OCN Oncology nursing certification validating
expertise in cancer care, chemotherapy
administration, symptom management, and
patient education.
Question 1
A 52-year-old female patient with a family history of breast cancer asks about
screening recommendations. According to current guidelines, which of the
following is the MOST appropriate recommendation?
A. Annual clinical breast examination starting at age 40
B. Mammography every 2 years starting at age 50
C. Annual mammography starting at age 40
D. Breast self-examination monthly starting at age 35
Answer: C. Annual mammography starting at age 40
Rationale: Current guidelines recommend annual mammography for women
beginning at age 40. Women with a family history of breast cancer may benefit
from earlier screening and genetic counseling. Clinical breast examinations and
breast self-awareness are important but are not a replacement for mammography.
The recommendation for biennial screening at age 50 applies to average-risk
women without family history, but annual screening starting at 40 is more
comprehensive.
Question 2
A patient with metastatic lung cancer is experiencing increasing pain and shortness
of breath. The patient tells the nurse, "I don't want any more treatments. I just want
to be comfortable." Which of the following is the nurse's PRIORITY action?
A. Contact the oncology social worker for counseling
B. Discuss the patient's wishes with the healthcare provider
C. Arrange a hospice consultation
D. Assess the patient's understanding of their prognosis and goals of care
,Answer: D. Assess the patient's understanding of their prognosis and goals of
care
Rationale: The priority action is to assess the patient's understanding of their
prognosis and goals of care. This allows the nurse to clarify misconceptions and
ensure the patient is making an informed decision. While arranging hospice,
involving social work, and discussing with the provider are important, they should
follow a thorough assessment of the patient's understanding and wishes.
Question 3
A patient who completed treatment for Hodgkin lymphoma 10 years ago presents
with a new lump in the breast. The nurse recognizes that this patient is at increased
risk for which of the following?
A. Recurrence of Hodgkin lymphoma
B. Secondary breast cancer due to prior radiation therapy
C. Benign breast disease
D. Metastatic disease from the original lymphoma
Answer: B. Secondary breast cancer due to prior radiation therapy
Rationale: Patients treated with mantle field radiation for Hodgkin lymphoma are
at significantly increased risk for secondary breast cancer. This risk is highest in
women treated before age 30 and typically emerges 10-15 years after treatment.
This is an example of a treatment-related consideration, specifically subsequent
malignancies. The nurse should ensure the patient receives appropriate screening
and follow-up care.
Question 4
A patient with advanced pancreatic cancer is considering hospice care. Which of
the following statements by the patient indicates a correct understanding of
hospice?
A. "Hospice means I will no longer receive any medical care"
B. "Hospice will help me live my remaining time with dignity and comfort"
C. "I can only receive hospice care in a facility"
D. "Hospice is only for patients who have less than one week to live"
,Answer: B. "Hospice will help me live my remaining time with dignity and
comfort"
Rationale: Hospice care focuses on comfort, dignity, and quality of life for
patients with a life expectancy of 6 months or less. It does not mean the patient
receives no care; rather, it shifts the focus from curative to palliative care. Hospice
can be provided in various settings, including the patient's home. The patient's
statement reflects an accurate understanding of the goals of hospice care.
Question 5
A patient with a new diagnosis of colorectal cancer is scheduled for surgery. The
nurse should include which of the following in the preoperative teaching?
A. Explanation that surgery alone is curative for all colorectal cancers
B. Information about the possibility of a temporary or permanent ostomy
C. Reassurance that chemotherapy will not be needed
D. Instructions to increase fiber intake immediately before surgery
Answer: B. Information about the possibility of a temporary or permanent
ostomy
Rationale: Depending on the location and extent of the tumor, colorectal surgery
may result in a temporary or permanent ostomy. Preoperative teaching should
include realistic information about this possibility to allow the patient to prepare
emotionally and physically. Surgery is not always curative alone, and
chemotherapy or radiation may be needed based on staging. Dietary instructions
should follow the surgeon's specific orders.
Question 6
A patient who is 5 years post-treatment for breast cancer asks about survivorship
care. Which of the following is the MOST appropriate component of survivorship
care?
A. Annual surveillance imaging for all patients
B. A survivorship care plan that includes surveillance, prevention, and
management of late effects
C. Discharge from oncology follow-up care
D. Annual complete blood count and comprehensive metabolic panel
, Answer: B. A survivorship care plan that includes surveillance, prevention,
and management of late effects
Rationale: Survivorship care plans are essential for coordinating follow-up care
after cancer treatment. They include recommendations for surveillance, prevention
of new cancers, management of late effects, and coordination with primary care
providers. Not all patients require annual imaging; surveillance is guided by cancer
type and risk. Discharge from oncology follow-up may occur but should be
accompanied by a clear survivorship plan.
Question 7
A patient with a 30-pack-year smoking history asks about lung cancer screening.
Which of the following is the MOST appropriate recommendation?
A. Annual chest X-ray
B. Low-dose computed tomography (LDCT) annually
C. Sputum cytology every 6 months
D. No screening is indicated
Answer: B. Low-dose computed tomography (LDCT) annually
Rationale: Annual low-dose CT screening is recommended for individuals aged
50-80 years with a 20-pack-year or greater smoking history who currently smoke
or have quit within the past 15 years. Chest X-ray and sputum cytology are not
recommended for lung cancer screening. This patient meets the criteria and should
be referred for LDCT screening.
Question 8
A patient with end-stage ovarian cancer is experiencing dyspnea and anxiety. The
nurse administers morphine sulfate as ordered. Which of the following is the
PRIMARY rationale for using morphine in this situation?
A. To treat pain
B. To induce sleep
C. To relieve dyspnea and anxiety
D. To hasten death
Answer: C. To relieve dyspnea and anxiety
expertise in cancer care, chemotherapy
administration, symptom management, and
patient education.
