RN Oncology Relias A Actual Exam Questions and Answers |Fall
2026/2027 Update | 100% Correct Latest (Graded A+)
QUESTION 1
A patient with metastatic breast cancer is prescribed paclitaxel. The nurse should monitor
primarily for which dose-limiting toxicity?
A. Neutropenia
B. Nephrotoxicity
C. Ototoxicity
D. Constipation
CORRECT ANSWER: A. Neutropenia
RATIONALE: Paclitaxel causes significant bone marrow suppression, particularly neutropenia,
which limits dosing. Nephrotoxicity and ototoxicity are hallmark toxicities of cisplatin, not
paclitaxel. Constipation is not a primary concern with this agent.
QUESTION 2
Which action demonstrates appropriate extravasation management for vesicant chemotherapy?
A. Apply heat to the site to increase absorption
B. Remove the IV line immediately after infusing an antidote
C. Aspirate any residual drug before removing the needle
D. Gently massage the area to promote circulation
CORRECT ANSWER: C. Aspirate any residual drug before removing the needle
RATIONALE: Aspirating the drug minimizes tissue injury by removing as much agent as possible
before withdrawing the catheter. Heat or massage may spread the vesicant and worsen
necrosis.
QUESTION 3
Which nursing intervention is most important for a patient receiving cisplatin?
A. Encourage fluid restriction
B. Monitor for hearing loss
C. Restrict potassium intake
D. Limit diuretic use
CORRECT ANSWER: B. Monitor for hearing loss
,RATIONALE: Cisplatin can cause cumulative ototoxicity and nephrotoxicity. Monitoring for
tinnitus or hearing loss helps detect early toxicity. Hydration should be encouraged, not
restricted.
QUESTION 4
A patient on doxorubicin develops dyspnea and lower extremity edema. What is the nurse’s
priority concern?
A. Allergic reaction
B. Congestive heart failure
C. Fluid overload due to IV therapy
D. Disease progression
CORRECT ANSWER: B. Congestive heart failure
RATIONALE: Doxorubicin is cardiotoxic, and cumulative dosing can lead to irreversible heart
failure. Symptoms of dyspnea and edema warrant cardiac evaluation.
QUESTION 5
Filgrastim (G-CSF) is administered after chemotherapy for what purpose?
A. To prevent anemia
B. To reduce infection risk by stimulating neutrophil production
C. To prevent thrombocytopenia
D. To increase appetite
CORRECT ANSWER: B. To reduce infection risk by stimulating neutrophil production
RATIONALE: Filgrastim promotes bone marrow recovery of neutrophils, reducing infection risk. It
does not correct anemia or thrombocytopenia directly.
QUESTION 6
The nurse is reinforcing chemotherapy education. The patient should be taught to avoid which
food during neutropenia?
A. Pasteurized milk
B. Fresh raw fruits and vegetables
C. Cooked poultry
D. Bottled water
,CORRECT ANSWER: B. Fresh raw fruits and vegetables
RATIONALE: Raw produce may contain bacteria harmful to immunocompromised patients. The
neutropenic diet avoids unpasteurized, raw, or undercooked foods.
QUESTION 7
Which symptom indicates potential tumor lysis syndrome?
A. Hypercalcemia and tachycardia
B. Paresthesia and muscle cramps
C. Decreased uric acid and hematuria
D. Hypokalemia and bradycardia
CORRECT ANSWER: B. Paresthesia and muscle cramps
RATIONALE: Tumor lysis syndrome leads to elevated potassium, phosphate, and uric acid, and
decreased calcium. Hypocalcemia can cause paresthesia and cramps.
QUESTION 8
A patient with Hodgkin lymphoma complains of itchy, red hands after bleomycin infusion. The
nurse suspects:
A. Allergic hypersensitivity reaction
B. Hand-foot syndrome
C. Neutropenic rash
D. Radiation recall injury
CORRECT ANSWER: A. Allergic hypersensitivity reaction
RATIONALE: Bleomycin can trigger hypersensitivity reactions presenting with rash or urticaria
during infusion. Hand-foot syndrome is typical of capecitabine.
