[Oncology Nursing] COMPLETE EXAM QUESTIONS AND
VERIFIED ANSWERS | 2026–2027 LATEST UPDATE |
GUARANTEED PASS | DETAILED RATIONALES | FULL STUDY
GUIDE | EXAM PREP | PRACTICE TEST | CERTIFICATION
PREPARATION
Section One: Questions 1–100
1. A 62-year-old patient with stage IIIB non-small cell lung cancer is receiving concurrent
chemoradiation. He reports severe odynophagia and has lost 5% of his body weight in the last
month. What is the most appropriate initial nursing intervention?
A. Administer a viscous lidocaine solution before meals
B. Recommend a mechanical soft diet with high-calorie supplements
C. Consult a speech-language pathologist for a swallowing evaluation
D. Collaborate with the dietitian to initiate parenteral nutrition
Correct Answer: C. Consult a speech-language pathologist for a swallowing evaluation
Rationale: Odynophagia in a patient receiving radiation to the chest can indicate severe mucositis or
esophagitis. However, before initiating dietary changes, a formal swallowing evaluation is critical to
assess aspiration risk and structural integrity. Viscous lidocaine provides temporary relief but does
not address underlying damage or risk. Parenteral nutrition is a later-step intervention if enteral
access fails. A mechanical soft diet may be appropriate but only after a safe swallowing plan is
established. This approach aligns with standard oncology nursing practice, ensuring safety and
appropriate nutritional support.
2. A patient receiving vincristine for acute lymphoblastic leukemia reports new-onset bilateral foot
drop and difficulty gripping objects. What is the priority nursing action?
A. Administer the prescribed PRN analgesic for neuropathic pain
B. Hold the next dose of vincristine and notify the healthcare provider
C. Instruct the patient to perform range-of-motion exercises daily
D. Reassure the patient that this is an expected and reversible side effect
Correct Answer: B. Hold the next dose of vincristine and notify the healthcare provider
Rationale: Vincristine is a known neurotoxic agent, and the development of motor neuropathy (foot
drop, hand weakness) is a dose-limiting toxicity. Holding the drug and notifying the provider is
essential to prevent irreversible nerve damage. Analgesics will not stop the progression, and while
range-of-motion exercises are beneficial, they do not address the underlying toxicity. Reassuring the
patient that this is expected and reversible is incorrect because this represents a significant adverse
reaction that warrants dose modification.
,3. Which of the following nursing actions is most effective in preventing tumor lysis syndrome (TLS)
in a patient with bulky Burkitt's lymphoma starting chemotherapy?
A. Administering allopurinol as prescribed
B. Monitoring serum potassium levels every 12 hours
C. Encouraging oral fluid intake of at least 3 liters per day
D. Applying ice packs to the bilateral flanks
Correct Answer: C. Encouraging oral fluid intake of at least 3 liters per day
Rationale: The cornerstone of TLS prevention is aggressive hydration to dilute serum uric acid,
potassium, and phosphorus and to promote renal excretion. Allopurinol is a second-line measure to
prevent uric acid production but is insufficient without hydration. Monitoring potassium is necessary
but is a surveillance action, not a preventative intervention. Ice packs to the flanks are not a standard
TLS prevention method.
4. A patient with breast cancer is receiving doxorubicin. Which assessment finding requires the
most immediate action?
A. Mild nausea and vomiting
B. Alopecia
C. A urine output of 30 mL/hr
D. A new onset of a non-productive cough and dyspnea on exertion
Correct Answer: D. A new onset of a non-productive cough and dyspnea on exertion
Rationale: Doxorubicin is an anthracycline with cumulative dose-dependent cardiotoxicity. A new
cough and dyspnea on exertion are early signs of cardiomyopathy or heart failure. This requires
immediate evaluation, likely with an echocardiogram. Nausea, alopecia, and a urine output of 30
mL/hr (which is within normal limits) are all expected or less critical findings.
5. A patient with ovarian cancer is receiving intraperitoneal (IP) chemotherapy. The nurse notes
that the patient's abdomen is distended and tense, and the patient reports severe abdominal pain
and difficulty breathing. What is the immediate nursing action?
A. Turn the patient to the left side
B. Clamp the IP catheter
C. Administer a bolus of normal saline to improve flow
D. Slow the infusion rate to 50 mL/hr
Correct Answer: B. Clamp the IP catheter
Rationale: A tense, distended abdomen with dyspnea and severe pain suggests intra-abdominal
hypertension or leakage of IP chemotherapy into the peritoneal space, potentially causing
compartment syndrome. Clamping the catheter stops the infusion and prevents further fluid
accumulation. Turning the patient or slowing the infusion does not address the acute pressure.
Administering more fluid would exacerbate the situation.