Question 1
A 52-year-old female patient with a family history of breast cancer asks about
screening recommendations. According to current guidelines, which of the
following is the MOST appropriate recommendation?
A. Annual clinical breast examination starting at age 40
B. Mammography every 2 years starting at age 50
C. Annual mammography starting at age 40
D. Breast self-examination monthly starting at age 35
Answer: C. Annual mammography starting at age 40
Rationale: Current guidelines recommend annual mammography for women
beginning at age 40. Women with a family history of breast cancer may benefit
from earlier screening and genetic counseling. Clinical breast examinations and
breast self-awareness are important but are not a replacement for mammography.
The recommendation for biennial screening at age 50 applies to average-risk
women without family history, but annual screening starting at 40 is more
comprehensive.
Question 2
A patient with metastatic lung cancer is experiencing increasing pain and shortness
of breath. The patient tells the nurse, "I don't want any more treatments. I just want
to be comfortable." Which of the following is the nurse's PRIORITY action?
A. Contact the oncology social worker for counseling
B. Discuss the patient's wishes with the healthcare provider
C. Arrange a hospice consultation
D. Assess the patient's understanding of their prognosis and goals of care
,Answer: D. Assess the patient's understanding of their prognosis and goals of
care
Rationale: The priority action is to assess the patient's understanding of their
prognosis and goals of care. This allows the nurse to clarify misconceptions and
ensure the patient is making an informed decision. While arranging hospice,
involving social work, and discussing with the provider are important, they should
follow a thorough assessment of the patient's understanding and wishes.
Question 3
A patient who completed treatment for Hodgkin lymphoma 10 years ago presents
with a new lump in the breast. The nurse recognizes that this patient is at increased
risk for which of the following?
A. Recurrence of Hodgkin lymphoma
B. Secondary breast cancer due to prior radiation therapy
C. Benign breast disease
D. Metastatic disease from the original lymphoma
Answer: B. Secondary breast cancer due to prior radiation therapy
Rationale: Patients treated with mantle field radiation for Hodgkin lymphoma are
at significantly increased risk for secondary breast cancer. This risk is highest in
women treated before age 30 and typically emerges 10-15 years after treatment.
This is an example of a treatment-related consideration, specifically subsequent
malignancies. The nurse should ensure the patient receives appropriate screening
and follow-up care.
Question 4
A patient with advanced pancreatic cancer is considering hospice care. Which of
the following statements by the patient indicates a correct understanding of
hospice?
A. "Hospice means I will no longer receive any medical care"
B. "Hospice will help me live my remaining time with dignity and comfort"
C. "I can only receive hospice care in a facility"
D. "Hospice is only for patients who have less than one week to live"
,Answer: B. "Hospice will help me live my remaining time with dignity and
comfort"
Rationale: Hospice care focuses on comfort, dignity, and quality of life for
patients with a life expectancy of 6 months or less. It does not mean the patient
receives no care; rather, it shifts the focus from curative to palliative care. Hospice
can be provided in various settings, including the patient's home. The patient's
statement reflects an accurate understanding of the goals of hospice care.
Question 5
A patient with a new diagnosis of colorectal cancer is scheduled for surgery. The
nurse should include which of the following in the preoperative teaching?
A. Explanation that surgery alone is curative for all colorectal cancers
B. Information about the possibility of a temporary or permanent ostomy
C. Reassurance that chemotherapy will not be needed
D. Instructions to increase fiber intake immediately before surgery
Answer: B. Information about the possibility of a temporary or permanent
ostomy
Rationale: Depending on the location and extent of the tumor, colorectal surgery
may result in a temporary or permanent ostomy. Preoperative teaching should
include realistic information about this possibility to allow the patient to prepare
emotionally and physically. Surgery is not always curative alone, and
chemotherapy or radiation may be needed based on staging. Dietary instructions
should follow the surgeon's specific orders.
Question 6
A patient who is 5 years post-treatment for breast cancer asks about survivorship
care. Which of the following is the MOST appropriate component of survivorship
care?
A. Annual surveillance imaging for all patients
B. A survivorship care plan that includes surveillance, prevention, and
management of late effects
C. Discharge from oncology follow-up care
D. Annual complete blood count and comprehensive metabolic panel
, Answer: B. A survivorship care plan that includes surveillance, prevention,
and management of late effects
Rationale: Survivorship care plans are essential for coordinating follow-up care
after cancer treatment. They include recommendations for surveillance, prevention
of new cancers, management of late effects, and coordination with primary care
providers. Not all patients require annual imaging; surveillance is guided by cancer
type and risk. Discharge from oncology follow-up may occur but should be
accompanied by a clear survivorship plan.
Question 7
A patient with a 30-pack-year smoking history asks about lung cancer screening.
Which of the following is the MOST appropriate recommendation?
A. Annual chest X-ray
B. Low-dose computed tomography (LDCT) annually
C. Sputum cytology every 6 months
D. No screening is indicated
Answer: B. Low-dose computed tomography (LDCT) annually
Rationale: Annual low-dose CT screening is recommended for individuals aged
50-80 years with a 20-pack-year or greater smoking history who currently smoke
or have quit within the past 15 years. Chest X-ray and sputum cytology are not
recommended for lung cancer screening. This patient meets the criteria and should
be referred for LDCT screening.
Question 8
A patient with end-stage ovarian cancer is experiencing dyspnea and anxiety. The
nurse administers morphine sulfate as ordered. Which of the following is the
PRIMARY rationale for using morphine in this situation?
A. To treat pain
B. To induce sleep
C. To relieve dyspnea and anxiety
D. To hasten death
Answer: C. To relieve dyspnea and anxiety
