Practice Test- Chemo Certification Latest Update 2024-2025

Actual Exam From Credible Source With 100 Questions

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OCN Practice Test 2024
(Q) What is the primary purpose for providing interprofessional oncology care?
a. delivering cost-effective services
b. standardizing patient communication
c. improving patient outcomes
d. meeting regulatory standards - :-c. improving patient outcomes
Quality of practice includes the oncology nurse participating in interprofessional
teams to address outcomes and enhance factors that promote safe and effective
patient outcomes.

(Q) What is the shortest phase of the cell cycle?

a. synthesis
b. gap 2
c. mitosis
d. gap 1 - :-c. mitosis
Mitosis is the shortest phase of the cell's life cycle.

(Q) A patient with cancer states "What is the point of living if I have cancer? I am
going to die anyway. I should just sit at home." Which of the following statements
made by the nurse offers the most therapeutic approach?
a. "let's explore some ways you can engage and enjoy life"
b. "a pessimistic attitude puts you at risk for depression. Are you depressed?"
c. "You sound anxious. Make sure to discuss this with your physician"
d. "I will refer you to the social worker to talk through your thoughts" - :-A. "let's
explore some ways you can engage and enjoy life"
A patient experiencing helplessness and possibly depression may benefit from
gently reframing negative thinking patterns.

(Q) A patient with intractable dyspnea at the end of life has not experienced any
relief with traditional interventions. Which of the following should the nurse next
consider?
a. informing the patient that there is nothing left to give them
b. calling anesthesia to intubate the patient
c. asking the treating physician to increase the doses of all the patient's
medications
d. discussing the initiating of palliative sedation with the interprofessional team
- :-d. discussing the initiating of palliative sedation with the interprofessional team
When therapies such as IV opioids, oxygen, diuretics, and benzodiazepines fail to
improve intractable dyspnea, palliative sedation could be considered in end-of-life
care

(Q) Which of the following best represents the psychological component of a

comprehensive pain assessment?
a. the aggravating factors of the experienced pain
b. the meaning of pain to the patient and family
the influence of religion on coping with pain
d. the economic impact of the pain and its treatment - :-b. the meaning of pain to
the patient and family
The meaning of pain to the patient and family is an example of the psychosocial
component of the comprehensive pain assessment.
(Q) A cancer education program for adults with low-literacy levels should include
which of the following?
a. frequent use of scored quizzes on new material
b. cartoon-type illustrations to explain concepts
c. multiple forms of the same message and repetition
d. medical terms so people become familiar with these words - :-c. multiple forms
of the same mesage and repetition
Repetition of concepts and using multiple ways to convey a message is
recommended, including the use of pictures and demonstrations.

(Q) One week after receiving chemotherapy, a patient is afebrile with generalized
oral erythema, xerostomia, white patches on the soft palate, and a lump-like
sensation with swallowing. Which of the following orders should the nurse
anticipate?
a. allopurinol mouthwash
b. amoxicillin
c. panendoscopy
d. fluconazole - :-d. fluconazole
Oral candida presents with redness and a "cottage cheese" appearance. Antifungal
medications are used to treat oral candidiasis.

(Q) Hormone therapy is effective for which two types of cancer?

a. breast and prostate
b. liver and chronic myeloid leukemia
c. lymphoma and gallbladder
d. sarcoma and small cell lung - :-a. breast and prostate
Hormone therapy has been successfully used to treat breast and prostate cancers.
 (Q) Which of the following is the best intervention to increase a patient's
adherence to taking oral chemotherapy at home?
a. instructing the patient to double the next dose if a dose is missed
b. having the patient pick up a refill at the next appointment if the supply runs out
c. calling the patient periodically to monitor for side effects and ask questions.
d. telling the patient to take over-the-counter medications as needed for nausea - :-
c. calling the patient periodically to monitor for side effects and ask questions
Follow-up telephone calls are known to help with medication adherence.

(Q) The nursing assessment for a patient who received bortezomib should
prioritize which of the following?
a. asking the patient basic orientation questions
b. asking the patient to demonstrate picking up a coin
c. documenting the patient's fluid intake for the past 24 hours
d. auscultating the patient's lung sounds - :-b. asking the patient to demonstrate
picking up a coin
Peripheral neuropathy, both early and late onset, is a common side effect of
bortezomib.

(Q) A patient with metastatic breast cancer reports the intermittent periods of
severe pain despite the use of opioid analgesics. In order to further evaluate the
patient's pain, the nurse should first recommend:
a. doubling the current dose of the analgesic
b. obtaining observations from caregivers
c. keeping a pain management diary
d. incorporating integrative modalities - :-c. keeping a pain management diary
A pain management diary is a useful tool in assisting a patient to evaluate the
effectiveness of the pain management plan.

(Q) Adjuvant therapy for colorectal cancer is administrered:

a. before primary therapy to shrink a tumor that is inoperable in its current state
b. to locally treat cancer with minimal harm to normal cells
c. after primary therapy to increase the chance of long-term, disease-free survival
d. at any time during therapy to cure the patient and kill cancer cells - :-c. after
primary therapy to increase the chance of long-term disease-free survival
The goal of adjuvant therapy is to target minimal, residual disease after definitive
treatment for patients at high risk for recurrence.

