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OCN Oncology Certified Nurse
Questions And Correct Answers
(Verified Answers) Plus Rationales 2026
Q&A Instant Download Pdf
___________________________________________________________________
1. A patient receiving cisplatin has a serum creatinine increase from 0.8 to 1.6
mg/dL and urine output of 20 mL/hr. Which intervention is the priority?
A. Administer the next cisplatin dose as scheduled
B. Hold cisplatin and notify the oncology provider
C. Administer potassium replacement immediately
D. Encourage a high-protein diet
Answer: Hold cisplatin and notify the oncology provider
Rationale: Cisplatin is nephrotoxic. A significant rise in creatinine with oliguria
suggests acute kidney injury and requires prompt evaluation before additional
nephrotoxic therapy is administered.
2. A patient receiving immune checkpoint inhibitor therapy develops six
watery stools daily with abdominal cramping. What is the most appropriate
nursing action?
A. Administer loperamide and reassess in 24 hours
B. Encourage a high-fiber diet
C. Notify the oncology team promptly for suspected immune-mediated colitis
D. Restrict all oral fluids
,Answer: Notify the oncology team promptly for suspected immune-mediated
colitis
Rationale: Significant diarrhea during immune checkpoint therapy may indicate
immune-mediated colitis. Early evaluation is essential because treatment may
require corticosteroids and temporary immunotherapy interruption.
3. A patient receiving doxorubicin reports burning and pain at the peripheral
IV site. What should the nurse do first?
A. Increase the infusion rate
B. Flush the line vigorously
C. Apply pressure to the site
D. Stop the infusion immediately and leave the catheter in place initially
Answer: Stop the infusion immediately and leave the catheter in place initially
Rationale: Doxorubicin is a vesicant. The infusion should be stopped
immediately while maintaining access for aspiration of residual drug and
administration of the appropriate extravasation management agent.
4. A patient with acute leukemia develops fever of 38.5°C (101.3°F) and an
absolute neutrophil count of 300/mm³. Which intervention is the priority?
A. Obtain a stool culture
B. Initiate the febrile-neutropenia protocol and obtain cultures promptly
C. Wait for the next scheduled CBC
D. Administer acetaminophen and discharge the patient
Answer: Initiate the febrile-neutropenia protocol and obtain cultures promptly
Rationale: Fever with profound neutropenia constitutes a medical emergency.
Cultures and empiric broad-spectrum antimicrobial therapy should be initiated
promptly according to institutional protocols.
5. A patient with metastatic breast cancer develops new confusion, lethargy,
and a serum calcium of 14.8 mg/dL. Which complication should the nurse
suspect?
,A. Tumor lysis syndrome
B. SIADH
C. Hypercalcemia of malignancy
D. Disseminated intravascular coagulation
Answer: Hypercalcemia of malignancy
Rationale: Severe hypercalcemia can occur with certain malignancies and may
cause neurologic changes, dehydration, constipation, weakness, and cardiac
abnormalities.
6. Which laboratory pattern is most consistent with tumor lysis syndrome?
A. Hypercalcemia, hypernatremia, hypouricemia
B. Hyperkalemia, hyperphosphatemia, hypocalcemia, and hyperuricemia
C. Hypokalemia, hypophosphatemia, hypercalcemia
D. Hypernatremia, hypokalemia, hypercalcemia
Answer: Hyperkalemia, hyperphosphatemia, hypocalcemia, and hyperuricemia
Rationale: Rapid malignant-cell destruction releases intracellular potassium,
phosphate, and nucleic acids, producing hyperkalemia, hyperphosphatemia,
secondary hypocalcemia, and hyperuricemia.
7. A patient receiving high-dose methotrexate has delayed clearance. Which
medication may be used as a rescue therapy to reduce methotrexate
toxicity?
A. Mesna
B. Dexrazoxane
C. Leucovorin
D. Filgrastim
Answer: Leucovorin
Rationale: Leucovorin rescue protects normal cells from methotrexate toxicity.
Delayed methotrexate clearance requires careful monitoring and may
necessitate intensified rescue and supportive measures.
, 8. A patient receiving bleomycin develops progressive dyspnea and a
nonproductive cough. Which assessment is most important?
A. Bowel sounds
B. Peripheral pulses
C. Pulmonary assessment and oxygenation status
D. Visual acuity
Answer: Pulmonary assessment and oxygenation status
Rationale: Bleomycin can cause pulmonary toxicity, including pneumonitis and
pulmonary fibrosis. New respiratory symptoms require prompt evaluation.
9. Which finding is most concerning in a patient receiving trastuzumab?
A. Mild alopecia
B. Grade 1 nausea
C. New dyspnea with decreased left ventricular ejection fraction
D. Mild taste alteration
Answer: New dyspnea with decreased left ventricular ejection fraction
Rationale: Trastuzumab can cause cardiomyopathy and reduced left ventricular
function. New cardiac symptoms and declining ejection fraction require prompt
assessment.
10.A patient receiving vincristine develops severe constipation and diminished
bowel sounds. Which toxicity is most likely responsible?
A. Nephrotoxicity
B. Hepatotoxicity
C. Peripheral and autonomic neuropathy
D. Hemorrhagic cystitis
Answer: Peripheral and autonomic neuropathy
Rationale: Vincristine commonly causes neurotoxicity, including peripheral
neuropathy and autonomic dysfunction that can produce constipation or ileus.
