Oncology Nursing Examination Guide
Comprehensive 300 Board-Style Review & Rationales
Author: Barbie Nurse Esther Email: WhatsApp: 0735913492
This comprehensive oncology nursing practice manual covers fundamental cell biology, carcinogenesis, chemotherapy management,
radiation therapy, oncologic emergencies, palliative care, and hematologic malignancies.
Module 1: Oncology Foundations & Cellular Biology (Q1 - Q50)
Question 1
Q1. Which feature distinguishes a malignant tumor from a benign tumor?
A. Encapsulated growth
B. Well-differentiated cells
C. Ability to metastasize and invade adjacent tissue
D. Slow and predictable growth rate
Correct Answer: C | Rationale: Malignant tumors are characterized by invasive growth, lack of encapsulation, poor differentiation
(anaplasia), and the ability to metastasize to distant organs.
Question 2
Q2. A patient undergoing genetic screening tests positive for the BRCA1 gene mutation. The nurse recognizes
that this increases the risk for:
A. Colon and stomach cancer
B. Breast and ovarian cancer
C. Lung and esophageal cancer
D. Renal and bladder cancer
Correct Answer: B | Rationale: BRCA1 and BRCA2 are tumor suppressor genes. Mutations significantly elevate the lifetime risk of
developing breast and ovarian cancers.
Question 3
Q3. In cancer staging using the TNM system, what does 'T2 N1 M0' indicate?
A. Primary tumor absent, distant node involvement, metastasis present
B. Intermediate primary tumor size, local regional lymph node involvement, no distant metastasis
C. In situ carcinoma with extensive distant metastasis
D. Large tumor, extensive distant lymph node spread, unknown metastasis status
Correct Answer: B | Rationale: T2 indicates intermediate tumor size/extent, N1 indicates regional lymph node involvement, and
M0 indicates no distant metastasis.
Barbie Nurse Esther | Oncology Nursing Page 1 of 69
, Question 4
Q4. A nurse is preparing to administer doxorubicin. Which baseline diagnostic assessment is imperative prior
to initiating treatment?
A. Pulmonary function tests
B. Echocardiogram / Left Ventricular Ejection Fraction (LVEF)
C. Serum creatinine and BUN
D. Brain MRI
Correct Answer: B | Rationale: Doxorubicin (an anthracycline) carries a significant risk of cardiotoxicity and cumulative heart
failure. Baseline LVEF evaluation via echocardiogram or MUGA scan is mandatory.
Question 5
Q5. A patient receiving intravenous vincristine reports numbness, tingling, and burning in their fingers and
toes. What is the priority nursing action?
A. Administer an IV bolus of normal saline
B. Stop the infusion and notify the healthcare provider of peripheral neuropathy
C. Apply ice packs to the client's hands and feet
D. Reassure the patient that this is a normal transient response
Correct Answer: B | Rationale: Vincristine is neurotoxic. Peripheral neuropathy (paresthesias, motor loss) is a major dose-limiting
toxicity. Neurologic changes require immediate clinical assessment and potential dose adjustment.
Question 6
Q6. During chemotherapy administration, the nurse notes extravasation of a vesicant drug. What is the
immediate first action?
A. Elevate the extremity and apply a warm compress
B. Stop the infusion immediately and disconnect the tubing
C. Inject 10 mL of normal saline into the line
D. Flush the line forcefully with heparin
Correct Answer: B | Rationale: The primary action in vesicant extravasation is to immediately stop the infusion to limit tissue
damage, leaving the catheter in place if an antidote is to be infiltrated.
Question 7
Q7. A client undergoing external beam radiation therapy to the neck develops dry desquamation of the skin.
Which skin care instruction should the nurse reinforce?
A. Apply scented petroleum jelly twice daily
B. Scrub the area vigorously with antibacterial soap
C. Wash gently with lukewarm water and mild soap, avoiding rubbing off radiation field marks
D. Use heating pads to soothe neck discomfort
Correct Answer: C | Rationale: Skin in the radiation field should be treated gently with mild soap and lukewarm water. Avoid
scrubbing, harsh chemicals, heating pads, or removing therapeutic skin markings.
Barbie Nurse Esther | Oncology Nursing Page 2 of 69
, Question 8
Q8. A patient with cervical cancer has an internal radioactive implant (brachytherapy). Which safety precaution
must the nurse implement?
A. Assign the patient to a multi-bed ward
B. Wear a lead apron and personal dosimeter badge during direct care
C. Allow visitors unlimited contact time as long as they stay 2 feet away
D. Pregnant staff members should provide morning hygiene care
Correct Answer: B | Rationale: Brachytherapy precautions include time, distance, and shielding. Staff must wear lead aprons,
personal dosimeters, and pregnant staff or young children must avoid exposure.
