ONS Certificate Exam All Questions/Answer Graded A+
2025/2026
5. What is the absolute neutrophil count for a patient who has a white blood cell count of
500/mm3 with 32% polysegmented neutrophils and 7% bands?
a. 100/mm3
b. 125/mm3
c. 195/mm3
d. 223/mm3 - c. 195/mm3
The absolute neutrophil count can be calculated by adding polysegmented neutrophils
and bands, converting to a percentage, and multiplying by the white blood cell count
(0.32 +0.07 = 0.39) x 500 = 195/mm3.
6. A patient with cancer receiving palliative services reports poor sleep, fatigue, and
frequently feeling worried. Which medication should the nurse expect to be prescribed
for the patient?
a. miratazapine
b. diphenhydramine
c. citalopram
d. methylphenidate - c. citalopram
The symptoms described are consistent with generalized anxiety. Selective serotonin
reuptake inhibitors, such as citalopram, are considered first-line for the management of
generalized anxiety disorder.
7. The nurse is assessing a patient with an ileostomy. The peristomal skin is
erythematous, excoriated, and bleeding. Which of the following complications should
the nurse first suspect?
a. stenosis requiring revision
b. improper pouch fit
c. increased output over baseline
d. allergy to device - b. improper pouch fit
8. Which of these factors is most likely to result in a higher incidence of acute graft-
versus- host disease?
a. female to male donation
b. HLA identical related donors
c. reduced intensity conditioning regimen
d. T cell depleted grafts - a. female to male donation
A male recipient receiving the stem cells of a female increases the risk for the
development of acute graft-versus-host disease.
9. A patient with cancer has a new onset of confusion, acute nausea, and blurred vision.
The nurse anticipates the physician to order which diagnostic test?
a. U/S of gallblader & bile ducts
b. CXR
, c. Skeletal scintigraphy
d. MRI of brain - d. MRI of brain
10. A patient reports odynophagia with progressive dysphagia, and weight loss of five
kilograms over the past month. The nurse should anticipate which diagnostic test to be
ordered next?
a. endoscopy
b. bone marrow biopsy
c. Xray of kidneys, ureters, bladder
d. echocardiogram - a. endoscopy
the patient presents with signs and symptoms of esophageal cancer. A diagnostic
evaluation would include an endoscopy.
11. A patient who received chemotherapy two weeks ago presents with temperature,
102.4ºF (39.1ºC); heart rate 145 beats per minute; respiration rate, 30 breaths per
minute; and blood pressure 80/38 mm Hg. The patient's white blood cell count is
18,000/mm3. Which oncologic emergency should the nurse suspect?
a. septic shock
b. cardiac tamponade
c. tumor lysis syndrome
d. malignant bowel obstruction - a. septic shock
Patients with sepsis present with signs of infection, including leukocytosis, hypotension,
fever, and tachycardia.
12. A patient with breast cancer has been receiving paclitaxel and would like to have a
manicure. What instructions should the patient receive?
a. soak hands in a 50% bleach soultion for 20 mins
b. ask for a prescription for a prophylactic antibiotic
c. apply artifical nails using a strong adhesive
d. use a non acetone polish remover - d. use a non acetone polish remover
Non-acetone polish remover will be gentler on the nail, maintaining healthy structure.
13. A patient who has been treated with whole-brain radiation reports a new onset of
headaches, photophobia, nausea and confusion. The nurse suspects that the patient is
experiencing:
a. hypercalcemia
b. sepsis
c. increased intracranial pressure
d. tumor lysis syndrome - c. increased intracranial pressure
Symptoms of increased intracranial pressure include headaches, nausea and vomiting,
and photophobia.
14. A patient with an increased risk of hypercalcemia should be taught to:
2025/2026
5. What is the absolute neutrophil count for a patient who has a white blood cell count of
500/mm3 with 32% polysegmented neutrophils and 7% bands?
a. 100/mm3
b. 125/mm3
c. 195/mm3
d. 223/mm3 - c. 195/mm3
The absolute neutrophil count can be calculated by adding polysegmented neutrophils
and bands, converting to a percentage, and multiplying by the white blood cell count
(0.32 +0.07 = 0.39) x 500 = 195/mm3.
6. A patient with cancer receiving palliative services reports poor sleep, fatigue, and
frequently feeling worried. Which medication should the nurse expect to be prescribed
for the patient?
a. miratazapine
b. diphenhydramine
c. citalopram
d. methylphenidate - c. citalopram
The symptoms described are consistent with generalized anxiety. Selective serotonin
reuptake inhibitors, such as citalopram, are considered first-line for the management of
generalized anxiety disorder.
7. The nurse is assessing a patient with an ileostomy. The peristomal skin is
erythematous, excoriated, and bleeding. Which of the following complications should
the nurse first suspect?
a. stenosis requiring revision
b. improper pouch fit
c. increased output over baseline
d. allergy to device - b. improper pouch fit
8. Which of these factors is most likely to result in a higher incidence of acute graft-
versus- host disease?
a. female to male donation
b. HLA identical related donors
c. reduced intensity conditioning regimen
d. T cell depleted grafts - a. female to male donation
A male recipient receiving the stem cells of a female increases the risk for the
development of acute graft-versus-host disease.
9. A patient with cancer has a new onset of confusion, acute nausea, and blurred vision.
The nurse anticipates the physician to order which diagnostic test?
a. U/S of gallblader & bile ducts
b. CXR
, c. Skeletal scintigraphy
d. MRI of brain - d. MRI of brain
10. A patient reports odynophagia with progressive dysphagia, and weight loss of five
kilograms over the past month. The nurse should anticipate which diagnostic test to be
ordered next?
a. endoscopy
b. bone marrow biopsy
c. Xray of kidneys, ureters, bladder
d. echocardiogram - a. endoscopy
the patient presents with signs and symptoms of esophageal cancer. A diagnostic
evaluation would include an endoscopy.
11. A patient who received chemotherapy two weeks ago presents with temperature,
102.4ºF (39.1ºC); heart rate 145 beats per minute; respiration rate, 30 breaths per
minute; and blood pressure 80/38 mm Hg. The patient's white blood cell count is
18,000/mm3. Which oncologic emergency should the nurse suspect?
a. septic shock
b. cardiac tamponade
c. tumor lysis syndrome
d. malignant bowel obstruction - a. septic shock
Patients with sepsis present with signs of infection, including leukocytosis, hypotension,
fever, and tachycardia.
12. A patient with breast cancer has been receiving paclitaxel and would like to have a
manicure. What instructions should the patient receive?
a. soak hands in a 50% bleach soultion for 20 mins
b. ask for a prescription for a prophylactic antibiotic
c. apply artifical nails using a strong adhesive
d. use a non acetone polish remover - d. use a non acetone polish remover
Non-acetone polish remover will be gentler on the nail, maintaining healthy structure.
13. A patient who has been treated with whole-brain radiation reports a new onset of
headaches, photophobia, nausea and confusion. The nurse suspects that the patient is
experiencing:
a. hypercalcemia
b. sepsis
c. increased intracranial pressure
d. tumor lysis syndrome - c. increased intracranial pressure
Symptoms of increased intracranial pressure include headaches, nausea and vomiting,
and photophobia.
14. A patient with an increased risk of hypercalcemia should be taught to:
