Ccancer nursing exam answers
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Cancer nursing exam preparation can cover:
- Cancer basics - terminology, risk factors, warning signs, staging and grading
- Diagnosis - biopsy, tumour markers, imaging, TNM classification
- Treatment - surgery, chemotherapy, radiotherapy, immunotherapy, hormonal and targeted therapy
- Nursing care - assessment, patient education, safe handling of cytotoxic drugs
- Treatment adverse effects - nausea, mucositis, alopecia, myelosuppression, extravasation
- Oncologic emergencies - neutropenic sepsis, spinal cord compression, superior vena cava syndrome, tumour lysis syndrome, hypercalcaemia
- Palliative and end-of-life care - pain control, symptom relief, communication and bereavement support
- Common cancers - breast, lung, cervical, colorectal, prostate, leukaemia and lymphoma
I can provide exam-style answers, short notes, MCQs with explanations, or a question-and-answer revision set. Which topic or specific exam question do you need?
Give me 50 cancer nursing MCQs with answers
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ONS chemotherapy administration safety guidelines vesicant extravasation neutropenic fever patient education
Cancer Nursing MCQs
1. Which finding in a patient receiving chemotherapy requires urgent assessment for possible infection?
A. Hair loss
B. Temperature of 38.3°C (101°F)
C. Mild fatigue
D. Metallic taste
A. Hair loss
B. Temperature of 38.3°C (101°F)
C. Mild fatigue
D. Metallic taste
Answer: B. Fever during chemotherapy may indicate febrile neutropenia and requires prompt evaluation.
2. The most important laboratory value for assessing infection risk in a patient receiving chemotherapy is the:
A. Platelet count
B. Hemoglobin
C. Absolute neutrophil count (ANC)
D. Serum albumin
A. Platelet count
B. Hemoglobin
C. Absolute neutrophil count (ANC)
D. Serum albumin
Answer: C. The ANC estimates the patient’s ability to fight bacterial and fungal infection.
3. Which instruction is most appropriate for a patient with neutropenia?
A. “Use rectal thermometers if you feel feverish.”
B. “Avoid people with colds or other infections.”
C. “Receive live vaccines as scheduled.”
D. “Eat raw eggs for extra protein.”
A. “Use rectal thermometers if you feel feverish.”
B. “Avoid people with colds or other infections.”
C. “Receive live vaccines as scheduled.”
D. “Eat raw eggs for extra protein.”
Answer: B. Reducing exposure to infectious illnesses is important. Rectal procedures and unsafe foods should generally be avoided in neutropenia.
4. A patient receiving chemotherapy has an ANC of 400 cells/mm³. This indicates:
A. Normal immunity
B. Severe neutropenia
C. Thrombocytopenia
D. Polycythemia
A. Normal immunity
B. Severe neutropenia
C. Thrombocytopenia
D. Polycythemia
Answer: B. An ANC below 500 cells/mm³ is severe neutropenia and carries a high infection risk.
5. Which assessment finding is most consistent with thrombocytopenia?
A. Petechiae
B. Productive cough
C. Jaundice
D. Bradycardia
A. Petechiae
B. Productive cough
C. Jaundice
D. Bradycardia
Answer: A. Petechiae, bruising, gum bleeding, and prolonged bleeding may occur with low platelets.
6. Which instruction should be given to a patient with thrombocytopenia?
A. Use a hard-bristled toothbrush.
B. Take aspirin for headaches.
C. Use an electric razor for shaving.
D. Receive intramuscular injections whenever possible.
A. Use a hard-bristled toothbrush.
B. Take aspirin for headaches.
C. Use an electric razor for shaving.
D. Receive intramuscular injections whenever possible.
Answer: C. An electric razor reduces the risk of cuts and bleeding. Aspirin and unnecessary IM injections may increase bleeding risk.
7. A common manifestation of chemotherapy-induced anemia is:
A. Fatigue and dyspnea on exertion
B. Increased platelet production
C. Fever and chills
D. Hematuria only
A. Fatigue and dyspnea on exertion
B. Increased platelet production
C. Fever and chills
D. Hematuria only
Answer: A. Reduced hemoglobin decreases oxygen-carrying capacity, causing fatigue, weakness, pallor, and exertional dyspnea.
