Oncology Nursing Comprehensive Examination
Questions and Verified Answers 2026-2027
Practice Test Bank & Comprehensive Clinical Assessment Guide for Oncology Nursing
1. A patient receiving intravenous vincristine reports numbness, tingling, and burning
pain in both feet. The nurse recognizes these symptoms as indicative of which
chemotherapy-induced complication?
A. Nephrotoxicity
B. Peripheral neuropathy
C. Ototoxicity
D. Cardiotoxicity
Rationale: Vincristine is a plant alkaloid that frequently causes peripheral neuropathy due to
microtubule disruption in peripheral nerves. Early signs include stocking-glove paresthesia
and loss of deep tendon reflexes.
2. A patient with non-Hodgkin lymphoma develops confusion, muscle weakness,
electrocardiogram changes including peaked T waves, and a serum potassium level of
6.8 mEq/L 24 hours after initiating combination chemotherapy. What emergency
condition is developing?
A. Tumor Lysis Syndrome (TLS)
B. Syndrome of Inappropriate Antidiuretic Hormone (SIADH)
C. Disseminated Intravascular Coagulation (DIC)
D. Superior Vena Cava Syndrome (SVCS)
Rationale: Tumor Lysis Syndrome occurs when rapid destruction of malignant cells releases
intracellular contents into the bloodstream, causing hyperkalemia, hyperphosphatemia,
hyperuricemia, and hypocalcemia.
3. During the administration of intravenous doxorubicin, the patient reports a sudden
burning sensation at the peripheral infusion site. The nurse observes swelling and lack
of blood return. What is the immediate priority nursing action?
A. Slow the infusion rate and apply a warm compress.
B. Stop the infusion immediately and disconnect the tubing.
C. Administer an intravenous bolus of normal saline.
D. Elevate the extremity and recheck blood return in 15 minutes.
Rationale: Doxorubicin is a potent vesicant. At the first sign of extravasation, the infusion
must be stopped immediately to minimize tissue necrosis and sloughing.
4. A patient undergoing radiation therapy for head and neck cancer experiences severe
dry mouth (xerostomia). Which intervention should the nurse recommend to alleviate
,discomfort?
A. Rinse the mouth daily with an alcohol-based mouthwash.
B. Use artificial saliva substitutes and frequent sipping of water.
C. Consume hot, spicy soups to stimulate salivary glands.
D. Increase consumption of citrus juices.
Rationale: Radiation damages salivary glands, leading to persistent xerostomia. Artificial
saliva, hydration, and avoiding irritating or alcohol-containing products help maintain oral
mucosa integrity.
5. A patient with lung cancer presents with facial edema, jugular venous distention,
shortness of breath, and prominent chest wall veins. Which oncologic emergency should
the nurse suspect?
A. Superior Vena Cava Syndrome
B. Spinal Cord Compression
C. Cardiac Tamponade
D. Hypercalcemia of Malignancy
Rationale: Superior Vena Cava Syndrome is caused by obstruction or compression of the
superior vena cava by thoracic tumors, resulting in impaired venous drainage from the head,
neck, and upper extremities.
6. Which diagnostic laboratory value indicates severe neutropenia in a patient
undergoing active myelosuppressive chemotherapy?
A. Absolute Neutrophil Count (ANC) of 1,200/mm³
B. Platelet count of 45,000/mm³
C. Absolute Neutrophil Count (ANC) of less than 500/mm³
D. White blood cell count of 4,000/mm³
Rationale: An ANC of less than 500/mm³ signifies severe neutropenia, placing the patient at
high risk for life-threatening systemic infections and septic shock.
7. A patient receiving high-dose cyclophosphamide is encouraged to maintain a fluid
intake of 3 liters daily and void frequently. This intervention is designed to prevent which
specific drug toxicity?
A. Hemorrhagic cystitis
B. Ototoxicity
C. Pulmonary fibrosis
D. Hepatotoxicity
Rationale: Acrolein, a metabolite of cyclophosphamide, irritates the bladder lining and causes
hemorrhagic cystitis. High fluid intake and frequent bladder emptying flush acrolein from the
urinary tract.
8. A patient with metastatic breast cancer presents with progressive lethargy, confusion,
, constipation, nausea, and a serum calcium level of 13.2 mg/dL. What is the initial medical
management priority?
