AOCNP ADVANCED PRACTICE
COMPREHENSIVE FINAL EXAM PREP
QUESTIONS AND ANSWERS
1. A patient with Li-Fraumeni syndrome is at a significantly increased risk for various
malignancies. Which germline mutation is most commonly associated with this autosomal
dominant condition?
A. BRCA1
B. PTEN
C. TP53
D. APC
Answer: C
Conceptual Explanation: Li-Fraumeni syndrome is caused by a germline mutation in the
TP53 tumor suppressor gene, leading to a high risk of sarcomas, breast cancer, brain
tumors, and adrenocortical carcinomas.
,2. In the context of Tumor Lysis Syndrome (TLS), which metabolic derangement is expected to
occur first?
A. Hypophosphatemia
B. Hypouricemia
C. Hypercalcemia
D. Hyperkalemia
Answer: D
Conceptual Explanation: TLS is characterized by the rapid release of intracellular
contents. Hyperkalemia is often the earliest sign, followed by hyperuricemia and
hyperphosphatemia (which causes secondary hypocalcemia).
3. Which diagnostic imaging modality is considered the gold standard for diagnosing Spinal
Cord Compression in oncology patients?
A. CT scan with contrast
B. MRI of the entire spine
C. Plain X-ray of the spine
D. Bone scan
Answer: B
Conceptual Explanation: MRI is the gold standard because it provides superior
visualization of the spinal cord, nerve roots, and the extent of the epidural mass.
, 4. A patient receiving a PD-1 inhibitor develops Grade 3 immune-related colitis. What is the
priority intervention for this patient?
A. Continue immunotherapy and start Loperamide
B. Permanently discontinue the PD-1 inhibitor and start high-dose corticosteroids
C. Administer broad-spectrum antibiotics
D. Switch to a CTLA-4 inhibitor immediately
Answer: B
Conceptual Explanation: Grade 3 immune-related adverse events (irAEs) usually require
permanent discontinuation of the immunotherapy and the initiation of high-dose
corticosteroids (1-2 mg/kg/day) to dampen the immune response.
5. What is the primary mechanism of action for Bevacizumab in treating metastatic colorectal
cancer?
A. Inhibition of EGFR signaling
B. Binding to VEGF ligand to prevent angiogenesis
C. Disruption of microtubule assembly
D. Direct DNA alkylation
Answer: B
COMPREHENSIVE FINAL EXAM PREP
QUESTIONS AND ANSWERS
1. A patient with Li-Fraumeni syndrome is at a significantly increased risk for various
malignancies. Which germline mutation is most commonly associated with this autosomal
dominant condition?
A. BRCA1
B. PTEN
C. TP53
D. APC
Answer: C
Conceptual Explanation: Li-Fraumeni syndrome is caused by a germline mutation in the
TP53 tumor suppressor gene, leading to a high risk of sarcomas, breast cancer, brain
tumors, and adrenocortical carcinomas.
,2. In the context of Tumor Lysis Syndrome (TLS), which metabolic derangement is expected to
occur first?
A. Hypophosphatemia
B. Hypouricemia
C. Hypercalcemia
D. Hyperkalemia
Answer: D
Conceptual Explanation: TLS is characterized by the rapid release of intracellular
contents. Hyperkalemia is often the earliest sign, followed by hyperuricemia and
hyperphosphatemia (which causes secondary hypocalcemia).
3. Which diagnostic imaging modality is considered the gold standard for diagnosing Spinal
Cord Compression in oncology patients?
A. CT scan with contrast
B. MRI of the entire spine
C. Plain X-ray of the spine
D. Bone scan
Answer: B
Conceptual Explanation: MRI is the gold standard because it provides superior
visualization of the spinal cord, nerve roots, and the extent of the epidural mass.
, 4. A patient receiving a PD-1 inhibitor develops Grade 3 immune-related colitis. What is the
priority intervention for this patient?
A. Continue immunotherapy and start Loperamide
B. Permanently discontinue the PD-1 inhibitor and start high-dose corticosteroids
C. Administer broad-spectrum antibiotics
D. Switch to a CTLA-4 inhibitor immediately
Answer: B
Conceptual Explanation: Grade 3 immune-related adverse events (irAEs) usually require
permanent discontinuation of the immunotherapy and the initiation of high-dose
corticosteroids (1-2 mg/kg/day) to dampen the immune response.
5. What is the primary mechanism of action for Bevacizumab in treating metastatic colorectal
cancer?
A. Inhibition of EGFR signaling
B. Binding to VEGF ligand to prevent angiogenesis
C. Disruption of microtubule assembly
D. Direct DNA alkylation
Answer: B
