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ATI Oncology Nursing Practice Exam Preparation
With Complete Questions And Correct Answers With
Rationales Already Graded A+ Brand New Version!!
Question 1
A patient with metastatic breast cancer is receiving doxorubicin. The
nurse notes a cumulative lifetime dose approaching 450 mg/m2. Which
assessment finding warrants immediate discontinuation of the
therapy?
A) Serum creatinine of 1.8 mg/dL
B) Ejection fraction decrease from 60% to 45%
C) White blood cell count of 3,000/mm3
D) Platelet count of 100,000/mm3
Answer: B
Explanation: Doxorubicin, an anthracycline, is associated with dose-
dependent cardiotoxicity, which manifests as a decline in left ventricular
ejection fraction (LVEF). A cumulative lifetime dose of 450 mg/m2 is the
threshold at which the risk of cardiomyopathy increases significantly. A
drop in LVEF from 60% to 45% indicates early cardiac dysfunction and is
the most critical indicator for holding further doses. Renal impairment
(A), leukopenia (C), and thrombocytopenia (D) are expected side effects
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and may require dose modification but do not independently mandate
immediate and permanent discontinuation of doxorubicin. Cardiac
monitoring is essential, and ejection fraction should be assessed
periodically throughout treatment.
Question 2
A patient undergoing external beam radiation therapy for lung cancer
reports erythema and dry desquamation over the treatment field. What
is the appropriate nursing intervention?
A) Apply topical corticosteroid cream three times daily
B) Wash the area with mild soap and water and pat dry
C) Apply a heating pad to promote local vasodilation
D) Cover the area with an adhesive occlusive dressing
Answer: B
Explanation: During radiation therapy, the skin in the treatment field is
vulnerable to injury. The standard of care includes gentle cleansing with
mild soap and water, followed by patting the area dry to prevent
further irritation. Topical corticosteroids (A) are generally avoided
unless specifically prescribed, as they can increase skin fragility. Heating
pads (C) should never be applied because heat exacerbates radiation-
induced skin reactions. Occlusive dressings (D) can trap moisture and
heat, increasing the risk of maceration and infection. The goal is to
minimize trauma, reduce friction, and keep the area clean and dry
without using irritants.
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Question 3
A patient receiving cisplatin chemotherapy reports tinnitus and a
feeling of ear fullness. Which laboratory value should the nurse
evaluate in relation to these symptoms?
A) Serum sodium
B) Serum potassium
C) Serum magnesium
D) Serum creatinine
Answer: D
Explanation: Cisplatin is a platinum-based chemotherapeutic agent
known for nephrotoxicity and ototoxicity. The symptoms of tinnitus and
ear fullness are early indicators of ototoxicity, which is correlated with
renal function. Cisplatin is primarily excreted renally, and impaired
clearance leads to higher peak plasma concentrations, worsening the
toxic effects. Therefore, the nurse should evaluate serum creatinine (D),
which reflects glomerular filtration and renal function. While electrolyte
imbalances (A, B, C) are also common with cisplatin, they do not directly
precipitate the ototoxic symptoms described. Adequate hydration and
monitoring of renal function are paramount in preventing or reducing
ototoxicity.
Question 4
A patient with acute lymphocytic leukemia is prescribed pegaspargase.
The nurse understands that this agent works by which mechanism?
A) Inhibiting topoisomerase II and causing DNA strand breaks
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B) Depleting asparagine, an essential amino acid for leukemic cells
C) Cross-linking DNA strands and inhibiting DNA replication
D) Stabilizing microtubules and disrupting mitotic spindle formation
Answer: B
Explanation: Pegaspargase is an enzymatic agent that functions by
depleting the circulating pools of asparagine. Leukemic cells lack the
enzyme asparagine synthetase, rendering them dependent on
exogenous asparagine for protein synthesis. By hydrolyzing this amino
acid, pegaspargase effectively starves the malignant cells, leading to
apoptosis. Option A describes topoisomerase inhibitors such as
etoposide, while option C describes alkylating agents like
cyclophosphamide, and option D describes taxanes such as paclitaxel.
Pegaspargase is unique in its metabolic mechanism and is associated
with toxicities such as pancreatitis, hepatotoxicity, and hypersensitivity.
Question 5
A patient is receiving trastuzumab for HER2-positive breast cancer. The
nurse should prioritize which assessment before each infusion?
A) Pulmonary auscultation for crackles
B) Left ventricular ejection fraction (LVEF)
C) Serum liver function tests
D) Complete blood count with differential
Answer: B
ATI Oncology Nursing Practice Exam Preparation
With Complete Questions And Correct Answers With
Rationales Already Graded A+ Brand New Version!!