OCN Oncology Certified Nurse
Questions And Correct Answers
(Verified Answers) Plus Rationales 2026
Q&A Instant Download Pdf
___________________________________________________________________
1. A patient receiving cisplatin has a serum creatinine increase from 0.8 to 1.6
mg/dL and urine output of 20 mL/hr. Which intervention is the priority?
A. Administer the next cisplatin dose as scheduled
B. Hold cisplatin and notify the oncology provider
C. Administer potassium replacement immediately
D. Encourage a high-protein diet
Answer: Hold cisplatin and notify the oncology provider
Rationale: Cisplatin is nephrotoxic. A significant rise in creatinine with oliguria
suggests acute kidney injury and requires prompt evaluation before additional
nephrotoxic therapy is administered.
2. A patient receiving immune checkpoint inhibitor therapy develops six
watery stools daily with abdominal cramping. What is the most appropriate
nursing action?
A. Administer loperamide and reassess in 24 hours
B. Encourage a high-fiber diet
C. Notify the oncology team promptly for suspected immune-mediated colitis
D. Restrict all oral fluids
,Answer: Notify the oncology team promptly for suspected immune-mediated
colitis
Rationale: Significant diarrhea during immune checkpoint therapy may indicate
immune-mediated colitis. Early evaluation is essential because treatment may
require corticosteroids and temporary immunotherapy interruption.
3. A patient receiving doxorubicin reports burning and pain at the peripheral
IV site. What should the nurse do first?
A. Increase the infusion rate
B. Flush the line vigorously
C. Apply pressure to the site
D. Stop the infusion immediately and leave the catheter in place initially
Answer: Stop the infusion immediately and leave the catheter in place initially
Rationale: Doxorubicin is a vesicant. The infusion should be stopped
immediately while maintaining access for aspiration of residual drug and
administration of the appropriate extravasation management agent.
4. A patient with acute leukemia develops fever of 38.5°C (101.3°F) and an
absolute neutrophil count of 300/mm³. Which intervention is the priority?
A. Obtain a stool culture
B. Initiate the febrile-neutropenia protocol and obtain cultures promptly
C. Wait for the next scheduled CBC
D. Administer acetaminophen and discharge the patient
Answer: Initiate the febrile-neutropenia protocol and obtain cultures promptly
Rationale: Fever with profound neutropenia constitutes a medical emergency.
Cultures and empiric broad-spectrum antimicrobial therapy should be initiated
promptly according to institutional protocols.
5. A patient with metastatic breast cancer develops new confusion, lethargy,
and a serum calcium of 14.8 mg/dL. Which complication should the nurse
suspect?
,A. Tumor lysis syndrome
B. SIADH
C. Hypercalcemia of malignancy
D. Disseminated intravascular coagulation
Answer: Hypercalcemia of malignancy
Rationale: Severe hypercalcemia can occur with certain malignancies and may
cause neurologic changes, dehydration, constipation, weakness, and cardiac
abnormalities.
6. Which laboratory pattern is most consistent with tumor lysis syndrome?
A. Hypercalcemia, hypernatremia, hypouricemia
B. Hyperkalemia, hyperphosphatemia, hypocalcemia, and hyperuricemia
C. Hypokalemia, hypophosphatemia, hypercalcemia
D. Hypernatremia, hypokalemia, hypercalcemia
Answer: Hyperkalemia, hyperphosphatemia, hypocalcemia, and hyperuricemia
Rationale: Rapid malignant-cell destruction releases intracellular potassium,
phosphate, and nucleic acids, producing hyperkalemia, hyperphosphatemia,
secondary hypocalcemia, and hyperuricemia.
7. A patient receiving high-dose methotrexate has delayed clearance. Which
medication may be used as a rescue therapy to reduce methotrexate
toxicity?
A. Mesna
B. Dexrazoxane
C. Leucovorin
D. Filgrastim
Answer: Leucovorin
Rationale: Leucovorin rescue protects normal cells from methotrexate toxicity.
Delayed methotrexate clearance requires careful monitoring and may
necessitate intensified rescue and supportive measures.
, 8. A patient receiving bleomycin develops progressive dyspnea and a
nonproductive cough. Which assessment is most important?
A. Bowel sounds
B. Peripheral pulses
C. Pulmonary assessment and oxygenation status
D. Visual acuity
Answer: Pulmonary assessment and oxygenation status
Rationale: Bleomycin can cause pulmonary toxicity, including pneumonitis and
pulmonary fibrosis. New respiratory symptoms require prompt evaluation.
9. Which finding is most concerning in a patient receiving trastuzumab?
A. Mild alopecia
B. Grade 1 nausea
C. New dyspnea with decreased left ventricular ejection fraction
D. Mild taste alteration
Answer: New dyspnea with decreased left ventricular ejection fraction
Rationale: Trastuzumab can cause cardiomyopathy and reduced left ventricular
function. New cardiac symptoms and declining ejection fraction require prompt
assessment.
10.A patient receiving vincristine develops severe constipation and diminished
bowel sounds. Which toxicity is most likely responsible?
A. Nephrotoxicity
B. Hepatotoxicity
C. Peripheral and autonomic neuropathy
D. Hemorrhagic cystitis
Answer: Peripheral and autonomic neuropathy
Rationale: Vincristine commonly causes neurotoxicity, including peripheral
neuropathy and autonomic dysfunction that can produce constipation or ileus.
