Getting ready for the NCLEX? Put your knowledge to the test with our NCLEX oncology quiz! Specifically crafted for nursing students and aspiring oncology nurses, this cancer and oncology quiz will guide you through symptom management and chemotherapy safety checks. Our medical oncology review features targeted oncology practice questions and realistic nursing oncology quiz case studies to strengthen critical-thinking skills. Jump into our Oncology NCLEX Practice Questions and explore key cancer nclex questions to identify gaps and build confidence. Ready to conquer your exam? Start now and level up your prep!
What term describes the spread of cancer cells from the primary tumor to distant organs?
Invasion
Angiogenesis
Hyperplasia
Metastasis
Metastasis refers to the process by which cancer cells travel through blood or lymphatic systems to establish secondary tumors in distant sites. It is a hallmark of malignant tumors and an important factor in staging and prognosis. Primary tumor invasion is local spread, while angiogenesis involves new blood vessel formation to feed tumors. For more information see: NCI: Metastasis.
Which of the following is the most common dose-limiting toxicity of many chemotherapeutic agents?
Cardiotoxicity
Neurotoxicity
Renal toxicity
Bone marrow suppression
Bone marrow suppression, resulting in neutropenia, thrombocytopenia, and anemia, is the most common dose-limiting toxicity for many cytotoxic drugs. It predisposes patients to infection and bleeding, requiring close monitoring of blood counts. While other toxicities like cardiotoxicity (e.g., doxorubicin) and nephrotoxicity (e.g., cisplatin) occur, marrow suppression is most frequent. See: NCI: Low Blood Counts.
What type of agent is cyclophosphamide classified as?
Alkylating agent
Mitotic inhibitor
Antimetabolite
Topoisomerase inhibitor
Cyclophosphamide is an alkylating agent that interferes with DNA replication by adding alkyl groups, leading to cell death. It is cell cycle nonspecific and used in various malignancies. Antimetabolites mimic nucleotides and act in S phase, while mitotic inhibitors affect microtubules. See details here: NCBI: Cyclophosphamide.
Tumor lysis syndrome most commonly occurs after initiating therapy for which of the following cancers?
Breast cancer
Prostate cancer
Acute lymphoblastic leukemia
Melanoma
Tumor lysis syndrome is most common after rapid cell breakdown in malignancies with high tumor burden and turnover like acute lymphoblastic leukemia and Burkitt lymphoma. It results in hyperuricemia, hyperkalemia, hyperphosphatemia, and hypocalcemia. Solid tumors less frequently precipitate TLS. More info: UpToDate: Tumor Lysis Syndrome.
Which serum tumor marker is most associated with monitoring treatment response in ovarian cancer?
AFP
CA 125
CEA
PSA
CA 125 is a glycoprotein often elevated in ovarian epithelial cancers and is used to monitor treatment response and detect recurrence. PSA is for prostate cancer, CEA is primarily colorectal and other carcinomas, and AFP is used in liver cancer and germ cell tumors. For more details see: NCI: CA 125.
A patient receiving external beam radiation to the head and neck complains of dry, erythematous skin in the treatment field. What is the best recommendation for skin care?
Scrub area with a washcloth
Use mild soap and pat dry gently
Cover with plastic wrap
Apply lotions containing alcohol
Patients should use gentle, fragrance-free cleansers and pat the skin dry to avoid further irritation. Alcohol-based lotions and harsh scrubbing can worsen dermatitis. Keeping the area clean and dry helps minimize skin breakdown. Radiation Skin Care guidelines: NCCN Guidelines.
Which precaution is most appropriate for a patient with neutropenia due to chemotherapy?
Encourage hand hygiene before meals
Perform unmasked nasotracheal suctioning
Use a standing water pitcher
Allow fresh flowers in the room
Encouraging hand hygiene reduces infection risk in neutropenic patients. Fresh flowers, standing water, and unmasked procedures increase the risk of microbial contamination. Neutropenic precautions include limiting exposure to potential pathogens. CDC Neutropenic Precautions: CDC Guidelines.
Which sign indicates extravasation of a vesicant chemotherapy drug?
Rapid swelling and pain at the IV site
Warmth and erythema spreading systemically
Headache and dizziness
Bruising on opposite limb
Extravasation of vesicant drugs causes localized pain, swelling, redness, and potential tissue necrosis at the infusion site. Immediate intervention is critical to limit damage. Systemic symptoms or remote bruising are not typical. Yale extravasation management: NCBI extravasation.
A patient with small cell lung cancer develops hyponatremia and confusion. Which paraneoplastic syndrome is most likely responsible?