A. Administer oral calcium supplements.
B. Initiate vigorous intravenous hydration with 0.9% normal saline.
C. Restrict fluid intake to 1 liter per day.
D. Administer high-dose thiazide diuretics.
Rationale: Hypercalcemia of malignancy requires intravenous 0.9% normal saline rehydration
to restore intravascular volume and promote renal calcium excretion.
9. An oncology nurse is providing education to a patient receiving internal radiation
therapy (brachytherapy) for cervical cancer. Which safety guideline must be reinforced?
A. Visitors may stay at the bedside for up to 4 hours per day.
B. Visitors must remain at least 6 feet away and limit visits to 30 minutes per day.
C. Pregnant visitors may visit for 15 minutes if wearing a lead apron.
D. The nurse must wear a personal dosimeter badge only when leaving the hospital.
Rationale: Radiation protection principles (time, distance, shielding) dictate limiting exposure
to 30 minutes per visitor per day at a distance of 6 feet. Pregnant visitors and children are
prohibited.
10. What is the primary purpose of administering Filgrastim (G-CSF) to a patient
receiving cytotoxic chemotherapy?
A. To stimulate neutrophil production and shorten the duration of neutropenia
B. To increase red blood cell counts and prevent anemia
C. To prevent chemotherapy-induced nausea and vomiting
D. To stimulate platelet production and prevent bleeding
Rationale: Filgrastim is a granulocyte colony-stimulating factor (G-CSF) that stimulates bone
marrow production of neutrophils, reducing infection risk during post-chemotherapy nadir.
11. A patient with prostate cancer is receiving androgen deprivation therapy (ADT). The
nurse should prepare the patient for which common long-term side effect?
A. Alopecia and mucositis
B. Osteoporosis and loss of bone mineral density
C. Peripheral neuropathy and foot drop
D. Severe pulmonary toxicity
Rationale: Suppression of testosterone via androgen deprivation therapy leads to bone loss,
increased fracture risk, hot flashes, fatigue, and loss of lean muscle mass.
12. A patient with metastatic colorectal cancer is scheduled to receive Bevacizumab. The
nurse understands that this monoclonal antibody works through which specific
mechanism?
A. Inhibiting vascular endothelial growth factor (VEGF) to prevent tumor angiogenesis
Questions and Verified Answers 2026-2027
Practice Test Bank & Comprehensive Clinical Assessment Guide for Oncology Nursing
1. A patient receiving intravenous vincristine reports numbness, tingling, and burning
pain in both feet. The nurse recognizes these symptoms as indicative of which
chemotherapy-induced complication?
A. Nephrotoxicity
B. Peripheral neuropathy
C. Ototoxicity
D. Cardiotoxicity
Rationale: Vincristine is a plant alkaloid that frequently causes peripheral neuropathy due to
microtubule disruption in peripheral nerves. Early signs include stocking-glove paresthesia
and loss of deep tendon reflexes.
2. A patient with non-Hodgkin lymphoma develops confusion, muscle weakness,
electrocardiogram changes including peaked T waves, and a serum potassium level of
6.8 mEq/L 24 hours after initiating combination chemotherapy. What emergency
condition is developing?
A. Tumor Lysis Syndrome (TLS)
B. Syndrome of Inappropriate Antidiuretic Hormone (SIADH)
C. Disseminated Intravascular Coagulation (DIC)
D. Superior Vena Cava Syndrome (SVCS)
Rationale: Tumor Lysis Syndrome occurs when rapid destruction of malignant cells releases
intracellular contents into the bloodstream, causing hyperkalemia, hyperphosphatemia,
hyperuricemia, and hypocalcemia.
3. During the administration of intravenous doxorubicin, the patient reports a sudden
burning sensation at the peripheral infusion site. The nurse observes swelling and lack
of blood return. What is the immediate priority nursing action?
A. Slow the infusion rate and apply a warm compress.
B. Stop the infusion immediately and disconnect the tubing.
C. Administer an intravenous bolus of normal saline.
D. Elevate the extremity and recheck blood return in 15 minutes.
Rationale: Doxorubicin is a potent vesicant. At the first sign of extravasation, the infusion
must be stopped immediately to minimize tissue necrosis and sloughing.
4. A patient undergoing radiation therapy for head and neck cancer experiences severe
dry mouth (xerostomia). Which intervention should the nurse recommend to alleviate
,discomfort?
