🩺 Introduction
Cancer nursing, also known as oncology nursing, is one of the most essential areas tested in the NCLEX-RN exam. Nurses play a critical role in identifying symptoms, managing side effects, and supporting patients through various stages of cancer treatment. To help you strengthen your understanding, we’ve prepared 100 NCLEX-style Oncology Nursing MCQs with detailed rationales. These questions cover chemotherapy, radiation therapy, palliative care, oncology pharmacology, and patient safety — all aligned with U.S. NCLEX exam standards.
Let’s test your knowledge and confidence in oncology nursing with these carefully curated practice questions.
🧠 NCLEX Oncology Nursing Practice Questions (1–25)
1. A nurse is caring for a client receiving chemotherapy. Which nursing action is most important to prevent infection?
A. Restrict all visitors
B. Monitor temperature daily
C. Perform hand hygiene before each contact
D. Encourage fresh fruits and vegetables
Answer: C. Perform hand hygiene before each contact
Rationale: Hand hygiene is the single most effective method to prevent infection in immunocompromised chemotherapy patients.
2. A patient receiving doxorubicin should be closely monitored for which side effect?
A. Nephrotoxicity
B. Cardiotoxicity
C. Neurotoxicity
D. Hepatotoxicity
Answer: B. Cardiotoxicity
Rationale: Doxorubicin, an anthracycline, is associated with cardiomyopathy and requires regular cardiac monitoring.
3. Which nursing diagnosis is most appropriate for a patient receiving radiation therapy to the neck?
A. Impaired skin integrity
B. Impaired gas exchange
C. Risk for aspiration
D. Altered nutrition
Answer: A. Impaired skin integrity
Rationale: Radiation to the neck often causes erythema, dryness, and skin breakdown at the treatment site.
4. What is the priority nursing intervention for a patient with tumor lysis syndrome?
A. Restrict fluids
B. Encourage low-calorie diet
C. Monitor serum potassium and uric acid
D. Administer beta blockers
Answer: C. Monitor serum potassium and uric acid
Rationale: Tumor lysis syndrome causes electrolyte imbalances; close monitoring helps prevent renal failure and cardiac issues.
5. A patient receiving chemotherapy complains of nausea. Which nursing intervention is most effective?
A. Offer large meals
B. Encourage spicy foods
C. Administer antiemetics before meals
D. Limit fluid intake
Answer: C. Administer antiemetics before meals
Rationale: Giving antiemetics 30–60 minutes before eating prevents nausea and vomiting, improving nutritional intake.
6. What should a nurse teach a patient about oral mucositis prevention during chemotherapy?
A. Use alcohol-based mouthwash
B. Brush teeth with a soft-bristled brush
C. Avoid rinsing the mouth
D. Eat acidic foods
Answer: B. Brush teeth with a soft-bristled brush
Rationale: Soft brushes prevent gum injury and reduce infection risk in immunocompromised patients.
7. The nurse notes a patient receiving bleomycin has shortness of breath. What is the nurse’s priority action?
A. Increase oxygen flow
B. Notify the provider immediately
C. Encourage ambulation
D. Record pulse oximetry
Answer: B. Notify the provider immediately
Rationale: Bleomycin toxicity can cause pulmonary fibrosis; any respiratory symptoms require urgent evaluation.
8. Which finding requires immediate intervention in a neutropenic patient?
A. Temperature of 100.4°F (38°C)
B. Fatigue
C. Hair loss
D. Mouth dryness
Answer: A. Temperature of 100.4°F (38°C)
Rationale: Even a slight fever in neutropenic patients may indicate life-threatening infection.
9. Which food should be avoided by a patient on neutropenic precautions?
A. Canned peaches
B. Pasteurized milk
C. Raw salad
D. Cooked meat
Answer: C. Raw salad
Rationale: Raw fruits and vegetables may harbor bacteria that can cause infection in immunocompromised patients.
10. What is a key nursing consideration when administering vesicant chemotherapy agents?
A. Use a small-gauge needle
B. Administer via a central venous line
C. Give rapidly to prevent irritation
D. Dilute in 100 mL of saline
Answer: B. Administer via a central venous line
Rationale: Vesicants can cause severe tissue necrosis if extravasation occurs; a central line ensures safe delivery.