8. Which adverse effect is most associated with doxorubicin?
A. Cardiotoxicity
B. Hearing loss
C. Hemorrhagic cystitis
D. Peripheral neuropathy only
A. Cardiotoxicity
B. Hearing loss
C. Hemorrhagic cystitis
D. Peripheral neuropathy only
Answer: A. Doxorubicin, an anthracycline, can cause dose-related cardiac injury.
9. Hemorrhagic cystitis is a serious adverse effect associated with:
A. Cyclophosphamide
B. Vincristine
C. Methotrexate
D. Bleomycin
A. Cyclophosphamide
B. Vincristine
C. Methotrexate
D. Bleomycin
Answer: A. Cyclophosphamide can irritate the bladder. Hydration and prescribed uroprotective measures help reduce risk.
10. Which symptom should a patient receiving bleomycin report immediately?
A. New cough or shortness of breath
B. Temporary hair loss
C. Mild nausea after meals
D. Dry skin
A. New cough or shortness of breath
B. Temporary hair loss
C. Mild nausea after meals
D. Dry skin
Answer: A. Bleomycin may cause pulmonary toxicity.
11. Which drug is particularly associated with peripheral neuropathy?
A. Vincristine
B. Cyclophosphamide
C. Doxorubicin
D. Methotrexate
A. Vincristine
B. Cyclophosphamide
C. Doxorubicin
D. Methotrexate
Answer: A. Vincristine can cause sensory and motor neuropathy, including constipation from autonomic nerve effects.
12. A patient receiving vincristine reports no bowel movement for 4 days. The nurse’s priority is to assess for:
A. Constipation related to autonomic neuropathy
B. Alopecia
C. Oral mucositis
D. Hemorrhagic cystitis
A. Constipation related to autonomic neuropathy
B. Alopecia
C. Oral mucositis
D. Hemorrhagic cystitis
Answer: A. Vincristine can reduce gastrointestinal motility and cause severe constipation or ileus.
13. During IV chemotherapy administration, a patient reports burning and pain at the infusion site. What is the nurse’s first action?
A. Increase the infusion rate
B. Stop the infusion
C. Apply pressure to the site
D. Remove the IV immediately
A. Increase the infusion rate
B. Stop the infusion
C. Apply pressure to the site
D. Remove the IV immediately
Answer: B. Stop the infusion immediately when extravasation is suspected. Follow the institution’s drug-specific extravasation protocol before removing the device. The ONS/ASCO extravasation guidance emphasizes rapid, standardized assessment and management.
14. Extravasation refers to:
A. A chemotherapy drug leaking into surrounding tissue
B. A drug reaction causing anaphylaxis
C. A decrease in white blood cells
D. A radiation skin reaction
A. A chemotherapy drug leaking into surrounding tissue
B. A drug reaction causing anaphylaxis
C. A decrease in white blood cells
D. A radiation skin reaction
Answer: A. Vesicant extravasation can cause severe local tissue injury.
15. The best action to prevent chemotherapy administration errors is to:
A. Administer drugs rapidly to reduce waiting time
B. Use independent verification according to policy
C. Rely only on the patient’s report of treatment
D. Skip checking laboratory results if the patient feels well
A. Administer drugs rapidly to reduce waiting time
B. Use independent verification according to policy
C. Rely only on the patient’s report of treatment
D. Skip checking laboratory results if the patient feels well
Answer: B. Safe chemotherapy practice includes verification of the prescription, patient identity, dose, route, regimen, and relevant laboratory results.
16. Which symptom is most characteristic of oral mucositis?
A. Painful mouth ulcers
B. Hearing loss
C. Blurred vision
D. Ankle edema
A. Painful mouth ulcers
B. Hearing loss
C. Blurred vision
D. Ankle edema
Answer: A. Mucositis causes oral soreness, erythema, ulceration, pain, and difficulty eating or swallowing.