A. Rinse the mouth daily with an alcohol-based mouthwash.
B. Use artificial saliva substitutes and frequent sipping of water.
C. Consume hot, spicy soups to stimulate salivary glands.
D. Increase consumption of citrus juices.
Rationale: Radiation damages salivary glands, leading to persistent xerostomia. Artificial
saliva, hydration, and avoiding irritating or alcohol-containing products help maintain oral
mucosa integrity.
5. A patient with lung cancer presents with facial edema, jugular venous distention,
shortness of breath, and prominent chest wall veins. Which oncologic emergency should
the nurse suspect?
A. Superior Vena Cava Syndrome
B. Spinal Cord Compression
C. Cardiac Tamponade
D. Hypercalcemia of Malignancy
Rationale: Superior Vena Cava Syndrome is caused by obstruction or compression of the
superior vena cava by thoracic tumors, resulting in impaired venous drainage from the head,
neck, and upper extremities.
6. Which diagnostic laboratory value indicates severe neutropenia in a patient
undergoing active myelosuppressive chemotherapy?
A. Absolute Neutrophil Count (ANC) of 1,200/mm³
B. Platelet count of 45,000/mm³
C. Absolute Neutrophil Count (ANC) of less than 500/mm³
D. White blood cell count of 4,000/mm³
Rationale: An ANC of less than 500/mm³ signifies severe neutropenia, placing the patient at
high risk for life-threatening systemic infections and septic shock.
7. A patient receiving high-dose cyclophosphamide is encouraged to maintain a fluid
intake of 3 liters daily and void frequently. This intervention is designed to prevent which
specific drug toxicity?
A. Hemorrhagic cystitis
B. Ototoxicity
C. Pulmonary fibrosis
D. Hepatotoxicity
Rationale: Acrolein, a metabolite of cyclophosphamide, irritates the bladder lining and causes
hemorrhagic cystitis. High fluid intake and frequent bladder emptying flush acrolein from the
urinary tract.
8. A patient with metastatic breast cancer presents with progressive lethargy, confusion,
, constipation, nausea, and a serum calcium level of 13.2 mg/dL. What is the initial medical
management priority?
A. Administer oral calcium supplements.
B. Initiate vigorous intravenous hydration with 0.9% normal saline.
C. Restrict fluid intake to 1 liter per day.
D. Administer high-dose thiazide diuretics.
Rationale: Hypercalcemia of malignancy requires intravenous 0.9% normal saline rehydration
to restore intravascular volume and promote renal calcium excretion.
9. An oncology nurse is providing education to a patient receiving internal radiation
therapy (brachytherapy) for cervical cancer. Which safety guideline must be reinforced?
A. Visitors may stay at the bedside for up to 4 hours per day.
B. Visitors must remain at least 6 feet away and limit visits to 30 minutes per day.
C. Pregnant visitors may visit for 15 minutes if wearing a lead apron.
D. The nurse must wear a personal dosimeter badge only when leaving the hospital.
Rationale: Radiation protection principles (time, distance, shielding) dictate limiting exposure
to 30 minutes per visitor per day at a distance of 6 feet. Pregnant visitors and children are
prohibited.
10. What is the primary purpose of administering Filgrastim (G-CSF) to a patient
receiving cytotoxic chemotherapy?
A. To stimulate neutrophil production and shorten the duration of neutropenia
B. To increase red blood cell counts and prevent anemia
C. To prevent chemotherapy-induced nausea and vomiting
D. To stimulate platelet production and prevent bleeding
Rationale: Filgrastim is a granulocyte colony-stimulating factor (G-CSF) that stimulates bone
marrow production of neutrophils, reducing infection risk during post-chemotherapy nadir.
11. A patient with prostate cancer is receiving androgen deprivation therapy (ADT). The
nurse should prepare the patient for which common long-term side effect?
A. Alopecia and mucositis
B. Osteoporosis and loss of bone mineral density
C. Peripheral neuropathy and foot drop
D. Severe pulmonary toxicity
Rationale: Suppression of testosterone via androgen deprivation therapy leads to bone loss,
increased fracture risk, hot flashes, fatigue, and loss of lean muscle mass.
12. A patient with metastatic colorectal cancer is scheduled to receive Bevacizumab. The
nurse understands that this monoclonal antibody works through which specific
mechanism?
A. Inhibiting vascular endothelial growth factor (VEGF) to prevent tumor angiogenesis
