Medical-Surgical Nursing: Oncology Practice Questions
Test yourself on Oncology with 12 original NCLEX-RN practice questions. Pick an answer to see instant feedback and a full explanation.
Free original practice questions for study purposes. Open Exam Prep is an independent study resource and is not affiliated with, endorsed by, or sponsored by the makers of NCLEX-RN.
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Answer the questions below — you get instant feedback and a full explanation for each.
1. A client receiving chemotherapy reports a temperature of 100.9 F (38.3 C) at home and has chills. Which instruction is the priority?
Explanation. Fever with chills during chemotherapy can indicate infection, especially when neutrophil counts may be low. Prompt reporting allows rapid assessment and treatment. Delaying care or masking fever can increase risk.
2. The nurse is teaching a client receiving external radiation to the chest. Which skin care instruction is most appropriate?
Explanation. Radiation skin should be protected from irritation. Clients should avoid harsh scrubbing, heat or cold extremes, and unapproved products. Treatment markings should be preserved unless the care team says otherwise.
3. A client with cancer is receiving opioid medication for persistent pain. Which statement by the client indicates a need for more teaching?
Explanation. Cancer pain should be treated promptly and safely. Fear that addiction always occurs is inaccurate and can lead to undertreatment. Constipation, sedation, and uncontrolled pain should be discussed with the care team.
4. The nurse is reviewing labs for a client after chemotherapy. Which result creates the greatest concern for infection risk?
Explanation. An absolute neutrophil count below 500/mm3 indicates severe neutropenia and high infection risk. Hemoglobin and platelets are relevant, but this ANC requires protective precautions and rapid fever reporting.
5. A client asks why antiemetic medication is prescribed before chemotherapy begins. Which response is best?
Explanation. Many chemotherapy regimens use prophylactic antiemetics because preventing nausea is often more effective than treating severe symptoms later. Persistent vomiting, dehydration signs, or inability to keep fluids down still require reporting.
6. The nurse is caring for a client with thrombocytopenia after cancer treatment. Which intervention should be included?
Explanation. Low platelets increase bleeding risk. Bleeding precautions include soft oral care, avoiding rectal temperatures, reducing unnecessary needle sticks, and avoiding aspirin or similar medicines unless specifically prescribed.
7. A client receiving chemotherapy has mouth soreness and small ulcers. Which nursing recommendation is most appropriate?
Explanation. Mucositis care focuses on gentle oral hygiene, bland rinses, soft foods, hydration, and reporting severe pain or inability to eat. Alcohol mouthwash, spicy foods, and stopping oral care can worsen irritation or infection risk.
8. The nurse is preparing to administer vesicant chemotherapy through a peripheral IV. Which finding requires immediate action before infusion continues?
Explanation. Coolness, swelling, and pain at the IV site may indicate infiltration or extravasation. Vesicants can cause tissue injury, so the infusion should not continue until the site is assessed and facility protocol is followed.
9. A client with advanced cancer tells the nurse, 'I want to focus on comfort, but my family wants more treatment.' What is the nurse's best initial response?
Explanation. The nurse should assess the client's understanding, values, and goals, then support communication with the provider and family. Client autonomy matters, but the first nursing response is therapeutic exploration and advocacy.
10. The nurse is teaching a client with a new implanted port. Which statement indicates correct understanding?
Explanation. Redness, swelling, drainage, pain, fever, or chills can signal infection or another complication and should be reported. Ports require sterile access by trained clinicians and ongoing infection prevention.
11. A client receiving head and neck radiation reports dry mouth and trouble swallowing dry foods. Which action is most helpful?
Explanation. Xerostomia and swallowing discomfort can be supported with moist foods, small frequent meals, fluids as allowed, oral care, and dietitian or speech therapy support when needed. Dry foods and irritating swabs can worsen discomfort.
12. The nurse is caring for a client at risk for tumor lysis syndrome after cancer therapy. Which finding should be reported promptly?
Explanation. Tumor lysis syndrome can cause electrolyte shifts and kidney injury. Muscle cramps, weakness, dysrhythmia symptoms, decreased urine output, or abnormal labs such as high potassium or uric acid require prompt reporting.
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FAQ
What oncology nursing topics are high yield for NCLEX med-surg?
Prioritize infection risk during chemotherapy, neutropenic precautions, bleeding precautions, safe chemotherapy administration, mucositis care, radiation skin care, pain control, ports, nutrition support, and urgent complications such as extravasation or tumor lysis syndrome.
How should I approach oncology priority questions?
Look first for fever during chemotherapy, airway or breathing problems, active bleeding, suspected extravasation, severe dehydration, mental status changes, or signs of electrolyte imbalance. These usually outrank routine teaching or stable expected side effects.
What side effects are commonly tested in oncology questions?
Common NCLEX-style cues include nausea, vomiting, fatigue, alopecia, mucositis, skin irritation from radiation, bone marrow suppression, infection risk, thrombocytopenia, anemia, and pain management needs.