17. Appropriate oral care for a patient with mucositis includes:
A. Alcohol-containing mouthwash every 2 hours
B. Gentle oral care with a soft toothbrush
C. Lemon-glycerin swabs
D. Very hot foods and beverages
A. Alcohol-containing mouthwash every 2 hours
B. Gentle oral care with a soft toothbrush
C. Lemon-glycerin swabs
D. Very hot foods and beverages
Answer: B. Gentle oral hygiene and avoidance of irritating products, alcohol, tobacco, spicy foods, and very hot foods can reduce discomfort.
18. The preferred initial nonpharmacologic method to reduce chemotherapy-related nausea may include:
A. Small frequent meals
B. Eating large fatty meals
C. Drinking alcohol with meals
D. Lying flat immediately after eating
A. Small frequent meals
B. Eating large fatty meals
C. Drinking alcohol with meals
D. Lying flat immediately after eating
Answer: A. Small frequent meals and avoiding strong odors, greasy foods, and large meals may help.
19. Which statement about cancer pain is correct?
A. Pain is expected and should be tolerated.
B. Opioids should never be used for cancer pain.
C. Pain should be assessed regularly using a validated scale.
D. Severe cancer pain is always psychological.
A. Pain is expected and should be tolerated.
B. Opioids should never be used for cancer pain.
C. Pain should be assessed regularly using a validated scale.
D. Severe cancer pain is always psychological.
Answer: C. Pain is subjective and should be assessed repeatedly, treated promptly, and reassessed for response.
20. A patient taking regular opioids for cancer pain should commonly receive education about preventing:
A. Constipation
B. Alopecia
C. Neutropenia
D. Photosensitivity only
A. Constipation
B. Alopecia
C. Neutropenia
D. Photosensitivity only
Answer: A. Constipation is common with opioids. A bowel regimen is often needed unless contraindicated.
21. Which is a frequent early manifestation of hypercalcaemia of malignancy?
A. Constipation and confusion
B. Severe neutropenia
C. Oral ulcers
D. Hemoptysis
A. Constipation and confusion
B. Severe neutropenia
C. Oral ulcers
D. Hemoptysis
Answer: A. Hypercalcaemia may cause weakness, constipation, nausea, excessive thirst, polyuria, confusion, and cardiac rhythm changes.
22. A patient with cancer reports new severe back pain, leg weakness, and urinary retention. The nurse should suspect:
A. Spinal cord compression
B. Alopecia
C. Mild chemotherapy nausea
D. Lymphedema
A. Spinal cord compression
B. Alopecia
C. Mild chemotherapy nausea
D. Lymphedema
Answer: A. Malignant spinal cord compression is an oncologic emergency requiring urgent medical evaluation. It should be considered in a patient with cancer and back pain plus weakness, sensory change, or sphincter symptoms.
23. Which symptom can indicate superior vena cava syndrome?
A. Facial swelling and dyspnea
B. Hair loss
C. Black tarry stool only
D. Painful urination only
A. Facial swelling and dyspnea
B. Hair loss
C. Black tarry stool only
D. Painful urination only
Answer: A. Obstruction of the superior vena cava can cause facial, neck, and upper-extremity swelling, dyspnea, cough, and distended chest veins.
24. Tumour lysis syndrome is most likely to occur:
A. After rapid destruction of a large burden of tumour cells
B. Only after radiation to the skin
C. In patients with mild anemia only
D. Years after cancer treatment ends
A. After rapid destruction of a large burden of tumour cells
B. Only after radiation to the skin
C. In patients with mild anemia only
D. Years after cancer treatment ends
Answer: A. Rapid release of intracellular contents can cause hyperuricaemia, hyperkalaemia, hyperphosphataemia, hypocalcaemia, and acute kidney injury.
25. Which laboratory value is most concerning in tumour lysis syndrome?
A. Elevated potassium
B. Mildly low albumin
C. Low haemoglobin only
D. Slightly raised cholesterol
A. Elevated potassium
B. Mildly low albumin
C. Low haemoglobin only
D. Slightly raised cholesterol
Answer: A. Hyperkalaemia can cause life-threatening cardiac dysrhythmias.
