ONCC Oncology Certified Nurse Examination Practice Test
Oncology nursing combines cancer-treatment knowledge with assessment of treatment effects, symptom relief, and patient education. Practice questions sample decisions involving chemotherapy precautions, treatment-related fatigue and mouth sores, opioid side effects, and warning signs such as new leg swelling or neurologic changes. These scenarios call for recognizing when a symptom may need prompt evaluation and explaining safe next steps.
Exam overview
About the ONCC Oncology Certified Nurse Examination Exam
Clinical judgment in oncology includes distinguishing expected effects from complications that may require urgent escalation. Nurses assess symptoms in context—for example, new watery diarrhea during immune checkpoint therapy, severe headache with known vertebral metastasis, or unilateral leg swelling while taking tamoxifen—and communicate concerning changes promptly. Other tasks include supporting symptom management, discussing fertility preservation before cytotoxic treatment, and assessing relevant risks before bisphosphonate therapy. Patient education may address safe handling of treatment-contaminated laundry, oral care and food choices for painful mouth sores, and the possible risks or interactions of complementary therapies. Effective preparation connects each clinical finding to an appropriate nursing response: focused assessment, symptom support, safety guidance, or timely contact with the oncology team.
Sample Practice Questions
Review a selection from this exam's published US Practice Tests practice bank.
A patient taking tamoxifen for hormone-sensitive breast cancer reports new unilateral leg swelling and tenderness. What should the nurse advise?
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Correct answer: BTamoxifen is associated with increased risk of venous thromboembolism. New unilateral swelling and tenderness require prompt evaluation; massage and unsupervised medication changes are not appropriate.
A patient with cancer who is receiving an opioid reports nausea but has no vomiting, abdominal pain, or other new symptoms. Which intervention is commonly appropriate for opioid-related nausea?
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Correct answer: AOpioids can cause nausea, particularly when therapy begins or doses change. Small, frequent meals and assessment for a prescribed antiemetic are reasonable supportive measures; persistent or severe symptoms warrant further evaluation. Patients should not stop or add medications without guidance.
A patient with cancer has a new, severe headache and difficulty moving both legs. The patient has a known vertebral metastasis. Which action is most appropriate?
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Correct answer: BNew motor weakness and severe back or head symptoms in a patient with vertebral metastases may signal metastatic spinal cord compression. This is an oncologic emergency requiring urgent evaluation and treatment to limit permanent neurologic injury.
A patient receiving an immune checkpoint inhibitor reports new watery diarrhea several times a day. What is the nurse’s best action?
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Correct answer: CImmune checkpoint inhibitors can cause immune-mediated inflammation of the bowel. New or worsening diarrhea should be promptly reported so the team can assess severity and determine appropriate management; patients should not simply wait or self-treat without guidance.
A patient receiving chemotherapy asks how to handle laundry contaminated with urine during the period specified by the treatment team after an infusion. Which guidance is most appropriate?
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Correct answer: BSome anticancer drugs or their metabolites may be present in body fluids after treatment. The patient should follow drug- and facility-specific precautions, using protective handling and hand hygiene rather than assuming all exposure has ended immediately.
A patient with cancer is considering a complementary therapy in addition to prescribed treatment. Which nursing response is best?
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Correct answer: CComplementary approaches can have side effects or interact with anticancer drugs and supportive medicines. The patient should share the specific product or practice with the oncology team before starting it and should not replace prescribed treatment without a clinician-guided plan.
A patient receiving cancer treatment has persistent fatigue that interferes with daily activities. Which nursing approach is most appropriate?
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Correct answer: ACancer-related fatigue may have multiple contributors, including treatment effects, anemia, sleep disruption, pain, and emotional distress. Assessment can identify treatable factors, while an individualized plan that balances activity and rest may support function. Activity recommendations should reflect the patient’s status and safety.
How to use this practice test
Access is free. The practice page offers up to 20 randomly selected questions from its 50-question bank in a session, with results shown afterward. Use the scenarios to check how you recognize treatment complications, prioritize patient concerns, and choose practical education or escalation steps; review any missed item by identifying the clinical cue that should guide the response.
Preparation tips
- For symptom scenarios, separate routine supportive-care needs from red flags such as severe new headache, leg swelling, or frequent watery diarrhea, and identify the urgency of follow-up.
- Review safe handling principles for body fluids after chemotherapy, including how to apply the treatment team's instructions to contaminated laundry.
- Practice counseling patients about fertility preservation before cytotoxic therapy and about discussing complementary therapies alongside prescribed cancer treatment.
- Connect common supportive-care problems—opioid-related nausea, treatment-associated fatigue, and painful oral mucositis—with focused assessment and practical nursing interventions.
- For medication-related questions, consider therapy-specific risks and baseline assessments, including thromboembolic warning signs with tamoxifen and relevant assessment before bisphosphonate treatment.