(Q) A patient with end-stage pancreatic cancer reports an inability to concentrate

and sleep, mood swings, and a sense of helplessness. The nurse best responds by:
a. facilitating a referral to palliative care for additional support
b. offering to take care of the patient's pets following the patient's death
c. requesting an assignment change to avoid feeling overburdened
d. asking the physician to initiate a nightly melatonin supplement - :-a. facilitating
a referral to palliative care for additional support
The nurse can offer palliative care services to provide emotional support,
interventions and guidance as related to the patient's distress and depression.

(Q) A patient with lung cancer will be discharged home after receiving etoposide
and cisplatin. Discharge instructions should include what information?
a. hiccups that develop should be reported immediately to the physician
b. a fever should be reported immediately to the physician
c. ringing in the ears is a side effect of etoposide and will improve in a few days
d. observe urine carefully for the next two days for blood and immediately report
its presence. - :-b. a fever should be reported immediately to the physician
Patient teaching after receiving chemotherapy includes follow-up care and
symptom management. The risks and symptoms of infection are most important.

(Q) A patient with breast cancer who received cyclophosphamide five years ago
reports a new onset of bruising and fatigue. The nurse suspects the development
of:
a. cardiomyopathy
b. leukoencephalopathy
c. liver failure
d. a subsequent leukemia - :-d. a subsequent leukemia
The risk of a patient developing a subsequent leukemia increases with the use of
alkylating agents.

(Q) Which side effect is reported as the most distressing to patients receiving
chemotherapy, radiation, or biotherapy?
a. nausea
b. fatigue
c. alopecia
d. fever - :-b. fatigue
Fatigue is reported as the most distressing symptom associated with cancer and it's
treatment.

(Q) A patient receiving chemotherapy reports fatigue. Which of the following

responses provides the best strategy for this patient to conserve energy?
a. "try to quickly perform all of your errands"
b. "keep frequently used items near you"
c. "ask for help from friends or family sparingly"
d. "refrain from using electric scooters in stores" - :-b. "keep frequently used items
near you"
Fatigued individuals should try to conserve energy by keeping frequently used
items close to them for ease of accessibility.

(Q) A patient's sister has tested positive for a BRCA mutation, but the patient has
a negative result. The patient begins to cry and says, "I was always the bad child".
What is the patient most likely experiencing?
a. survivor guilt
b. transmitter guilt
c. sibling rivalry
d. reactive depression - :-a. survivor guilt
Survivor guilt occurs when a person tests negative and feel guilty as to why they
were fortunate enough to test negative when a relative tested positive.

(Q) Oligodendroglial tumors originate from cells that maintain the function of
the:
a. synovial fluid
b. myelin sheath
c. lymph
d. plasma - :-b. myelin sheath
Oligodendrocytes are cells that develop and maintain the myelin sheath

(Q) Radiation-induced diarrhea is treated with which of the following

medications?
a. neomycin
b. loperamide
c. cholestyramine
d. glutamine - :-b. loperamide
The use of loperamide continues to be the recommended standard of practice for
patients with radiation-induced diarrhea.

(Q) Which of the following is an advantage of an implanted vascular access

device over a tunneled central venous catheter?
a. unlimited ability to access the device
b. decreased risk of infection
c. short-term use
d. low cost of insertion - :-b. decreased risk of infection
Implanted vascular access devices have a lower risk of infection than tunneled
central venous catheters.

(Q) A patient with a neuroendocrine tumor reports flushing, wheezing, and

abdominal cramping most mornings after eating. Which food is most likely to
trigger these symptoms?
a. bananas
b. strawberries
c. muffins
d. eggs - :-a. bananas
Bananas have a high content of vasoactive amines, serotonin, tryptamine,
dopamine, and norepinephrine and may trigger symptoms of carcinoid syndrome.

(Q) A standard element of palliative care consultation is most likely to include

which of the following?
a. exploring the goals of care
b. planning simulation for radiation treatment
c. choosing a chemotherapy treatment regimen
d. discussing further financial planning - :-a. exploring the goals of care
Exploring the patient's goals of care is a standard element of a palliative care
consult.

(Q) Which of the following is a common a preventable cause of anxiety for a

patient with cancer?
a. uncontrolled pain
b. spiritual distress
c. distressing memories
d. delirium - :-a. uncontrolled pain
Chronic anxiety and depression can be caused by chronic, poorly controlled pain.

(Q) Excessive use of smokeless tobacco and alcohol increases the risk for a
patient to develop which type of cancer?
a. lung
b. gastric
c. laryngeal
d. hepatocellular - :-c. laryngeal
The combined use of alcohol and tobacco synergistically increases the risk of
laryngeal cancer by about 50%.

(Q) Which type of education theory suggests that learning results from personal
internal and external incentives?
a. cognitive
b. motivational
c. social
d. behavioral - :-b. motivational
Motivational learning theory is one in which learning results from intrinsic or
external motives.

(Q) A patient with esophageal cancer is experiencing dysphagia. Which of the

following is the best strategy the nurse can suggest to maximize the patient's
nutrition?
a. maintaining the current eating pattern to avoid disrupting the gut
b. encouraging soft, moist foods such as puddings and soups
c. eating one large meal a day
d. cutting meats up into small bites - :-b. encouraging soft, moist foods such as
puddings and soups
Encouraging soft, moist foods eases the mechanics of swallowing while still
maintaining oral nutrition.

