OCN Study Guide: 2000 Q&A + Secret Guide Oncology Certified Nurse (OCN) Exam ONCC

16 of 150. A patient with multiple myeloma is undergoing stem cell mobilization with granulocyte-colony stimulating factor (G-CSF). On day 4, the peripheral blood CD34+ count is 8 cells/µL. The patient is scheduled for apheresis at 0800 the next morning. Based on the CD34+ count and the schedule, which intervention is most appropriate?

30 of 150. A 35-year-old female with early-stage breast cancer appears withdrawn and tearful during her preoperative assessment. She states, “I don’t know if I can go through with this surgery; my mother died on the operating table.” Which assessment approach is best?

29 of 150. A patient receiving whole-brain radiation therapy (WBRT) for brain metastases is currently on a tapering dose of dexamethasone. The patient reports a return of morning headaches and nausea. Which action demonstrates the nurse’s understanding of the underlying pathophysiology?

28 of 150. A patient receiving high-dose rate (HDR) brachytherapy via a balloon catheter for breast cancer expresses concern about exposing her family to radiation. Which statement by the nurse best addresses this concern?

27 of 150. An 8-year-old child with high-risk neuroblastoma has progressed despite aggressive therapy. The parents wish to enroll the child in hospice for home-based support but refuse to discontinue palliative chemotherapy and scheduled blood transfusions. Based on the Concurrent Care for Children provision, which action is appropriate?

26 of 150. A patient with high-grade glioblastoma has lost decision-making capacity. The patient’s spouse prioritizes comfort and time at home, while the patient’s adult children insist on continued hospitalization and aggressive interventions. No advance directive is on file.

25 of 150. A patient receiving chemotherapy for metastatic colon cancer has a hemoglobin of 9.8 g/dL. The provider orders epoetin alfa. The nurse reviews the chart and notes a transferrin saturation (TSAT) of 18% and a ferritin level of 90 ng/mL.

24 of 150. A 62-year-old Asian female who is a never-smoker is diagnosed with stage IV lung adenocarcinoma. When developing the patient’s education plan regarding treatment options, the nurse should prioritize information related to which factor?

23 of 150. A patient with multiple myeloma receiving bortezomib therapy reports a burning sensation and a vesicular rash in a dermatomal pattern on the left flank. The patient is currently taking prophylactic acyclovir. What is the priority nursing intervention?

22 of 150. A Spanish-speaking patient presents with neutropenic fever. The patient’s adult daughter, who speaks fluent English, insists on interpreting to “make her mother more comfortable” and expedite care. Consistent with CLAS (Culturally and Linguistically Appropriate Services) standards, what is the best response?

21 of 150. A patient with a history of nasopharyngeal carcinoma treated with high-dose radiation therapy three years ago presents with a dental abscess requiring extraction of a mandibular molar. The patient is currently asymptomatic regarding the jaw bone itself.

20 of 150. A patient receiving daily radiation therapy for head and neck cancer lives in a rural area 50 miles from the treatment center. The patient reports missing two consecutive treatments because of the inability to afford gasoline. The patient is ambulatory and does not require medical monitoring during transport.

19 of 150. A patient with a known carboplatin hypersensitivity is undergoing a 12-step rapid desensitization protocol. During Step 8, the patient reports mild palmar pruritus and flushing, but vital signs remain stable. Which nursing action aligns with standard desensitization management principles?

18 of 150. A 62-year-old patient with metastatic pancreatic cancer presents with increasing fatigue and weight loss after two lines of chemotherapy. The oncologist proposes a third-line agent. The patient tells the nurse, “I am so tired of the hospital, but my family wants me to keep fighting.”

17 of 150. A patient with metastatic castration-resistant prostate cancer is receiving the second infusion of sipuleucel-T. Fifteen minutes into the infusion, the patient develops uncontrollable rigors and a temperature of 38.5°C (101.3°F), but remains hemodynamically stable with no respiratory distress. What is the most appropriate intervention?

