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OCN Practice Questions #1 Questions and Answers Latest updated 2023
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OCN Practice Questions #1Which of the following is not routinely included as part of a diagnostic work-up for
colorectal cancer?
a. barium enema
b. colonoscopy
c. bone marrow biopsy
d. carcinoembryonic antigen (CEA) - answer c. bone marrow biopsy
A bone marrow biopsy is not routinely performed as part of a diagnostic work-up for
colorectal cancer. Barium enemas provide a clear picture of the large intestine and are
useful in detection of smaller tumors. Colonoscopy provides increased visualization and
the ability to biopsy lesions. CEA is elevated in later stages of colorectal cancer and
may have prognostic value at diagnosis or disease recurrence.
You are a registered nurse working in an outpatient infusion center and have begun
administration of paclitaxel on a newly-diagnosed breast cancer patient. The patient
mentions that she is feeling flushed and shows you a small hive on her left cheek. Your
next course of action is to:
a. reassure the patient that this is a normal side effect of paclitaxel
b. give the patient 50mg of IV Benadryl
c. immediately stop the infusion and notify the oncologist
d. decrease the rate of paclitaxel by 50% - answer c. immediately stop the infusion
and notify the oncologist
The patient is experiencing signs of an infusion reaction with the potential for
anaphylaxis. The nurse must be alert to recognize signs and symptoms of an early
infusion reaction to avoid an anaphylactic response. The first step in addressing an
infusion reaction is to immediately stop the infusion and notify the physician.
A 62-year-old male patient diagnosed with stage 3 SCLC is admitted to the oncology
unit with somnolence, weakness, nausea, vomiting, and diffuse abdominal pain. His
wife reports that he has become increasingly weak over the past three days and has
exhibited a change in mental status. She reports that he has not had a bowel movement
in five days. Which of the following oncologic complications is a likely explanation for the
patient's clinical presentation?
a. superior vena cava syndrome
b. septic shock
c. liver metastasis
d. hypercalcemia - answer d. hypercalcemia
Hypercalcemia is the oncologic complication that presents with symptoms of mental
status change, weakness, nausea, vomiting, constipation and abdominal pain. Small
cell lung cancer is a malignancy commonly associated with hypercalcemia. Superior
,vena cava syndrome presents as edema of the face, neck, and upper extremities;
respiratory compromise, chest pain, headache, dizziness and a feeling of facial fullness.
The clinical features of septic shock include tachypnea, nausea, diarrhea, confusion,
and ultimately oliguria and metabolic acidosis. The patient may experience some of
these same symptoms with liver metastasis as well.
Which of the following chemotherapeutic agents is classified as a Vinca alkaloid?
a. docetaxel
b. topotecan
c. oxaliplatin
d. vinblastine - answer d. vinblastine
Vinca alkaloids are a subset of chemotherapeutic drugs derived from the Madagascar
periwinkle plant that exert their cytotoxic effects by halting cell division and causing cell
death. Vinblastine is a plant alkaloid, and more specifically, a vinca alkaloid. Docetaxel
is also a plant alkaloid, derived from Taxanes. Topotecan is also plant alkaloid but is
more specifically classified as a Camptothecin analog. Oxaliplatin is not a plant alkaloid,
it is an alkylating agent known as a 'metal salt'.
Which of the following treatment examples best describes adjuvant therapy?
a. a 53-year-old patient receives chemotherapy and radiation for a diagnosis of stage 3
breast cancer
b. a 64-year-old patient diagnosed with stage 3 ovarian cancer receives chemotherapy
after undergoing a total abdominal hysterectomy and bilateral salpingo-oophorectomy
c. a 42-year-old patient diagnosed with stage 1 breast cancer undergoes a lumpectomy
with lymph node biopsy
d. an 80-year-old patient diagnosed with chronic leukemia receives oral chemotherapy
with regular monitoring by her oncologist - answer b. chemotherapy following surgery
Adjuvant therapy is an additional cancer treatement given after the primary treatment to
minimize the risk of cancer recurrence. In example B, they patient underwent surgery as
a primary treatment with chemotherapy given as adjuvant therapy. Primary treatment is
defined as the first treatment given and is also referred to as first line treatment,
induction treatment, or primary therapy.
A 60-year-old male patient newly diagnosed with small cell carcinoma of the right lung is
admitted to the oncology unit with a chief complaint of facial and neck swelling as well
as a cough. A diagnosis of superior vena cava syndrome is made. Which of the
following treatment options would you expect to see ordered for this patient?
a. thoracentesis under local anesthesia
b. chemotherapy with adjuvant radiation therapy
c. transfusion of two units of PRBCs
d. surgical consultation to place a chest tube - answer b. chemotherapy with
adjuvant radiation therapy
The correct answer is chemotherapy with adjuvant radiation therapy to shrink the tumor
and to elevate the obstruction that is causing the syndrome. Thoracentesis and chest
tube p[placement would be viable treatment options for a pleural effusion. Transfusion
,of packed red blood cells would not be suitable treatment option for superior vena cava
syndrome.
