OCN Well Set Practice Test 2025

Which of the following is not routinely included as part of a diagnostic work-up for colorectal cancer? Bone marrow biopsy Carcinoembryonic antigen (CEA) Colonoscopy Barium enema - Correct Answer-bone marrow biopsy -A bone marrow biopsy is not routinely performed as part of a diagnostic work-up for colorectal cancer. -Barium enemas provide a clear picture of the large intestine and are useful in detection of smaller tumors. -Colonoscopy provides increased visualization and the ability to biopsy lesions. -CEA is elevated in later stages of colorectal cancer and may have prognostic value at diagnosis or disease recurrence. You are a registered nurse working in an outpatient infusion center and have begun administration of paclitaxel on a newly-diagnosed breast cancer patient. The patient mentions that she is feeling flushed and shows you a small hive on her left cheek. Your next course of action is to: -decrease the rate of paclitaxel by 50%. reassure the patient that this is a normal side effect of paclitaxel. -give the patient 50mg of IV Benadryl. -immediately stop the infusion and notify the oncologist. - Correct Answer-immediately stop the infusion and notify the oncologist. The patient is experiencing signs of an infusion reaction with the potential for anaphylaxis. The nurse must be alert to recognize signs and symptoms of an early infusion reaction to avoid an anaphylactic response. The first step in addressing an infusion reaction is to immediately stop the infusion and notify the physician. A 62-year-old male patient diagnosed with stage 3 small cell lung cancer is admitted to the oncology unit with somnolence, weakness, nausea, vomiting, and diffuse abdominal pain. His wife reports that he has become increasingly weak over the past three days and has exhibited a change in mental status. She reports that he has not had a bowel movement in five days. Which of the following oncologic complications is a likely explanation for the patient's clinical presentation? Liver metastasis Septic shock Hypercalcemia Superior vena cava syndrome - Correct Answer-Hypercalcemia Hypercalcemia is the oncologic complication that presents with symptoms of mental status change, weakness, nausea, vomiting, constipation, and abdominal pain. Small cell lung cancer is a malignancy commonly associated with hypercalcemia. Superior vena cava syndrome presents as edema of the face, neck, and upper extremities; respiratory compromise, chest pain, headache, dizziness and a feeling of facial fullness. The clinical features of septic shock include tachypnea, nausea, diarrhea, confusion, and ultimately oliguria and metabolic acidosis. The patient may experience some of these same symptoms with liver metastasis as well. Which of the following chemotherapeutic agents is classified as a Vinca alkaloid? Docetaxel Topotecan Etoposide Oxaliplatin - Correct Answer-Etoposide Vinca alkaloids are a class of chemotherapeutic agents that exert their cytotoxic effects by binding to microtubular proteins during the metaphase of the cell cycle, causing mitotic arrest. Etoposide is a Vinca alkaloid. Docetaxel is a taxane derivative. Topotecan is a topoisomerase I inhibitor. Oxaliplatin is an anti-metabolite. Which of the following treatment examples best describes adjuvant therapy? A 53-year-old patient receives chemotherapy and radiation for a diagnosis of stage 3 breast cancer. An 80-year-old patient diagnosed with chronic leukemia receives oral chemotherapy with regular monitoring by her oncologist. A 64-year-old patient diagnosed with stage 3 ovarian cancer receives chemotherapy after undergoing a total abdominal hysterectomy and bilateral salpingo-oophorectomy. A 42-year-old patient diagnosed with stage 1 breast cancer undergoes a lumpectomy with lymph node biopsy. - Correct Answer-A 64-year-old patient diagnosed with stage 3 ovarian cancer receives chemotherapy after undergoing a total abdominal hysterectomy and bilateral salpingo-oophorectomy. Adjuvant therapy is an additional cancer treatment given after the primary treatment to minimize the risk of cancer recurrence. In "A 64-year-old patient diagnosed with stage 3...", the patient underwent surgery as a primary treatment with chemotherapy given as adjuvant therapy. Primary treatment is defined as the first treatment given and is also referred to as first line treatment, induction treatment, or primary therapy. A 60-year-old male patient newly diagnosed with small cell carcinoma of the right lung is admitted to the oncology unit with a chief complaint of facial and neck swelling as well as a cough. A diagnosis of superior vena cava syndrome is made. Which of the following treatment options would you expect to see ordered for this patient? Surgical consultation to place a chest tube Transfusion of two units of packed red blood cells Chemotherapy with adjuvant radiation therapy Thoracentesis under local anesthesia - Correct Answer-Chemotherapy with adjuvant radiation therapy The correct answer is chemotherapy with adjuvant radiation therapy to shrink the tumor and to elevate the obstruction that is causing the syndrome. Thoracentesis and chest tube placement would be viable treatment options for a pleural effusion. Transfusion of packed red blood cells would not be a suitable treatment option for superior vena cava syndrome. Which of the following would you include as part of discharge instructions for a patient diagnosed with head and neck cancer and who has received radiation therapy? -Apply soothing ointments to the lips for dryness and cracking. -All of these answer choices. -Rinse the mouth several times per day with a baking soda and warm water solution. -None of these answer choices. -Moisten foods with sauces, gravies and other liquids. -Use a soft, nylon toothbrush when brushing teeth. - Correct Answer-All of these answer choices. Patients diagnosed with head and neck cancer who are being treated with radiation therapy are at risk for oral mucositis. Application of soothing ointments for dryness of the lips, using a soft nylon toothbrush, oral baking soda rinses and moistening food with sauces or gravies are all appropriate teaching points for patients undergoing radiation therapy to the head and neck. Which chromosome is associated with chronic myelogenous leukemia? Chromosome 7 Philadelphia chromosome Chromosome 13 P53 - Correct Answer-The Philadelphia chromosome is present in nearly all CML cases and is detected by cytogenetic analysis. In only 5-10% of CML cases is the Philadelphia chromosome absent. Chromosome 7 is linked to leukemias, lymphomas and MDS syndrome. Chromosome 13 is linked to retinoblastoma and other types of cancer. P53 is a tumor suppressor protein A patient presents with a new diagnosis of non-small cell lung cancer. In the patient's medical record you learn that the tumor in the right lung is 4 cm x 6 cm and has invaded the visceral pleura. There is evidence of metastases in the mediastinal and subcarinal nodes as well as distant metastasis in the liver. Based on TNM staging, you realize that the patient has which stage of non-small cell lung cancer? Stage 2 Stage 3a Stage 3b Stage 4 - Correct Answer-Stage 4 The TNM system for cancer staging outlined by the American Joint Committee on Cancer (AJCC) assesses three basic components: size of the primary tumor, absence or presence of regional lymph nodes and the absence or presence of distant metastatic disease. Any evidence of distant metastasis per TNM staging would classify the cancer as stage 4. Which of the following is an example of a "B symptom" associated with lymphoma? Headache Painful lymph nodes Night sweats Edema - Correct Answer-"B symptoms" associated with a lymphoma diagnosis are a key factor in the staging of the disease. The presence of B symptoms is associated with a poorer prognosis. Unexplained fever, drenching night sweats, weight loss and pruritus are all B symptoms associated with lymphoma. Headache, edema, and painful lymph nodes are not classified as B symptoms. A 25-year-old female patient newly diagnosed with stage 4 Hodgkin's lymphoma presents to the outpatient oncology unit for her first dose of chemotherapy. You receive orders to administer ABVD. Which of the following would be appropriate to teach the patient regarding her chemotherapy? The chemotherapy will be administered intravenously. If you experience any pain or burning at your IV site, notify me right away as some of the medications can cause tissue damage if they lea