ONS/ONCC Chemotherapy and
Immunotherapy Certificate
Examination Total OF
Questions: 200 WITH ANSWERS
ALREADY GRADED A+ LATTEST
2025-2026
Format: Multiple Choice (A, B, C, D)
Time Limit: 4 hours
Instructions: Select the single best answer for each question.
Section 1: Safe Handling & Hazardous Drugs (1–20)
1. According to USP <800>, which of the following activities requires the use of a closed system
transfer device (CSTD)?
A) Administering oral methotrexate tablets
B) Crushing capecitabine tablets for a feeding tube
C) Drawing up normal saline for flush
D) Applying topical fluorouracil cream with gloved hands
Correct Answer: B
2. A nurse accidentally spills less than 5 mL of IV cyclophosphamide on the floor. The first action
is:
A) Wipe the spill with absorbent pads
B) Restrict access to the area
,C) Notify the hazardous drug spill team
D) Use bleach to decontaminate
Correct Answer: B
3. Which personal protective equipment (PPE) is the minimum required when administering IV
cisplatin via a CSTD?
A) One pair of chemotherapy gloves
B) Two pairs of chemotherapy gloves, gown, and eye protection
C) Standard medical gloves and a mask
D) Chemotherapy gloves and a respirator
Correct Answer: B
4. A nurse who is pregnant should:
A) Avoid handling all hazardous drugs, including oral formulations
B) Handle only oral hazardous drugs with double gloves
C) Administer IV chemotherapy if a CSTD is used
D) Continue handling all drugs, as risk is minimal
Correct Answer: A
5. Which statement about hazardous drug waste disposal is correct?
A) Empty IV bags can go into regular trash
B) Trace waste (e.g., gloves) must go into yellow chemotherapy waste container
C) Body fluids from a patient within 48 hours of chemotherapy are not hazardous
D) Unused vials can be thrown into sharps container
Correct Answer: B
6. A nurse experiences a needle stick from a needle used to draw blood from a patient who
received doxorubicin 4 hours ago. The immediate action is:
A) Squeeze the wound to express blood
B) Wash with soap and water, then report to occupational health
C) Apply bleach to the puncture site
D) Wait 24 hours to see if symptoms develop
,Correct Answer: B
7. Which of the following is a NIOSH Group 1 hazardous drug (requires maximum containment)?
A) Rituximab
B) Cyclophosphamide
C) Trastuzumab
D) Bevacizumab
Correct Answer: B
8. When preparing IV vincristine in a biological safety cabinet (BSC), the nurse should:
A) Work with the sash fully open for visibility
B) Use aseptic non-touch technique only; no BSC needed
C) Place all supplies inside the BSC before starting
D) Keep the blower off to reduce noise
Correct Answer: C
9. A patient receiving oral lenalidomide accidentally drops a capsule on the floor. The correct
action is:
A) Pick it up with a wet paper towel and discard in regular trash
B) Pick it up with gloved hands and dispose in hazardous waste container
C) Leave it for environmental services
D) Crush it and flush down the sink
Correct Answer: B
10. Which of the following patients requires a hazardous drug spill kit in their home?
A) All patients on oral chemotherapy
B) Only patients on IV chemotherapy
C) Patients on oral targeted therapy with teratogenic risk
D) No patients require a home spill kit
Correct Answer: C
, 11. The maximum time a chemotherapy drug can remain on a preparation surface before
cleaning is:
A) 1 hour
B) 2 hours
C) 4 hours
D) No time limit if not visible
Correct Answer: C
12. Which of the following is a trace chemotherapy waste item?
A) A full, unused vial of carboplatin
B) An empty IV bag that contained paclitaxel
C) A patient’s bed linen 72 hours after chemotherapy
D) A syringe containing 10 mL of methotrexate
Correct Answer: B
13. A nurse is reconstituting IV cyclophosphamide powder. The vial becomes pressurized. The
nurse should:
A) Quickly open the vial to release pressure
B) Use a venting needle with a hydrophobic filter
C) Discard the vial immediately
D) Add more diluent to decrease pressure
Correct Answer: B
14. Which of the following is a requirement for a medical surveillance program per OSHA?
A) Annual chest x-ray for all oncology nurses
B) Baseline and annual health history and physical exam for exposed workers
C) Monthly complete blood count for all nurses
D) Genetic testing before handling hazardous drugs
Correct Answer: B
15. A patient on home oral etoposide vomits 30 minutes after taking the dose. The nurse should
instruct:
Immunotherapy Certificate
Examination Total OF
Questions: 200 WITH ANSWERS
ALREADY GRADED A+ LATTEST
2025-2026
Format: Multiple Choice (A, B, C, D)
Time Limit: 4 hours
Instructions: Select the single best answer for each question.