Which of the following would you include as part of discharge instructions for a patient
diagnosed with head and neck cancer and who has received radiation therapy?
a. apply soothing ointments to the lips for dryness and cracking
b. use a soft, nylon toothbrush when brushing teeth
c. rinse the mouth several times per day with a baking soda and warm water solution
d. all of the above - answer d. all the of the above
Patients diagnosed with head and neck cancer who are being treated with radiation
therapy are at risk for oral mucositis. Application of soothing ointments for dryness of
the lips, using a soft nylon toothbrush, oral baking soda rinses are moistening food with
sauces or gravies are all appropriate teaching points for patients undergoing radiation
therapy to the head and neck.
Which chromosome is associated with chronic myelogenous leukemia (CML)?
a. chromosome 7
b. Philadelphia chromosome
c. chromosome 13
d. P53 - answer b. Philadelphia chromosome
The Philadelphia chromosome is present in nearly all CML cases and is detected by
cytogenic analysis. In only 5-10% of CML cases is the Philadelphia chromosome
absent. Chromosome 7 is linked to leukemia, lymphomas, and MDS syndrome.
Chromosome 13 is linked to retinoblastoma and other types of cancer. P53 is a tumor
suppressor protein.
A patient presents with a new diagnosis of non-small cell lung cancer. In the patient's
medical record you learn that the tumor in the right lung is 4 cm x 6 cm and has invaded
the visceral pleura. There is evidence of metastases in the mediastinal and subcarinal
nodes as well as distant metastasis in the liver. Based on TNM staging, you realize that
the patient has which stage of non-small cell lung cancer?
a. stage 2
b. stage 3a
c. stage 3b
d. stage 4 - answer d. stage 4
The TNM system for cancer staging outlined by the American Joint Committee on
Cancer (AJCC) assesses three basic components: size of the primary tumor, absence
or presence of regional lymph nodes, and the absence or presence of distant metastatic
disease. Any evidence of distant metastasis per TNM staging would classify the cancer
as Stage 4.
Which of the following is an example of a "B symptom" associated with lymphoma?
a. headache
b. painful lymph nodes
c. night sweats
d. edema - answer c. night sweats
, "B symptoms" associated with a lymphoma diagnosis are a key factor in the staging of
the disease. The presence of B symptoms is associated with a poorer prognosis.
Unexplained fever, drenching night sweats, weight loss and pruritus are all B symptoms
associated with lymphoma. Headache, edema, and painful lymph nodes are not
classified as B symptoms.
A 25-year-old female patient newly diagnosed with stage 4 Hodgkin's lymphoma
presents to the outpatient oncology unit for her first dose of chemotherapy. You receive
orders to administer ABVD. Which of the following would be appropriate to teach the
patient regarding her chemotherapy?
a. "the chemotherapy will be administered intravenously. If you experience any pain or
burning at your IV site, notify me right away as some of the medications can cause
tissue damage if they leak out of the vein into the tissue."
b. "Your chemotherapy drugs are considered monoclonal antibodies and may cause an
allergic reaction. Please let me know if you experience fever, chills, nausea, or sweating
during your infusion"
c. "The chemotherapy you are receiving does not affect fertility. You can continue to
family plan as usual"
d. "the chemotherapy you are receiving is not likely to cause hair loss" - answer a.
ABVD are vesicants
Vesicant chemotherapeutic agents such as those utilized in ABVD have the potential to
cause severe tissue damage if they leak into the subcutaneous tissue during an
extravasation. ABVD can cause infertility as well as birth defects. None of the
medications in ABVD are classified as monoclonal antibodies. ABVD will cause hair loss
as a side effect.
Which of the following agents is classified as a tyrosine kinase inhibitor?
a. Rituximab
b. Bortezomib
c. Trastuzumab
d. Sunitinib - answer d. Sunitinib
Tyrosine kinase inhibitors are defined as antineoplastic agents that interfere with cell
communication and growth through inhibition of the tyrosine kinase enzymes. Sunitinib
is a tyrosine kinase inhibitor indicated in the treatment of gastrointestinal stromal
tumors. Rituximab and trastuzumab are classified as monoclonal antibodies.
Bortezomib is a proteasome inhibitor.
One of the most common primary cancers with a high incidence of brain metastasis
includes?
a. melanoma
b. non-Hodgkin's lymphoma
c. ovarian cancer
d. thyroid cancer - answer a. melanoma
Approximately 170,000 cases of brain metastases are diagnosed in the United States
each year. Although any malignancy can lead to metastasis, malnoma and lung, breast,
renal and colon cancers account for the greatest majority of brain metastases. Sixty-five
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