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Free OCN Practice Questions

10 free, exam-style Oncology Certified Nurse (OCN) practice questions with answers and explanations. No signup required. Work through them below, then take the full free OCN practice test to study every exam domain.

The OCN exam has 165 questions and runs 3 hours.

These 10 free OCN questions are organized by exam domain, so you can see how each part of the Oncology Certified Nurse blueprint is tested. Reveal the answer and explanation under each question.

Domain 1: Cancer Continuum - Health Promotion, Screening, Diagnosis, and Staging (varies)

Question 1

A breast cancer survivor who received doxorubicin-based chemotherapy 5 years ago reports increasing shortness of breath and fatigue. The nurse should suspect:

  1. Recurrent breast cancer
  2. Chemotherapy-induced peripheral neuropathy
  3. Pulmonary fibrosis
  4. Treatment-related cardiotoxicity
Show answer & explanation

Correct answer: D - Treatment-related cardiotoxicity

Domain 2: Treatment Modalities - Surgery, Radiation, Chemotherapy, Immunotherapy, Transplant (varies)

Question 2

A patient with multiple myeloma presents with confusion, excessive thirst, and constipation. These symptoms are MOST likely caused by:

  1. Syndrome of inappropriate ADH
  2. Hypercalcemia
  3. Tumor lysis syndrome
  4. Hypoglycemia
Show answer & explanation

Correct answer: B - Hypercalcemia

Domain 3: Symptom Management and Palliative Care (varies)

Question 3

A patient who has received bleomycin is scheduled for surgery. The nurse should communicate to the anesthesia team that:

  1. No special precautions are needed
  2. The patient requires additional sedation
  3. High-concentration oxygen should be avoided
  4. The patient requires antibiotic prophylaxis
Show answer & explanation

Correct answer: C - High-concentration oxygen should be avoided

Question 4

A patient is Day +18 post-allogeneic transplant and develops a maculopapular rash on the palms and soles with profuse watery diarrhea. The nurse should suspect:

  1. Acute graft-versus-host disease
  2. Cytomegalovirus reactivation with gastrointestinal involvement
  3. Capillary leak syndrome with fluid retention
  4. Severe cutaneous adverse drug reaction with systemic involvement
Show answer & explanation

Correct answer: A - Acute graft-versus-host disease

Question 5

A patient's LVEF drops from 60% to 42% after four cycles of doxorubicin. The nurse should anticipate that the oncologist will:

  1. Hold or discontinue doxorubicin due to cardiac dysfunction
  2. Continue doxorubicin with closer cardiac monitoring
  3. Increase the doxorubicin dose to complete treatment faster
  4. Add trastuzumab to improve cardiac function
Show answer & explanation

Correct answer: A - Hold or discontinue doxorubicin due to cardiac dysfunction

Domain 4: Oncologic Emergencies (varies)

Question 6

A patient with an ANC of 300/mm³ presents with a temperature of 38.5°C. The PRIORITY nursing action is to:

  1. Obtain blood cultures and notify the physician within 2-4 hours
  2. Administer acetaminophen and implement strict isolation precautions immediately
  3. Obtain blood cultures and initiate broad-spectrum antibiotics within 60 minutes
  4. Place patient in reverse isolation and obtain complete blood count stat
Show answer & explanation

Correct answer: C - Obtain blood cultures and initiate broad-spectrum antibiotics within 60 minutes

Question 7

A patient receiving morphine 60 mg PO every 4 hours is being converted to IV morphine. The equianalgesic IV dose per 4 hours is:

  1. 60 mg IV
  2. 30 mg IV
  3. 10 mg IV
  4. 20 mg IV
Show answer & explanation

Correct answer: D - 20 mg IV

Domain 5: Psychosocial Dimensions of Care (varies)

Question 8

A cancer patient presents with new-onset back pain that worsens when lying down and improves when sitting. This pattern is MOST suspicious for:

  1. Herniated disc with nerve compression
  2. Muscle strain from positioning
  3. Spinal metastasis
  4. Renal colic from kidney stone
Show answer & explanation

Correct answer: C - Spinal metastasis

Question 9

A patient receiving chemotherapy for Burkitt lymphoma develops peaked T waves on the cardiac monitor, a potassium of 7.2 mEq/L, a phosphorus of 8.5 mg/dL, and a calcium of 6.8 mg/dL. This clinical picture is MOST consistent with:

  1. Tumor lysis syndrome
  2. Acute phosphate nephropathy
  3. Rhabdomyolysis with acute kidney injury
  4. Chemotherapy-induced cardiomyopathy
Show answer & explanation

Correct answer: A - Tumor lysis syndrome

Domain 6: Professional Practice - Evidence-Based Practice, Ethics, and Education (varies)

Question 10

A cancer patient states, 'I feel like a burden to my family. They would be better off without me.' The nurse should:

  1. Acknowledge the patient's feelings and schedule a follow-up appointment with the social worker within the week
  2. Directly assess for suicidal ideation by asking if the patient is thinking about harming themselves
  3. Document the statement in the medical record and notify the attending physician during regular rounds
  4. Validate the patient's concerns while gently exploring their relationship dynamics with family members
Show answer & explanation

Correct answer: B - Directly assess for suicidal ideation by asking if the patient is thinking about harming themselves

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