OCN Exam Flashcards

Q: How many questions are on the OCN exam?

The Oncology Certified Nurse exam has 165 multiple-choice questions: 145 scored questions and 20 pretest questions. The time limit is 3 hours, and ONCC uses a scaled passing score of 55 on its 25-75 scale.

Q: What should OCN flashcards cover?

OCN flashcards should cover cancer biology, treatment modalities, chemotherapy and immunotherapy concepts, symptom management, oncologic emergencies, survivorship, palliative care, and patient education.

Q: How long should I study for the OCN exam?

Most candidates should plan 90-140 focused hours, with extra time for weak oncology pharmacology, treatment side effects, and emergency-management topics.

Question 1

OCN Credential Focus

Accepted Answer

OCN certification validates adult oncology nursing knowledge. It supports professional recognition but does not replace RN licensure, employer competency validation, or state scope-of-practice rules.

Question 2

OCN Eligibility Core

Accepted Answer

Candidates need an active unencumbered RN license, recent RN experience, recent adult oncology nursing practice hours, and recent oncology education before applying.

Question 3

OCN Exam Format

Accepted Answer

The exam has 165 multiple-choice questions. Only 145 are scored; 20 are pretest items mixed into the test and should be answered like any other question.

Question 4

OCN Passing Score

Accepted Answer

The passing standard is a scaled score of 55 on ONCC's 25-75 scale. It is not a raw percent correct and cannot be directly converted from a practice-test percentage.

Question 5

Generic Drug Name Rule

Accepted Answer

ONCC exams use generic drug names. Study medications by generic name, drug class, mechanism, major toxicities, monitoring, and patient teaching.

Question 6

Blueprint-Weighted Studying

Accepted Answer

Study time should follow the OCN blueprint. Symptom management/supportive care and treatment modalities deserve repeated review because they represent the largest share of content.

Question 7

Cancer Prevention Counseling

Accepted Answer

Prioritize risks that are important and changeable, such as tobacco use, UV exposure, alcohol use, vaccination gaps, physical inactivity, and occupational exposures. Teach without blame.

Question 8

Screening vs Diagnostic Evaluation

Accepted Answer

Screening applies to asymptomatic people. New symptoms, abnormal findings, or positive screening results require diagnostic follow-up rather than routine screening advice.

Question 9

Hereditary Cancer Referral

Accepted Answer

Refer for genetic risk assessment when history suggests inherited risk, such as young-onset cancer, multiple relatives in a pattern, rare cancers, or multiple primary cancers.

Question 10

Oncology Navigation

Accepted Answer

Navigation reduces delays by coordinating appointments, clarifying next steps, addressing barriers, and closing referral loops across diagnosis, treatment, survivorship, and end-of-life care.

Question 11

Survivorship Care Plan

Accepted Answer

A survivorship plan summarizes diagnosis and treatment, surveillance needs, late effects, health maintenance, recurrence symptoms, psychosocial needs, and who owns follow-up care.

Question 12

Palliative Care Timing

Accepted Answer

Palliative care can begin at diagnosis and continue with disease-directed therapy. It focuses on symptom relief, communication, goals, caregiver support, and quality of life.

Question 13

Benign vs Malignant Tumors

Accepted Answer

Malignant tumors can invade surrounding tissue and metastasize. Benign tumors may still cause problems by location or pressure, but they do not metastasize.

Question 14

TNM Staging

Accepted Answer

TNM describes tumor extent, regional lymph node involvement, and distant metastasis. Nurses use staging to understand prognosis, treatment intent, teaching needs, and surveillance plans.

Question 15

Performance Status

Accepted Answer

Performance status estimates functional ability and treatment tolerance. Declining function can affect eligibility for therapy, need for rehabilitation, goals-of-care discussions, and safety planning.

Question 16

Tumor Markers

Accepted Answer

Tumor markers can help with monitoring, prognosis, or treatment response in selected cancers, but they usually cannot diagnose cancer by themselves and must be interpreted in context.

