OCN Practice Questions with Answers &
Rationales LATTEST 2025-2026 100
QUESTIONS AND ANSWERS + RATIONILES
ALREADYDY GRADED A+
DOMAIN I: CARE CONTINUUM (19%)
1. A 55-year-old female with a family history of breast cancer asks about screening
recommendations. According to current guidelines, when should screening mammography
begin for average-risk women?
A. Age 40
B. Age 45
C. Age 50
D. Age 55
Answer: A
Rationale: The USPSTF recommends that average-risk women begin screening mammography
at age 40. Women with a family history or other risk factors may need earlier or more frequent
screening. Health promotion and early detection are key components of the care continuum.
2. A 68-year-old male with a 40-pack-year smoking history presents for a health maintenance
visit. Which screening test is recommended for lung cancer?
A. Chest X-ray annually
B. Low-dose CT scan annually
C. Sputum cytology
D. PET scan
Answer: B
Rationale: The USPSTF recommends annual low-dose CT screening for lung cancer in adults
1
, aged 50-80 with a 20-pack-year smoking history who currently smoke or have quit within the
past 15 years. This is an example of screening and early detection in the care continuum.
3. A patient with advanced cancer is discussing advance directives with the nurse. Which
statement by the patient indicates understanding of advance care planning?
A. "My living will appoints someone to make decisions for me."
B. "A durable power of attorney for healthcare allows me to name someone to make decisions if
I cannot."
C. "Once I sign an advance directive, I cannot change it."
D. "Advance directives are only for patients who are terminally ill."
Answer: B
Rationale: A durable power of attorney for healthcare allows a person to name a healthcare
proxy to make decisions if they become unable to do so. A living will (A) outlines treatment
preferences, not appointment of a decision-maker. Advance directives can be changed (C) and
are not only for terminally ill patients (D).
4. A breast cancer survivor reports persistent fatigue and "brain fog" 18 months after
completing chemotherapy. This is best described as:
A. An acute side effect
B. A chronic side effect
C. A delayed-onset side effect
D. A subsequent malignancy
Answer: C
Rationale: Persistent fatigue and cognitive changes occurring months to years after treatment
are delayed-onset side effects. Acute side effects occur during treatment; chronic side effects
persist indefinitely; subsequent malignancies are new cancers caused by prior treatment.
5. A hospice nurse is caring for a patient with terminal cancer. Which intervention is most
appropriate for managing terminal secretions ("death rattle")?
A. Suctioning the oropharynx
B. Administering scopolamine or glycopyrrolate
C. Placing the patient in Trendelenburg position
D. Administering IV fluids
2
, Answer: B
Rationale: Terminal secretions are managed with anticholinergic medications such as
scopolamine or glycopyrrolate to reduce secretions. Suctioning (A) can be distressing and is not
recommended. Positioning (C) and IV fluids (D) are not effective for this symptom.
6. A patient is receiving hospice care. The family asks the nurse what to expect during the
dying process. Which statement by the nurse is most accurate?
A. "Most patients experience significant pain at the end of life."
B. "Decreased appetite and increased sleeping are common near the end of life."
C. "Patients usually remain alert and oriented until the very end."
D. "Respirations typically become deeper and more regular."
Answer: B
Rationale: Decreased appetite, increased sleeping, withdrawal, and changes in breathing
patterns are common near the end of life. Pain (A) can be managed, not all patients experience
it. Alertness (C) often decreases. Respirations (D) become irregular, not deeper and more
regular.
7. A cancer survivor reports concerns about recurrence. The nurse's best response is to:
A. Reassure the patient that recurrence is unlikely
B. Acknowledge the concern and discuss follow-up care and surveillance
C. Recommend the patient see a psychiatrist
D. Tell the patient to stop worrying
Answer: B
Rationale: Recurrence concerns are common among cancer survivors. The nurse should
acknowledge the concern and provide information about follow-up care, surveillance, and what
symptoms to report. Reassurance without addressing the concern (A) is not therapeutic.
8. A patient with a new cancer diagnosis is being navigated through the healthcare system.
The nurse's role in navigation includes:
A. Coordinating care across multiple providers and settings
B. Making all treatment decisions for the patient
C. Arranging financial compensation for the patient
D. Providing only emotional support
3
, Answer: A
Rationale: Navigation and coordination of care involves helping patients move through the
complex healthcare system, coordinating appointments, and ensuring communication between
providers. The nurse does not make treatment decisions (B) or arrange financial compensation
(C).
9. A patient is being discharged after completing initial cancer treatment. Which of the
following is most important for survivorship care planning?
A. A summary of treatment received and a plan for follow-up care
B. A list of all medications the patient has ever taken
C. A referral to a support group
D. A financial plan for future medical expenses
Answer: A
Rationale: A survivorship care plan includes a summary of treatment received and a plan for
follow-up care, including surveillance for recurrence and management of late effects. This is a
key component of survivorship care.
10. A patient with metastatic cancer is considering hospice care. The nurse explains that
hospice care is appropriate when:
A. The patient has less than 6 months to live
B. The patient has failed all treatment options
C. The patient's prognosis is 6 months or less if the disease runs its usual course
D. The patient is no longer able to ambulate
Answer: C
Rationale: Hospice care is appropriate when a patient has a prognosis of 6 months or less if the
disease runs its usual course, and the patient has decided to focus on comfort rather than
curative treatment. While many patients have less than 6 months (A), the formal criterion is the
prognosis.
11. A 62-year-old female is diagnosed with breast cancer. Her sister was also diagnosed with
breast cancer at age 45. Which of the following is the most appropriate recommendation
regarding genetic counseling?
