AOCNP EXAM ADVANCED ONCOLOGY
CERTIFIED NURSE PRACTITIONER
PRACTICE TEST
1. Which of the following genetic mutations is most commonly associated with Lynch
syndrome (Hereditary Non-Polyposis Colorectal Cancer)?
A. BRCA1 and BRCA2
B. TP53 mutation
C. APC gene mutation
D. MLH1, MSH2, MSH6, and PMS2
Answer: D
Conceptual Explanation: Lynch syndrome is caused by germline mutations in DNA
mismatch repair (MMR) genes, specifically MLH1, MSH2, MSH6, and PMS2.
2. A patient receiving high-dose cisplatin therapy is at risk for acute and delayed emesis.
Which neurokinin-1 (NK1) receptor antagonist is commonly utilized in a triplet antiemetic
regimen?
A. Ondansetron
,B. Dexamethasone
C. Metoclopramide
D. Aprepitant
Answer: D
Conceptual Explanation: Aprepitant is a NK1 receptor antagonist used to prevent both
acute and delayed chemotherapy-induced nausea and vomiting (CINV).
3. In the management of Cytokine Release Syndrome (CRS) following CAR-T cell therapy,
which medication is considered the first-line targeted therapy for Grade 2 or higher severity?
A. Etanercept
B. Methylprednisolone
C. Cyclophosphamide
D. Tocilizumab
Answer: D
Conceptual Explanation: Tocilizumab, an IL-6 receptor antagonist, is the standard of care
for managing significant CRS secondary to CAR-T cell therapy.
4. A patient with breast cancer has a pathology report indicating HER2/neu 2+ by
immunohistochemistry (IHC). What is the next essential step to determine HER2 status?
A. Begin Trastuzumab immediately
B. Perform Fluorescence in situ Hybridization (FISH) testing
, C. Re-biopsy the tumor margin
D. Order an Oncotype DX score
Answer: B
Conceptual Explanation: An IHC score of 2+ is considered equivocal. Reflective testing
with FISH is required to determine if the HER2 gene is amplified.
5. Which of the following electrolyte abnormalities is characteristic of Tumor Lysis Syndrome
(TLS)?
A. Hypokalemia, Hypophosphatemia, Hypercalcemia
B. Hyponatremia, Hyperkalemia, Hypercalcemia
C. Hypernatremia, Hypokalemia, Hypercalcemia
D. Hyperkalemia, Hyperphosphatemia, Hypocalcemia
Answer: D
Conceptual Explanation: TLS is characterized by the release of intracellular contents,
leading to high potassium, high phosphorus, high uric acid, and secondary low calcium.
6. A patient on pembrolizumab presents with Grade 3 diarrhea and abdominal pain. After
ruling out infection, which intervention is most appropriate?
A. Prescribe Loperamide and continue pembrolizumab
B. Dose reduce the next cycle of pembrolizumab
C. Permanently discontinue immunotherapy and start antibiotics
CERTIFIED NURSE PRACTITIONER
PRACTICE TEST
1. Which of the following genetic mutations is most commonly associated with Lynch
syndrome (Hereditary Non-Polyposis Colorectal Cancer)?
A. BRCA1 and BRCA2
B. TP53 mutation
C. APC gene mutation
D. MLH1, MSH2, MSH6, and PMS2
Answer: D
Conceptual Explanation: Lynch syndrome is caused by germline mutations in DNA
mismatch repair (MMR) genes, specifically MLH1, MSH2, MSH6, and PMS2.
2. A patient receiving high-dose cisplatin therapy is at risk for acute and delayed emesis.
Which neurokinin-1 (NK1) receptor antagonist is commonly utilized in a triplet antiemetic
regimen?
A. Ondansetron
,B. Dexamethasone
C. Metoclopramide
D. Aprepitant
Answer: D
Conceptual Explanation: Aprepitant is a NK1 receptor antagonist used to prevent both
acute and delayed chemotherapy-induced nausea and vomiting (CINV).
3. In the management of Cytokine Release Syndrome (CRS) following CAR-T cell therapy,
which medication is considered the first-line targeted therapy for Grade 2 or higher severity?
A. Etanercept
B. Methylprednisolone
C. Cyclophosphamide
D. Tocilizumab
Answer: D
Conceptual Explanation: Tocilizumab, an IL-6 receptor antagonist, is the standard of care
for managing significant CRS secondary to CAR-T cell therapy.
4. A patient with breast cancer has a pathology report indicating HER2/neu 2+ by
immunohistochemistry (IHC). What is the next essential step to determine HER2 status?
A. Begin Trastuzumab immediately
B. Perform Fluorescence in situ Hybridization (FISH) testing
, C. Re-biopsy the tumor margin
D. Order an Oncotype DX score
Answer: B
Conceptual Explanation: An IHC score of 2+ is considered equivocal. Reflective testing
with FISH is required to determine if the HER2 gene is amplified.
5. Which of the following electrolyte abnormalities is characteristic of Tumor Lysis Syndrome
(TLS)?
A. Hypokalemia, Hypophosphatemia, Hypercalcemia
B. Hyponatremia, Hyperkalemia, Hypercalcemia
C. Hypernatremia, Hypokalemia, Hypercalcemia
D. Hyperkalemia, Hyperphosphatemia, Hypocalcemia
Answer: D
Conceptual Explanation: TLS is characterized by the release of intracellular contents,
leading to high potassium, high phosphorus, high uric acid, and secondary low calcium.
6. A patient on pembrolizumab presents with Grade 3 diarrhea and abdominal pain. After
ruling out infection, which intervention is most appropriate?
A. Prescribe Loperamide and continue pembrolizumab
B. Dose reduce the next cycle of pembrolizumab
C. Permanently discontinue immunotherapy and start antibiotics
