Lung Cancer Practice Exam (Latest 2025/2026) –
Verified Questions, Answers & Rationales
This comprehensive practice exam covers the pathophysiology, risk factors, clinical
presentation, diagnostic evaluation, pharmacologic management, nursing
interventions, and patient education for Lung Cancer. Each question includes
the correct answer in bold and a detailed rationale in italics based on current
evidence-based guidelines and oncology nursing standards .
Section 1: Epidemiology & Pathophysiology (Questions 1-15)
Question 1:
A nurse is teaching a community health class about lung cancer. Which statement
accurately describes the current epidemiology of lung cancer?
A) Squamous cell carcinoma remains the most common type of lung cancer
B) Adenocarcinoma is now the most common type of lung cancer
C) Small cell carcinoma accounts for approximately 50% of all lung cancers
D) Lung cancer incidence is decreasing only in women
*Rationale: The incidence of adenocarcinoma has been rising such that it is now
the most common type of lung cancer. About 85% of lung cancers are non-small
cell carcinoma (comprising adenocarcinoma 45%, squamous carcinoma 30%, and
undifferentiated large cell carcinoma 15%) .*
Question 2:
The nurse understands that the majority of primary lung lesions are classified as:
A) Small cell carcinomas
B) Bronchogenic carcinomas
C) Sarcomas of the lung
D) Mesotheliomas
,Rationale: The vast majority of primary lung lesions are bronchogenic carcinomas
that are tumors of the airway epithelium. These tumors are further differentiated
as small-cell carcinomas or non-small-cell carcinomas, and include
adenocarcinomas, squamous cell carcinomas, and large-cell carcinomas .
Question 3:
Which type of lung cancer is characterized by the ability to synthesize bioactive
products and hormones such as adrenocorticotropic hormone (ACTH) or
antidiuretic hormone (ADH)?
A) Adenocarcinoma
B) Squamous cell carcinoma
C) Small cell carcinoma
D) Large cell carcinoma
Rationale: Small-cell carcinomas can synthesize bioactive products and hormones,
such as adrenocorticotropic hormones; antidiuretic hormone, a parathormone-like
hormone; and gastrin-releasing peptide. Adenocarcinomas, squamous cell
carcinomas, and large-cell carcinomas are classified as non-small-cell carcinomas.
They do not possess this ability .
Question 4:
A patient diagnosed with lung cancer asks the nurse to explain the difference
between small cell and non-small cell lung cancer. Which response by the nurse is
most accurate?
A) "Small cell lung cancer is less aggressive and has a better prognosis"
B) "Non-small cell lung cancer always responds better to chemotherapy"
C) "Small cell lung cancer tends to grow more quickly and spread earlier, while
non-small cell lung cancer is more common and treated differently"
D) "There is no difference in treatment between these two types"
*Rationale: Small cell lung cancer (SCLC) is characterized by rapid growth, early
metastasis, and initial responsiveness to chemotherapy and radiation, but it has a
poorer overall prognosis. Non-small cell lung cancer (NSCLC) is more common
,(about 85% of cases) and includes adenocarcinoma, squamous cell, and large cell
subtypes. Treatment approaches differ significantly between SCLC and NSCLC .*
Question 5:
According to the TNM staging system for lung cancer, what does the "T"
designation indicate?
A) Tumor size, location, and degree of invasion
B) Lymph node involvement
C) Presence of distant metastases
D) Type of cancer cells
Rationale: The TNM staging system for lung cancer is based upon the size, location
and degree of invasion of the primary tumour (T), the involvement of lymph nodes
(N) and the presence of distant metastases (M) . T refers to the primary tumor
characteristics .
Question 6:
A patient with a 2.5 cm tumor in the periphery of the left upper lobe has no lymph
node involvement or distant metastases on PET/CT. According to TNM staging, this
is classified as:
A) T1aN0M0
B) T1cN0M0
C) T2N0M0
D) T1N1M0
Rationale: A tumor >2 cm and <3 cm is classified as T1c. With no lymph node
involvement (N0) and no distant metastases (M0), the complete staging is
T1cN0M0, which is Stage IA3 .
Question 7:
The nurse is explaining lung cancer classifications to a patient. Which statement
correctly describes squamous cell carcinoma?
A) It is more common in women and non-smokers
B) It is strongly associated with smoking and typically occurs centrally in the
, lungs
C) It has the best prognosis of all lung cancer types
D) It rarely metastasizes
Rationale: Squamous cell carcinoma is the most common type of lung cancer in
men, strongly associated with smoking, and typically presents as a central (hilar)
tumor. It is more likely to cavitate than other types .
Question 8:
Which of the following are established risk factors for developing lung cancer?
(Select all that apply)
A) Cigarette smoking
B) Asbestos exposure
C) Exposure to radon gas
D) Ionizing radiation
E) High physical activity level
Rationale: Risk factors for lung cancer include cigarette smoking (the leading
cause), exposure to environmental carcinogens including asbestos and uranium,
radon exposure, and ionizing radiation . Non-small cell carcinoma is associated
with cigarette smoking and exposure to environmental carcinogens, including
asbestos and uranium . Physical activity does not increase lung cancer risk.
Question 9:
A patient asks why cigarette smoking is the leading cause of lung cancer. The
nurse's best response is:
A) "Cigarettes are addictive, which makes people smoke more"
B) "Cigarettes contain more than 700 chemicals, 70 of which are known
carcinogens"
C) "Smoking weakens the immune system"
D) "Smoking introduces foreign substances into the body"
Rationale: Cigarette smoke contains a large amount of chemicals, many of which
are carcinogenic. Although it is addictive and a foreign substance to the body, this
Verified Questions, Answers & Rationales
This comprehensive practice exam covers the pathophysiology, risk factors, clinical
presentation, diagnostic evaluation, pharmacologic management, nursing
interventions, and patient education for Lung Cancer. Each question includes
the correct answer in bold and a detailed rationale in italics based on current
evidence-based guidelines and oncology nursing standards .