Question 9
Q9. A patient receiving chemotherapy develops a absolute neutrophil count (ANC) of 350/mm³ and a fever of
38.5°C (101.3°F). What is the highest priority nursing intervention?
A. Administer antipyretics and recheck temperature in 4 hours
B. Obtain blood cultures and initiate prompt broad-spectrum IV antibiotics
C. Place the patient in contact isolation and monitor oral fluids
D. Administer a dose of filgrastim subcutaneously
Correct Answer: B | Rationale: Febrile neutropenia is a life-threatening medical emergency. Broad-spectrum IV antibiotic therapy
must be initiated within 1 hour after obtaining immediate blood cultures.
Question 10
Q10. A client with small cell lung carcinoma presents with facial edema, jugular vein distention, and dyspnea.
The nurse suspects:
A. Tumor Lysis Syndrome (TLS)
B. Superior Vena Cava (SVC) Syndrome
C. Spinal Cord Compression
D. Cardiac Tamponade
Correct Answer: B | Rationale: SVC syndrome occurs when tumor compression obstructs blood flow through the superior vena
cava, causing facial/periorbital edema, neck vein engorgement, and respiratory distress.
Question 11
Q11. Which laboratory finding is characteristic of Tumor Lysis Syndrome (TLS)?
A. Hypercalcemia, hypokalemia, hypophosphatemia
B. Hyperkalemia, hyperphosphatemia, hyperuricemia, and hypocalcemia
C. Hyponatremia, hypoglycemia, elevated alkaline phosphatase
D. Hypokalemia, hypercalcemia, low uric acid
Correct Answer: B | Rationale: Massive cellular breakdown in TLS releases intracellular contents into circulation, leading to
hyperkalemia, hyperphosphatemia, hyperuricemia, and secondary hypocalcemia.
Question 12
Q12. Which feature distinguishes a malignant tumor from a benign tumor?
A. Encapsulated growth
B. Well-differentiated cells
C. Ability to metastasize and invade adjacent tissue
D. Slow and predictable growth rate
Correct Answer: C | Rationale: Malignant tumors are characterized by invasive growth, lack of encapsulation, poor differentiation
(anaplasia), and the ability to metastasize to distant organs.
Barbie Nurse Esther | Oncology Nursing Page 3 of 69
, Question 13
Q13. A patient undergoing genetic screening tests positive for the BRCA1 gene mutation. The nurse recognizes
that this increases the risk for:
A. Colon and stomach cancer
B. Breast and ovarian cancer
C. Lung and esophageal cancer
D. Renal and bladder cancer
Correct Answer: B | Rationale: BRCA1 and BRCA2 are tumor suppressor genes. Mutations significantly elevate the lifetime risk of
developing breast and ovarian cancers.
Question 14
Q14. In cancer staging using the TNM system, what does 'T2 N1 M0' indicate?
A. Primary tumor absent, distant node involvement, metastasis present
B. Intermediate primary tumor size, local regional lymph node involvement, no distant metastasis
C. In situ carcinoma with extensive distant metastasis
D. Large tumor, extensive distant lymph node spread, unknown metastasis status
Correct Answer: B | Rationale: T2 indicates intermediate tumor size/extent, N1 indicates regional lymph node involvement, and
M0 indicates no distant metastasis.
Question 15
Q15. A nurse is preparing to administer doxorubicin. Which baseline diagnostic assessment is imperative prior
to initiating treatment?
A. Pulmonary function tests
B. Echocardiogram / Left Ventricular Ejection Fraction (LVEF)
C. Serum creatinine and BUN
D. Brain MRI
Correct Answer: B | Rationale: Doxorubicin (an anthracycline) carries a significant risk of cardiotoxicity and cumulative heart
failure. Baseline LVEF evaluation via echocardiogram or MUGA scan is mandatory.
Question 16
Q16. A patient receiving intravenous vincristine reports numbness, tingling, and burning in their fingers and
toes. What is the priority nursing action?
A. Administer an IV bolus of normal saline
B. Stop the infusion and notify the healthcare provider of peripheral neuropathy
C. Apply ice packs to the client's hands and feet
D. Reassure the patient that this is a normal transient response
Correct Answer: B | Rationale: Vincristine is neurotoxic. Peripheral neuropathy (paresthesias, motor loss) is a major dose-limiting
toxicity. Neurologic changes require immediate clinical assessment and potential dose adjustment.