Question 17

Clinical Trial Phases

Accepted Answer

Early trials emphasize dose, safety, and toxicity. Later trials compare effectiveness, monitor outcomes, and may involve larger patient groups. Informed consent is always essential.

Question 18

Evidence-Based Oncology Nursing

Accepted Answer

Evidence-based practice combines current research, clinical expertise, patient preferences, and local policy. It is stronger than habit, tradition, or anecdote alone.

Question 19

Chemotherapy Cycles

Accepted Answer

Chemotherapy is often given in cycles to target cancer cells while allowing normal tissues, especially marrow and mucosa, time to recover between treatments.

Question 20

Vesicant Extravasation

Accepted Answer

Suspected vesicant extravasation requires stopping the infusion, leaving access in place, following the drug-specific protocol, notifying the provider, and documenting assessment and interventions.

Question 21

Anthracycline Cardiotoxicity

Accepted Answer

Anthracyclines such as doxorubicin can impair cardiac function. Monitor for dyspnea, edema, fatigue, reduced ejection fraction, and other signs of heart failure.

Question 22

Cisplatin Toxicity Priorities

Accepted Answer

Cisplatin can cause nephrotoxicity, ototoxicity, neuropathy, and significant nausea. Hydration status, renal function, urine output, hearing changes, and antiemetic adherence are key.

Question 23

Radiation Skin Care

Accepted Answer

Teach gentle cleansing, protection from friction and sun, avoidance of unapproved products on the treatment field, and prompt reporting of moist desquamation or infection signs.

Question 24

Brachytherapy Safety

Accepted Answer

Brachytherapy places radiation close to or inside the tumor. Nursing priorities include time, distance, shielding, source precautions, visitor limits, and clear instructions if a source dislodges.

Question 25

Immune Checkpoint Inhibitors

Accepted Answer

Checkpoint inhibitors can trigger immune-related adverse events in organs such as colon, lung, liver, skin, endocrine glands, and kidneys. New inflammatory symptoms need early reporting.

Question 26

Targeted Therapy Concept

Accepted Answer

Targeted therapies act on specific molecular pathways or receptors. Patient teaching should connect the target to expected benefit, unique toxicities, adherence, and required monitoring.

Question 27

Oral Anticancer Therapy

Accepted Answer

Oral therapy requires the same safety attention as infusion therapy: correct schedule, missed-dose instructions, interaction review, safe handling, storage, adherence checks, and toxicity reporting.

Question 28

Allogeneic Transplant Risk

Accepted Answer

Allogeneic transplant uses donor cells and can cause graft-versus-host disease. Watch for rash, diarrhea, liver changes, mucosal symptoms, infection, and need for immunosuppression.

Question 29

Safe Handling of Hazardous Drugs

Accepted Answer

Use proper personal protective equipment, closed-system transfer devices when required, spill procedures, disposal controls, and pregnancy or reproductive-risk protections according to policy.

Question 30

Central Line Assessment

Accepted Answer

Before using a central line, assess patency, blood return per policy, dressing integrity, infection signs, patient symptoms, and any concern for malposition or thrombosis.

Question 31

Port Complication Red Flags

Accepted Answer

Pain, swelling, absent blood return, leakage, fever, erythema, arm or neck swelling, or respiratory symptoms can signal complications and require escalation before treatment continues.

Question 32

Opioid Breakthrough Pain

Accepted Answer

Breakthrough pain is a flare despite baseline analgesia. Assess pattern, triggers, sedation, bowel regimen, adherence, and whether the long-acting regimen needs adjustment.

Question 33

Opioid-Induced Constipation

Accepted Answer

Constipation from opioids is expected and does not usually improve with tolerance. Prevention often requires stimulant laxatives, bowel assessment, hydration, mobility, and escalation if obstructive symptoms appear.

