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The numbers and emergencies that recur on the OCN. Skim before test day, then prove it with practice.
Exam facts
- 165 questions (145 scored), 3 hours
- Biggest area: Symptom Management & Supportive Care (25%)
Neutropenia & infection
- ANC = WBC × (% segs + % bands)
- Severe neutropenia: ANC < 500; greatest risk at the nadir, ~7–14 days post-chemo
- Febrile neutropenia is an emergency — cultures + antibiotics promptly
Oncologic emergencies to recognize fast
- Tumor lysis syndrome — ↑K, ↑phosphate, ↑uric acid, ↓calcium
- Spinal cord compression — new/worsening back pain with neuro changes
- SVC syndrome — facial/arm swelling, dyspnea
- Hypercalcemia of malignancy — treat with hydration and bisphosphonates
Chemo safety
- Vesicant extravasation — stop the infusion, leave the device to aspirate, give antidote if indicated
- Follow safe-handling precautions for hazardous drugs
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Sources & references
The exam facts on this page are drawn from official certifying-body materials, reviewed 2026-06-18 by the DrCertifications exam-prep team (10+ years in exam preparation and publishing).