(Q) A patient wiht a permanent colostomy expresses concern about engaging in

sexual intercourse. The nurse first recommends:
a. tracking bowel habits to best schedule sexual intercourse
b. replacing the ostomy appliance just before engaging in sexual intercourse
c. eating immediately before engaging in sexual intercourse
d. having further discussions with a therapist prior to having sexual intercourse - :-
a. tracking bowel habits to best schedule intercourse
By being aware of their bowel habits, a patient will be able to better plan sexual
activities around expected bowel movements.
 (Q) A patient with leukemia demonstrates an adequate understanding of the
teaching provided regarding chemotherapy and myelosuppression by stating:
"myelosuppression is:
a. when laboratory values show an elevation in the white blood cell count
b. unintentional prior to a bone marrow transplant
c. the overreaction of the body's immune system to a medication
d. a potential and probable side effect of my cancer treatments - :-d. a potential
and probable side effect of my cancer treatments
Chemotherapy will decrease the response by the immune system by causing
neutropenia, anemia, and thrombocytopenia, collectively known as
myelosuppression.

(Q) The use of oral contraceptives for more than five years may provide
protection from developing which of the following cancers?
a. thyroid
b. cervical
c. ovarian
d. breast - :-c. ovarian
Oral contraceptives have demonstrated risk reduction of ovarian cancer.

(Q) Which of the following is observed in at least half of all patients who are
receiving cetuximab?
a. dermatologic toxicity
b. tumor lysis syndrome
c. infusion reaction
d. venous thromboembolism - :-a. dermatologic toxicity
Dermatologic toxicities are the common side effect of epidermal growth factor
inhibiting medications.
 (Q) Risk factors for a patient to develop lymphedema following surgery for breast
cancer include:
a. adjuvant hormonal therapy
b. an axillary node dissection
c. a low body mass index
d. immediate reconstruction - :-b. an axillary node dissection
Factors that increase the risk of lymphedema in addition to axillary surgery are
radiation, high-risk breast cancers large tumors with positive nodes and lympho-
vascular invasion, and obesity.

(Q) A 78-year-old patient with prostate cancer and cardiovascular disease is

taking naproxen twice a day and a daily dose of aspirin. The nurse instructs the
patient to:
a. take the medications on an empty stomach
b. expect and increase in swelling of the extremities during the evening
c. speak with the physician about adding a cytoprotectant
d. space the medications at least one hour apart - :-c. speak with the physician
about adding a cytoprotectant
Patients receiving cyclooxygenase-1 inhibitors who are high risk based on
existing cardiac disease should consider the addition of a cytoprotectant.

(Q) Which of the following chemotherapy orders should the nurse question:
a. intramuscular asparaginase
b. intrathecal vincristine
c. intraperitoneal cisplatin
d. subcutaneous bortezomib - :-b. intrathecal vincristine
Vincristine is fatal if administered intrathecally.

(Q) A 64-year-old Black patient with prostate cancer asks if there is any advice he
should give to his adult sons regarding prostate screening. The nurse's best
response is to recommend shared-decision making for:
a. prostatic acid phosphatase testing beginning at age 45 years
b. prostate-specific antigen testing beginning at age 45 years
c. a transrectal ultrasound beginning at age 45 years
d. an ultrasound-guided biopsy of the prostate beginning at age 45 years - :-b.
prostate-specific antigen testing beginning at age 45 years
The American Cancer Society recommends a shared-decision making
conversation about prostate-specific antigen testing and digital rectal examination
beginning at age 45 years for men with a high risk of developing prostate cancer.

(Q) Which of the following patients would benefit most from the use of an
erythropoiesis-stimulating agent?
a. a patient at the end of life who is reporting increased visceral pain
b. a patient with new melanoma and a platelet count of 132,000/mm3
c. a patient presenting with severe fatigue and a hemoglobin of 7.5 g/dL
d. a patient with a new fever and a white blood cell count of 4,000/mm3 - :-c. a
patient presenting with severe fatigue and a hemoglobin of 7.5 g/dL
The use of erythropoiesis-stimulating agents to correct anemia with hemoglobin
levels less than 10 g/dL may aid in decreasing fatigue.

(Q) A patient with breast cancer is scheduled for a left-sided mastectomy. The
physician orders baseline measurements of limb volume on the left side before
surgery to assess for which complication?
a. shortened limb
b. range of motion restrictions
c. fatty deposits
d. lymphedema - :-d. lymphedema
Baseline limb volume measurements are a reliable, valid and cost effective
method to monitor for the development of lymphedema.

(Q) A patient with an unresectable T2 N2 M1 adenocarcinoma of the colon is

receiving fluorouracil and leucovorin. What is the goal of this treatment regimen?
a. promote radiosensitivity
b. control cancer cell growth
c. promote cellular transformation
d. increase cellular contact inhibition - :-b. control cancer cell growth
A colon cancer with staging T2 N2 M1 is a stage IV cancer, which is metastatic
cancer. Chemotherapy in this setting is given to control cancer cell growth.

(Q) Alkylating agents exert their effects by:

a. causing the release of toxic free radicals inside the cell, triggering cell apoptosis
b. attaching to CD52 on the surface of B and T cells, resulting in antibody-
dependent lysis
c. disrupting folate-dependent metabolic processes essential for cell replication
d. binding to DNA strands, preventing DNA replication and cell division - :-d.
binding to DNA strands, preventing DNA replication and cell division
Alkylating agents break the DNA helix strand and interfere with DNA replication.

(Q) An allogenic stem cell transplant is used to treat which of the following
conditions?
a. Waldenstrom macroglobulinemia
b. acute lymphoblastic leukemia
c. breast cancer
d. germ cell tumors - :-b. acute lymphoblastic leukemia
An allogeneic stem cell transplant can be used to treat acute lymphocytic
leukemia.

(Q) A patient receiving targeted therapy reports yellow, crusted papules and
itching on the shoulders. The nurse should suggest which of the following
interventions?
a. using a retinoid-based moisturizer twice a day
b. washing the skin with a deodorant soap
c. applying a lotion with dimethicone
d. diluting bathwater with half-strength Dakins solution - :-c. applying a lotion
with dimethicone
The development of a rash is a frequent side effect of targeted therapy. Using a
lotion with dimethicone may provide additional moisture to dry, irritated skin.

(Q) A factor that is most likely to decrease the risk of extravasation includes:
a. administration of the medication below a recent venipuncture site
b. placement of a peripheral IV line at the patient's bedside using ultrasound
c. development of a fibrin sheath at the catheter tip
d. an adequately secured needle into an implanted vascular access device - :-d. an
adequately secured needle into an implanted vascular access device
An adequately secured needle into an implanted vascular access device is most
likely to decrease the risk of an extravasation.

(Q) A patient with Hodgkin lymphoma is most likely to develop which of the
following subsequent malignancies?
a. leukemia
b. ovarian cancer
c. colorectal cancer
d. melanoma - :-a. leukemia
Patients with Hodgkin lymphoma have an increased risk of subsequent
malignancy including leukemia and myelodysplastic syndrome, non-Hodgkin
lymphoma, breast, lung and thyroid cancers.

(Q) The infusion center nurse is unable to accommodate the patient's preferred
chemotherapy treatment day. The patient slaps the table and says, "I do not
understand all this. Why do I have to change everything around?" The nurse
recognizes the patient is most likely demonstrating:
a. an attempt to gain control over the situation
b. anger that is conflicting with his diagnosis
c. threatening behavior that requires de-escalation
d. symptoms of underlying depression - :-a. an attempt to gain control over the
situation
Anger and a lack of flexibility may be patient behaviors indicative of a loss of
control and powerlessness.

(Q) Which of the following is a risk factor for cancer treatment-related

pneumonitis?
a. oxygen therapy at low concentrations
b. concomitant use of steroids
c. less than 60 years of age
d. mantle field radiation - :-d. mantle field radiation
The risk of pneumonitis is increased when having a large volume of lung included
in the treatment field.
 (Q) The nurse has collected and analyzed data to identify, monitor, and improve
the effectiveness of oncology nursing care. Which standard of oncology nursing
practice does this best exemplify?
a. patient advocacy
b. resource utilization
c. collaboration
d. collegiality - :-b. resource ultilization
Resource utilization requires the oncology nurse to evaluate, critique, and
mobilize the most appropriate resources to maximize patient outcomes.

(Q) A patient with salivary gland cancer will be receiving radiation therapy. The
nurse should plan for which side effect and anticipate which potential
intervention?
a. alopecia and a list of local wig salons
b. severe oral mucositis and insertion of a feeding tube
c. dermatitis and topical vitamin E oil
d. bone marrow suppression and weekly complete blood counts - :-b. severe oral
mucositis and insertion of a feeding tube
Radiation therapy for a patient with head and neck cancer is likely to cause severe
mucositis, and a feeding tube may need to be considered for nutritional support.

(Q) A patient who is receiving vinblastine is reporting burning and stinging at the
IV insertion site. The nurse should next:
a. administer sodium thiosulfate
b. apply a warm pack to the site
c. apply a cold pack to the site
d. administer dexrazoxane - :-b. apply a warm pack to the site
Burning and stinging at the insertion site of vinblastine infusion indicates a
potential extravasation. The nurse should apply a warm pack to the site.

(Q) Which population is most at risk for undertreatment of pain at the end of life?
a. elderly
b. young adults
c. men
d. obese adults - :-a. elderly
Individuals at particular risk for undertreatment of pain symptoms at the end of
life are the elderly, minorities, and women.

(Q) An asymptomatic patient with breast cancer received a lumpectomy and

completed treatment with curative intent six months ago. The nurse should expect
which of the following tests to be ordered for ongoing surveillance?
a. mammogram
b. magnetic resonance imaging of the breast
c. computed tomography scans of chest, abdomen and pelvis
d. PET-CT - :-a. mammogram
Mammograms should be continued annually.

