OCN Study Guide: All-In-One Guide + 4 Exam Practice Test (1400 Questions), Latest for Oncology Certified Nurse(OCN), OrganizationName ONCC

A 22-year-old female presents to the outpatient oncology clinic for follow-up after an abnormal Pap smear showing HSIL. She expresses concern about developing cervical cancer and asks the nurse what she can do to lower her risk. Her history includes initiation of sexual activity at age 17 and inconsistent condom use. Which modifiable risk factor should the nurse prioritize for counseling?

A 58-year-old patient newly diagnosed with acute myeloid leukemia expresses intense anxiety and refuses to sign consent for the scheduled bone marrow biopsy, stating, “I can’t handle any more tests; just tell me what to do.” The patient is tearful, pacing the room, and reports feeling overwhelmed by the diagnosis. Which nursing action is *most* appropriate to address this loss of personal control?

When an oncology patient exhibits sudden urticaria, bronchospasm, and hypotension immediately after starting an infusion of a monoclonal antibody, which intervention is the immediate priority?

When an oncology patient initiates discussion about sexual dysfunction concerns following treatment, which action by the nurse aligns with the foundational principle of the PLISSIT model and current oncology nursing standards?

Which tumor suppressor gene is primarily responsible for initiating cell cycle arrest in response to DNA damage, allowing for repair before replication proceeds?

According to ICH-GCP guidelines, which action is required for documenting a minor protocol deviation determined to have no impact on participant safety or data integrity?

A 48-year-old patient receiving outpatient chemotherapy for stage III colon cancer expresses significant anxiety about finances. They work full-time as a warehouse manager but are experiencing fatigue impacting their ability to lift heavy objects, a core job requirement. They state, “I can’t afford to lose my health insurance, but I’m worried I’ll get fired if I ask for lighter duty.” Which action by the nurse is *most* appropriate *initially*?

An oncology nurse on an inpatient unit is preparing a patient with newly diagnosed acute myeloid leukemia (AML) for potential enrollment in a therapeutic clinical trial. The patient just returned from a bone marrow biopsy under moderate sedation. The research coordinator arrives with the consent form, stating the trial requires enrollment within 24 hours of diagnosis confirmation. The patient appears drowsy, answers questions vaguely, and asks the nurse, “What did the doctor say again?” What is the nurse’s *priority* action regarding the consent process?

When considering prognostic factors for pancreatic adenocarcinoma, which tumor marker demonstrates the strongest independent prognostic value for overall survival according to current staging systems?

During the transition from active treatment to survivorship care for a patient, which primary nursing action is essential to proactively address potential strain on the patient’s family support system?

A 65-year-old male, 18 months post-completion of concurrent chemoradiation (cisplatin + IMRT) for Stage III oropharyngeal cancer, is seen in the head and neck oncology clinic. He reports significant difficulty opening his mouth wide enough to eat solid foods or undergo dental exams, which has progressively worsened over the last year. Physical exam reveals severely restricted jaw opening (<25mm interincisal distance), firmness in the masticatory muscles, and no signs of active mucositis or infection. The oncology nurse recognizes this as a potential long-term complication. What is the *primary* chronic side effect underlying this patient's presentation?

A 58-year-old patient recently diagnosed with Stage I non-small cell lung cancer (NSCLC) is seen in the oncology clinic for initial treatment planning. The patient has a 40-pack-year smoking history and currently smokes one pack per day. The patient expresses a desire to “do everything possible to beat this.” Which modifiable risk factor intervention should the oncology nurse prioritize discussing with the patient *at this visit* to improve long-term outcomes?

When escalating conflict within a family system is identified as the primary barrier to a patient’s timely cancer treatment decision-making, which initial nursing intervention aligns most closely with evidence-based psychosocial support principles?

An oncology nurse assesses a 55-year-old patient with metastatic breast cancer admitted for back pain. The patient reports new bilateral leg weakness (strength 3/5) and urinary incontinence overnight. Vital signs are stable, and she denies trauma. Current medications include gabapentin and acetaminophen. Which intervention is the *most urgent*?

A 42-year-old patient receiving doxorubicin via a newly placed peripheral IV in their left forearm suddenly cries out in pain. The nurse assesses the site and finds erythema, swelling extending 3 cm proximally, and no blood return. The infusion is stopped immediately. The nurse confirms extravasation of this vesicant anthracycline. The clinic protocol requires immediate action per ONS guidelines. Which action should the nurse take *first* after stopping the infusion and leaving the catheter in place?

