ONCOLOGY NURSING EXAM REVIEW 2026 / COMPLETE CANCER
NURSING STUDY GUIDE WITH PRACTICE QUESTIONS, ANSWERS AND
DETAILED RATIONALES
1. A 58-year-old client recently diagnosed with colorectal cancer is preparing
to begin chemotherapy. During the pre-treatment assessment, the nurse
reviews the client’s laboratory results, nutritional status, medication history,
and understanding of treatment. Which nursing action is most important
before the first chemotherapy dose is administered?
A. Encourage the client to avoid all physical activity during treatment
B. Verify the prescribed chemotherapy regimen, client identification,
treatment protocol, and required laboratory values
C. Instruct the client to discontinue all prescribed medications until
chemotherapy is completed
D. Restrict oral fluids for 24 hours before chemotherapy begins
Answer: B
2. A client receiving chemotherapy for acute leukemia develops a temperature
of 38.4°C (101.1°F), chills, and generalized weakness. The most recent
laboratory results show a markedly decreased absolute neutrophil count.
Which nursing action should receive the highest priority?
A. Encourage ambulation to improve circulation
B. Administer an antidiarrheal medication
C. Notify the healthcare provider promptly and initiate appropriate infection
precautions
D. Offer a high-fiber meal to promote intestinal health
Answer: C
3. A client undergoing radiation therapy for head and neck cancer reports
painful swallowing, dry mouth, and difficulty maintaining adequate oral
intake. Which nursing intervention is most appropriate for supporting
nutrition and comfort during treatment?
A. Encourage frequent small meals consisting of soft, moist, nonirritating
foods
pg. 1
, B. Encourage citrus juices before every meal to stimulate saliva production
C. Provide very hot foods because heat increases oral blood flow
D. Recommend alcohol-based mouthwash several times daily
Answer: A
4. A client with metastatic cancer reports persistent severe pain despite taking
prescribed analgesics. The client states, “I am afraid that if I take the
medicine now, it will not work later when my pain becomes worse.” Which
response by the nurse is most appropriate?
A. “You should wait until your pain becomes unbearable before taking
medication.”
B. “Pain medication is generally most effective when used only once each
day.”
C. “You should avoid reporting pain because cancer pain is expected.”
D. “Regularly prescribed analgesia can help prevent severe pain from
becoming established.”
Answer: D
5. A client with advanced cancer develops increasing fatigue, anorexia, weight
loss, and weakness despite receiving nutritional counseling. The family asks
why the client continues to lose weight even though they are providing
frequent meals. Which explanation is most appropriate?
A. Cancer-associated metabolic changes can contribute to progressive
weight and muscle loss despite nutritional intake
B. The client is intentionally refusing food because of depression
C. The condition is caused exclusively by inadequate family support
D. Increasing the meal frequency will always reverse the weight loss
Answer: A
6. A client receiving a vesicant chemotherapy medication through a peripheral
intravenous catheter reports burning and pain at the insertion site. The
nurse observes swelling and blanching around the catheter. What should
the nurse do first?
A. Increase the infusion rate to dilute the medication
pg. 2
, B. Stop the infusion and follow the established extravasation protocol
C. Flush the catheter forcefully with normal saline
D. Apply pressure directly over the swollen area and continue therapy
Answer: B
7. A client with breast cancer is receiving chemotherapy and asks why the
nurse repeatedly checks the mouth and asks about swallowing. Which
complication is the nurse primarily assessing for?
A. Mucositis and oral tissue injury related to treatment
B. Hyperthyroidism caused by chemotherapy
C. Permanent hearing loss caused by oral ulcers
D. Increased bone density caused by altered nutrition
Answer: A
8. A client receiving chemotherapy develops nausea several hours after
treatment despite receiving an antiemetic before the infusion. Which
nursing intervention is most appropriate?