11. A patient with cancer reports severe bone pain due to metastasis. Which medication is most appropriate?
A. NSAIDs
B. Acetaminophen
C. Opioid analgesics
D. Antihistamines
Answer: C. Opioid analgesics
Rationale: Cancer-related pain is often severe and best managed with opioids following the WHO pain ladder.
12. The nurse should teach patients receiving radiation to:
A. Wash the treated area with hot water
B. Use mild soap and pat dry
C. Apply perfume or lotion to the site
D. Cover the area with adhesive bandages
Answer: B. Use mild soap and pat dry
Rationale: Gentle cleansing prevents further skin irritation and promotes healing.
13. Which laboratory finding indicates bone marrow suppression from chemotherapy?
A. Hemoglobin 13 g/dL
B. Platelets 50,000/mm³
C. WBC 8,000/mm³
D. Hematocrit 40%
Answer: B. Platelets 50,000/mm³
Rationale: Low platelet count indicates thrombocytopenia, a common chemotherapy side effect.
14. A patient receiving chemotherapy develops mouth ulcers. What should the nurse suggest?
A. Lemon-flavored mouthwash
B. Ice chips during chemotherapy
C. Spicy foods
D. Carbonated drinks
Answer: B. Ice chips during chemotherapy
Rationale: Cryotherapy constricts blood vessels and reduces drug exposure to oral mucosa.
15. Which nursing intervention helps manage fatigue during cancer treatment?
A. Encourage strict bed rest
B. Promote balanced rest and activity
C. Avoid physical activity
D. Provide high-calorie junk food
Answer: B. Promote balanced rest and activity
Rationale: Mild activity improves circulation and energy levels, preventing deconditioning.
16. A nurse caring for a patient on chemotherapy notices petechiae. What should be assessed first?
A. Heart rate
B. Platelet count
C. Bowel sounds
D. Temperature
Answer: B. Platelet count
Rationale: Petechiae indicate thrombocytopenia; platelet count should be monitored immediately.
17. A patient with prostate cancer is receiving leuprolide. Which side effect should the nurse monitor?
A. Hypoglycemia
B. Hot flashes
C. Hypotension
D. Increased libido
Answer: B. Hot flashes
Rationale: Leuprolide decreases testosterone levels, leading to symptoms similar to menopause.
18. What safety measure should be implemented for a patient receiving internal radiation therapy (brachytherapy)?
A. Allow unlimited visitors
B. Encourage staff to spend more time in the room
C. Limit time near the patient and maintain distance
D. Remove radiation signs when off duty
Answer: C. Limit time near the patient and maintain distance
Rationale: Radiation safety involves time, distance, and shielding to minimize exposure.
19. Which symptom suggests spinal cord compression in a cancer patient?
A. Nausea and vomiting
B. Back pain and weakness
C. Headache
D. Tachycardia
Answer: B. Back pain and weakness
Rationale: Spinal cord compression is an oncologic emergency requiring immediate evaluation.
20. Which intervention best supports nutrition in a patient with anorexia due to chemotherapy?
A. Encourage large meals
B. Provide small, frequent, high-protein meals
C. Restrict fluids
D. Offer bland, low-protein snacks
Answer: B. Provide small, frequent, high-protein meals
Rationale: Small, nutrient-dense meals improve intake and maintain strength.
21. A nurse teaches a patient about neutropenia precautions. Which statement shows understanding?
A. “I’ll avoid large crowds.”
B. “I can share utensils at home.”
C. “I’ll eat raw fruits.”
D. “I’ll skip handwashing if I wear gloves.”
Answer: A. “I’ll avoid large crowds.”
Rationale: Avoiding crowds reduces infection risk for neutropenic patients.
22. The nurse monitors for which complication in a patient receiving cisplatin?
A. Ototoxicity
B. Hypokalemia
C. Hypertension
D. Constipation
Answer: A. Ototoxicity
Rationale: Cisplatin can cause hearing loss; auditory testing is necessary.
23. A patient with leukemia has a platelet count of 25,000/mm³. Which action is most important?
A. Encourage flossing
B. Avoid intramuscular injections
C. Ambulate twice daily
D. Give aspirin for pain
Answer: B. Avoid intramuscular injections
Rationale: Low platelets increase bleeding risk; injections can cause hematomas.
24. A nurse observes redness and swelling at a chemotherapy IV site. What should the nurse do first?
A. Apply heat
B. Stop the infusion immediately
C. Elevate the arm
D. Flush the line
Answer: B. Stop the infusion immediately
Rationale: Redness and swelling suggest extravasation; stopping infusion prevents tissue damage.
25. Which intervention is most effective in preventing stomatitis during chemotherapy?
A. Avoid oral hygiene
B. Rinse mouth with saline
C. Use alcohol mouthwash
D. Drink carbonated beverages
Answer: B. Rinse mouth with saline
Rationale: Saline mouth rinses maintain moisture and reduce mucosal irritation.
👩⚕️NCLEX Prioritization and Delegation Practice Test
🩹 NCLEX Cardiac Nursing Questions
🚑 NCLEX Wound Care Practice Questions
🧠 NCLEX Oncology Nursing Practice Questions (26–50)
26. Which instruction should the nurse include for a patient at risk of bleeding due to thrombocytopenia?
A. Use a firm toothbrush
B. Avoid straining during bowel movements
C. Use aspirin for pain
D. Engage in contact sports
Answer: B. Avoid straining during bowel movements
Rationale: Valsalva maneuver can increase intracranial pressure and cause bleeding in thrombocytopenic patients.
27. A nurse is caring for a client undergoing bone marrow transplantation. What is the priority nursing action post-transplant?
A. Provide high-fiber diet
B. Maintain strict hand hygiene and isolation
C. Encourage frequent visitors
D. Give live vaccines
Answer: B. Maintain strict hand hygiene and isolation
Rationale: After transplantation, the patient is immunocompromised and highly vulnerable to infection.
28. Which laboratory value should be closely monitored in a patient receiving methotrexate?
A. Serum calcium
B. Liver function tests
C. Serum potassium
D. Platelet count only
Answer: B. Liver function tests
Rationale: Methotrexate is hepatotoxic; periodic liver monitoring is crucial.
29. The nurse recognizes which symptom as an early sign of septic shock in neutropenic patients?
A. Hypotension
B. Fever
C. Bradycardia
D. Cyanosis
Answer: B. Fever
Rationale: Fever is often the earliest and sometimes only sign of infection in neutropenic patients.
30. A patient on chemotherapy reports tingling in hands and feet. What is the likely cause?
A. Nephrotoxicity
B. Peripheral neuropathy
C. Dehydration
D. Anemia
Answer: B. Peripheral neuropathy
Rationale: Drugs like vincristine and cisplatin damage peripheral nerves causing neuropathy.
31. What dietary recommendation supports recovery during cancer treatment?
A. High-protein, high-calorie meals
B. Low-protein, low-fat diet
C. Only clear liquids
D. Low-calorie diet
Answer: A. High-protein, high-calorie meals
Rationale: Protein and calories help maintain strength, support immune function, and promote healing.
32. Which nursing action reduces radiation exposure for healthcare staff?
A. Staying close to patient for long periods
B. Rotating staff and minimizing exposure time
C. Wearing double gloves only
D. Removing radiation signs after procedure
Answer: B. Rotating staff and minimizing exposure time
Rationale: Time, distance, and shielding minimize radiation exposure risk.
33. A patient receiving chemotherapy has uric acid crystals in urine. Which medication may be prescribed?
A. Allopurinol
B. Furosemide
C. Prednisone
D. Metformin
Answer: A. Allopurinol
Rationale: Allopurinol prevents uric acid buildup associated with tumor lysis syndrome.
34. Which finding indicates superior vena cava (SVC) syndrome in a patient with lung cancer?
A. Headache and facial swelling
B. Abdominal distension
C. Leg cramps
D. Cough with hemoptysis
Answer: A. Headache and facial swelling
Rationale: Obstruction of SVC causes venous congestion, facial edema, and dyspnea.
