Oncology Certified Nurse (OCN) practice test
exam
1. Question: Which laboratory value is most critical to monitor
for infection risk in a patient receiving myelosuppressive
chemotherapy?
A. Hemoglobin
B. Platelet count
C. Absolute neutrophil count
D. White blood cell count with differential
Answer: C
Rationale: The absolute neutrophil count is the most sensitive
indicator of infection risk. An ANC below 500/mm3 significantly
increases susceptibility to infection, and fever in a neutropenic
patient is a medical emergency.
2. Question: What is the most common oncologic emergency
characterized by fever, tachycardia, and hypotension?
A. Tumor lysis syndrome
B. Sepsis
C. Spinal cord compression
D. Superior vena cava syndrome
Answer: B
,Rationale: Sepsis is the most common oncologic emergency.
Neutropenic patients are at high risk, and early recognition with
broad-spectrum antibiotics is critical.
3. Question: Which finding is characteristic of superior vena
cava syndrome?
A. Bilateral lower extremity edema
B. Facial edema, distended neck veins, and dyspnea
C. Unilateral arm swelling
D. Ascites
Answer: B
Rationale: SVCS occurs when the superior vena cava is
compressed by tumor or thrombosis. Classic signs include facial
and neck edema, distended neck veins, and respiratory distress.
4. Question: Which symptom requires immediate intervention
in a patient with suspected spinal cord compression?
A. Back pain
B. Numbness in the legs
C. Urinary incontinence
D. Fatigue
Answer: C
,Rationale: Urinary incontinence or retention indicates
significant spinal cord compression and is a medical emergency.
Immediate corticosteroids and radiation are required to
prevent permanent paralysis.
5. Question: Which electrolyte abnormality is most commonly
associated with tumor lysis syndrome?
A. Hyperkalemia
B. Hypokalemia
C. Hypernatremia
D. Hypocalcemia
Answer: A
Rationale: Tumor lysis syndrome causes hyperkalemia,
hyperphosphatemia, hyperuricemia, and hypocalcemia due to
rapid cell destruction. Hyperkalemia is the most immediately
life-threatening.
6. Question: Which medication is used to prevent tumor lysis
syndrome in high-risk patients?
A. Furosemide
B. Allopurinol
C. Calcium gluconate
, D. Sodium bicarbonate
Answer: B
Rationale: Allopurinol inhibits xanthine oxidase, reducing uric
acid production. It is used prophylactically in patients at high
risk for tumor lysis syndrome.
7. Question: What is the priority nursing intervention for a
patient receiving intravenous vesicant chemotherapy?
A. Administer rapidly
B. Assess for blood return before and during infusion
C. Use a small peripheral vein
D. Apply warm compresses after infusion
Answer: B
Rationale: Blood return confirms proper IV placement.
Vesicants cause severe tissue damage if extravasation occurs,
so patency must be verified.
8. Question: Which finding indicates extravasation of a vesicant
chemotherapy agent?
A. Mild erythema at the IV site
B. Swelling and pain at the IV site
C. Blanching at the IV site
exam
1. Question: Which laboratory value is most critical to monitor
for infection risk in a patient receiving myelosuppressive
chemotherapy?
A. Hemoglobin
B. Platelet count
C. Absolute neutrophil count
D. White blood cell count with differential
Answer: C
Rationale: The absolute neutrophil count is the most sensitive
indicator of infection risk. An ANC below 500/mm3 significantly
increases susceptibility to infection, and fever in a neutropenic
patient is a medical emergency.
2. Question: What is the most common oncologic emergency
characterized by fever, tachycardia, and hypotension?
A. Tumor lysis syndrome
B. Sepsis
C. Spinal cord compression
D. Superior vena cava syndrome
Answer: B
,Rationale: Sepsis is the most common oncologic emergency.
Neutropenic patients are at high risk, and early recognition with
broad-spectrum antibiotics is critical.
3. Question: Which finding is characteristic of superior vena
cava syndrome?
A. Bilateral lower extremity edema
B. Facial edema, distended neck veins, and dyspnea
C. Unilateral arm swelling
D. Ascites
Answer: B
Rationale: SVCS occurs when the superior vena cava is
compressed by tumor or thrombosis. Classic signs include facial
and neck edema, distended neck veins, and respiratory distress.
4. Question: Which symptom requires immediate intervention
in a patient with suspected spinal cord compression?
A. Back pain
B. Numbness in the legs
C. Urinary incontinence
D. Fatigue
Answer: C
,Rationale: Urinary incontinence or retention indicates
significant spinal cord compression and is a medical emergency.
Immediate corticosteroids and radiation are required to
prevent permanent paralysis.
5. Question: Which electrolyte abnormality is most commonly
associated with tumor lysis syndrome?
A. Hyperkalemia
B. Hypokalemia
C. Hypernatremia
D. Hypocalcemia
Answer: A
Rationale: Tumor lysis syndrome causes hyperkalemia,
hyperphosphatemia, hyperuricemia, and hypocalcemia due to
rapid cell destruction. Hyperkalemia is the most immediately
life-threatening.
6. Question: Which medication is used to prevent tumor lysis
syndrome in high-risk patients?
A. Furosemide
B. Allopurinol
C. Calcium gluconate
, D. Sodium bicarbonate
Answer: B
Rationale: Allopurinol inhibits xanthine oxidase, reducing uric
acid production. It is used prophylactically in patients at high
risk for tumor lysis syndrome.
7. Question: What is the priority nursing intervention for a
patient receiving intravenous vesicant chemotherapy?
A. Administer rapidly
B. Assess for blood return before and during infusion
C. Use a small peripheral vein
D. Apply warm compresses after infusion
Answer: B
Rationale: Blood return confirms proper IV placement.
Vesicants cause severe tissue damage if extravasation occurs,
so patency must be verified.
8. Question: Which finding indicates extravasation of a vesicant
chemotherapy agent?
A. Mild erythema at the IV site
B. Swelling and pain at the IV site
C. Blanching at the IV site