QUESTION 9
Which environmental factor most strongly increases lung cancer risk?
A. Formaldehyde exposure
B. Radon gas
C. Asbestos
D. Tobacco smoke
, CORRECT ANSWER: D. Tobacco smoke
RATIONALE: Cigarette smoke is the leading preventable cause of lung cancer, far surpassing
other environmental risks.
QUESTION 10
The nurse is preparing rituximab infusion for a patient with non-Hodgkin lymphoma. What is
the most critical nursing action?
A. Prehydrate with 500 mL normal saline
B. Monitor closely during the first 15–30 minutes for infusion reaction
C. Give immediately after chemotherapy to increase efficacy
D. Administer over 15 minutes to prevent fatigue
CORRECT ANSWER: B. Monitor closely during the first 15–30 minutes for infusion reaction
RATIONALE: Rituximab can cause life-threatening infusion reactions, especially initially. Vitals
should be monitored closely during and after early doses.
QUESTION 11
A patient treated with cyclophosphamide reports new-onset dysuria and hematuria. Which
nursing intervention is the priority?
A. Encourage oral fluid intake
B. Administer mesna as prescribed
C. Apply warm compresses
D. Restrict fluids
CORRECT ANSWER: B. Administer mesna as prescribed
RATIONALE: Mesna binds acrolein (a toxic metabolite of cyclophosphamide) to prevent
hemorrhagic cystitis. Aggressive hydration also helps, but mesna directly neutralizes the irritant.
QUESTION 12
During patient education about radiation therapy, which statement indicates the need for
further teaching?
A. “I will use mild soap and pat my skin dry.”
B. “I can apply scented lotion if my skin feels dry.”
C. “I should protect the treated area from sunlight.”
D. “Loose cotton clothing is best.”
2026/2027 Update | 100% Correct Latest (Graded A+)
QUESTION 1
A patient with metastatic breast cancer is prescribed paclitaxel. The nurse should monitor
primarily for which dose-limiting toxicity?
A. Neutropenia
B. Nephrotoxicity
C. Ototoxicity
D. Constipation
CORRECT ANSWER: A. Neutropenia
RATIONALE: Paclitaxel causes significant bone marrow suppression, particularly neutropenia,
which limits dosing. Nephrotoxicity and ototoxicity are hallmark toxicities of cisplatin, not
paclitaxel. Constipation is not a primary concern with this agent.
QUESTION 2
Which action demonstrates appropriate extravasation management for vesicant chemotherapy?
A. Apply heat to the site to increase absorption
B. Remove the IV line immediately after infusing an antidote
C. Aspirate any residual drug before removing the needle
D. Gently massage the area to promote circulation
CORRECT ANSWER: C. Aspirate any residual drug before removing the needle
RATIONALE: Aspirating the drug minimizes tissue injury by removing as much agent as possible
before withdrawing the catheter. Heat or massage may spread the vesicant and worsen
necrosis.
QUESTION 3
Which nursing intervention is most important for a patient receiving cisplatin?
A. Encourage fluid restriction
B. Monitor for hearing loss
C. Restrict potassium intake
D. Limit diuretic use
CORRECT ANSWER: B. Monitor for hearing loss
,RATIONALE: Cisplatin can cause cumulative ototoxicity and nephrotoxicity. Monitoring for
tinnitus or hearing loss helps detect early toxicity. Hydration should be encouraged, not
restricted.
QUESTION 4
A patient on doxorubicin develops dyspnea and lower extremity edema. What is the nurse’s
priority concern?
