2026 OCN Oncology Certified Nurse Exam New Latest
Version with All Questions from Actual Exam 100%
Correct Answers and Rationale
Mitotic (M) - answers -:Mitotic - cell division occurs in 4 phase: prophase, metaphase,
anaphase, and telophase. These phases describe the separation of the chromosomes within the
cell, the creation of mitotic spindles, the signals to start cell division, and the creation of 2 new
daughter cells. Cytokinesis is the process of division of cytoplasm within the cell, ensuring the
separation of chromosomes at the right time and place to create each daughter cell
appropriately.
Acquired Mutations - answers -:Occur over one's lifetime (not passed from parents). They are
isolated to a specific cell and are caused by extrinsic factors like exposure to carcinogens
(tobacco smoke, alcohol, viruses, and chemicals).
Germline Mutations - answers -:Also known as heredity, are passed from parents to child. They
account for up the 20% of cancers (breast and colon). The genetic mutation or malformation is
found in the sperm and/or egg of the parent and begins at conception. Are permanent and
affect every cell in the body. When mutation is present, the cells grow and divide with the DNA
malformation. Lynch syndrome is an example and is associated with colon cancer.
Tumor Supressor Genes - answers -:Ordinary genes within cells that act as protectors to
decrease cell division activity, correct DNA mistakes, and promote apoptosis (cell death). Most
tumor suppressor gene mutations are acquired and not inherited.
Oncogene: HER2 - answers -:More than a quarter of breast cancer cells will overexpress HER2,
which is a protein that monitors and controls cancer growth and metastases. HER2 is also found
in ovarian cancers.
, Oncogene: RAS genes - answers -:Found in approximately a third of pancreatic, lung, colorectal
cancers. A mutated RAS gene causes uncontrolled cellular growth and impaired cell death
signals, potentially causing resistance to chemotherapy and other anti-cancer agents.
Carcinogenesis: Initiation Phase - answers -:Development of a permanent genetic mutation
(whether acquired or inherited) within a tumor suppressor gene or oncogene. Cellular
immortalization and uncontrolled cell growth occur during this phase.
Carcinogenesis: Promotion Phase - answers -:The stage between premalignant and invasive
cancer development. It can take an extended period to develop a cancer cell, so progression has
the potential to be reversible with chemoprevention medications (I.E. Tamoxifen or Proscar).
Carcinogenesis: Transformation Stage - answers -:The cells are deprived of necessary oxygen
and exposed to elevated levels of cellular waste products, which promotes the cells to
transform into unhealthy cells. They also signal that would impede uncontrolled proliferation.
Carcinogenesis: Progression Stage - answers -:The rapid proliferation of the mutated unhealthy
cells. During this phase, the cancer cell is well developed and has the opportunity for local
invasion as well as the potential to cause metastases.
Stage of Tumor: Stage I - answers -:Hyperplasia (hyper means "more"). Healthy cells look and
act normal but are overexpressed. An example is endometrial hyperplasia.
Stage of Tumor: Stage II - answers -:Dysplasia: Builds upon hyperplasia; looks disorganized,
rather than normal. An example is cervical dysplasia, which can be moderate to severe.
Stage of Tumor: Stage III - answers -:Carcinoma in situ: Cells have grown and spread within the
organ; isolated to the organ of origin with no spread. It does not resemble the cell of origin and
is abnormal, which is referred to as anaplasia.
Version with All Questions from Actual Exam 100%
Correct Answers and Rationale
Mitotic (M) - answers -:Mitotic - cell division occurs in 4 phase: prophase, metaphase,
anaphase, and telophase. These phases describe the separation of the chromosomes within the
cell, the creation of mitotic spindles, the signals to start cell division, and the creation of 2 new
daughter cells. Cytokinesis is the process of division of cytoplasm within the cell, ensuring the
separation of chromosomes at the right time and place to create each daughter cell
appropriately.
Acquired Mutations - answers -:Occur over one's lifetime (not passed from parents). They are
isolated to a specific cell and are caused by extrinsic factors like exposure to carcinogens
(tobacco smoke, alcohol, viruses, and chemicals).
Germline Mutations - answers -:Also known as heredity, are passed from parents to child. They
account for up the 20% of cancers (breast and colon). The genetic mutation or malformation is
found in the sperm and/or egg of the parent and begins at conception. Are permanent and
affect every cell in the body. When mutation is present, the cells grow and divide with the DNA
malformation. Lynch syndrome is an example and is associated with colon cancer.
Tumor Supressor Genes - answers -:Ordinary genes within cells that act as protectors to
decrease cell division activity, correct DNA mistakes, and promote apoptosis (cell death). Most
tumor suppressor gene mutations are acquired and not inherited.
Oncogene: HER2 - answers -:More than a quarter of breast cancer cells will overexpress HER2,
which is a protein that monitors and controls cancer growth and metastases. HER2 is also found
in ovarian cancers.
, Oncogene: RAS genes - answers -:Found in approximately a third of pancreatic, lung, colorectal
cancers. A mutated RAS gene causes uncontrolled cellular growth and impaired cell death
signals, potentially causing resistance to chemotherapy and other anti-cancer agents.
Carcinogenesis: Initiation Phase - answers -:Development of a permanent genetic mutation
(whether acquired or inherited) within a tumor suppressor gene or oncogene. Cellular
immortalization and uncontrolled cell growth occur during this phase.
Carcinogenesis: Promotion Phase - answers -:The stage between premalignant and invasive
cancer development. It can take an extended period to develop a cancer cell, so progression has
the potential to be reversible with chemoprevention medications (I.E. Tamoxifen or Proscar).
Carcinogenesis: Transformation Stage - answers -:The cells are deprived of necessary oxygen
and exposed to elevated levels of cellular waste products, which promotes the cells to
transform into unhealthy cells. They also signal that would impede uncontrolled proliferation.
Carcinogenesis: Progression Stage - answers -:The rapid proliferation of the mutated unhealthy
cells. During this phase, the cancer cell is well developed and has the opportunity for local
invasion as well as the potential to cause metastases.
Stage of Tumor: Stage I - answers -:Hyperplasia (hyper means "more"). Healthy cells look and
act normal but are overexpressed. An example is endometrial hyperplasia.
Stage of Tumor: Stage II - answers -:Dysplasia: Builds upon hyperplasia; looks disorganized,
rather than normal. An example is cervical dysplasia, which can be moderate to severe.
Stage of Tumor: Stage III - answers -:Carcinoma in situ: Cells have grown and spread within the
organ; isolated to the organ of origin with no spread. It does not resemble the cell of origin and
is abnormal, which is referred to as anaplasia.
