ATI MED SURG ONCOLOGY LATEST UPDATED 2025-2026 REAL
FINAL EXAM WITH COMPLETE DETAILED QUESTIONS AND
CORRECT VERIFIED ANSWERS ALREADY A+ GRADED
1. A client receiving chemotherapy reports nausea and vomiting 24 hours after treatment. Which type of
emesis is the client experiencing?
A) Acute
B) Anticipatory
C) Breakthrough
D) Delayed
CORRECT ANSWER: D – Delayed emesis occurs more than 24 hours after chemotherapy, often
associated with cisplatin, cyclophosphamide, or doxorubicin. Rationale: Acute emesis occurs within 24
hours; anticipatory is conditioned response; breakthrough occurs despite prophylaxis.
2. A client with neutropenia has a temperature of 101.5°F (38.6°C). What is the nurse’s priority action?
A) Administer acetaminophen as ordered
B) Obtain blood cultures and initiate broad-spectrum antibiotics
C) Apply a cooling blanket
D) Recheck temperature in 30 minutes
CORRECT ANSWER: B – Fever in a neutropenic client is a medical emergency requiring immediate
cultures and antibiotics. Rationale: Neutropenia impairs infection response; delay can lead to sepsis and
death.
3. A client undergoing external beam radiation for lung cancer reports fatigue. Which intervention is
most appropriate?
,A) Encourage complete bed rest until fatigue subsides
B) Advise the client to increase physical activity to moderate levels
C) Restrict fluids to prevent nocturia
D) Administer a stimulant medication daily
CORRECT ANSWER: B – Moderate exercise such as walking helps reduce radiation-induced fatigue.
Rationale: Complete rest worsens fatigue; hydration is important; stimulants are not first-line.
4. A client with breast cancer is receiving tamoxifen. The nurse should monitor for which adverse effect?
A) Hot flashes and risk of thromboembolism
B) Peripheral neuropathy
C) Hemorrhagic cystitis
D) Cardiotoxicity
CORRECT ANSWER: A – Tamoxifen, a selective estrogen receptor modulator, causes hot flashes and
increases risk of DVT/PE. Rationale: Neuropathy is from taxanes; hemorrhagic cystitis from
cyclophosphamide; cardiotoxicity from doxorubicin or trastuzumab.
5. A client with small cell lung cancer develops syndrome of inappropriate antidiuretic hormone (SIADH).
Which laboratory finding is expected?
A) Serum sodium 128 mEq/L
B) Serum potassium 5.8 mEq/L
C) Serum glucose 45 mg/dL
D) Serum calcium 12.5 mg/dL
CORRECT ANSWER: A – SIADH causes dilutional hyponatremia due to excess water retention. Rationale:
Hyperkalemia, hypoglycemia, and hypercalcemia are not characteristic of SIADH.
,6. A client receiving cisplatin reports tinnitus and hearing loss. The nurse should suspect which
complication?
A) Ototoxicity
B) Nephrotoxicity
C) Neurotoxicity
D) Hepatotoxicity
CORRECT ANSWER: A – Cisplatin is known for irreversible ototoxicity, manifesting as tinnitus and high-
frequency hearing loss. Rationale: Nephrotoxicity is also common but presents with renal labs;
neurotoxicity presents with paresthesia.
7. A client undergoing chemotherapy has a platelet count of 20,000/mm³. Which precaution is most
important?
A) Neutropenic precautions
B) Bleeding precautions
C) Contact precautions
D) Droplet precautions
CORRECT ANSWER: B – Severe thrombocytopenia (platelets <50,000) requires bleeding precautions: soft
toothbrush, no IM injections, fall prevention. Rationale: Neutropenic precautions apply to low WBC, not
low platelets.
8. A client with advanced cancer reports pain rated 8/10. Morphine is ordered. Which side effect
requires anticipatory guidance?
A) Hypertension
B) Constipation
C) Diarrhea
D) Urinary frequency
, CORRECT ANSWER: B – Opioids cause constipation via decreased peristalsis; tolerance does not develop.
Rationale: Laxatives should be prescribed prophylactically. Respiratory depression is another concern
but not anticipatory guidance for all.
9. A client with leukemia develops tumor lysis syndrome after chemotherapy. Which laboratory finding
is most consistent?
A) Hypokalemia
B) Hypophosphatemia
C) Hypercalcemia
D) Hyperuricemia
CORRECT ANSWER: D – Tumor lysis syndrome causes hyperuricemia, hyperkalemia, hyperphosphatemia,
and hypocalcemia. Rationale: Uric acid rises from rapid cell breakdown; allopurinol or rasburicase may
be given.
10. A client receiving doxorubicin should be monitored for which life-threatening adverse effect?
A) Pulmonary fibrosis
B) Hemorrhagic cystitis
C) Cardiotoxicity
D) Ototoxicity
CORRECT ANSWER: C – Doxorubicin (anthracycline) causes cumulative dose-related cardiomyopathy and
heart failure. Rationale: Pulmonary fibrosis from bleomycin; hemorrhagic cystitis from
cyclophosphamide; ototoxicity from cisplatin.
11. A client post-chemotherapy has a white blood cell count of 1,200/mm³. Which food should the nurse
recommend avoiding?
