000/mm³
Explanation: Severe thrombocytopenia significantly increases the risk of spontaneous
hemorrhage and warrants bleeding precautions and possible platelet transfusion.
4. A patient receiving doxorubicin therapy is most at risk for developing:
A. Nephrotoxicity
B. Neurotoxicity
C. Hepatic encephalopathy
D. Cardiomyopathy
Explanation: Doxorubicin is associated with cumulative dose-dependent cardiotoxicity, which
may lead to irreversible cardiomyopathy and heart failure.
5. During administration of vesicant chemotherapy through a peripheral IV, the patient
reports burning and pain at the site. What should the nurse do first?
A. Flush the IV line with saline
B. Remove the catheter immediately without aspiration
C. Continue the infusion at a slower rate
D. Stop the infusion and assess for extravasation
Explanation: Pain and burning may indicate extravasation. Immediate cessation of the infusion
minimizes tissue injury and allows appropriate management.
6. A patient with syndrome of inappropriate antidiuretic hormone secretion secondary to
small-cell lung cancer would most likely exhibit:
A. Hypernatremia
B. Hypercalcemia
C. Hyponatremia
D. Hyperkalemia
