OCN-Oncology Certified Nurse Exam 2026/2027 |
Practice Questions And Answers 2026/2027 | Complete
Questions And Answers (Verified Answers) | Exam Prep
Comprehensive Exam Guide 2026&2027
1. A patient receiving chemotherapy reports a temperature of 38.3°C (101°F) and chills.
The patient's absolute neutrophil count is 400/mm³. Which action should the oncology
nurse take first?
A. Administer acetaminophen and reassess in 1 hour
B. Initiate the neutropenic fever protocol and notify the provider immediately
C. Encourage oral fluids and monitor the temperature every 4 hours
D. Place the patient on protective isolation and wait for culture results
Answer: B
Febrile neutropenia is an oncologic emergency. Prompt cultures and empiric broad-spectrum
antibiotics are essential because infection can progress rapidly when neutrophil counts are
severely reduced.
2. A patient receiving doxorubicin through a peripheral IV reports burning at the infusion
site. The nurse notes swelling and erythema around the catheter. What is the priority
action?
A. Stop the infusion immediately
B. Flush the catheter with normal saline
C. Apply a warm compress and continue the infusion
D. Increase the infusion rate to complete treatment quickly
Answer: A
Doxorubicin is a vesicant. Burning, swelling, and erythema suggest extravasation. The
infusion must be stopped immediately while the catheter is generally left in place initially for
aspiration and administration of the appropriate antidote according to protocol.
3. A patient receiving cisplatin has a serum creatinine that has increased significantly from
baseline. Which assessment finding is most important for the nurse to report?
A. Mild nausea after meals
B. Metallic taste
C. Decreased urine output
D. Temporary alopecia
,Answer: C
Cisplatin can cause significant nephrotoxicity. A decline in urine output may indicate
worsening renal impairment and requires prompt evaluation before additional nephrotoxic
therapy is administered.
4. A patient undergoing chemotherapy asks why a complete blood count is obtained before
each treatment cycle. Which response is most appropriate?
A. “It determines whether your cancer has completely responded.”
B. “It identifies whether your blood counts are adequate for safe treatment.”
C. “It determines whether you need radiation therapy.”
D. “It confirms that chemotherapy will prevent recurrence.”
Answer: B
CBC results help determine whether treatment-related myelosuppression has reached a level
that could make the next chemotherapy cycle unsafe.
5. A patient receiving radiation therapy to the head and neck develops painful oral
mucositis. Which intervention should the nurse recommend?
A. Use an alcohol-based mouthwash after every meal
B. Brush vigorously with a firm toothbrush
C. Rinse frequently with a prescribed or saline/bicarbonate oral solution
D. Consume acidic fruit juices to stimulate saliva production
Answer: C
Gentle oral care and nonirritating rinses help maintain oral hygiene, reduce discomfort, and
limit trauma to compromised mucosa. Alcohol-containing products and acidic substances can
worsen irritation.
6. A patient with metastatic breast cancer develops new severe back pain, bilateral leg
weakness, and difficulty walking. Which complication should the oncology nurse suspect?
A. Hypercalcemia
B. Spinal cord compression
C. Chemotherapy-induced neuropathy
D. Bone marrow suppression
Answer: B
New severe back pain accompanied by neurologic deficits in a patient with cancer raises
concern for metastatic spinal cord compression, which requires urgent assessment and
treatment to prevent permanent neurologic impairment.
,7. A patient with advanced cancer has a serum calcium level of 13.8 mg/dL and reports
constipation, thirst, and confusion. Which intervention should the nurse anticipate?
A. Fluid restriction
B. Aggressive hydration and treatment to lower calcium
C. Calcium supplementation
D. Increased dietary calcium
Answer: B
Malignancy-associated hypercalcemia can cause dehydration, constipation, altered mental
status, and cardiac abnormalities. IV hydration and therapies that lower serum calcium are
commonly required.
8. A patient receiving vincristine reports new difficulty buttoning clothing and numbness in
both feet. What adverse effect should the nurse recognize?
A. Peripheral neuropathy
B. Nephrotoxicity
C. Cardiomyopathy
D. Hemorrhagic cystitis
Answer: A
Vincristine commonly causes dose-related peripheral neurotoxicity. New sensory or motor
changes should be assessed and communicated because severe neuropathy may require
treatment modification.