Section 1: Epidemiology & Pathophysiology (Questions 1-15)
Question 1:
A nurse is teaching a community health class about lung cancer. Which statement
accurately describes the current epidemiology of lung cancer?
A) Squamous cell carcinoma remains the most common type of lung cancer
B) Adenocarcinoma is now the most common type of lung cancer
C) Small cell carcinoma accounts for approximately 50% of all lung cancers
D) Lung cancer incidence is decreasing only in women
*Rationale: The incidence of adenocarcinoma has been rising such that it is now
the most common type of lung cancer. About 85% of lung cancers are non-small
cell carcinoma (comprising adenocarcinoma 45%, squamous carcinoma 30%, and
undifferentiated large cell carcinoma 15%) .*
Question 2:
The nurse understands that the majority of primary lung lesions are classified as:
A) Small cell carcinomas
B) Bronchogenic carcinomas
C) Sarcomas of the lung
D) Mesotheliomas
,Rationale: The vast majority of primary lung lesions are bronchogenic carcinomas
that are tumors of the airway epithelium. These tumors are further differentiated
as small-cell carcinomas or non-small-cell carcinomas, and include
adenocarcinomas, squamous cell carcinomas, and large-cell carcinomas .
Question 3:
Which type of lung cancer is characterized by the ability to synthesize bioactive
products and hormones such as adrenocorticotropic hormone (ACTH) or
antidiuretic hormone (ADH)?
A) Adenocarcinoma
B) Squamous cell carcinoma
C) Small cell carcinoma
D) Large cell carcinoma
Rationale: Small-cell carcinomas can synthesize bioactive products and hormones,
such as adrenocorticotropic hormones; antidiuretic hormone, a parathormone-like
hormone; and gastrin-releasing peptide. Adenocarcinomas, squamous cell
carcinomas, and large-cell carcinomas are classified as non-small-cell carcinomas.
They do not possess this ability .
Question 4:
A patient diagnosed with lung cancer asks the nurse to explain the difference
between small cell and non-small cell lung cancer. Which response by the nurse is
most accurate?
A) "Small cell lung cancer is less aggressive and has a better prognosis"
B) "Non-small cell lung cancer always responds better to chemotherapy"
C) "Small cell lung cancer tends to grow more quickly and spread earlier, while
non-small cell lung cancer is more common and treated differently"
D) "There is no difference in treatment between these two types"
*Rationale: Small cell lung cancer (SCLC) is characterized by rapid growth, early
metastasis, and initial responsiveness to chemotherapy and radiation, but it has a
poorer overall prognosis. Non-small cell lung cancer (NSCLC) is more common
,(about 85% of cases) and includes adenocarcinoma, squamous cell, and large cell
subtypes. Treatment approaches differ significantly between SCLC and NSCLC .*
Question 5:
According to the TNM staging system for lung cancer, what does the "T"
designation indicate?
A) Tumor size, location, and degree of invasion
B) Lymph node involvement
C) Presence of distant metastases
D) Type of cancer cells
Rationale: The TNM staging system for lung cancer is based upon the size, location
and degree of invasion of the primary tumour (T), the involvement of lymph nodes
(N) and the presence of distant metastases (M) . T refers to the primary tumor
characteristics .
Question 6:
A patient with a 2.5 cm tumor in the periphery of the left upper lobe has no lymph
node involvement or distant metastases on PET/CT. According to TNM staging, this
is classified as:
A) T1aN0M0
B) T1cN0M0
C) T2N0M0
D) T1N1M0
Rationale: A tumor >2 cm and <3 cm is classified as T1c. With no lymph node
involvement (N0) and no distant metastases (M0), the complete staging is
T1cN0M0, which is Stage IA3 .
Question 7:
The nurse is explaining lung cancer classifications to a patient. Which statement
correctly describes squamous cell carcinoma?
A) It is more common in women and non-smokers
B) It is strongly associated with smoking and typically occurs centrally in the
, lungs
C) It has the best prognosis of all lung cancer types
D) It rarely metastasizes
Rationale: Squamous cell carcinoma is the most common type of lung cancer in
men, strongly associated with smoking, and typically presents as a central (hilar)
tumor. It is more likely to cavitate than other types .
Question 8:
Which of the following are established risk factors for developing lung cancer?
(Select all that apply)
A) Cigarette smoking
B) Asbestos exposure
C) Exposure to radon gas
D) Ionizing radiation
E) High physical activity level
Rationale: Risk factors for lung cancer include cigarette smoking (the leading
cause), exposure to environmental carcinogens including asbestos and uranium,
radon exposure, and ionizing radiation . Non-small cell carcinoma is associated
with cigarette smoking and exposure to environmental carcinogens, including
asbestos and uranium . Physical activity does not increase lung cancer risk.
Question 9:
A patient asks why cigarette smoking is the leading cause of lung cancer. The
nurse's best response is:
A) "Cigarettes are addictive, which makes people smoke more"
B) "Cigarettes contain more than 700 chemicals, 70 of which are known
carcinogens"
C) "Smoking weakens the immune system"
D) "Smoking introduces foreign substances into the body"
Rationale: Cigarette smoke contains a large amount of chemicals, many of which
are carcinogenic. Although it is addictive and a foreign substance to the body, this
