Oncology Nursing Exam 2025/2026
With Correct Verified Answers | Oncology Nursing Society Standards | OCN Certification
Preparation
Overview
This 2025/2026 validated resource contains the complete oncology nursing
examination package with correct verified answers and detailed rationales. Essential
for registered nurses preparing for OCN certification and demonstrating advanced competency
in cancer care.
Key Features
✓ Correct Verified Answers with ONS evidence
✓ Updated 2025/2026 Oncology Standards
✓ Comprehensive Cancer Care Coverage
✓ Clinical Scenario Applications
✓ OCN Certification Alignment
Assessment Components
OCN Actual Exam: 165 Questions (125 scored, 40 pretest)
Practice Assessment: 165 Questions with Verified Answer Rationales
Core Content Areas
Cancer Pathophysiology & Biology (25 Questions)
Treatment Modalities (30 Questions)
Symptom Management (30 Questions)
Psychosocial Dimensions (20 Questions)
Survivorship & Palliative Care (20 Questions)
Professional Performance (20 Questions)
Health Promotion & Early Detection (20 Questions)
Answer Format
Correct verified answers in bold green with:
ONS evidence-based rationales
Clinical guideline applications
Symptom management pathways
Emergency intervention protocols
🔹
Critical Updates 2025/2026
🔹
NEW - Updated chemotherapy protocols
🔹
UPDATED - Immunotherapy guidelines
REVISED - Pain management standards
,🔹 MODIFIED - Survivorship care models
Study Materials Include
✓ ONS practice guidelines
✓ Chemotherapy administration references
✓ Symptom management algorithms
✓ Emergency response protocols
Assessment Features
✓ Timed certification simulation
✓ Performance analytics by domain
✓ Customized competency recommendations
✓ Knowledge domain tracking
Oncology Nursing Certification (OCN)
Practice Exam 2025/2026 (165
Questions)
Cancer Pathophysiology & Biology (Questions 1-25)
Question 1: Which gene mutation is most commonly associated with hereditary
breast and ovarian cancer syndrome, leading to impaired DNA double-strand
break repair?
A) TP53
B) BRCA1/BRCA2
C) RAS
D) MYC
Rationale: ONS/ONCC: BRCA mutations increase lifetime breast cancer risk to 55–72% and
ovarian to 39–44%; PARP inhibitors target this pathway.
Question 2: Tumor lysis syndrome results from massive cell death releasing
intracellular contents. Which electrolyte shift poses the greatest immediate
cardiac risk in a patient with acute lymphoblastic leukemia starting induction
therapy?
A) Hypocalcemia
B) Hyperkalemia
C) Hyponatremia
D) Hypophosphatemia
, Rationale: Potassium >6 mEq/L causes peaked T waves, arrhythmias; treat with calcium
gluconate, insulin/glucose, albuterol.
Question 3: According to the hallmarks of cancer, what enables replicative
immortality in malignant cells through maintenance of chromosome ends?
A) Apoptosis evasion
B) Telomerase activation
C) Angiogenesis
D) Metastasis
Rationale: Hanahan & Weinberg: unlimited divisions; targeted by telomere therapies in
development.
Question 4: Superior vena cava syndrome typically presents with facial edema and
dyspnea. What is the most common underlying malignancy causing mediastinal
compression in non-small cell lung cancer patients?
A) Adenocarcinoma
B) Squamous cell carcinoma
C) Small cell
D) Carcinoid
Rationale: Central location; urgent radiation/steroid therapy.
Question 5: In the three-step carcinogenesis model, which phase involves genetic
alterations that are fixed and irreversible, leading to malignant transformation
after promotional stimuli?
A) Initiation
B) Progression
C) Promotion
D) Latency
Rationale: Clonal expansion of initiated cells into invasive cancer.
Question 6: Paraneoplastic syndrome in small cell lung cancer commonly
manifests as Cushing syndrome due to ectopic production of which hormone?
A) Insulin
B) ACTH
C) PTHrP
D) Erythropoietin
Rationale: Hypokalemia, hypertension; treat underlying tumor.
Question 7: What is the primary mechanism of genomic instability in hereditary
nonpolyposis colorectal cancer (Lynch syndrome)?