A. Encourage three large meals immediately after chemotherapy
B. Restrict all oral intake until nausea completely resolves
C. Provide prescribed antiemetic therapy and encourage small, frequent
meals
D. Encourage the client to drink carbonated beverages exclusively
Answer: C
9. A client with cancer is scheduled for an implanted central venous access
device. The client asks why this device is being recommended instead of
repeated peripheral IV insertions. Which explanation is most accurate?
A. It eliminates the need for monitoring during chemotherapy
B. It allows reliable venous access for medications that may require
prolonged or repeated administration
C. It prevents every possible complication associated with chemotherapy
D. It guarantees that chemotherapy will not damage normal tissues
Answer: B
pg. 3
, 10. A client receiving chemotherapy has a platelet count of 28,000/mm³ and
develops bleeding from the gums while brushing the teeth. Which nursing
intervention is most appropriate?
A. Encourage use of a hard-bristled toothbrush
B. Administer aspirin for discomfort
C. Use bleeding precautions and avoid unnecessary invasive procedures
D. Encourage vigorous flossing after every meal
Answer: C
11. A client receiving chemotherapy has an absolute neutrophil count of
400/mm³. Which instruction should the nurse emphasize when preparing
the client for discharge?
A. Report fever or other signs of infection immediately
B. Eat raw eggs daily to increase protein intake
C. Receive live vaccines without consulting the oncology team
D. Visit crowded public locations daily to maintain activity
Answer: A
12. A client with cancer develops thrombocytopenia following chemotherapy.
Which finding should the nurse recognize as requiring immediate attention?
A. Mild fatigue after walking
B. Petechiae accompanied by persistent nosebleeding
C. Temporary decrease in appetite
D. Mild alteration in taste
Answer: B
13. A client receiving radiation therapy to the abdomen reports diarrhea and
abdominal cramping. Which nursing recommendation is most appropriate?
A. Encourage foods and fluids that are well tolerated and avoid known
gastrointestinal irritants
B. Encourage large amounts of raw vegetables at every meal
C. Recommend high-fat meals to slow intestinal motility
D. Restrict all fluids until diarrhea stops
Answer: A
pg. 4
NURSING STUDY GUIDE WITH PRACTICE QUESTIONS, ANSWERS AND
DETAILED RATIONALES
1. A 58-year-old client recently diagnosed with colorectal cancer is preparing
to begin chemotherapy. During the pre-treatment assessment, the nurse
reviews the client’s laboratory results, nutritional status, medication history,
and understanding of treatment. Which nursing action is most important
before the first chemotherapy dose is administered?
A. Encourage the client to avoid all physical activity during treatment
B. Verify the prescribed chemotherapy regimen, client identification,
treatment protocol, and required laboratory values
C. Instruct the client to discontinue all prescribed medications until
chemotherapy is completed
D. Restrict oral fluids for 24 hours before chemotherapy begins
Answer: B
2. A client receiving chemotherapy for acute leukemia develops a temperature
of 38.4°C (101.1°F), chills, and generalized weakness. The most recent
laboratory results show a markedly decreased absolute neutrophil count.
Which nursing action should receive the highest priority?
A. Encourage ambulation to improve circulation
B. Administer an antidiarrheal medication
C. Notify the healthcare provider promptly and initiate appropriate infection
precautions
D. Offer a high-fiber meal to promote intestinal health
Answer: C
3. A client undergoing radiation therapy for head and neck cancer reports
painful swallowing, dry mouth, and difficulty maintaining adequate oral
intake. Which nursing intervention is most appropriate for supporting
nutrition and comfort during treatment?
A. Encourage frequent small meals consisting of soft, moist, nonirritating
foods
pg. 1
, B. Encourage citrus juices before every meal to stimulate saliva production
C. Provide very hot foods because heat increases oral blood flow
D. Recommend alcohol-based mouthwash several times daily
Answer: A
4. A client with metastatic cancer reports persistent severe pain despite taking
prescribed analgesics. The client states, “I am afraid that if I take the
medicine now, it will not work later when my pain becomes worse.” Which
response by the nurse is most appropriate?
A. “You should wait until your pain becomes unbearable before taking
medication.”
B. “Pain medication is generally most effective when used only once each
day.”
C. “You should avoid reporting pain because cancer pain is expected.”
D. “Regularly prescribed analgesia can help prevent severe pain from
becoming established.”
Answer: D
5. A client with advanced cancer develops increasing fatigue, anorexia, weight
loss, and weakness despite receiving nutritional counseling. The family asks
why the client continues to lose weight even though they are providing
frequent meals. Which explanation is most appropriate?
A. Cancer-associated metabolic changes can contribute to progressive
weight and muscle loss despite nutritional intake
B. The client is intentionally refusing food because of depression
C. The condition is caused exclusively by inadequate family support
D. Increasing the meal frequency will always reverse the weight loss
Answer: A
6. A client receiving a vesicant chemotherapy medication through a peripheral
intravenous catheter reports burning and pain at the insertion site. The
nurse observes swelling and blanching around the catheter. What should
the nurse do first?
A. Increase the infusion rate to dilute the medication
pg. 2
, B. Stop the infusion and follow the established extravasation protocol
C. Flush the catheter forcefully with normal saline
D. Apply pressure directly over the swollen area and continue therapy
Answer: B
7. A client with breast cancer is receiving chemotherapy and asks why the
nurse repeatedly checks the mouth and asks about swallowing. Which
complication is the nurse primarily assessing for?
A. Mucositis and oral tissue injury related to treatment
B. Hyperthyroidism caused by chemotherapy
C. Permanent hearing loss caused by oral ulcers
D. Increased bone density caused by altered nutrition
Answer: A
8. A client receiving chemotherapy develops nausea several hours after
treatment despite receiving an antiemetic before the infusion. Which
nursing intervention is most appropriate?
A. Encourage three large meals immediately after chemotherapy
B. Restrict all oral intake until nausea completely resolves
C. Provide prescribed antiemetic therapy and encourage small, frequent
meals
D. Encourage the client to drink carbonated beverages exclusively
Answer: C
9. A client with cancer is scheduled for an implanted central venous access
device. The client asks why this device is being recommended instead of
repeated peripheral IV insertions. Which explanation is most accurate?
A. It eliminates the need for monitoring during chemotherapy
B. It allows reliable venous access for medications that may require
prolonged or repeated administration
C. It prevents every possible complication associated with chemotherapy
D. It guarantees that chemotherapy will not damage normal tissues
Answer: B
pg. 3
, 10. A client receiving chemotherapy has a platelet count of 28,000/mm³ and
develops bleeding from the gums while brushing the teeth. Which nursing
intervention is most appropriate?
A. Encourage use of a hard-bristled toothbrush
B. Administer aspirin for discomfort
C. Use bleeding precautions and avoid unnecessary invasive procedures
D. Encourage vigorous flossing after every meal
Answer: C
11. A client receiving chemotherapy has an absolute neutrophil count of
400/mm³. Which instruction should the nurse emphasize when preparing
the client for discharge?
A. Report fever or other signs of infection immediately
B. Eat raw eggs daily to increase protein intake
C. Receive live vaccines without consulting the oncology team
D. Visit crowded public locations daily to maintain activity
Answer: A
12. A client with cancer develops thrombocytopenia following chemotherapy.
Which finding should the nurse recognize as requiring immediate attention?
A. Mild fatigue after walking
B. Petechiae accompanied by persistent nosebleeding
C. Temporary decrease in appetite
D. Mild alteration in taste
Answer: B
13. A client receiving radiation therapy to the abdomen reports diarrhea and
abdominal cramping. Which nursing recommendation is most appropriate?
A. Encourage foods and fluids that are well tolerated and avoid known
gastrointestinal irritants
B. Encourage large amounts of raw vegetables at every meal
C. Recommend high-fat meals to slow intestinal motility
D. Restrict all fluids until diarrhea stops
Answer: A
pg. 4
