Oncology Certification

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Sample questions from Oncology Certification

This material has 90 questions with answers and rationales. Here are the first 5.

1. 1.At change of shift on an oncology unit, a 68-year-old client receiving chemotherapy has a temperature of 38.3 C, HR 112, BP 92/54, and ANC 400/mm3. Which action should the nurse take first?

   • A.Administer acetaminophen and reassess in 1 hour
   • B.Encourage oral fluids and recheck the temperature
   • C.Obtain blood cultures and notify the provider immediately
   • D.Place the client on neutropenic precautions before reporting the findings

   Rationale: Fever with profound neutropenia and hypotension suggests neutropenic sepsis, which requires immediate cultures and rapid treatment. Acetaminophen could mask fever and delay evaluation. Fluids and precautions are appropriate, but neither replaces urgent escalation and cultures.

2. 2.At an infusion center, a 59-year-old client receiving doxorubicin reports burning at the peripheral IV site. The area is swollen and the infusion is running. What should the nurse do first?

   • A.Remove the catheter immediately and apply firm pressure
   • B.Flush the line with saline to determine whether it is patent
   • C.Slow the infusion and reassess the site in 10 minutes
   • D.Stop the infusion and leave the catheter in place for aspiration and management

   Rationale: Burning and swelling during vesicant administration suggest extravasation; the infusion must be stopped immediately. The catheter is initially left in place so residual drug can be aspirated and the prescribed extravasation protocol followed. Flushing spreads the vesicant, and continuing at a slower rate risks tissue injury.

3. 3.Refer to the client's chart. A 58-year-old client receiving chemotherapy has a new platelet count of 18,000/mm3. Which action is the priority?

   • A.Administer an intramuscular antiemetic as prescribed
   • B.Institute bleeding precautions and notify the provider about the result
   • C.Encourage vigorous toothbrushing to reduce oral bacteria
   • D.Assist the client to walk unaccompanied to maintain independence

   Rationale: The platelet count has fallen to 18,000/mm3, creating a substantial bleeding risk, so bleeding precautions and prompt provider notification are priorities. Intramuscular injections can cause hematoma. Vigorous brushing and unassisted walking increase mucosal and injury-related bleeding risk.

4. 4.In a medical oncology clinic, a 66-year-old client taking oral capecitabine reports three loose stools in 24 hours and asks whether to take the next dose. Which response is best?

   • A.Hold the dose and contact the oncology team for instructions about diarrhea management
   • B.Continue the medication and wait until the next scheduled visit
   • C.Take an extra dose after the next meal
   • D.Take an over-the-counter antidiarrheal without contacting the oncology team

   Answer and rationale are in the full material.

5. 5.In an outpatient infusion unit, a 72-year-old client is scheduled for a monoclonal antibody infusion. The client develops wheezing and facial flushing shortly after it starts. What is the priority action?

   • A.Stop the infusion and initiate the facility's hypersensitivity response
   • B.Reduce the infusion rate by half
   • C.Document the findings and continue observing
   • D.Offer oral fluids and reassess in 15 minutes

   Answer and rationale are in the full material.