A) Chromosomal translocation
B) Mismatch repair gene defects (MLH1, MSH2)
C) APC mutation
D) KRAS
With Correct Verified Answers | Oncology Nursing Society Standards | OCN Certification
Preparation
Overview
This 2025/2026 validated resource contains the complete oncology nursing
examination package with correct verified answers and detailed rationales. Essential
for registered nurses preparing for OCN certification and demonstrating advanced competency
in cancer care.
Key Features
✓ Correct Verified Answers with ONS evidence
✓ Updated 2025/2026 Oncology Standards
✓ Comprehensive Cancer Care Coverage
✓ Clinical Scenario Applications
✓ OCN Certification Alignment
Assessment Components
OCN Actual Exam: 165 Questions (125 scored, 40 pretest)
Practice Assessment: 165 Questions with Verified Answer Rationales
Core Content Areas
Cancer Pathophysiology & Biology (25 Questions)
Treatment Modalities (30 Questions)
Symptom Management (30 Questions)
Psychosocial Dimensions (20 Questions)
Survivorship & Palliative Care (20 Questions)
Professional Performance (20 Questions)
Health Promotion & Early Detection (20 Questions)
Answer Format
Correct verified answers in bold green with:
ONS evidence-based rationales
Clinical guideline applications
Symptom management pathways
Emergency intervention protocols
🔹
Critical Updates 2025/2026
🔹
NEW - Updated chemotherapy protocols
🔹
UPDATED - Immunotherapy guidelines
REVISED - Pain management standards
,🔹 MODIFIED - Survivorship care models
Study Materials Include
✓ ONS practice guidelines
✓ Chemotherapy administration references
✓ Symptom management algorithms
✓ Emergency response protocols
Assessment Features
✓ Timed certification simulation
✓ Performance analytics by domain
✓ Customized competency recommendations
✓ Knowledge domain tracking
Oncology Nursing Certification (OCN)
Practice Exam 2025/2026 (165
Questions)
Cancer Pathophysiology & Biology (Questions 1-25)
Question 1: Which gene mutation is most commonly associated with hereditary
breast and ovarian cancer syndrome, leading to impaired DNA double-strand
break repair?
A) TP53
B) BRCA1/BRCA2
C) RAS
D) MYC
Rationale: ONS/ONCC: BRCA mutations increase lifetime breast cancer risk to 55–72% and
ovarian to 39–44%; PARP inhibitors target this pathway.
Question 2: Tumor lysis syndrome results from massive cell death releasing
intracellular contents. Which electrolyte shift poses the greatest immediate
cardiac risk in a patient with acute lymphoblastic leukemia starting induction
therapy?
A) Hypocalcemia
B) Hyperkalemia
C) Hyponatremia
D) Hypophosphatemia
, Rationale: Potassium >6 mEq/L causes peaked T waves, arrhythmias; treat with calcium
gluconate, insulin/glucose, albuterol.
Question 3: According to the hallmarks of cancer, what enables replicative
immortality in malignant cells through maintenance of chromosome ends?
A) Apoptosis evasion
B) Telomerase activation
C) Angiogenesis
D) Metastasis
Rationale: Hanahan & Weinberg: unlimited divisions; targeted by telomere therapies in
development.
Question 4: Superior vena cava syndrome typically presents with facial edema and
dyspnea. What is the most common underlying malignancy causing mediastinal
compression in non-small cell lung cancer patients?
A) Adenocarcinoma
B) Squamous cell carcinoma
C) Small cell
D) Carcinoid
Rationale: Central location; urgent radiation/steroid therapy.
Question 5: In the three-step carcinogenesis model, which phase involves genetic
alterations that are fixed and irreversible, leading to malignant transformation
after promotional stimuli?
A) Initiation
B) Progression
C) Promotion
D) Latency
Rationale: Clonal expansion of initiated cells into invasive cancer.
Question 6: Paraneoplastic syndrome in small cell lung cancer commonly
manifests as Cushing syndrome due to ectopic production of which hormone?
A) Insulin
B) ACTH
C) PTHrP
D) Erythropoietin
Rationale: Hypokalemia, hypertension; treat underlying tumor.
Question 7: What is the primary mechanism of genomic instability in hereditary
nonpolyposis colorectal cancer (Lynch syndrome)?
A) Chromosomal translocation
B) Mismatch repair gene defects (MLH1, MSH2)
C) APC mutation
D) KRAS