26. The primary purpose of radiation therapy is to:
A. Deliver targeted ionizing radiation to damage tumour-cell DNA
B. Increase white blood cell production
C. Eliminate all surgical risk
D. Replace chemotherapy in every patient
A. Deliver targeted ionizing radiation to damage tumour-cell DNA
B. Increase white blood cell production
C. Eliminate all surgical risk
D. Replace chemotherapy in every patient
Answer: A. Radiation damages DNA and limits cancer-cell division, though normal tissues in the treatment field can also be affected.
27. Which instruction is appropriate for skin in a radiation treatment field?
A. Scrub the area vigorously.
B. Use perfumed lotions unless prescribed.
C. Protect the area from direct sun exposure.
D. Apply adhesive tape directly over markings.
A. Scrub the area vigorously.
B. Use perfumed lotions unless prescribed.
C. Protect the area from direct sun exposure.
D. Apply adhesive tape directly over markings.
Answer: C. Radiation-treated skin is sensitive. Use gentle care and protect it from sun, friction, and extremes of temperature.
28. A common effect of radiation therapy is:
A. Fatigue
B. Immediate neutropenia in every patient
C. Sudden hair growth
D. Increased appetite in all patients
A. Fatigue
B. Immediate neutropenia in every patient
C. Sudden hair growth
D. Increased appetite in all patients
Answer: A. Fatigue is common and may accumulate during treatment.
29. Internal radiation therapy is also known as:
A. Brachytherapy
B. Cryotherapy
C. Immunotherapy
D. Phototherapy
A. Brachytherapy
B. Cryotherapy
C. Immunotherapy
D. Phototherapy
Answer: A. Brachytherapy places a radioactive source inside or close to the tumour.
30. When caring for a patient with a sealed internal radiation source, the nurse should generally:
A. Follow time, distance, and shielding principles
B. Encourage unlimited visitors at the bedside
C. Remove the source if it becomes dislodged using bare hands
D. Ignore radiation safety instructions
A. Follow time, distance, and shielding principles
B. Encourage unlimited visitors at the bedside
C. Remove the source if it becomes dislodged using bare hands
D. Ignore radiation safety instructions
Answer: A. Follow local radiation-safety policies. Limit time near the source, maximize distance, and use prescribed shielding.
31. If a radioactive implant becomes dislodged, the nurse should first:
A. Pick it up with bare hands
B. Use forceps and place it in the designated shielded container, following policy
C. Flush it down the toilet
D. Place it in the patient’s bedside drawer
A. Pick it up with bare hands
B. Use forceps and place it in the designated shielded container, following policy
C. Flush it down the toilet
D. Place it in the patient’s bedside drawer
Answer: B. Do not handle a radioactive source with bare hands. Follow the facility radiation-safety procedure immediately.
32. Lymphedema after breast cancer treatment most commonly affects the:
A. Arm on the affected side
B. Both lower legs equally
C. Face only
D. Abdomen only
A. Arm on the affected side
B. Both lower legs equally
C. Face only
D. Abdomen only
Answer: A. Lymph node removal or radiation can impair lymph drainage, producing swelling, heaviness, or tightness in the affected arm.
33. Which teaching is appropriate for a patient at risk of upper-limb lymphedema?
A. Avoid skin injury and infection in the affected arm.
B. Wear tight jewelry on the affected arm.
C. Ignore swelling unless it is painful.
D. Use the affected arm for repeated blood pressure measurements if possible.
A. Avoid skin injury and infection in the affected arm.
B. Wear tight jewelry on the affected arm.
C. Ignore swelling unless it is painful.
D. Use the affected arm for repeated blood pressure measurements if possible.
Answer: A. Skin protection, prompt infection treatment, and individualized limb precautions are important. Follow the patient’s oncology and surgical team guidance.
34. Which statement best describes cancer staging?
A. It describes the extent of cancer spread.
B. It describes the microscopic appearance only.
C. It is based only on pain severity.
D. It is the same as tumour grading.
A. It describes the extent of cancer spread.
B. It describes the microscopic appearance only.
C. It is based only on pain severity.
D. It is the same as tumour grading.
Answer: A. Staging assesses the extent of disease, often using TNM classification. Grading describes how abnormal tumour cells appear and how aggressively they may behave.