9. A patient receiving chemotherapy has a platelet count of 18,000/mm³. Which nursing
intervention is most appropriate?
A. Encourage vigorous tooth brushing
B. Use an intramuscular route for medications
C. Implement bleeding precautions
D. Encourage aspirin for headache prevention
Answer: C
Severe thrombocytopenia increases bleeding risk. Bleeding precautions include avoiding
unnecessary invasive procedures, monitoring for bleeding, and using gentle oral care.
10. A patient asks why chemotherapy can cause hair loss. Which explanation is most
accurate?
A. Chemotherapy permanently destroys all hair follicles
B. Chemotherapy targets rapidly dividing cells, including cells within hair follicles
, C. Hair loss occurs because chemotherapy causes dehydration
D. Hair loss indicates that the chemotherapy dose is excessive
Answer: B
Many cytotoxic agents affect rapidly dividing normal cells, including hair follicle cells,
resulting in temporary or sometimes treatment-specific alopecia.
11. A patient receiving immunotherapy develops persistent diarrhea and abdominal
cramping. What is the nurse's priority concern?
A. Expected dietary intolerance
B. Immune-mediated colitis
C. Mild dehydration only
D. Opioid withdrawal
Answer: B
Immune checkpoint inhibitors can cause immune-mediated colitis. Persistent or significant
diarrhea requires prompt assessment because corticosteroid therapy and treatment
interruption may be necessary.
12. A patient taking oral antineoplastic medication says, “I sometimes skip the dose when I
feel better.” What is the best nursing response?
A. “That is acceptable if your symptoms improve.”
B. “Take two doses the next time you remember.”
C. “Let's review the prescribed schedule and discuss what to do if a dose is missed.”
D. “Stop treatment until your next clinic visit.”
Answer: C
Adherence to oral anticancer therapy is important, but missed-dose instructions vary by
medication. The nurse should provide medication-specific education rather than
recommending an unscheduled extra dose.
13. A patient receiving bleomycin develops a new dry cough and increasing dyspnea.
Which complication requires immediate evaluation?
A. Pulmonary toxicity
B. Mild anemia
C. Alopecia
D. Constipation
Answer: A
Practice Questions And Answers 2026/2027 | Complete
Questions And Answers (Verified Answers) | Exam Prep
Comprehensive Exam Guide 2026&2027
1. A patient receiving chemotherapy reports a temperature of 38.3°C (101°F) and chills.
The patient's absolute neutrophil count is 400/mm³. Which action should the oncology
nurse take first?
A. Administer acetaminophen and reassess in 1 hour
B. Initiate the neutropenic fever protocol and notify the provider immediately
C. Encourage oral fluids and monitor the temperature every 4 hours
D. Place the patient on protective isolation and wait for culture results
Answer: B
Febrile neutropenia is an oncologic emergency. Prompt cultures and empiric broad-spectrum
antibiotics are essential because infection can progress rapidly when neutrophil counts are
severely reduced.
2. A patient receiving doxorubicin through a peripheral IV reports burning at the infusion
site. The nurse notes swelling and erythema around the catheter. What is the priority
action?
A. Stop the infusion immediately
B. Flush the catheter with normal saline
C. Apply a warm compress and continue the infusion
D. Increase the infusion rate to complete treatment quickly
Answer: A
Doxorubicin is a vesicant. Burning, swelling, and erythema suggest extravasation. The
infusion must be stopped immediately while the catheter is generally left in place initially for
aspiration and administration of the appropriate antidote according to protocol.
3. A patient receiving cisplatin has a serum creatinine that has increased significantly from
baseline. Which assessment finding is most important for the nurse to report?
A. Mild nausea after meals
B. Metallic taste
C. Decreased urine output
D. Temporary alopecia
,Answer: C
Cisplatin can cause significant nephrotoxicity. A decline in urine output may indicate
worsening renal impairment and requires prompt evaluation before additional nephrotoxic
therapy is administered.
4. A patient undergoing chemotherapy asks why a complete blood count is obtained before
each treatment cycle. Which response is most appropriate?
A. “It determines whether your cancer has completely responded.”
B. “It identifies whether your blood counts are adequate for safe treatment.”
C. “It determines whether you need radiation therapy.”
D. “It confirms that chemotherapy will prevent recurrence.”
Answer: B
CBC results help determine whether treatment-related myelosuppression has reached a level
that could make the next chemotherapy cycle unsafe.