A) Peeled apples
B) Yogurt with live cultures
FINAL EXAM WITH COMPLETE DETAILED QUESTIONS AND
CORRECT VERIFIED ANSWERS ALREADY A+ GRADED
1. A client receiving chemotherapy reports nausea and vomiting 24 hours after treatment. Which type of
emesis is the client experiencing?
A) Acute
B) Anticipatory
C) Breakthrough
D) Delayed
CORRECT ANSWER: D – Delayed emesis occurs more than 24 hours after chemotherapy, often
associated with cisplatin, cyclophosphamide, or doxorubicin. Rationale: Acute emesis occurs within 24
hours; anticipatory is conditioned response; breakthrough occurs despite prophylaxis.
2. A client with neutropenia has a temperature of 101.5°F (38.6°C). What is the nurse’s priority action?
A) Administer acetaminophen as ordered
B) Obtain blood cultures and initiate broad-spectrum antibiotics
C) Apply a cooling blanket
D) Recheck temperature in 30 minutes
CORRECT ANSWER: B – Fever in a neutropenic client is a medical emergency requiring immediate
cultures and antibiotics. Rationale: Neutropenia impairs infection response; delay can lead to sepsis and
death.
3. A client undergoing external beam radiation for lung cancer reports fatigue. Which intervention is
most appropriate?
,A) Encourage complete bed rest until fatigue subsides
B) Advise the client to increase physical activity to moderate levels
C) Restrict fluids to prevent nocturia
D) Administer a stimulant medication daily
CORRECT ANSWER: B – Moderate exercise such as walking helps reduce radiation-induced fatigue.
Rationale: Complete rest worsens fatigue; hydration is important; stimulants are not first-line.
4. A client with breast cancer is receiving tamoxifen. The nurse should monitor for which adverse effect?
A) Hot flashes and risk of thromboembolism
B) Peripheral neuropathy
C) Hemorrhagic cystitis
D) Cardiotoxicity
CORRECT ANSWER: A – Tamoxifen, a selective estrogen receptor modulator, causes hot flashes and
increases risk of DVT/PE. Rationale: Neuropathy is from taxanes; hemorrhagic cystitis from
cyclophosphamide; cardiotoxicity from doxorubicin or trastuzumab.
5. A client with small cell lung cancer develops syndrome of inappropriate antidiuretic hormone (SIADH).
Which laboratory finding is expected?
A) Serum sodium 128 mEq/L
B) Serum potassium 5.8 mEq/L
C) Serum glucose 45 mg/dL
D) Serum calcium 12.5 mg/dL
CORRECT ANSWER: A – SIADH causes dilutional hyponatremia due to excess water retention. Rationale:
Hyperkalemia, hypoglycemia, and hypercalcemia are not characteristic of SIADH.
,6. A client receiving cisplatin reports tinnitus and hearing loss. The nurse should suspect which
complication?
A) Ototoxicity
B) Nephrotoxicity
C) Neurotoxicity
D) Hepatotoxicity
CORRECT ANSWER: A – Cisplatin is known for irreversible ototoxicity, manifesting as tinnitus and high-
frequency hearing loss. Rationale: Nephrotoxicity is also common but presents with renal labs;
neurotoxicity presents with paresthesia.
7. A client undergoing chemotherapy has a platelet count of 20,000/mm³. Which precaution is most
important?
A) Neutropenic precautions
B) Bleeding precautions
C) Contact precautions
D) Droplet precautions
CORRECT ANSWER: B – Severe thrombocytopenia (platelets <50,000) requires bleeding precautions: soft
toothbrush, no IM injections, fall prevention. Rationale: Neutropenic precautions apply to low WBC, not
low platelets.
8. A client with advanced cancer reports pain rated 8/10. Morphine is ordered. Which side effect
requires anticipatory guidance?
A) Hypertension
B) Constipation
C) Diarrhea
D) Urinary frequency
, CORRECT ANSWER: B – Opioids cause constipation via decreased peristalsis; tolerance does not develop.
Rationale: Laxatives should be prescribed prophylactically. Respiratory depression is another concern
but not anticipatory guidance for all.
9. A client with leukemia develops tumor lysis syndrome after chemotherapy. Which laboratory finding
is most consistent?
A) Hypokalemia
B) Hypophosphatemia
C) Hypercalcemia
D) Hyperuricemia
CORRECT ANSWER: D – Tumor lysis syndrome causes hyperuricemia, hyperkalemia, hyperphosphatemia,
and hypocalcemia. Rationale: Uric acid rises from rapid cell breakdown; allopurinol or rasburicase may
be given.
10. A client receiving doxorubicin should be monitored for which life-threatening adverse effect?
A) Pulmonary fibrosis
B) Hemorrhagic cystitis
C) Cardiotoxicity
D) Ototoxicity
CORRECT ANSWER: C – Doxorubicin (anthracycline) causes cumulative dose-related cardiomyopathy and
heart failure. Rationale: Pulmonary fibrosis from bleomycin; hemorrhagic cystitis from
cyclophosphamide; ototoxicity from cisplatin.
11. A client post-chemotherapy has a white blood cell count of 1,200/mm³. Which food should the nurse
recommend avoiding?
A) Peeled apples
B) Yogurt with live cultures