35. In the TNM staging system, “N” refers to:
A. Regional lymph node involvement
B. Nausea severity
C. Nutritional status
D. Neurologic function
A. Regional lymph node involvement
B. Nausea severity
C. Nutritional status
D. Neurologic function
Answer: A. TNM stands for primary tumour, regional lymph nodes, and distant metastasis.
36. Palliative care is best described as care that:
A. Focuses on comfort and quality of life at any stage of serious illness
B. Is provided only in the last 24 hours of life
C. Means that all cancer treatment must stop
D. Is limited to analgesic administration
A. Focuses on comfort and quality of life at any stage of serious illness
B. Is provided only in the last 24 hours of life
C. Means that all cancer treatment must stop
D. Is limited to analgesic administration
Answer: A. Palliative care can be given alongside disease-directed treatment and addresses physical, psychological, social, and spiritual needs.
37. Which nursing intervention best supports a patient who has just received a new cancer diagnosis?
A. Provide clear information, allow questions, and assess emotional needs.
B. Avoid discussing the diagnosis.
C. Provide information only to family members.
D. Tell the patient not to cry.
A. Provide clear information, allow questions, and assess emotional needs.
B. Avoid discussing the diagnosis.
C. Provide information only to family members.
D. Tell the patient not to cry.
Answer: A. Therapeutic communication includes active listening, honest information within scope, privacy, and referral to appropriate supports.
38. Which is an appropriate question when assessing cancer-related fatigue?
A. “How does the fatigue affect your daily activities?”
B. “Why are you not trying harder?”
C. “You should not feel tired, correct?”
D. “Have you stopped all fluids?”
A. “How does the fatigue affect your daily activities?”
B. “Why are you not trying harder?”
C. “You should not feel tired, correct?”
D. “Have you stopped all fluids?”
Answer: A. Functional impact helps guide individualized management of fatigue.
39. Which intervention may help manage cancer-related fatigue?
A. Balancing rest with planned light activity as tolerated
B. Complete bed rest for all patients
C. Avoiding all social contact permanently
D. Skipping meals
A. Balancing rest with planned light activity as tolerated
B. Complete bed rest for all patients
C. Avoiding all social contact permanently
D. Skipping meals
Answer: A. Activity, energy conservation, sleep support, nutrition, symptom control, and treatment of reversible causes may help.
40. A patient with a newly created colostomy is most likely to need teaching about:
A. Stoma assessment and pouch care
B. Eye-drop administration only
C. Hearing-aid maintenance only
D. Applying a limb cast
A. Stoma assessment and pouch care
B. Eye-drop administration only
C. Hearing-aid maintenance only
D. Applying a limb cast
Answer: A. Nursing care includes assessing stoma colour and output, protecting peristomal skin, and supporting self-care adaptation.
41. A healthy stoma should generally appear:
A. Pink to red and moist
B. Black and dry
C. Blue and cold
D. Pale, hard, and painful
A. Pink to red and moist
B. Black and dry
C. Blue and cold
D. Pale, hard, and painful
Answer: A. A pink or red moist stoma usually indicates adequate blood supply. A dark, dusky, pale, or black stoma requires urgent evaluation.
42. A patient receiving immune checkpoint inhibitor therapy develops new diarrhea and abdominal pain. The nurse should suspect:
A. Immune-mediated colitis
B. Expected harmless alopecia
C. A normal radiation skin reaction
D. Improved immune function only
A. Immune-mediated colitis
B. Expected harmless alopecia
C. A normal radiation skin reaction
D. Improved immune function only
Answer: A. Immunotherapy can cause immune-related adverse events involving the bowel, lungs, liver, endocrine organs, skin, and other systems. Prompt reporting and assessment are needed.