An oncology nurse is developing a community outreach program focused on primary prevention of smoking-related cancers in a region with high lung cancer incidence rates. Data indicates a significant portion of new smokers are adolescents initiating use through flavored e-cigarettes. The nurse must prioritize an intervention strategy aligning with epidemiological principles and targeting a key modifiable risk factor. Which strategy holds the strongest evidence for reducing smoking initiation at the population level within this context?

A 48-year-old female patient, 18 months post-lumpectomy and adjuvant chemotherapy followed by tamoxifen for Stage II ER+ breast cancer, reports significant dyspareunia and loss of libido to her oncology nurse during a routine follow-up. She tearfully states her husband is becoming distant, and she fears her marriage is failing. The nurse has 10 minutes before the next appointment. Which initial nursing action is *most* appropriate?

An oncology nurse in a survivorship clinic counsels a 58-year-old female patient diagnosed with stage I estrogen receptor-positive (ER+) breast cancer 2 years ago, now disease-free. The patient has a BMI of 30, consumes 4 alcoholic drinks weekly, and reports sedentary habits. She states, “I want to prevent this from coming back. What lifestyle change matters *most*?” Which evidence-based modifiable risk factor reduction should the nurse emphasize for reducing recurrence risk?

In the context of suspected cardiac tamponade in an oncology patient presenting with hypotension, jugular venous distension, and muffled heart sounds, which nursing action is the *immediate* priority?

In managing acute increased intracranial pressure (ICP) in an adult oncology patient with a suspected metastatic brain tumor, which non-invasive nursing intervention should be prioritized *first* to reduce ICP based on established neuro-oncologic emergency guidelines?

According to the Medicare Hospice Benefit, what is the primary eligibility criterion requiring a patient’s active decision for enrollment?

A 68-year-old patient with metastatic lung cancer is receiving home hospice care. They report severe dyspnea at rest (rated 8/10) despite using oxygen at 2 L/min via nasal cannula. The patient is opioid-naïve. On assessment, the nurse notes audible secretions with respirations. The hospice nurse must prioritize symptom relief within the constraints of the home setting. Which intervention is most appropriate for the nurse to initiate first?

A 62-year-old patient with metastatic non-small cell lung cancer is admitted to the oncology unit with new-onset headache and confusion over 8 hours. Upon assessment, the oncology nurse notes the patient is lethargic, has a right-sided dilated pupil sluggish to react, and vomited once. Vital signs show BP 170/90 mmHg, HR 56/min, RR 18/min, SpO2 97% on room air. The nurse anticipates an urgent CT scan will be ordered. Which action should the nurse prioritize *while awaiting the CT scan*?

A 45-year-old patient with acute myeloid leukemia is 24 hours post-initiation of induction chemotherapy (high-dose cytarabine and daunorubicin). They are receiving aggressive IV hydration and rasburicase for TLS prophylaxis. Current vital signs are stable. Labs show: K+ 4.0 mEq/L, uric acid 2.0 mg/dL, phosphate 6.8 mg/dL (down from 8.2 mg/dL 12 hours ago), ionized calcium 0.8 mmol/L (normal 1.12-1.32), creatinine 1.5 mg/dL (baseline 0.8 mg/dL). The patient reports new-onset perioral numbness and tingling in their fingers. The nurse notes a prolonged QT interval on the cardiac monitor. What is the nurse’s *most appropriate* intervention?

Six months after completing chemoradiation and a radical hysterectomy for cervical cancer, a 42-year-old patient reports painful intercourse causing significant relationship strain. She mentions vaginal dryness but declines discussion, stating, “It’s not important compared to surviving.” What is the nurse’s most appropriate initial response?

According to NIOSH and ONS guidelines for hazardous drug safe handling, what is the maximum acceptable timeframe for initiating decontamination of a surface contaminated with an antineoplastic agent spill?

A 55-year-old patient with metastatic breast cancer involving multiple lytic lesions in the femur reports new, localized “deep aching” pain (5/10) in the mid-left thigh, specifically when walking or bearing weight. They have no history of fracture. The oncology nurse should be *most* concerned about the risk for:

For a patient undergoing an allogeneic hematopoietic stem cell transplant, what is the standard timing for initiating cyclosporine as part of graft-versus-host disease (GVHD) prophylaxis?

When a competent adult patient with cancer explicitly requests that specific prognostic information not be shared with their family, what is the oncology nurse’s primary ethical obligation regarding advocacy?

While administering vincristine via peripheral IV to a patient with diffuse large B-cell lymphoma, the nurse notes the patient reports a burning sensation at the site. The IV flushes with mild resistance, and blood return is absent. The nurse stops the infusion immediately. What is the *next* critical nursing action?