(Q) Which of the following offers the most likely reason that a patient with stage
III cervical cancer may defer discussions about body image alterations and sexual
intimacy prior to initiating treatment?
a. concern of being perceived as vain
b. depersonalization of the disease experience
c. unrealistic expectations of outcomes
d. expectation of experiencing minimal symptoms of treatment - :-a. concern of
being perceived as vain
Patients may feel that they are being egocentric and be embarrassed about
discussing sexuality in light of a serious illness.

(Q) When should a premenopausal patient with cancer expect to resume

menstruation following the completion of active treatment?
a. one year
b. two years
c. six months
d. three months - :-d. three months
If premenopausal women do not experience a return of menses within three
months of treatment completion, ovarian failure is considered to be permanent.

(Q) A 42-year-old man approaches the nurse at a cancer outreach health fair and
states both his mother and grandmother have died from colon cancer. The nurse
should strongly urge him to speak to his primary care provider about:
a. obtaining a blood sample to assess for increased liver function enzymes
b. a referral to a colorectal surgeon
c. a referral to a genetic counselor
d. vitamin C supplementation - :-c. a referral to a genetic counselor
Genetic counseling is highly recommended for patients who have a strong family
history of colorectal cancer.

(Q) A patient with cancer is considering entering a clinical trial that compares the
current standard treatment with a new treatment. This is an example of which
phase of a clinical trial?
a. 3
b. 1
c. 2
d. 4 - :-a. 3
Phase 3 clinical trials have a primary goal of establishing efficacy and comparing
a new treatment with the current standard.

(Q) Which of the following classes of medication will most significantly increase
the risk for the development of a cytokine-release syndrome reaction?
a. platinum compounds
b. anthracyclines
c. taxanes
d. monoclonal antibodies - :-d. monoclonal antibodies
Monoclonal antibodies can cause the development of cytokine-release syndrome.

(Q) The nurse counsels a 32-yar-old patient with breast cancer and her partner
about contraception prior to initiating chemotherapy. Which of the following
statements made by the patient indicates an adequate understanding of the
recommendations?
a. "hormone-based pills are the easiest and safest method of birth control"
b. "I do not need to worry about birth control while receiving chemotherapy"
c. "I will use birth control pills or a reliable barrier method as recommended by
my physician"
d. "I will call my gynecologist to discuss having my tubes tied" - :-c. I will use
birth control pills or a reliable barrier method as recommended by my physician
Patients who are sexually active and fertile should use a reliable form of birth
control.
 (Q) A patient receiving chimeric antigen receptor (CAR) T- cell therapy is most
likely to experience which adverse event?
a. acneiform rash
b. hemorrhagic cystitis
c. pneumonitis
d. B-cell aplasia - :-d. B-cell aplasia
Chimeric antigen receptor (CAR) T-cell therapy is associated with cytokine
release syndrome, tumor lysis syndrome, neurologic symptoms, and B-cell
aplasia.

(Q) Which reference would assist the nurse in determining an antineoplastic

agent's characteristics and safe handling precautions?
a. ONS Statement on the Scope and Standards of Oncology Nursing Practice
b. The Joint Commission Hospital Patient Safety Goals
c. National Comprehensive Cancer Network Clinical Practice Guidelines in
Oncology
d. NIOSH List of Antineoplastic and Other Hazardous Drugs in Healthcare
Settings - :-d. NIOSH List of Antineoplastic and Other Hazardous Drugs in
Healthcare Settings
The National Institute for Occupational Safety and Health (NIOSH) maintains a
current list of all antineoplastic hazardous medications, their characteristics, and
personal protective equipment required for safe handling and administration.

(Q) Which of the following statements made by a patient with cancer indicates
the best understanding about hospice services?
a. "Hospice means I am giving up any hope for improvement"
b. "Hospice means I am imminently dying"
c. "My family and I will be provided with comfort and dignity"
d. "I will not receive any treatment for my illnesses" - :-c. "My family and I will
be provided with comfort and dignity"
Hospice provides care for patients and family in all aspects of end-of-life care
planning, as well as help for the surviving family after a patient's death.

(Q) Patients who require chronic platelet transfusions may develop antibodies and
require further products to be:
a. leukoreduced
b. from multiple, random donors
c. volume reduced
d. washed - :-a. leukoreduced
Leukoreduced platelets are indicated for patients expecting multiple platelet
transfusions to reduce the incidence of alloimmunization.

(Q) Which of the following is the best recommendation for the nurse to provide a
patient to promote adequate oral hygiene while receiving chemotherapy?
a. minimizing the use of dental floss to reduce the risk of bleeding
b. using an alcohol-based mouthwash twice a day to kill bacteria
c. assessing the oral cavity daily to identify potential changes
d. allowing for only the occasional use of tobacco products - :-c. assessing the oral
cavity daily to identify potential changes
Teach the patient how to perform a self-assessment of their oral cavity to
recognize any changes that may cause further issues.

(Q) Which of the following actions is most likely to help a patient with cancer
who is struggling with a loss of control?
a. collaborating with the patient in making decisions about their care
b. reminding the patient frequently to think positively
c. encouraging the patient to channel any anger toward the interprofessional care
team
d. ending communication with the interprofessional care team after the completion
of active treatment - :-a. collaborating with the patient in making decisions about
their care
Collaborating with patients and giving them the opportunity to participate in
decisions about their care affirm their value and competence.