Question 34

Chemotherapy-Induced Nausea

Accepted Answer

Prevention works better than rescue. Match antiemetics to emetic risk, timing, prior response, breakthrough symptoms, hydration status, constipation, anxiety, and home medication access.

Question 35

Oral Mucositis

Accepted Answer

Mucositis care includes frequent gentle oral care, pain control, infection assessment, nutrition support, avoidance of irritants, and escalation when intake or airway safety is threatened.

Question 36

Cancer-Related Fatigue

Accepted Answer

Assess reversible contributors such as anemia, sleep disruption, depression, pain, medications, infection, and deconditioning. Activity pacing and tailored exercise often help more than prolonged bed rest.

Question 37

Chemotherapy-Induced Peripheral Neuropathy

Accepted Answer

Peripheral neuropathy may cause numbness, tingling, pain, weakness, gait instability, or difficulty with fine motor tasks. Safety teaching and prompt dose-toxicity communication are important.

Question 38

Hand-Foot Syndrome

Accepted Answer

Hand-foot syndrome causes painful redness, swelling, peeling, or tenderness on palms and soles. Reduce friction and heat, moisturize, protect skin, and report functional impairment.

Question 39

Lymphedema Management

Accepted Answer

Lymphedema care focuses on early recognition, skin protection, infection prevention, compression or therapy referral, exercise guidance, and avoiding trauma to the affected limb when possible.

Question 40

Dyspnea in Advanced Cancer

Accepted Answer

Assess reversible causes first, then support positioning, airflow, anxiety reduction, oxygen when hypoxemic, and prescribed opioids for refractory breathlessness when appropriate.

Question 41

Febrile Neutropenia

Accepted Answer

Fever during neutropenia is an emergency. Follow the urgent pathway for assessment, cultures as ordered, rapid antibiotics, provider notification, and sepsis monitoring.

Question 42

Tumor Lysis Syndrome

Accepted Answer

Tumor lysis syndrome results from rapid cancer cell breakdown. Watch for hyperkalemia, hyperphosphatemia, hypocalcemia, hyperuricemia, renal injury, dysrhythmias, seizures, and need for urgent treatment.

Question 43

Spinal Cord Compression

Accepted Answer

New back pain with weakness, sensory changes, gait problems, or bladder and bowel dysfunction suggests cord compression. Treat as urgent to protect neurologic function.

Question 44

Superior Vena Cava Syndrome

Accepted Answer

Facial or upper-extremity swelling, dyspnea, cough, distended neck veins, and head fullness can indicate impaired venous return from the upper body and require prompt evaluation.

Question 45

Hypercalcemia of Malignancy

Accepted Answer

Concerning findings include weakness, confusion, constipation, polyuria, dehydration, and dysrhythmias. Management commonly emphasizes hydration, cardiac monitoring, and ordered calcium-lowering therapy.

Question 46

DIC in Oncology

Accepted Answer

Disseminated intravascular coagulation causes abnormal clotting and bleeding from clotting factor consumption. Monitor bleeding, thrombosis, labs, hemodynamics, and treatment of the underlying trigger.

Question 47

Cytokine Release Syndrome

Accepted Answer

After cellular or immune therapy, fever, hypotension, hypoxia, and organ dysfunction can signal cytokine release syndrome. Early grading and escalation are critical.

Question 48

Therapeutic Communication in Distress

Accepted Answer

When a patient expresses fear, guilt, anger, or despair, first assess meaning and emotion. Avoid false reassurance, judgment, or immediately changing the subject.

Question 49

Culturally Congruent Oncology Care

Accepted Answer

Ask about the patient's values, decision-making preferences, language needs, spiritual practices, and family roles. Use qualified interpreters rather than family members for medical interpretation.

Question 50

Financial Toxicity

Accepted Answer

Cancer costs can cause missed appointments, unfilled prescriptions, unsafe dose changes, and distress. Screen for barriers and connect patients with social work, pharmacy, and assistance resources.

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