4
Rationales LATTEST 2025-2026 100
QUESTIONS AND ANSWERS + RATIONILES
ALREADYDY GRADED A+
DOMAIN I: CARE CONTINUUM (19%)
1. A 55-year-old female with a family history of breast cancer asks about screening
recommendations. According to current guidelines, when should screening mammography
begin for average-risk women?
A. Age 40
B. Age 45
C. Age 50
D. Age 55
Answer: A
Rationale: The USPSTF recommends that average-risk women begin screening mammography
at age 40. Women with a family history or other risk factors may need earlier or more frequent
screening. Health promotion and early detection are key components of the care continuum.
2. A 68-year-old male with a 40-pack-year smoking history presents for a health maintenance
visit. Which screening test is recommended for lung cancer?
A. Chest X-ray annually
B. Low-dose CT scan annually
C. Sputum cytology
D. PET scan
Answer: B
Rationale: The USPSTF recommends annual low-dose CT screening for lung cancer in adults
1
, aged 50-80 with a 20-pack-year smoking history who currently smoke or have quit within the
past 15 years. This is an example of screening and early detection in the care continuum.
3. A patient with advanced cancer is discussing advance directives with the nurse. Which
statement by the patient indicates understanding of advance care planning?
A. "My living will appoints someone to make decisions for me."
B. "A durable power of attorney for healthcare allows me to name someone to make decisions if
I cannot."
C. "Once I sign an advance directive, I cannot change it."
D. "Advance directives are only for patients who are terminally ill."
Answer: B
Rationale: A durable power of attorney for healthcare allows a person to name a healthcare
proxy to make decisions if they become unable to do so. A living will (A) outlines treatment
preferences, not appointment of a decision-maker. Advance directives can be changed (C) and
are not only for terminally ill patients (D).
4. A breast cancer survivor reports persistent fatigue and "brain fog" 18 months after
completing chemotherapy. This is best described as:
A. An acute side effect
B. A chronic side effect
C. A delayed-onset side effect
D. A subsequent malignancy
Answer: C
Rationale: Persistent fatigue and cognitive changes occurring months to years after treatment
are delayed-onset side effects. Acute side effects occur during treatment; chronic side effects
persist indefinitely; subsequent malignancies are new cancers caused by prior treatment.
5. A hospice nurse is caring for a patient with terminal cancer. Which intervention is most
appropriate for managing terminal secretions ("death rattle")?
A. Suctioning the oropharynx
B. Administering scopolamine or glycopyrrolate
C. Placing the patient in Trendelenburg position
D. Administering IV fluids
2
, Answer: B
Rationale: Terminal secretions are managed with anticholinergic medications such as
scopolamine or glycopyrrolate to reduce secretions. Suctioning (A) can be distressing and is not
recommended. Positioning (C) and IV fluids (D) are not effective for this symptom.
6. A patient is receiving hospice care. The family asks the nurse what to expect during the
dying process. Which statement by the nurse is most accurate?
A. "Most patients experience significant pain at the end of life."
B. "Decreased appetite and increased sleeping are common near the end of life."
C. "Patients usually remain alert and oriented until the very end."
D. "Respirations typically become deeper and more regular."
Answer: B
Rationale: Decreased appetite, increased sleeping, withdrawal, and changes in breathing
patterns are common near the end of life. Pain (A) can be managed, not all patients experience
it. Alertness (C) often decreases. Respirations (D) become irregular, not deeper and more
regular.
7. A cancer survivor reports concerns about recurrence. The nurse's best response is to:
A. Reassure the patient that recurrence is unlikely
B. Acknowledge the concern and discuss follow-up care and surveillance
C. Recommend the patient see a psychiatrist
D. Tell the patient to stop worrying
Answer: B
Rationale: Recurrence concerns are common among cancer survivors. The nurse should
acknowledge the concern and provide information about follow-up care, surveillance, and what
symptoms to report. Reassurance without addressing the concern (A) is not therapeutic.
8. A patient with a new cancer diagnosis is being navigated through the healthcare system.
The nurse's role in navigation includes:
A. Coordinating care across multiple providers and settings
B. Making all treatment decisions for the patient
C. Arranging financial compensation for the patient
D. Providing only emotional support
3
, Answer: A
Rationale: Navigation and coordination of care involves helping patients move through the
complex healthcare system, coordinating appointments, and ensuring communication between
providers. The nurse does not make treatment decisions (B) or arrange financial compensation
(C).
9. A patient is being discharged after completing initial cancer treatment. Which of the
following is most important for survivorship care planning?
A. A summary of treatment received and a plan for follow-up care
B. A list of all medications the patient has ever taken
C. A referral to a support group
D. A financial plan for future medical expenses
Answer: A
Rationale: A survivorship care plan includes a summary of treatment received and a plan for
follow-up care, including surveillance for recurrence and management of late effects. This is a
key component of survivorship care.
10. A patient with metastatic cancer is considering hospice care. The nurse explains that
hospice care is appropriate when:
A. The patient has less than 6 months to live
B. The patient has failed all treatment options
C. The patient's prognosis is 6 months or less if the disease runs its usual course
D. The patient is no longer able to ambulate
Answer: C
Rationale: Hospice care is appropriate when a patient has a prognosis of 6 months or less if the
disease runs its usual course, and the patient has decided to focus on comfort rather than
curative treatment. While many patients have less than 6 months (A), the formal criterion is the
prognosis.
11. A 62-year-old female is diagnosed with breast cancer. Her sister was also diagnosed with
breast cancer at age 45. Which of the following is the most appropriate recommendation
regarding genetic counseling?
4