Barbie Nurse Esther | Oncology Nursing Page 4 of 69
Comprehensive 300 Board-Style Review & Rationales
Author: Barbie Nurse Esther Email: WhatsApp: 0735913492
This comprehensive oncology nursing practice manual covers fundamental cell biology, carcinogenesis, chemotherapy management,
radiation therapy, oncologic emergencies, palliative care, and hematologic malignancies.
Module 1: Oncology Foundations & Cellular Biology (Q1 - Q50)
Question 1
Q1. Which feature distinguishes a malignant tumor from a benign tumor?
A. Encapsulated growth
B. Well-differentiated cells
C. Ability to metastasize and invade adjacent tissue
D. Slow and predictable growth rate
Correct Answer: C | Rationale: Malignant tumors are characterized by invasive growth, lack of encapsulation, poor differentiation
(anaplasia), and the ability to metastasize to distant organs.
Question 2
Q2. A patient undergoing genetic screening tests positive for the BRCA1 gene mutation. The nurse recognizes
that this increases the risk for:
A. Colon and stomach cancer
B. Breast and ovarian cancer
C. Lung and esophageal cancer
D. Renal and bladder cancer
Correct Answer: B | Rationale: BRCA1 and BRCA2 are tumor suppressor genes. Mutations significantly elevate the lifetime risk of
developing breast and ovarian cancers.
Question 3
Q3. In cancer staging using the TNM system, what does 'T2 N1 M0' indicate?
A. Primary tumor absent, distant node involvement, metastasis present
B. Intermediate primary tumor size, local regional lymph node involvement, no distant metastasis
C. In situ carcinoma with extensive distant metastasis
D. Large tumor, extensive distant lymph node spread, unknown metastasis status
Correct Answer: B | Rationale: T2 indicates intermediate tumor size/extent, N1 indicates regional lymph node involvement, and
M0 indicates no distant metastasis.
Barbie Nurse Esther | Oncology Nursing Page 1 of 69
, Question 4
Q4. A nurse is preparing to administer doxorubicin. Which baseline diagnostic assessment is imperative prior
to initiating treatment?
A. Pulmonary function tests
B. Echocardiogram / Left Ventricular Ejection Fraction (LVEF)
C. Serum creatinine and BUN
D. Brain MRI
Correct Answer: B | Rationale: Doxorubicin (an anthracycline) carries a significant risk of cardiotoxicity and cumulative heart
failure. Baseline LVEF evaluation via echocardiogram or MUGA scan is mandatory.
Question 5
Q5. A patient receiving intravenous vincristine reports numbness, tingling, and burning in their fingers and
toes. What is the priority nursing action?
A. Administer an IV bolus of normal saline
B. Stop the infusion and notify the healthcare provider of peripheral neuropathy
C. Apply ice packs to the client's hands and feet
D. Reassure the patient that this is a normal transient response
Correct Answer: B | Rationale: Vincristine is neurotoxic. Peripheral neuropathy (paresthesias, motor loss) is a major dose-limiting
toxicity. Neurologic changes require immediate clinical assessment and potential dose adjustment.
Question 6
Q6. During chemotherapy administration, the nurse notes extravasation of a vesicant drug. What is the
immediate first action?
A. Elevate the extremity and apply a warm compress
B. Stop the infusion immediately and disconnect the tubing
C. Inject 10 mL of normal saline into the line
D. Flush the line forcefully with heparin
Correct Answer: B | Rationale: The primary action in vesicant extravasation is to immediately stop the infusion to limit tissue
damage, leaving the catheter in place if an antidote is to be infiltrated.
Question 7
Q7. A client undergoing external beam radiation therapy to the neck develops dry desquamation of the skin.
Which skin care instruction should the nurse reinforce?
A. Apply scented petroleum jelly twice daily
B. Scrub the area vigorously with antibacterial soap
C. Wash gently with lukewarm water and mild soap, avoiding rubbing off radiation field marks
D. Use heating pads to soothe neck discomfort
Correct Answer: C | Rationale: Skin in the radiation field should be treated gently with mild soap and lukewarm water. Avoid
scrubbing, harsh chemicals, heating pads, or removing therapeutic skin markings.
Barbie Nurse Esther | Oncology Nursing Page 2 of 69
, Question 8
Q8. A patient with cervical cancer has an internal radioactive implant (brachytherapy). Which safety precaution
must the nurse implement?
A. Assign the patient to a multi-bed ward
B. Wear a lead apron and personal dosimeter badge during direct care
C. Allow visitors unlimited contact time as long as they stay 2 feet away
D. Pregnant staff members should provide morning hygiene care
Correct Answer: B | Rationale: Brachytherapy precautions include time, distance, and shielding. Staff must wear lead aprons,
personal dosimeters, and pregnant staff or young children must avoid exposure.
Question 9
Q9. A patient receiving chemotherapy develops a absolute neutrophil count (ANC) of 350/mm³ and a fever of
38.5°C (101.3°F). What is the highest priority nursing intervention?
A. Administer antipyretics and recheck temperature in 4 hours
B. Obtain blood cultures and initiate prompt broad-spectrum IV antibiotics
C. Place the patient in contact isolation and monitor oral fluids
D. Administer a dose of filgrastim subcutaneously
Correct Answer: B | Rationale: Febrile neutropenia is a life-threatening medical emergency. Broad-spectrum IV antibiotic therapy
must be initiated within 1 hour after obtaining immediate blood cultures.
Question 10
Q10. A client with small cell lung carcinoma presents with facial edema, jugular vein distention, and dyspnea.
The nurse suspects:
A. Tumor Lysis Syndrome (TLS)
B. Superior Vena Cava (SVC) Syndrome
C. Spinal Cord Compression
D. Cardiac Tamponade
Correct Answer: B | Rationale: SVC syndrome occurs when tumor compression obstructs blood flow through the superior vena
cava, causing facial/periorbital edema, neck vein engorgement, and respiratory distress.
Question 11
Q11. Which laboratory finding is characteristic of Tumor Lysis Syndrome (TLS)?
A. Hypercalcemia, hypokalemia, hypophosphatemia
B. Hyperkalemia, hyperphosphatemia, hyperuricemia, and hypocalcemia
C. Hyponatremia, hypoglycemia, elevated alkaline phosphatase
D. Hypokalemia, hypercalcemia, low uric acid
Correct Answer: B | Rationale: Massive cellular breakdown in TLS releases intracellular contents into circulation, leading to
hyperkalemia, hyperphosphatemia, hyperuricemia, and secondary hypocalcemia.
Question 12
Q12. Which feature distinguishes a malignant tumor from a benign tumor?
A. Encapsulated growth
B. Well-differentiated cells
C. Ability to metastasize and invade adjacent tissue
D. Slow and predictable growth rate
Correct Answer: C | Rationale: Malignant tumors are characterized by invasive growth, lack of encapsulation, poor differentiation
(anaplasia), and the ability to metastasize to distant organs.
Barbie Nurse Esther | Oncology Nursing Page 3 of 69
, Question 13
Q13. A patient undergoing genetic screening tests positive for the BRCA1 gene mutation. The nurse recognizes
that this increases the risk for:
A. Colon and stomach cancer
B. Breast and ovarian cancer
C. Lung and esophageal cancer
D. Renal and bladder cancer
Correct Answer: B | Rationale: BRCA1 and BRCA2 are tumor suppressor genes. Mutations significantly elevate the lifetime risk of
developing breast and ovarian cancers.
Question 14
Q14. In cancer staging using the TNM system, what does 'T2 N1 M0' indicate?
A. Primary tumor absent, distant node involvement, metastasis present
B. Intermediate primary tumor size, local regional lymph node involvement, no distant metastasis
C. In situ carcinoma with extensive distant metastasis
D. Large tumor, extensive distant lymph node spread, unknown metastasis status
Correct Answer: B | Rationale: T2 indicates intermediate tumor size/extent, N1 indicates regional lymph node involvement, and
M0 indicates no distant metastasis.
Question 15
Q15. A nurse is preparing to administer doxorubicin. Which baseline diagnostic assessment is imperative prior
to initiating treatment?
A. Pulmonary function tests
B. Echocardiogram / Left Ventricular Ejection Fraction (LVEF)
C. Serum creatinine and BUN
D. Brain MRI
Correct Answer: B | Rationale: Doxorubicin (an anthracycline) carries a significant risk of cardiotoxicity and cumulative heart
failure. Baseline LVEF evaluation via echocardiogram or MUGA scan is mandatory.
Question 16
Q16. A patient receiving intravenous vincristine reports numbness, tingling, and burning in their fingers and
toes. What is the priority nursing action?
A. Administer an IV bolus of normal saline
B. Stop the infusion and notify the healthcare provider of peripheral neuropathy
C. Apply ice packs to the client's hands and feet
D. Reassure the patient that this is a normal transient response
Correct Answer: B | Rationale: Vincristine is neurotoxic. Peripheral neuropathy (paresthesias, motor loss) is a major dose-limiting
toxicity. Neurologic changes require immediate clinical assessment and potential dose adjustment.
Barbie Nurse Esther | Oncology Nursing Page 4 of 69