Question 1
A patient with metastatic breast cancer is receiving doxorubicin. The
nurse notes a cumulative lifetime dose approaching 450 mg/m2. Which
assessment finding warrants immediate discontinuation of the
therapy?
A) Serum creatinine of 1.8 mg/dL
B) Ejection fraction decrease from 60% to 45%
C) White blood cell count of 3,000/mm3
D) Platelet count of 100,000/mm3
Answer: B
Explanation: Doxorubicin, an anthracycline, is associated with dose-
dependent cardiotoxicity, which manifests as a decline in left ventricular
ejection fraction (LVEF). A cumulative lifetime dose of 450 mg/m2 is the
threshold at which the risk of cardiomyopathy increases significantly. A
drop in LVEF from 60% to 45% indicates early cardiac dysfunction and is
the most critical indicator for holding further doses. Renal impairment
(A), leukopenia (C), and thrombocytopenia (D) are expected side effects
,2|Page
and may require dose modification but do not independently mandate
immediate and permanent discontinuation of doxorubicin. Cardiac
monitoring is essential, and ejection fraction should be assessed
periodically throughout treatment.
Question 2
A patient undergoing external beam radiation therapy for lung cancer
reports erythema and dry desquamation over the treatment field. What
is the appropriate nursing intervention?
A) Apply topical corticosteroid cream three times daily
B) Wash the area with mild soap and water and pat dry
C) Apply a heating pad to promote local vasodilation
D) Cover the area with an adhesive occlusive dressing
Answer: B
Explanation: During radiation therapy, the skin in the treatment field is
vulnerable to injury. The standard of care includes gentle cleansing with
mild soap and water, followed by patting the area dry to prevent
further irritation. Topical corticosteroids (A) are generally avoided
unless specifically prescribed, as they can increase skin fragility. Heating
pads (C) should never be applied because heat exacerbates radiation-
induced skin reactions. Occlusive dressings (D) can trap moisture and
heat, increasing the risk of maceration and infection. The goal is to
minimize trauma, reduce friction, and keep the area clean and dry
without using irritants.
,3|Page
Question 3
A patient receiving cisplatin chemotherapy reports tinnitus and a
feeling of ear fullness. Which laboratory value should the nurse
evaluate in relation to these symptoms?
A) Serum sodium
B) Serum potassium
C) Serum magnesium
D) Serum creatinine
Answer: D
Explanation: Cisplatin is a platinum-based chemotherapeutic agent
known for nephrotoxicity and ototoxicity. The symptoms of tinnitus and
ear fullness are early indicators of ototoxicity, which is correlated with
renal function. Cisplatin is primarily excreted renally, and impaired
clearance leads to higher peak plasma concentrations, worsening the
toxic effects. Therefore, the nurse should evaluate serum creatinine (D),
which reflects glomerular filtration and renal function. While electrolyte
imbalances (A, B, C) are also common with cisplatin, they do not directly
precipitate the ototoxic symptoms described. Adequate hydration and
monitoring of renal function are paramount in preventing or reducing
ototoxicity.
Question 4
A patient with acute lymphocytic leukemia is prescribed pegaspargase.
The nurse understands that this agent works by which mechanism?
A) Inhibiting topoisomerase II and causing DNA strand breaks
, 4|Page
B) Depleting asparagine, an essential amino acid for leukemic cells
C) Cross-linking DNA strands and inhibiting DNA replication
D) Stabilizing microtubules and disrupting mitotic spindle formation
Answer: B
Explanation: Pegaspargase is an enzymatic agent that functions by
depleting the circulating pools of asparagine. Leukemic cells lack the
enzyme asparagine synthetase, rendering them dependent on
exogenous asparagine for protein synthesis. By hydrolyzing this amino
acid, pegaspargase effectively starves the malignant cells, leading to
apoptosis. Option A describes topoisomerase inhibitors such as
etoposide, while option C describes alkylating agents like
cyclophosphamide, and option D describes taxanes such as paclitaxel.
Pegaspargase is unique in its metabolic mechanism and is associated
with toxicities such as pancreatitis, hepatotoxicity, and hypersensitivity.
Question 5
A patient is receiving trastuzumab for HER2-positive breast cancer. The
nurse should prioritize which assessment before each infusion?
A) Pulmonary auscultation for crackles
B) Left ventricular ejection fraction (LVEF)
C) Serum liver function tests
D) Complete blood count with differential
Answer: B