,6. A patient with lung cancer is receiving palliative radiation to the spine for painful bone
metastases. The patient expresses fear about the radiation causing severe burns. What is the
nurse's best response?
A. "Radiation therapy today is very targeted and rarely causes skin changes."
B. "We will monitor your skin closely, and topical treatments are available if a reaction occurs."
C. "It is normal to experience a sunburn-like reaction, but it resolves quickly."
D. "Skin reactions are uncommon with spinal radiation, but I will examine your skin daily."
Correct Answer: D. Skin reactions are uncommon with spinal radiation, but I will examine your skin
daily.
Rationale: Radiation to the spine typically does not involve skin folds or high-friction areas; thus,
severe skin reactions are less common. However, it is crucial to acknowledge the patient's fear and
provide a realistic, reassuring, and professional response. Examining the skin daily is the best practice
for all patients receiving radiation to any area. The other options either minimize the concern or
provide incorrect information about the likelihood of skin reactions.
7. A patient with a history of multiple myeloma is prescribed bortezomib. The patient reports new-
onset severe, burning pain in the hands and feet. Which complementary therapy should the nurse
recommend to manage this side effect?
A. Applying warm compresses to the hands and feet
B. Participating in a structured physical therapy program
C. Using capsaicin cream on the affected areas
D. Wearing loose-fitting socks and shoes
Correct Answer: D. Wearing loose-fitting socks and shoes
Rationale: Bortezomib commonly causes peripheral neuropathy. Loose-fitting socks and shoes help
reduce mechanical pressure, which can exacerbate neuropathic pain. Warm compresses can be
dangerous if sensation is diminished, capsaicin cream is not a primary recommendation for this type
of neuropathy, and while physical therapy may be beneficial, it is not the first-line management
recommendation for acute symptoms. Protecting the extremities from pressure and injury is the most
immediate, safest, and most effective nursing recommendation.
8. A 75-year-old patient with prostate cancer is starting on a GnRH agonist (leuprolide). The patient
has a history of hypertension and diabetes. What is the most important adverse effect to monitor
related to this therapy?
A. Bone pain
B. Hyperglycemia
C. Hot flashes
D. Fluid retention
Correct Answer: B. Hyperglycemia
, Rationale: GnRH agonists are associated with metabolic changes including insulin resistance and
hyperglycemia. In a patient with pre-existing diabetes, this is a critically important adverse effect to
monitor. While hot flashes are common and bone pain can occur with flare, they are not the most
serious in this patient's context. Fluid retention is a less common and less specific concern.
9. A patient with non-Hodgkin lymphoma is being evaluated for chimeric antigen receptor (CAR) T-
cell therapy. The nurse knows that a major indicator of potential success with this therapy is:
A. The patient's ability to tolerate high-dose chemotherapy
B. The presence of a complete response to initial therapies
C. The patient's age and performance status
D. The tumor's expression of the CD19 antigen
Correct Answer: D. The tumor's expression of the CD19 antigen
Rationale: CAR T-cell therapy is targeted therapy; success depends on the presence of the specific
antigen (e.g., CD19 for some lymphomas and leukemias) on the tumor cells. While performance
status and prior responses are important prognostic indicators, the expression of the target antigen is
essential for the therapy to work. Tolerating chemotherapy is not specific to CAR T-cell therapy
success.
10. A patient is receiving intravenous magnesium sulfate as part of a chemotherapy regimen. The
patient reports feeling flushed and warm. What is the most likely cause of this reaction, and what
should the nurse do?
A. Anaphylactic reaction; stop the infusion and administer epinephrine
B. Extravasation; stop the infusion and aspirate the site
C. Expected side effect of magnesium; slow the infusion rate
D. Hypermagnesemia; draw a stat magnesium level
Correct Answer: C. Expected side effect of magnesium; slow the infusion rate
Rationale: Intravenous magnesium can cause peripheral vasodilation, leading to a feeling of flushing
and warmth. This is a known, expected side effect. Slowing the infusion rate usually resolves this
symptom. Anaphylaxis would present with more severe symptoms like hypotension, urticaria, and
respiratory distress. Extravasation would present with pain, swelling, and erythema at the IV site, not
systemic warmth. While a magnesium level is appropriate in some contexts, the flushing is likely due
to the rate of administration.
11. A patient with gastric cancer has a newly placed percutaneous endoscopic gastrostomy (PEG)
tube. The nurse is providing discharge teaching. Which statement indicates the patient correctly
understands the care of the PEG tube?