Section 1: Safe Handling & Hazardous Drugs (1–20)
1. According to USP <800>, which of the following activities requires the use of a closed system
transfer device (CSTD)?
A) Administering oral methotrexate tablets
B) Crushing capecitabine tablets for a feeding tube
C) Drawing up normal saline for flush
D) Applying topical fluorouracil cream with gloved hands
Correct Answer: B
2. A nurse accidentally spills less than 5 mL of IV cyclophosphamide on the floor. The first action
is:
A) Wipe the spill with absorbent pads
B) Restrict access to the area
,C) Notify the hazardous drug spill team
D) Use bleach to decontaminate
Correct Answer: B
3. Which personal protective equipment (PPE) is the minimum required when administering IV
cisplatin via a CSTD?
A) One pair of chemotherapy gloves
B) Two pairs of chemotherapy gloves, gown, and eye protection
C) Standard medical gloves and a mask
D) Chemotherapy gloves and a respirator
Correct Answer: B
4. A nurse who is pregnant should:
A) Avoid handling all hazardous drugs, including oral formulations
B) Handle only oral hazardous drugs with double gloves
C) Administer IV chemotherapy if a CSTD is used
D) Continue handling all drugs, as risk is minimal
Correct Answer: A
5. Which statement about hazardous drug waste disposal is correct?
A) Empty IV bags can go into regular trash
B) Trace waste (e.g., gloves) must go into yellow chemotherapy waste container
C) Body fluids from a patient within 48 hours of chemotherapy are not hazardous
D) Unused vials can be thrown into sharps container
Correct Answer: B
6. A nurse experiences a needle stick from a needle used to draw blood from a patient who
received doxorubicin 4 hours ago. The immediate action is:
A) Squeeze the wound to express blood
B) Wash with soap and water, then report to occupational health
C) Apply bleach to the puncture site
D) Wait 24 hours to see if symptoms develop
,Correct Answer: B
7. Which of the following is a NIOSH Group 1 hazardous drug (requires maximum containment)?
A) Rituximab
B) Cyclophosphamide
C) Trastuzumab
D) Bevacizumab
Correct Answer: B
8. When preparing IV vincristine in a biological safety cabinet (BSC), the nurse should:
A) Work with the sash fully open for visibility
B) Use aseptic non-touch technique only; no BSC needed
C) Place all supplies inside the BSC before starting
D) Keep the blower off to reduce noise
Correct Answer: C
9. A patient receiving oral lenalidomide accidentally drops a capsule on the floor. The correct
action is:
A) Pick it up with a wet paper towel and discard in regular trash
B) Pick it up with gloved hands and dispose in hazardous waste container
C) Leave it for environmental services
D) Crush it and flush down the sink
Correct Answer: B
10. Which of the following patients requires a hazardous drug spill kit in their home?
A) All patients on oral chemotherapy
B) Only patients on IV chemotherapy
C) Patients on oral targeted therapy with teratogenic risk
D) No patients require a home spill kit
Correct Answer: C
, 11. The maximum time a chemotherapy drug can remain on a preparation surface before
cleaning is:
A) 1 hour
B) 2 hours
C) 4 hours
D) No time limit if not visible
Correct Answer: C
12. Which of the following is a trace chemotherapy waste item?
A) A full, unused vial of carboplatin
B) An empty IV bag that contained paclitaxel
C) A patient’s bed linen 72 hours after chemotherapy
D) A syringe containing 10 mL of methotrexate
Correct Answer: B
13. A nurse is reconstituting IV cyclophosphamide powder. The vial becomes pressurized. The
nurse should:
A) Quickly open the vial to release pressure
B) Use a venting needle with a hydrophobic filter
C) Discard the vial immediately
D) Add more diluent to decrease pressure
Correct Answer: B
14. Which of the following is a requirement for a medical surveillance program per OSHA?
A) Annual chest x-ray for all oncology nurses
B) Baseline and annual health history and physical exam for exposed workers
C) Monthly complete blood count for all nurses
D) Genetic testing before handling hazardous drugs
Correct Answer: B
15. A patient on home oral etoposide vomits 30 minutes after taking the dose. The nurse should
instruct:
