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Oncology Certified Nurse Questions And
Correct Answers (Verified Answers) Plus
Rationales 2026 Q&A Instant Download
Pdf
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1. A patient with metastatic colorectal cancer receiving oxaliplatin reports
new difficulty buttoning clothing and numbness in the fingertips. Which
intervention is most appropriate?
A. Administer the next dose without modification
B. Assess for chemotherapy-induced peripheral neuropathy and notify the
oncology provider
C. Apply a heating pad to the hands
D. Encourage increased dietary potassium
Answer: B. Assess for chemotherapy-induced peripheral neuropathy and notify
the oncology provider
Rationale: Oxaliplatin commonly causes cumulative sensory neuropathy. Early
recognition allows dose modification and safety interventions before functional
impairment becomes severe.
2. A patient receiving cisplatin has a urine output of 15 mL/hr and a rising
serum creatinine. Which complication is the nurse most concerned about?
,A. Tumor lysis syndrome
B. Hypercalcemia
C. Nephrotoxicity
D. SIADH
Answer: C. Nephrotoxicity
Rationale: Cisplatin can cause significant renal tubular injury. Decreased urine
output and rising creatinine require prompt assessment and intervention.
3. A patient receiving chemotherapy develops a temperature of 38.4°C
(101.1°F). The absolute neutrophil count is 400/mm³. What is the priority
action?
A. Recheck the temperature in 4 hours
B. Administer acetaminophen and discharge the patient
C. Obtain a stool specimen
D. Initiate urgent evaluation and empiric management for febrile neutropenia
Answer: D. Initiate urgent evaluation and empiric management for febrile
neutropenia
Rationale: Fever in a profoundly neutropenic patient is an oncologic emergency
because infection can progress rapidly without typical inflammatory findings.
4. Which laboratory abnormality is most characteristic of tumor lysis
syndrome?
A. Hypokalemia
B. Hypophosphatemia
C. Hyperuricemia
D. Hypercalcemia
Answer: C. Hyperuricemia
Rationale: Rapid tumor-cell destruction releases nucleic acids that are
metabolized to uric acid. Tumor lysis syndrome may also produce hyperkalemia,
hyperphosphatemia, and hypocalcemia.
, 5. A patient with leukemia has a platelet count of 12,000/mm³. Which nursing
intervention is most appropriate?
A. Encourage vigorous tooth brushing
B. Administer aspirin for headache
C. Institute bleeding precautions
D. Encourage intramuscular injections
Answer: C. Institute bleeding precautions
Rationale: Severe thrombocytopenia substantially increases bleeding risk.
Avoiding trauma, invasive procedures, aspirin, and other platelet-inhibiting
medications is important.
6. A patient receiving immune checkpoint inhibitor therapy develops six
watery stools daily and abdominal cramping. What complication should the
nurse suspect?
A. Opioid withdrawal
B. Immune-mediated colitis
C. Tumor lysis syndrome
D. Chemotherapy-induced constipation
Answer: B. Immune-mediated colitis
Rationale: Immune checkpoint inhibitors can cause inflammatory
gastrointestinal immune-related adverse events. Significant diarrhea requires
prompt grading, evaluation, and treatment.
7. A patient receiving pembrolizumab reports profound fatigue, dizziness, and
hypotension. Which endocrine complication should be considered?
A. Hyperthyroidism only
B. Adrenal insufficiency
C. Hyperparathyroidism
D. Diabetes insipidus
Answer: B. Adrenal insufficiency
, Rationale: Immune checkpoint inhibitors can cause hypophysitis or primary
adrenal insufficiency. Hypotension, fatigue, weakness, and electrolyte
abnormalities warrant urgent evaluation.
8. A patient with cancer suddenly develops facial edema, dyspnea, and
distended neck veins. Which condition is most concerning?
A. Disseminated intravascular coagulation
B. Superior vena cava syndrome
C. Hypercalcemia
D. Radiation dermatitis
Answer: B. Superior vena cava syndrome
Rationale: Obstruction of superior vena cava blood flow can cause facial and
upper-extremity edema, venous distention, cough, and respiratory compromise.
9. A patient with metastatic breast cancer develops severe back pain, bilateral
leg weakness, and urinary retention. What is the priority concern?
A. Chemotherapy-induced neuropathy
B. Spinal cord compression
C. Peripheral arterial disease
D. Hypocalcemia
Answer: B. Spinal cord compression
Rationale: Malignant spinal cord compression is an oncologic emergency.
Prompt imaging and treatment are necessary to reduce the risk of permanent
neurologic deficits.
10.A patient with multiple myeloma reports constipation, confusion, and
increased thirst. Which abnormality is most likely?