(Q) Which of the following is a characteristic of a nitrosourea?

a. breaking DNA strands
b. targeting topoisomerase 1
c. binding to tumor cells overexpressing antigens
d. damaging microtubules - :-a. breaking DNA strands
Medications classified as nitrosoureas act by breaking the DNA helix strand and
inducing cell death.

(Q) A patient with cancer exhibits progressive neurologic changes including

agitation, confusion, and weakness and has a serum sodium level of 122 mEq/L.
Which oncologic emergency should the nurse suspect?
a. cardiac tamponade
b. SIADH
c. DIC
d. superior vena cava syndrome - :-b. SIADH
A patient with syndrome of inappropriate antidiuretic hormone and moderate
hyponatremia may demonstrate progressive neurologic changes that include
agitation, confusion, weakness, hallucinations and ataxia with lowered serum
sodium values.
 (Q) A chimeric monoclonal antibody is a combination of mouse and which source
of antibody?
a. cow
b. horse
c. plant
d. human - :-d. human
Chimeric antibodies are made up of approximately 70% human and 30% foreign
antibodies.

(Q) A patient has completed chemotherapy and radiation to the mediastinum and
is now reporting difficulty with completing activities of daily living due to
dyspnea. What is the patient most likely experiencing?
a. deconditioning
b. pneumonitis
c. cardiac tamponade
d. recurrence of disease - :-b. pneumonitis
Because lung tissue is radiosensitive, radiation pneumonitis may occur after
completion of radiation treatment, with dyspnea as a classic sign.

(Q) Upon diagnosis of an invasive ductal adenocarcinoma of the pancreas, the

disease will most likely:
a. metastasize to bone
b. demonstrate spread to the liver
c. display widespread fat necrosis
d. remain confined to the primary site - :-b. demonstrate spread to the liver
Invasive ductal adenocarcinoma of the pancreas has often metastasized at the time
of diagnosis. The most common site of metastasis is the liver.
(Q) The nurse teaches a patient that the survivorship care plan is used to:
a. provide instructions to the employer to make accommodations upon the return
to work
b. replaces the patient's electronic medical record
c. take the place of discussions with their oncologist following the completion of
treatment
d. provide clear direction for ongoing care and surveillance following treatment
- :-d. provide clear direction for ongoing care and surveillance following treatment
A survivorship care plan is provided to a patient upon the completion of treatment
to provide information on the treatments received, possible long term effects, and
healthy lifestyle choices and screenings throughout a patient's lifetime.

(Q) What grade is assigned when the grade of tumor is unable to be determined?
a. Grade X
b. Grade 4
c. Grade 2
d. Grade 1 - :-a. Grade X
Grade X indicates that the tumor grade is unable to be determined.

(Q) The nurse teaches a patient about the goals of a palliative chemotherapy
regimen. Which of the following statements best indicates that there was a clear
understanding by the patient?
a. "My cancer will be eliminated when I am done with my chemotherapy"
b. "This chemotherapy will shrink my tumors so that my pain is lessened"
c. "This chemotherapy will be given in high doses over a shorter period of time"
d. "This chemotherapy will shrink and kill all of my cancer" - :-b. This
chemotherapy will shrink my tumors so that my pain is lessened
The goal of palliative chemotherapy is to use treatment to reduce significant
symptoms of the cancer, but will not offer a cure.

(Q) A patient has recently been informed of progressive metastatic disease. The
nurse observes a change in the behavior of the patient, who now appears
withdrawn and is easily tearful. The nurse understands that anticipatory grief is:
a. an unconscious process
b. unacknowledged
c. long-term
d. unresolved - :-a. an unconscious process
Anticipatory grief is an unconscious process that can be brought on by receiving
bad news.

(Q) Which of the following behaviors demonstrated by the spouse of a patient

who has died best exemplifies complicated grief?
a. experiencing intermittent bouts of joy mixed with sorrow
b. seeking out new organizations to join
c. attending a support group for family members of patients with cancer
d. removing all pictures from the house and refusing to discuss the decedent - :-d.
removing all pictures from the house and refusing to discuss the decedent
Complicated grief is unresolved grief that persists over time and interferes with
the ability to perform activities of daily living.

(Q) A patient with cancer receiving the eight dose of carboplatin suddenly
becomes anxious and states, "I cannot breathe." What should the nurse do first?
a. take the patient's vital signs and call the treating physician
b. stop the infusion and stay with the patient
c. start a second IV and give diphenhydramine 50 mg IVP
d. administer 2L oxygen by nasal cannula and slow the rate of the infusion - :-b.
stop the infusion and stay with the patient
If a patient begins to experience signs and symptoms of a hypersensitivity
reaction, administration of the offending agent must be stopped immediately, the
IV site maintained, and a call for help be made, as the nurse must remain with the
patient.

(Q) The nurse should teach a patient receiving intraperitoneal cisplatin to expect:
a. the medication to be cold and to experience significant pain
b. to take nothing by mouth for 12 hours prior to treatment
c. frequent position changes while the medication is administered
d. to travel to the operating room to receive the medication under fluoroscopy - :-
c. frequent position changes while the medication is administered
Nursing care management of the patient receiving intraperitoneal medication
includes encouraging repositioning from side to side every 15 minutes during the
dwell time.