A. "I will flush the tube with 30 mL of water before and after each feeding."
B. "I will rotate the tube 180 degrees once a week to prevent skin breakdown."
C. "If I have a fever, I will take acetaminophen and wait a few hours before calling."
D. "It is normal to see some redness and swelling around the stoma site."
VERIFIED ANSWERS | 2026–2027 LATEST UPDATE |
GUARANTEED PASS | DETAILED RATIONALES | FULL STUDY
GUIDE | EXAM PREP | PRACTICE TEST | CERTIFICATION
PREPARATION
Section One: Questions 1–100
1. A 62-year-old patient with stage IIIB non-small cell lung cancer is receiving concurrent
chemoradiation. He reports severe odynophagia and has lost 5% of his body weight in the last
month. What is the most appropriate initial nursing intervention?
A. Administer a viscous lidocaine solution before meals
B. Recommend a mechanical soft diet with high-calorie supplements
C. Consult a speech-language pathologist for a swallowing evaluation
D. Collaborate with the dietitian to initiate parenteral nutrition
Correct Answer: C. Consult a speech-language pathologist for a swallowing evaluation
Rationale: Odynophagia in a patient receiving radiation to the chest can indicate severe mucositis or
esophagitis. However, before initiating dietary changes, a formal swallowing evaluation is critical to
assess aspiration risk and structural integrity. Viscous lidocaine provides temporary relief but does
not address underlying damage or risk. Parenteral nutrition is a later-step intervention if enteral
access fails. A mechanical soft diet may be appropriate but only after a safe swallowing plan is
established. This approach aligns with standard oncology nursing practice, ensuring safety and
appropriate nutritional support.
2. A patient receiving vincristine for acute lymphoblastic leukemia reports new-onset bilateral foot
drop and difficulty gripping objects. What is the priority nursing action?
A. Administer the prescribed PRN analgesic for neuropathic pain
B. Hold the next dose of vincristine and notify the healthcare provider
C. Instruct the patient to perform range-of-motion exercises daily
D. Reassure the patient that this is an expected and reversible side effect
Correct Answer: B. Hold the next dose of vincristine and notify the healthcare provider
Rationale: Vincristine is a known neurotoxic agent, and the development of motor neuropathy (foot
drop, hand weakness) is a dose-limiting toxicity. Holding the drug and notifying the provider is
essential to prevent irreversible nerve damage. Analgesics will not stop the progression, and while
range-of-motion exercises are beneficial, they do not address the underlying toxicity. Reassuring the
patient that this is expected and reversible is incorrect because this represents a significant adverse
reaction that warrants dose modification.
,3. Which of the following nursing actions is most effective in preventing tumor lysis syndrome (TLS)
in a patient with bulky Burkitt's lymphoma starting chemotherapy?
A. Administering allopurinol as prescribed
B. Monitoring serum potassium levels every 12 hours
C. Encouraging oral fluid intake of at least 3 liters per day
D. Applying ice packs to the bilateral flanks
Correct Answer: C. Encouraging oral fluid intake of at least 3 liters per day
Rationale: The cornerstone of TLS prevention is aggressive hydration to dilute serum uric acid,
potassium, and phosphorus and to promote renal excretion. Allopurinol is a second-line measure to
prevent uric acid production but is insufficient without hydration. Monitoring potassium is necessary
but is a surveillance action, not a preventative intervention. Ice packs to the flanks are not a standard
TLS prevention method.
4. A patient with breast cancer is receiving doxorubicin. Which assessment finding requires the
most immediate action?
A. Mild nausea and vomiting
B. Alopecia
C. A urine output of 30 mL/hr
D. A new onset of a non-productive cough and dyspnea on exertion
Correct Answer: D. A new onset of a non-productive cough and dyspnea on exertion
Rationale: Doxorubicin is an anthracycline with cumulative dose-dependent cardiotoxicity. A new
cough and dyspnea on exertion are early signs of cardiomyopathy or heart failure. This requires
immediate evaluation, likely with an echocardiogram. Nausea, alopecia, and a urine output of 30
mL/hr (which is within normal limits) are all expected or less critical findings.
5. A patient with ovarian cancer is receiving intraperitoneal (IP) chemotherapy. The nurse notes
that the patient's abdomen is distended and tense, and the patient reports severe abdominal pain
and difficulty breathing. What is the immediate nursing action?
A. Turn the patient to the left side
B. Clamp the IP catheter
C. Administer a bolus of normal saline to improve flow
D. Slow the infusion rate to 50 mL/hr
Correct Answer: B. Clamp the IP catheter
Rationale: A tense, distended abdomen with dyspnea and severe pain suggests intra-abdominal
hypertension or leakage of IP chemotherapy into the peritoneal space, potentially causing
compartment syndrome. Clamping the catheter stops the infusion and prevents further fluid
accumulation. Turning the patient or slowing the infusion does not address the acute pressure.
Administering more fluid would exacerbate the situation.
,6. A patient with lung cancer is receiving palliative radiation to the spine for painful bone
metastases. The patient expresses fear about the radiation causing severe burns. What is the
nurse's best response?
A. "Radiation therapy today is very targeted and rarely causes skin changes."
B. "We will monitor your skin closely, and topical treatments are available if a reaction occurs."
C. "It is normal to experience a sunburn-like reaction, but it resolves quickly."
D. "Skin reactions are uncommon with spinal radiation, but I will examine your skin daily."
Correct Answer: D. Skin reactions are uncommon with spinal radiation, but I will examine your skin
daily.
Rationale: Radiation to the spine typically does not involve skin folds or high-friction areas; thus,
severe skin reactions are less common. However, it is crucial to acknowledge the patient's fear and
provide a realistic, reassuring, and professional response. Examining the skin daily is the best practice
for all patients receiving radiation to any area. The other options either minimize the concern or
provide incorrect information about the likelihood of skin reactions.
7. A patient with a history of multiple myeloma is prescribed bortezomib. The patient reports new-
onset severe, burning pain in the hands and feet. Which complementary therapy should the nurse
recommend to manage this side effect?
A. Applying warm compresses to the hands and feet
B. Participating in a structured physical therapy program
C. Using capsaicin cream on the affected areas
D. Wearing loose-fitting socks and shoes
Correct Answer: D. Wearing loose-fitting socks and shoes
Rationale: Bortezomib commonly causes peripheral neuropathy. Loose-fitting socks and shoes help
reduce mechanical pressure, which can exacerbate neuropathic pain. Warm compresses can be
dangerous if sensation is diminished, capsaicin cream is not a primary recommendation for this type
of neuropathy, and while physical therapy may be beneficial, it is not the first-line management
recommendation for acute symptoms. Protecting the extremities from pressure and injury is the most
immediate, safest, and most effective nursing recommendation.
8. A 75-year-old patient with prostate cancer is starting on a GnRH agonist (leuprolide). The patient
has a history of hypertension and diabetes. What is the most important adverse effect to monitor
related to this therapy?
A. Bone pain
B. Hyperglycemia
C. Hot flashes
D. Fluid retention
Correct Answer: B. Hyperglycemia
, Rationale: GnRH agonists are associated with metabolic changes including insulin resistance and
hyperglycemia. In a patient with pre-existing diabetes, this is a critically important adverse effect to
monitor. While hot flashes are common and bone pain can occur with flare, they are not the most
serious in this patient's context. Fluid retention is a less common and less specific concern.
9. A patient with non-Hodgkin lymphoma is being evaluated for chimeric antigen receptor (CAR) T-
cell therapy. The nurse knows that a major indicator of potential success with this therapy is:
A. The patient's ability to tolerate high-dose chemotherapy
B. The presence of a complete response to initial therapies
C. The patient's age and performance status
D. The tumor's expression of the CD19 antigen
Correct Answer: D. The tumor's expression of the CD19 antigen
Rationale: CAR T-cell therapy is targeted therapy; success depends on the presence of the specific
antigen (e.g., CD19 for some lymphomas and leukemias) on the tumor cells. While performance
status and prior responses are important prognostic indicators, the expression of the target antigen is
essential for the therapy to work. Tolerating chemotherapy is not specific to CAR T-cell therapy
success.
10. A patient is receiving intravenous magnesium sulfate as part of a chemotherapy regimen. The
patient reports feeling flushed and warm. What is the most likely cause of this reaction, and what
should the nurse do?
A. Anaphylactic reaction; stop the infusion and administer epinephrine
B. Extravasation; stop the infusion and aspirate the site
C. Expected side effect of magnesium; slow the infusion rate
D. Hypermagnesemia; draw a stat magnesium level
Correct Answer: C. Expected side effect of magnesium; slow the infusion rate
Rationale: Intravenous magnesium can cause peripheral vasodilation, leading to a feeling of flushing
and warmth. This is a known, expected side effect. Slowing the infusion rate usually resolves this
symptom. Anaphylaxis would present with more severe symptoms like hypotension, urticaria, and
respiratory distress. Extravasation would present with pain, swelling, and erythema at the IV site, not
systemic warmth. While a magnesium level is appropriate in some contexts, the flushing is likely due
to the rate of administration.
11. A patient with gastric cancer has a newly placed percutaneous endoscopic gastrostomy (PEG)
tube. The nurse is providing discharge teaching. Which statement indicates the patient correctly
understands the care of the PEG tube?
A. "I will flush the tube with 30 mL of water before and after each feeding."
B. "I will rotate the tube 180 degrees once a week to prevent skin breakdown."
C. "If I have a fever, I will take acetaminophen and wait a few hours before calling."
D. "It is normal to see some redness and swelling around the stoma site."