A. Hypokalemia
B. Hyponatremia
C. Hypercalcemia
D. Hypomagnesemia
Oncology Certified Nurse Questions And
Correct Answers (Verified Answers) Plus
Rationales 2026 Q&A Instant Download
___________________________________________________________________
1. A patient with metastatic colorectal cancer receiving oxaliplatin reports
new difficulty buttoning clothing and numbness in the fingertips. Which
intervention is most appropriate?
A. Administer the next dose without modification
B. Assess for chemotherapy-induced peripheral neuropathy and notify the
oncology provider
C. Apply a heating pad to the hands
D. Encourage increased dietary potassium
Answer: B. Assess for chemotherapy-induced peripheral neuropathy and notify
the oncology provider
Rationale: Oxaliplatin commonly causes cumulative sensory neuropathy. Early
recognition allows dose modification and safety interventions before functional
impairment becomes severe.
2. A patient receiving cisplatin has a urine output of 15 mL/hr and a rising
serum creatinine. Which complication is the nurse most concerned about?
,A. Tumor lysis syndrome
B. Hypercalcemia
C. Nephrotoxicity
D. SIADH
Answer: C. Nephrotoxicity
Rationale: Cisplatin can cause significant renal tubular injury. Decreased urine
output and rising creatinine require prompt assessment and intervention.
3. A patient receiving chemotherapy develops a temperature of 38.4°C
(101.1°F). The absolute neutrophil count is 400/mm³. What is the priority
action?
A. Recheck the temperature in 4 hours
B. Administer acetaminophen and discharge the patient
C. Obtain a stool specimen
D. Initiate urgent evaluation and empiric management for febrile neutropenia
Answer: D. Initiate urgent evaluation and empiric management for febrile
neutropenia
Rationale: Fever in a profoundly neutropenic patient is an oncologic emergency
because infection can progress rapidly without typical inflammatory findings.
4. Which laboratory abnormality is most characteristic of tumor lysis
syndrome?
A. Hypokalemia
B. Hypophosphatemia
C. Hyperuricemia
D. Hypercalcemia
Answer: C. Hyperuricemia
Rationale: Rapid tumor-cell destruction releases nucleic acids that are
metabolized to uric acid. Tumor lysis syndrome may also produce hyperkalemia,
hyperphosphatemia, and hypocalcemia.
, 5. A patient with leukemia has a platelet count of 12,000/mm³. Which nursing
intervention is most appropriate?
A. Encourage vigorous tooth brushing
B. Administer aspirin for headache
C. Institute bleeding precautions
D. Encourage intramuscular injections
Answer: C. Institute bleeding precautions
Rationale: Severe thrombocytopenia substantially increases bleeding risk.
Avoiding trauma, invasive procedures, aspirin, and other platelet-inhibiting
medications is important.
6. A patient receiving immune checkpoint inhibitor therapy develops six
watery stools daily and abdominal cramping. What complication should the
nurse suspect?
A. Opioid withdrawal
B. Immune-mediated colitis
C. Tumor lysis syndrome
D. Chemotherapy-induced constipation
Answer: B. Immune-mediated colitis
Rationale: Immune checkpoint inhibitors can cause inflammatory
gastrointestinal immune-related adverse events. Significant diarrhea requires
prompt grading, evaluation, and treatment.
7. A patient receiving pembrolizumab reports profound fatigue, dizziness, and
hypotension. Which endocrine complication should be considered?
A. Hyperthyroidism only
B. Adrenal insufficiency
C. Hyperparathyroidism
D. Diabetes insipidus
Answer: B. Adrenal insufficiency
, Rationale: Immune checkpoint inhibitors can cause hypophysitis or primary
adrenal insufficiency. Hypotension, fatigue, weakness, and electrolyte
abnormalities warrant urgent evaluation.
8. A patient with cancer suddenly develops facial edema, dyspnea, and
distended neck veins. Which condition is most concerning?
A. Disseminated intravascular coagulation
B. Superior vena cava syndrome
C. Hypercalcemia
D. Radiation dermatitis
Answer: B. Superior vena cava syndrome
Rationale: Obstruction of superior vena cava blood flow can cause facial and
upper-extremity edema, venous distention, cough, and respiratory compromise.
9. A patient with metastatic breast cancer develops severe back pain, bilateral
leg weakness, and urinary retention. What is the priority concern?
A. Chemotherapy-induced neuropathy
B. Spinal cord compression
C. Peripheral arterial disease
D. Hypocalcemia
Answer: B. Spinal cord compression
Rationale: Malignant spinal cord compression is an oncologic emergency.
Prompt imaging and treatment are necessary to reduce the risk of permanent
neurologic deficits.
10.A patient with multiple myeloma reports constipation, confusion, and
increased thirst. Which abnormality is most likely?
A. Hypokalemia
B. Hyponatremia
C. Hypercalcemia
D. Hypomagnesemia