(Q) A patient receiving chemotherapy continues to have nausea and vomiting

before each treatment, despite the use of antiemetics. The patient is crying and
wishes to stop treatment. What is an appropriate nursing intervention?
a. recommend that the healthcare provider reduce the chemotherapy dose
b. suggest the healthcare provider discontinue further treatment
c. discuss integrative therapy options with the patient
d. explain to the patient that everyone receiving chemotherapy experiences nausea
and vomiting - :-c. discuss integrative therapy options with the patient
Complementary or integrative therapy, such as massage, music therapy, or
acupuncture can help with anticipatory nausea.

(Q) A headache and constipation are potential side effects of which antiemetic?
a. ondansetron
b. metoclopramide
c. prochlorperazine
d. haloperidol - :-a. ondansetron
Headache and constipation are known side effects of 5-HT3 antagonists including
ondansetron.

(Q) A patient with sepsis reports hematuria and dyspnea. The lab values include
platelets 37,000/mm3; prothrombin time 21 seconds; partial thromboplastin time
43 seconds; and fibrinogen 100 mg/dL. Which of the following is the most likely
cause?
a. hemorrhagic cystitis
b. immune thrombocytopenia
c. DIC
d. heparin-induced thrombocytopenia - :-c. DIC
Sepsis and infection can disrupt the clotting cascade, causing disseminated
intravascular coagulation.

(Q) A patient with melanoma presents with confusion, expressive aphasia,

bradycardia, and respiratory depression. The nurse suspects which of the
following oncologic emergencies?
a. tumor lysis syndrome
b. increased intracranial pressure
c. hypercalcemia
d. superior vena cava syndrome - :-b. increased intracranial pressure
A patient with melanoma is at high risk for developing brain metastasis. Altered
mental status, changes in speech and expression, bradycardia, and respiratory
depression are potential symptoms of increased intracranial pressure.
(Q) A patient who is imminently dying at home is experiencing delirium. Which
medication would best manage this symptom?
a. diphenhydramine
b. haloperidol
c. phenytoin
d. hydromorphone - :-b. haloperidol
Haloperidol is the most widely studied and used antipsychotic for the management
of delirium.

(Q) The family members of a patient who is dying disagree on the decision to
insert a feeding tube. What action should the nurse take next?
a. meet with the family to discuss the goals of care
b. contact social work to begin the process for state guardianship
c. explain that only an ethics committee can make this decision
d. encourage the family to review similar cases in the media - :-a. meet with the
family to discuss the goals of care
Families often have a difficult time agreeing to goals of care for the patient.
Coordinating a family meeting is a supportive structure to educate family
members, answer questions, and promote communication with the professional
health team.

(Q) Which statement expressed by the spouse of a patient receiving services

through the Hospice Medicare Benefit indicates and adequate understanding of the
teaching provided?
a. "Coverage for curative chemotherapy treatments will continue for the next
several months"
b. "I can expect a home health aide to come in several times a day to help me with
meal preparation"
c. "This benefit will only cover medications deemed necessary to control my
spouse's pain"
d. "I should contact my hospice provider prior to taking my spouse to the
emergency department" - :-d. "I should contact my hospice provider prior to
taking my spouse to the emergency department"
Patients and families should be taught to contact the contracted hospice provider
prior to calling an ambulance for transport to an emergency department.

(Q) The best way for the nurse to initiate conversations about sexuality with a
patient who has cancer is by which of the following?
a. sharing personal experiences with the patient
b. providing literature about sexuality to the patient
c. inquiring about the patient's sexual history
d. asking the patient open-ended questions - :-d. asking the patient open-ended
questions
The best way to approach the subject of sexuality is by asking open-ended
questions and using active listening skills.

(Q) Squamous cell carcinoma of the head and neck tends to metastasize to which
organ?
a. kidney
b. stomach
c. lung
d. heart - :-c. lung
Squamous cell carcinoma of the head and neck is most likely to metastasize to the
lung.
 (Q) Which of the following medications should be ordered for a patient with
cancer who is receiving palliative care services and experiencing severe,
nociceptive pain?
a. an antipsychotic
b. an anticholinergic
c. an opioid
d. an antiemetic - :-c. an opioid
A patient with cancer experiencing severe nociceptive pain should receive an
opioid.

(Q) The nurse should suggest which of the following interventions to a patient
experiencing dry desquamation?
a. a wet-to-dry dressing
b. a moisturizing skin cream
c. cornstarch
d. a hydrogel dressing - :-b. a moisturizing skin cream
General guidelines suggest that hydration of the skin with an emollient is helpful
in promoting comfort and reducing pruritus.

(Q) A patient with metastatic renal cell cancer is tired, confused, has not had a
bowel movement in five days, and requires assistance with ambulation. Vital signs
include heart rate, 55 beats per minute; respiratory rate, 18 breaths per minute; and
blood pressure, 100/60 mm Hg. What is the patient most likely experiencing?
a. hypercalcemia
b. treatment side effects
c. symptoms of metastasis
d. spinal cord compression - :-a. hypercalcemia
A delay in diagnosis of hypercalcemia often occurs due to nonspecificity of
symptoms, which include constipation, lethargy, and confusion. The patient with
hypercalcemia may also present with bradycardia due to depression of the
conduction system.