A. Allergic reaction
B. Congestive heart failure
C. Fluid overload due to IV therapy
D. Disease progression
CORRECT ANSWER: B. Congestive heart failure
RATIONALE: Doxorubicin is cardiotoxic, and cumulative dosing can lead to irreversible heart
failure. Symptoms of dyspnea and edema warrant cardiac evaluation.
QUESTION 5
Filgrastim (G-CSF) is administered after chemotherapy for what purpose?
A. To prevent anemia
B. To reduce infection risk by stimulating neutrophil production
C. To prevent thrombocytopenia
D. To increase appetite
CORRECT ANSWER: B. To reduce infection risk by stimulating neutrophil production
RATIONALE: Filgrastim promotes bone marrow recovery of neutrophils, reducing infection risk. It
does not correct anemia or thrombocytopenia directly.
QUESTION 6
The nurse is reinforcing chemotherapy education. The patient should be taught to avoid which
food during neutropenia?
A. Pasteurized milk
B. Fresh raw fruits and vegetables
C. Cooked poultry
D. Bottled water
,CORRECT ANSWER: B. Fresh raw fruits and vegetables
RATIONALE: Raw produce may contain bacteria harmful to immunocompromised patients. The
neutropenic diet avoids unpasteurized, raw, or undercooked foods.
QUESTION 7
Which symptom indicates potential tumor lysis syndrome?
A. Hypercalcemia and tachycardia
B. Paresthesia and muscle cramps
C. Decreased uric acid and hematuria
D. Hypokalemia and bradycardia
CORRECT ANSWER: B. Paresthesia and muscle cramps
RATIONALE: Tumor lysis syndrome leads to elevated potassium, phosphate, and uric acid, and
decreased calcium. Hypocalcemia can cause paresthesia and cramps.
QUESTION 8
A patient with Hodgkin lymphoma complains of itchy, red hands after bleomycin infusion. The
nurse suspects:
A. Allergic hypersensitivity reaction
B. Hand-foot syndrome
C. Neutropenic rash
D. Radiation recall injury
CORRECT ANSWER: A. Allergic hypersensitivity reaction
RATIONALE: Bleomycin can trigger hypersensitivity reactions presenting with rash or urticaria
during infusion. Hand-foot syndrome is typical of capecitabine.
QUESTION 9
Which environmental factor most strongly increases lung cancer risk?
A. Formaldehyde exposure
B. Radon gas
C. Asbestos
D. Tobacco smoke
, CORRECT ANSWER: D. Tobacco smoke
RATIONALE: Cigarette smoke is the leading preventable cause of lung cancer, far surpassing
other environmental risks.
QUESTION 10
The nurse is preparing rituximab infusion for a patient with non-Hodgkin lymphoma. What is
the most critical nursing action?
A. Prehydrate with 500 mL normal saline
B. Monitor closely during the first 15–30 minutes for infusion reaction
C. Give immediately after chemotherapy to increase efficacy
D. Administer over 15 minutes to prevent fatigue
CORRECT ANSWER: B. Monitor closely during the first 15–30 minutes for infusion reaction
RATIONALE: Rituximab can cause life-threatening infusion reactions, especially initially. Vitals
should be monitored closely during and after early doses.
QUESTION 11
A patient treated with cyclophosphamide reports new-onset dysuria and hematuria. Which
nursing intervention is the priority?
A. Encourage oral fluid intake
B. Administer mesna as prescribed
C. Apply warm compresses
D. Restrict fluids
CORRECT ANSWER: B. Administer mesna as prescribed
RATIONALE: Mesna binds acrolein (a toxic metabolite of cyclophosphamide) to prevent
hemorrhagic cystitis. Aggressive hydration also helps, but mesna directly neutralizes the irritant.
QUESTION 12
During patient education about radiation therapy, which statement indicates the need for
further teaching?
A. “I will use mild soap and pat my skin dry.”
B. “I can apply scented lotion if my skin feels dry.”
C. “I should protect the treated area from sunlight.”
D. “Loose cotton clothing is best.”
