ONS/ONCC CHEMOTHERAPY
IMMUNOTHERAPY CERTIFICATION
EXAM (2026) QUESTIONS AND
(DETAILED ANSWERS) PLUS
RATIONALES WITH COMPLETE
SOLUTIONS
1. Alkylating agents primarily work by:
A. Inhibiting microtubule formation
B. Cross-linking DNA strands
C. Blocking growth factor receptors
D. Inhibiting tyrosine kinase
Answer: B
Rationale: Alkylating agents form DNA cross-links, preventing DNA replication and inducing
cell death.
2. Antimetabolites exert their effect by:
A. Mimicking normal metabolites
B. Disrupting tubulin formation
C. Blocking epidermal growth factor
D. Enhancing DNA repair
Answer: A
Rationale: Antimetabolites resemble normal substrates and interfere with DNA/RNA synthesis.
3. Taxanes (e.g., paclitaxel) act by:
A. Inhibiting DNA polymerase
B. Stabilizing microtubules
,C. Alkylating DNA
D. Blocking RNA transcription
Answer: B
Rationale: Taxanes prevent microtubule disassembly, disrupting mitosis.
4. Platinum agents (cisplatin, carboplatin) are associated with:
A. Cardiotoxicity
B. Nephrotoxicity
C. Hyperglycemia
D. Neuropathy only
Answer: B
Rationale: Platinum agents frequently cause renal toxicity, requiring hydration and monitoring.
5. A monoclonal antibody ending in “-mab” usually targets:
A. DNA replication
B. Specific cell surface antigens
C. MicroRNAs
D. Mitochondria
Answer: B
Rationale: –mab drugs are designed to target specific antigens on cells.
2. Safe Handling & Administration
6. Before administering chemotherapy, nurses must confirm:
A. Patient’s insurance status
B. Identity, drug, dose, route, time
C. Family history of cancer
D. Previous surgical outcomes
Answer: B
Rationale: The “Five Rights” ensure safe administration.
, 7. Extravasation refers to:
A. A fever post-chemo
B. Infiltration of vesicant into tissue
C. Hair loss from therapy
D. Nausea unresponsive to antiemetics
Answer: B
Rationale: Extravasation is leakage of a chemo agent into surrounding tissue, risking tissue
injury.
8. The primary purpose of PPE when handling chemo drugs is to:
A. Avoid contamination
B. Reduce nursing workload
C. Prevent infection
D. Encourage patient participation
Answer: A
Rationale: PPE protects providers from hazardous drug exposure.
9. Chemotherapy preparation should occur in:
A. A positive airflow room
B. A biosafety cabinet/chemo isolator
C. A shared patient room
D. The hallway
Answer: B
Rationale: Biological safety cabinets minimize aerosol exposures.
10. During central line chemo administration, nurses must:
A. Flush only if symptomatic
B. Confirm blood return before and during infusion
C. Administer quickly
D. Use IM injections
Answer: B
Rationale: Confirming blood return ensures proper catheter placement.
IMMUNOTHERAPY CERTIFICATION
EXAM (2026) QUESTIONS AND
(DETAILED ANSWERS) PLUS
RATIONALES WITH COMPLETE
SOLUTIONS
1. Alkylating agents primarily work by:
A. Inhibiting microtubule formation
B. Cross-linking DNA strands
C. Blocking growth factor receptors
D. Inhibiting tyrosine kinase
Answer: B
Rationale: Alkylating agents form DNA cross-links, preventing DNA replication and inducing
cell death.
2. Antimetabolites exert their effect by:
A. Mimicking normal metabolites
B. Disrupting tubulin formation
C. Blocking epidermal growth factor
D. Enhancing DNA repair
Answer: A
Rationale: Antimetabolites resemble normal substrates and interfere with DNA/RNA synthesis.
3. Taxanes (e.g., paclitaxel) act by:
A. Inhibiting DNA polymerase
B. Stabilizing microtubules
,C. Alkylating DNA
D. Blocking RNA transcription
Answer: B
Rationale: Taxanes prevent microtubule disassembly, disrupting mitosis.
4. Platinum agents (cisplatin, carboplatin) are associated with:
A. Cardiotoxicity
B. Nephrotoxicity
C. Hyperglycemia
D. Neuropathy only
Answer: B
Rationale: Platinum agents frequently cause renal toxicity, requiring hydration and monitoring.
5. A monoclonal antibody ending in “-mab” usually targets:
A. DNA replication
B. Specific cell surface antigens
C. MicroRNAs
D. Mitochondria
Answer: B
Rationale: –mab drugs are designed to target specific antigens on cells.
2. Safe Handling & Administration
6. Before administering chemotherapy, nurses must confirm:
A. Patient’s insurance status
B. Identity, drug, dose, route, time
C. Family history of cancer
D. Previous surgical outcomes
Answer: B
Rationale: The “Five Rights” ensure safe administration.
, 7. Extravasation refers to:
A. A fever post-chemo
B. Infiltration of vesicant into tissue
C. Hair loss from therapy
D. Nausea unresponsive to antiemetics
Answer: B
Rationale: Extravasation is leakage of a chemo agent into surrounding tissue, risking tissue
injury.
8. The primary purpose of PPE when handling chemo drugs is to:
A. Avoid contamination
B. Reduce nursing workload
C. Prevent infection
D. Encourage patient participation
Answer: A
Rationale: PPE protects providers from hazardous drug exposure.
9. Chemotherapy preparation should occur in:
A. A positive airflow room
B. A biosafety cabinet/chemo isolator
C. A shared patient room
D. The hallway
Answer: B
Rationale: Biological safety cabinets minimize aerosol exposures.
10. During central line chemo administration, nurses must:
A. Flush only if symptomatic
B. Confirm blood return before and during infusion
C. Administer quickly
D. Use IM injections
Answer: B
Rationale: Confirming blood return ensures proper catheter placement.