Ectopic ACTH secretion
Syndrome of inappropriate antidiuretic hormone (SIADH)
Polycythemia vera
Hypercalcemia of malignancy
SIADH is common in small cell lung cancer and leads to water retention, hyponatremia, and neurological symptoms like confusion. Ectopic ACTH causes Cushing's syndrome, while hypercalcemia is seen in squamous cell carcinoma. Polycythemia vera is a myeloproliferative disorder, not a paraneoplastic syndrome of SCLC. For more see: NCBI: SIADH.
Which laboratory finding is most indicative of tumor lysis syndrome?
Hyperuricemia
Hypophosphatemia
Hypercalcemia
Hypokalemia
Tumor lysis syndrome is characterized by rapid release of intracellular contents, causing hyperuricemia, hyperkalemia, hyperphosphatemia, and secondary hypocalcemia. Hyperuricemia can lead to renal failure. Hypokalemia and hypophosphatemia are not typical. See guidelines: ASCO: TLS.
Which assessment finding best suggests spinal cord compression in a patient with metastatic cancer?
Bilateral lower extremity weakness and numbness
Right upper quadrant abdominal pain
Severe, localized bone pain aggravated by movement
Isolated headache and visual changes
Spinal cord compression presents with back pain followed by neurological deficits such as bilateral lower extremity weakness, numbness, and bowel/bladder dysfunction. Headache suggests central nervous system involvement, while RUQ pain is unrelated. Early recognition is vital to prevent permanent damage. See: NCCN: Spinal Cord Compression.
Trastuzumab targets which receptor, and what is its primary associated cardiotoxicity?
HER2; left ventricular dysfunction
EGFR; pulmonary fibrosis
VEGFR; hypertension
PD-1; immune-mediated myocarditis
Trastuzumab is a monoclonal antibody that binds to the HER2 receptor in breast cancer, and a known adverse effect is left ventricular dysfunction leading to heart failure. EGFR inhibitors cause pulmonary issues, VEGFR inhibitors cause hypertension, and checkpoint inhibitors like PD-1 blockers may cause myocarditis. More: NCBI: Trastuzumab Cardiotoxicity.
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Study Outcomes
Understand Core Oncology Concepts -
Gain familiarity with cancer pathophysiology, staging, and common tumor markers to build a solid foundation for oncology nursing.
Apply Evidence-Based Interventions -
Learn to select and prioritize nursing interventions for chemotherapy, radiation, and palliative care based on best practice guidelines.
Analyze Clinical Scenarios -
Develop critical-thinking skills by evaluating patient presentations, lab results, and treatment responses in oncology case studies.
Differentiate Symptom Management Strategies -
Identify appropriate methods for managing side effects such as nausea, pain, and immunosuppression in cancer patients.
Enhance Test-Taking Speed and Accuracy -
Practice timed oncology practice questions to boost confidence, improve pacing, and reduce exam anxiety.
Review Comprehensive Oncology Knowledge -
Solidify understanding of key oncology topics through targeted nursing oncology quiz questions and medical oncology review.
Cheat Sheet
TNM Staging System -
The TNM classification (Tumor size, Node involvement, Metastasis) from the American Joint Committee on Cancer standardizes cancer staging to guide prognosis and treatment decisions. Remember "T for Tumor, N for Nodes, M for Metastasis" to quickly recall staging during the NCLEX oncology quiz and apply AJCC guidelines accurately.
Body Surface Area (BSA) for Chemotherapy Dosing -
Chemotherapy dosing often relies on the Mosteller formula: BSA (m2) = √([height cm × weight kg] ÷ 3600) to optimize drug efficacy while minimizing toxicity (National Cancer Institute). Practice with examples - such as calculating a 70 kg, 170 cm patient's BSA (~1.80 m2) - and use the mnemonic "Square root for safety" to reinforce accuracy.
Radiation Therapy Principles -
Fractionated radiation therapy allows healthy cells to repair between doses and follows the ALARA ("As Low As Reasonably Achievable") safety principle set by the National Council on Radiation Protection and Measurements. Always verify cumulative dose limits and ensure proper shielding to protect both patients and healthcare staff.
Oncologic Emergency: Tumor Lysis Syndrome -
Tumor lysis syndrome results from rapid cancer cell breakdown leading to hyperuricemia, hyperkalemia, and hyperphosphatemia; management includes IV fluids, allopurinol or rasburicase, and electrolyte monitoring (American Society of Clinical Oncology). Recall "U-R-I-C-A" for Uric acid ↑, Renal failure risk, IV fluids, Check electrolytes, Allopurinol/rasburicase to streamline your response.
Neutropenia and ANC Monitoring -
Calculate Absolute Neutrophil Count (ANC) using ANC = WBC (×10³/µL) × (%segs + %bands) ÷ 100 to assess infection risk, with ANC < 500 cells/µL indicating high danger (CDC). The phrase "Fever in neutropenia means trouble" helps you remember prompt culture collection and empiric antibiotics are critical.