(Q) A patient is preparing to receive an autologous stem cell transplant. Which

type of access device will the patient most likely have placed?
a. peripheral IV catheter
b. peripherally inserted central catheter
c. apheresis catheter
d. midline catheter - :-c. apheresis catheter
A patient receiving an autologous stem cell transplant will most likely have an
apheresis catheter inserted.

(Q) A 24-year-old patient who received carmustine as a child reports a persistent

cough and shortness of breath. The nurse understands that the patient is at an
increased risk for developing pulmonary: a. empyema
b. aspergillosis
c. emboli
d. fibrosis - :-d. fibrosis
Nitrosoureas can cause pulmonary fibrosis.

(Q) Which medication in a patient's profile should be reported to the physician

before administering cyclophosphamide?
a. citalopram
b. allopurinol
c. metoprolol
d. amitriptyline - :-b. allopurinol
The concomitant use of allopurinol can increase the toxicity of the agent,
particularly bone marrow depression by decreasing renal excretion.

(Q) What is a primary goal of treatment for a patient with muscle-invasive

bladder cancer receiving radiation therapy?
a. prepare the body for chemotherapy
b. prevent further spread of disease to the brain
c. minimize the time to surgery
d. preserve the function of the bladder - :-d. preserve the function of the bladder
Radiotherapy for muscle-invasive bladder cancer can be used to preserve the
bladder and maximize quality of life, without compromising long-term disease-
specific survival.

(Q) The use of the spouse as a translator for a non-English speaking patient is:
a. not recommended
b. used to increase patient comfort levels
c. allowed once the spouse passes a certification test
d. permitted if a professional is not available - :-a. not recommended
Significant others are not recommended as translators because of role conflicts or
inability to communicate complex medical terminology.

(Q) When does a nadir typically occur after the completion of a chemotherapy
treatment cycle?
a. 3 weeks
b. 5 weeks
c. 10-14 days
d. 1-3 days - :-c. 10-14 days
Nadir dates may vary, but most typically occur 10-14 days after a patient received
chemotherapy.

(Q) Which of the following has been attributed to foreign-born women with
breast cancer having a lower survival rate than women with breast cancer who
were born in the United States?
a. histologic grade of the tumor
b. access to mammography screening
c. country from where the women have immigrated
d. differences in the treatment protocols - :-b. access to mammography screening
Patients from other countries may have more significant barriers to obtaining
recommended screenings and care, leading to diagnosis at later stages and
decreased survival.

(Q) An understanding of immunology is important when developing cancer

therapies because it:
a. predicts how well treatment will be tolerated
b. influences treatment choices to maintain bone marrow function
c. identifies how T cells, B cells, and natural killer cells work
d. explains how free radicals are eliminated from the body - :-c. identifies how T
cells, B cells, and natural killer cells work
The goals of research in immunology include the ability to understand how the
immune system cells work.

(Q) A patient with metastatic prostate cancer reports decreased urine output and
back pain. What is the nurse's next intervention?
a. refer to physical therapy for an evaluation
b. explain the common symptoms of prostate cancer
c. assess for sensory changes or weakness
d. advise an increase in the use of prescribed pain medication - :-c. assess for
sensory changes or weakness
A full neurologic assessment is indicated for a patient with prostate cancer
reporting urinary changes, and back pain to further evaluate for a spinal cord
compression.

(Q) Which of the following is recommended for the management of a patient with
a function gastrointestinal tract who is experiencing cancer-related anorexia-
cachexia syndrome?
a. parenteral support
b. progestinal agents
c. anabolic steroids
d. high-fat snacks - :-b. progestinal agents
Progestinal agents are used to manage cancer-related anorexia-cachexia
syndrome.

(Q) A patient with stage IIIC ovarian cancer who has relapsed after receiving
first-line therapy demonstrates an understanding of her condition by stating which
of the following?
a. "I am glad I will not need any additional treatment"
b. "I know I must have been overdoing it a bit"
c. "These symptoms must be a result of chemotherapy"
d. "What clinical trials are available for recurrent disease" - :-d. what clinical trials
are available for recurrent disease
Many patients with stage IIIC ovarian cancer will develop a relapse after
successful completion of first line therapies. Clinical trials are appropriate for
patients who have had recent recurrences of ovarian cancer and should be
explored.
(Q) Which of the following should be included in the initial treatment of a patient
with increased intracranial pressure?
a. dexamethasone
b. lorazepam
c. labetalol
d. furosemide - :-a. dexamethasone
Dexamethasone is the steroid of choice to reduce inflammation related to
increased intracranial pressure due to its rapid onset.

(Q) Within what timeframe will chemotherapy-induced alopecia normally begin

after receiving a first treatment?
a. 2 weeks
b. 3 months
c. 1 month
d. 24 hours - :-a. 2 weeks
Hair loss from chemotherapy usually begins 7-15 days after beginning treatment.

(Q) Which medication is most likely to cause oral mucositis?

a. rituximab
b. fluorouracil
c. dexamethasone
d. interleukin-2 - :-b. fluorouracil
Fluorouracil increases the risk of mucositis either alone or in combination with
other chemotherapy agents.