1 of 150. A nurse is educating a patient with Stage III colon cancer about the rationale for adjuvant chemotherapy following surgical resection. The patient questions the need for systemic treatment since the visible tumor was completely removed and postoperative scans are clear.

15 of 150. A patient receiving oxaliplatin through a peripheral IV line complains of stinging and redness at the insertion site. The nurse suspects extravasation and stops the infusion. In contrast to the management of most DNA-binding vesicants, which thermal intervention is prioritized for this patient and why?

14 of 150. A patient with diffuse large B-cell lymphoma (DLBCL) is being educated on the mechanism of action for Axicabtagene ciloleucel, a CD19-directed CAR T-cell therapy. When distinguishing this therapy from the patient’s endogenous immune response, the nurse emphasizes that CAR T-cells have been engineered to overcome which specific limitation of standard T-cell recognition?

13 of 150. A 72-year-old patient with glioblastoma and mild cognitive deficits is being enrolled in a therapeutic trial. The patient’s Legally Authorized Representative (LAR) has signed the informed consent. However, when the nurse approaches to administer the investigational agent, the patient clamps their mouth shut and physically pushes the nurse’s hand away.

12 of 150. A 60-year-old female with head and neck cancer is scheduled for high-dose cisplatin (100 mg/m²). She has a history of severe motion sickness and is highly concerned about vomiting. Which antiemetic regimen aligns with current guidelines for this clinical scenario?

11 of 150. A patient receiving an aromatase inhibitor for two years reports new-onset “brain fog” and difficulty concentrating. The patient also mentions waking up frequently due to hot flashes and feeling exhausted during the day. What is the nurse’s best course of action?

10 of 150. A patient is prescribed a multi-drug chemotherapy regimen consisting of cyclophosphamide (irritant), doxorubicin (vesicant), and fluorouracil (irritant) via a peripheral line. The patient has limited venous access, and the nurse must determine the appropriate sequencing.

9 of 150. A 45-year-old patient who completed adjuvant chemotherapy for breast cancer six months ago reports persistent difficulty multitasking and word-finding at work. The patient expresses significant anxiety about job performance but denies physical fatigue or sleep disturbances. Which intervention should the nurse prioritize?

8 of 150. A patient with acute myeloid leukemia (AML) is midway through induction therapy with an absolute neutrophil count (ANC) of 0/mm³. The patient reports new, vague perirectal discomfort but denies fever or chills. Vital signs are stable. What is the priority nursing intervention?

7 of 150. A 52-year-old female client presents for a well-woman exam. She underwent a total abdominal hysterectomy three years ago for cervical intraepithelial neoplasia grade 3 (CIN 3) with clear margins. She has no other history of gynecologic malignancy and asks if she still requires cervical cancer screening. Which recommendation is most appropriate for this client?

6 of 150. A patient with multiple myeloma is scheduled to receive high-dose melphalan conditioning followed by an autologous hematopoietic stem cell transplant. The nurse identifies this patient as high-risk for severe oral mucositis. Which intervention should the nurse prioritize to prevent mucosal injury in this specific clinical scenario?

5 of 150. A 45-year-old female patient with a history of Stage II ER-positive, HER2-negative breast cancer completed lumpectomy and radiation therapy one year ago and is currently taking tamoxifen. She presents for a follow-up reporting new, persistent lower back pain that wakes her at night. What is the most appropriate next step in the management of this patient?

4 of 150. A 55-year-old lymphoma survivor one year post-treatment reports significant difficulty multitasking and remembering names at work, causing high levels of distress. The patient fears early-onset dementia. Which approach best addresses this patient’s cognitive dysfunction?

3 of 150. A 28-year-old male with a confirmed genetic mutation for Lynch syndrome (HNPCC) presents for care. He is asymptomatic and had a normal baseline colonoscopy at age 25. What is the recommended surveillance interval for this patient?

2 of 150. A patient with head and neck cancer receiving concurrent chemoradiation presents with Grade 3 mucositis, thick secretions, and a 5% weight loss over two weeks. The patient refuses oral intake, stating, “It hurts too much to swallow, so I’d rather just sleep.” Which intervention prioritizes the management of this symptom cascade?