5. A patient receiving radiation therapy to the head and neck develops painful oral
mucositis. Which intervention should the nurse recommend?
A. Use an alcohol-based mouthwash after every meal
B. Brush vigorously with a firm toothbrush
C. Rinse frequently with a prescribed or saline/bicarbonate oral solution
D. Consume acidic fruit juices to stimulate saliva production
Answer: C
Gentle oral care and nonirritating rinses help maintain oral hygiene, reduce discomfort, and
limit trauma to compromised mucosa. Alcohol-containing products and acidic substances can
worsen irritation.
6. A patient with metastatic breast cancer develops new severe back pain, bilateral leg
weakness, and difficulty walking. Which complication should the oncology nurse suspect?
A. Hypercalcemia
B. Spinal cord compression
C. Chemotherapy-induced neuropathy
D. Bone marrow suppression
Answer: B
New severe back pain accompanied by neurologic deficits in a patient with cancer raises
concern for metastatic spinal cord compression, which requires urgent assessment and
treatment to prevent permanent neurologic impairment.
,7. A patient with advanced cancer has a serum calcium level of 13.8 mg/dL and reports
constipation, thirst, and confusion. Which intervention should the nurse anticipate?
A. Fluid restriction
B. Aggressive hydration and treatment to lower calcium
C. Calcium supplementation
D. Increased dietary calcium
Answer: B
Malignancy-associated hypercalcemia can cause dehydration, constipation, altered mental
status, and cardiac abnormalities. IV hydration and therapies that lower serum calcium are
commonly required.
8. A patient receiving vincristine reports new difficulty buttoning clothing and numbness in
both feet. What adverse effect should the nurse recognize?
A. Peripheral neuropathy
B. Nephrotoxicity
C. Cardiomyopathy
D. Hemorrhagic cystitis
Answer: A
Vincristine commonly causes dose-related peripheral neurotoxicity. New sensory or motor
changes should be assessed and communicated because severe neuropathy may require
treatment modification.
9. A patient receiving chemotherapy has a platelet count of 18,000/mm³. Which nursing
intervention is most appropriate?
A. Encourage vigorous tooth brushing
B. Use an intramuscular route for medications
C. Implement bleeding precautions
D. Encourage aspirin for headache prevention
Answer: C
Severe thrombocytopenia increases bleeding risk. Bleeding precautions include avoiding
unnecessary invasive procedures, monitoring for bleeding, and using gentle oral care.
10. A patient asks why chemotherapy can cause hair loss. Which explanation is most
accurate?
A. Chemotherapy permanently destroys all hair follicles
B. Chemotherapy targets rapidly dividing cells, including cells within hair follicles
, C. Hair loss occurs because chemotherapy causes dehydration
D. Hair loss indicates that the chemotherapy dose is excessive
Answer: B
Many cytotoxic agents affect rapidly dividing normal cells, including hair follicle cells,
resulting in temporary or sometimes treatment-specific alopecia.
11. A patient receiving immunotherapy develops persistent diarrhea and abdominal
cramping. What is the nurse's priority concern?
A. Expected dietary intolerance
B. Immune-mediated colitis
C. Mild dehydration only
D. Opioid withdrawal
Answer: B
Immune checkpoint inhibitors can cause immune-mediated colitis. Persistent or significant
diarrhea requires prompt assessment because corticosteroid therapy and treatment
interruption may be necessary.
12. A patient taking oral antineoplastic medication says, “I sometimes skip the dose when I
feel better.” What is the best nursing response?
A. “That is acceptable if your symptoms improve.”
B. “Take two doses the next time you remember.”
C. “Let's review the prescribed schedule and discuss what to do if a dose is missed.”
D. “Stop treatment until your next clinic visit.”
Answer: C
Adherence to oral anticancer therapy is important, but missed-dose instructions vary by
medication. The nurse should provide medication-specific education rather than
recommending an unscheduled extra dose.
13. A patient receiving bleomycin develops a new dry cough and increasing dyspnea.
Which complication requires immediate evaluation?
A. Pulmonary toxicity
B. Mild anemia
C. Alopecia
D. Constipation
Answer: A