43. Which symptom in a patient receiving immunotherapy requires prompt reporting?
A. New shortness of breath
B. Wearing a hat
C. Mild temporary change in hair texture
D. Requesting family support
A. New shortness of breath
B. Wearing a hat
C. Mild temporary change in hair texture
D. Requesting family support
Answer: A. New dyspnea can indicate immune-mediated pneumonitis or another urgent cardiopulmonary problem.
44. A central venous access device is commonly used in cancer care primarily to:
A. Facilitate repeated IV therapy and blood sampling
B. Eliminate infection risk
C. Replace all oral medications
D. Avoid the need for any assessments
A. Facilitate repeated IV therapy and blood sampling
B. Eliminate infection risk
C. Replace all oral medications
D. Avoid the need for any assessments
Answer: A. Central lines facilitate treatment but require careful infection prevention, patency assessment, and dressing care.
45. Which finding may indicate a central-line infection?
A. Fever with redness or drainage at the insertion site
B. Stable dressing with no symptoms
C. Temporary hair loss
D. Mild hunger before breakfast
A. Fever with redness or drainage at the insertion site
B. Stable dressing with no symptoms
C. Temporary hair loss
D. Mild hunger before breakfast
Answer: A. Fever, chills, redness, swelling, tenderness, or drainage require prompt assessment.
46. Which measure is most important in preventing central-line-associated infection?
A. Meticulous hand hygiene and aseptic technique
B. Reusing contaminated gloves
C. Opening the line unnecessarily
D. Ignoring a loose dressing
A. Meticulous hand hygiene and aseptic technique
B. Reusing contaminated gloves
C. Opening the line unnecessarily
D. Ignoring a loose dressing
Answer: A. Hand hygiene and aseptic line care are core infection-prevention measures.
47. The nurse should teach a patient receiving oral chemotherapy to:
A. Take the medication exactly as prescribed and report missed doses for guidance.
B. Double the next dose if one is missed.
C. Share unused medication with another patient.
D. Stop treatment when symptoms improve without contacting the team.
A. Take the medication exactly as prescribed and report missed doses for guidance.
B. Double the next dose if one is missed.
C. Share unused medication with another patient.
D. Stop treatment when symptoms improve without contacting the team.
Answer: A. Oral anticancer therapy requires strict adherence and drug-specific safety instructions. Do not double doses unless specifically instructed.
48. Which is a priority safety principle when handling oral antineoplastic drugs at home?
A. Follow the oncology team’s handling, storage, and disposal instructions.
B. Crush all tablets before taking them.
C. Store medicines where children can access them.
D. Dispose of medications in household drains.
A. Follow the oncology team’s handling, storage, and disposal instructions.
B. Crush all tablets before taking them.
C. Store medicines where children can access them.
D. Dispose of medications in household drains.
Answer: A. Some agents must not be crushed or split, and safe storage and disposal are required.
49. Which finding may indicate depression in a patient with cancer and should prompt further assessment?
A. Persistent low mood and loss of interest
B. Asking questions about treatment
C. Wanting family present
D. Taking prescribed antiemetics
A. Persistent low mood and loss of interest
B. Asking questions about treatment
C. Wanting family present
D. Taking prescribed antiemetics
Answer: A. Persistent low mood, hopelessness, sleep or appetite changes, social withdrawal, and suicidal thoughts require assessment and appropriate support.
50. A patient receiving chemotherapy calls the clinic and reports a temperature of 38.2°C (100.8°F), chills, and feeling unwell. The nurse’s best response is:
A. “Take acetaminophen and call tomorrow.”
B. “Come for urgent assessment now or follow your oncology emergency instructions.”
C. “Wait until the fever reaches 40°C.”
D. “Drink fluids and continue usual activities.”
A. “Take acetaminophen and call tomorrow.”
B. “Come for urgent assessment now or follow your oncology emergency instructions.”
C. “Wait until the fever reaches 40°C.”
D. “Drink fluids and continue usual activities.”
Answer: B. Fever with chills during chemotherapy may be febrile neutropenia. It requires urgent medical assessment, rather than self-treating and delaying evaluation.
These questions are for exam revision. Exact fever thresholds, protective precautions, extravasation treatment, radiation precautions, and central-line protocols can vary by institution and chemotherapy regimen.
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