35. A nurse teaches about infection prevention during chemotherapy. Which statement requires further teaching?
A. “I’ll wear a mask in crowded places.”
B. “I’ll avoid fresh flowers in my room.”
C. “I’ll eat raw vegetables for nutrition.”
D. “I’ll wash my hands frequently.”
Answer: C. “I’ll eat raw vegetables for nutrition.”
Rationale: Raw foods can contain harmful bacteria; cooked foods are safer for immunocompromised patients.
36. A patient receiving tamoxifen for breast cancer should be monitored for:
A. Osteoporosis
B. Endometrial cancer
C. Hyperthyroidism
D. Hypoglycemia
Answer: B. Endometrial cancer
Rationale: Tamoxifen increases the risk of uterine malignancies due to estrogenic effects.
37. A nurse assesses a patient with nausea during chemotherapy. What complementary intervention can help?
A. Aromatherapy with citrus
B. Deep breathing and relaxation techniques
C. Loud music therapy
D. High-intensity exercise
Answer: B. Deep breathing and relaxation techniques
Rationale: Relaxation reduces anxiety and helps control chemotherapy-induced nausea.
38. The nurse educates a patient about alopecia. Which statement shows understanding?
A. “Hair loss will be permanent.”
B. “My hair may regrow a different color or texture.”
C. “I should wash my hair daily with hot water.”
D. “I can color my hair during chemotherapy.”
Answer: B. “My hair may regrow a different color or texture.”
Rationale: Hair often regrows after chemotherapy, sometimes with altered characteristics.
39. The priority nursing action for a patient with hypercalcemia due to bone metastasis is:
A. Restrict fluids
B. Encourage mobility and hydration
C. Limit calcium intake only
D. Provide high-calcium diet
Answer: B. Encourage mobility and hydration
Rationale: Movement and fluids help prevent calcium reabsorption and renal stones.
40. A nurse caring for a patient receiving chemotherapy notes white patches in the mouth. What is the likely cause?
A. Viral infection
B. Oral candidiasis
C. Mucositis
D. Stomatitis
Answer: B. Oral candidiasis
Rationale: Chemotherapy suppresses immunity, allowing fungal infections like thrush to develop.
41. Which lab finding indicates need for blood transfusion in a chemotherapy patient?
A. Hemoglobin 7.5 g/dL
B. Platelets 150,000/mm³
C. WBC 8,000/mm³
D. Hematocrit 40%
Answer: A. Hemoglobin 7.5 g/dL
Rationale: Severe anemia requires transfusion to maintain adequate oxygen delivery.
42. Which sign indicates an oncologic emergency in a patient with cancer?
A. Constipation
B. Facial swelling and shortness of breath
C. Loss of appetite
D. Mild fatigue
Answer: B. Facial swelling and shortness of breath
Rationale: Suggests superior vena cava syndrome — a medical emergency requiring immediate attention.
43. A nurse is teaching about safe handling of chemotherapy drugs. Which instruction is correct?
A. Use gloves and gown when handling body fluids
B. No protective gear is required
C. Flush all chemo waste in sink
D. Dispose of equipment in regular trash
Answer: A. Use gloves and gown when handling body fluids
Rationale: Chemotherapy can be excreted in body fluids; protective measures prevent exposure.
44. Which patient statement indicates correct understanding about radiation tattoo marks?
A. “I can scrub them off after treatment.”
B. “They should be kept intact for positioning.”
C. “They are for decoration.”
D. “They can be removed anytime.”
Answer: B. “They should be kept intact for positioning.”
Rationale: Tattoo marks guide radiation alignment; they must remain throughout treatment.
45. What is the most common symptom of bone marrow suppression after chemotherapy?
A. Headache
B. Fatigue
C. Constipation
D. Hypertension
Answer: B. Fatigue
Rationale: Anemia from bone marrow suppression reduces oxygen delivery, causing fatigue.
46. A nurse is caring for a patient on chemotherapy who reports bleeding gums. Which lab result explains this?
A. WBC 8,500/mm³
B. Platelets 40,000/mm³
C. Hemoglobin 13 g/dL
D. Sodium 135 mEq/L
Answer: B. Platelets 40,000/mm³
Rationale: Thrombocytopenia causes gum bleeding and bruising.
47. What teaching should a nurse provide to a patient using an implanted chemotherapy port?
A. “It can stay in place for months with proper care.”
B. “You must avoid showers.”
C. “It’s removed after every use.”
D. “It requires daily flushing at home.”
Answer: A. “It can stay in place for months with proper care.”
Rationale: Implanted ports allow long-term venous access for chemotherapy administration.
48. The nurse teaches a client about managing diarrhea during chemotherapy. Which statement shows understanding?
A. “I will eat spicy food to improve taste.”
B. “I’ll drink plenty of fluids and eat low-fiber foods.”
C. “I’ll take laxatives if needed.”
D. “I’ll eat raw vegetables.”
Answer: B. “I’ll drink plenty of fluids and eat low-fiber foods.”
Rationale: Low-fiber foods and hydration prevent dehydration and reduce intestinal irritation.
49. What is the best nursing action for a client experiencing extravasation during chemotherapy?
A. Stop the infusion and notify provider
B. Apply warm compress immediately
C. Continue at a slower rate
D. Flush with saline
Answer: A. Stop the infusion and notify provider
Rationale: Stopping the infusion prevents further tissue injury from vesicant leakage.
50. A patient undergoing radiation complains of dry mouth. Which nursing intervention is most effective?
A. Provide frequent sips of water and sugar-free gum
B. Offer caffeinated drinks
C. Limit oral fluids
D. Encourage alcohol-based mouthwash
Answer: A. Provide frequent sips of water and sugar-free gum
Rationale: Saliva substitutes and hydration relieve xerostomia caused by radiation.
🧾 NCLEX Microbiology Questions
NCLEX Oncology Nursing MCQs (51–75)
51. A patient receiving chemotherapy reports mouth ulcers and pain. What nursing intervention is most appropriate?
A. Encourage citrus fruits for vitamin C
B. Perform frequent mouth care with normal saline
C. Use alcohol-based mouthwash
D. Avoid mouth rinsing to prevent irritation
✅ Answer: B. Perform frequent mouth care with normal saline
💡 Rationale: Chemotherapy can cause mucositis; gentle saline rinses reduce infection risk and promote healing.
52. A nurse caring for a patient on radiation therapy should:
A. Remove all skin markings daily
B. Use scented lotion to moisturize skin
C. Avoid applying any lotion to the treatment area unless prescribed
D. Expose the area to sunlight to promote healing
✅ Answer: C. Avoid applying any lotion to the treatment area unless prescribed
💡 Rationale: Only approved lotions should be used to avoid skin irritation and radiation burns.
53. Which finding indicates tumor lysis syndrome?
A. Hypokalemia
B. Hyperuricemia
C. Hypophosphatemia
D. Hypocalcemia
✅ Answer: B. Hyperuricemia
💡 Rationale: Rapid tumor cell breakdown releases uric acid, potassium, and phosphate — leading to metabolic imbalances.
54. During chemotherapy, a patient complains of numbness and tingling in the hands and feet. This is a sign of:
A. Neutropenia
B. Peripheral neuropathy
C. Thrombocytopenia
D. Anemia
✅ Answer: B. Peripheral neuropathy
💡 Rationale: Certain chemotherapy drugs (like vincristine) cause nerve damage leading to neuropathy.
55. A patient receiving chemotherapy has a platelet count of 40,000/mm³. What nursing action is most appropriate?
A. Encourage brushing with a soft toothbrush
B. Administer IM injections
C. Use a straight razor for shaving
D. Encourage contact sports for exercise
✅ Answer: A. Encourage brushing with a soft toothbrush
💡 Rationale: Thrombocytopenia increases bleeding risk; soft brushes help prevent gum injury.
56. A nurse should recognize which lab result as most concerning in a patient receiving chemotherapy?
A. WBC: 2,000/mm³
B. Hgb: 12 g/dL
C. Platelets: 200,000/mm³
D. RBC: 5 million/mm³
✅ Answer: A. WBC: 2,000/mm³
💡 Rationale: Severe leukopenia increases the risk of life-threatening infection.
57. Which precaution should be taken when handling a patient’s bodily fluids after chemotherapy?
A. Standard precautions for 24 hours
B. Use gloves and gown for 48 hours
C. No protection needed
D. Use gloves for one week
✅ Answer: B. Use gloves and gown for 48 hours
💡 Rationale: Chemotherapy drugs are excreted in body fluids up to 48 hours post-administration.
58. The best dietary advice for a patient with cancer-related cachexia is:
A. Low-calorie, high-fiber meals
B. High-protein, high-calorie small frequent meals
C. Low-protein diet
D. Bland and restricted diet
✅ Answer: B. High-protein, high-calorie small frequent meals
💡 Rationale: These foods help maintain weight and promote tissue repair.
59. Which sign indicates extravasation during chemotherapy infusion?
A. Pain and redness at IV site
B. Generalized itching
C. Elevated temperature
D. Slow infusion rate
✅ Answer: A. Pain and redness at IV site
💡 Rationale: Vesicant drugs can cause tissue necrosis; stop infusion immediately if extravasation occurs.
60. What is the priority nursing diagnosis for a client with bone metastasis?
A. Risk for infection
B. Impaired skin integrity
C. Risk for pathologic fracture
D. Disturbed body image
✅ Answer: C. Risk for pathologic fracture
💡 Rationale: Cancer weakens bones, making them more susceptible to fractures.
61. What should a nurse teach a patient about alopecia due to chemotherapy?
A. Hair loss is usually permanent
B. Avoid wigs or scarves
C. Hair will regrow after therapy ends
D. Shave the head to prevent scalp infection
✅ Answer: C. Hair will regrow after therapy ends
💡 Rationale: Hair loss is temporary; regrowth often begins a few months post-treatment.
62. Which is an early sign of septicemia in an immunocompromised cancer patient?
A. Hypotension
B. Fever
C. Oliguria
D. Cyanosis
✅ Answer: B. Fever
💡 Rationale: Fever is often the first indicator of infection in neutropenic patients.
63. A patient with leukemia is placed in protective isolation. Which action by the nurse is correct?
A. Allow fresh flowers in the room
B. Encourage raw fruit juices
C. Use strict hand hygiene before contact
D. Encourage family visits without masks
✅ Answer: C. Use strict hand hygiene before contact
💡 Rationale: Protective isolation prevents infection in immunocompromised patients.
64. A cancer patient receiving opioids develops constipation. The nurse should:
A. Discontinue opioid therapy
B. Encourage fluids, fiber, and stool softeners
C. Restrict activity to conserve energy
D. Avoid fiber intake
✅ Answer: B. Encourage fluids, fiber, and stool softeners
💡 Rationale: Opioids slow bowel motility; supportive care prevents discomfort and impaction.
65. Which complication is most associated with superior vena cava syndrome?
A. Swelling of the face and neck
B. Severe abdominal pain
C. Lower limb paralysis
D. Decreased urine output
✅ Answer: A. Swelling of the face and neck
💡 Rationale: Compression of the superior vena cava causes venous congestion in the upper body.
66. What nursing action helps prevent hemorrhagic cystitis during chemotherapy?
A. Restrict fluids
B. Encourage increased oral hydration
C. Administer high-protein diet
D. Apply heat to the abdomen
✅ Answer: B. Encourage increased oral hydration
💡 Rationale: Hydration helps flush out toxic metabolites that can irritate the bladder.
67. A patient with metastatic breast cancer reports bone pain. Which intervention is most effective?
A. Heat therapy
B. Position changes only
C. Radiation therapy for pain relief
D. Massage over painful area
✅ Answer: C. Radiation therapy for pain relief
💡 Rationale: Radiation can shrink tumors, easing pressure and pain from bone metastasis.
68. Which symptom indicates spinal cord compression in a cancer patient?
A. Back pain and muscle weakness
B. Headache
C. Dyspnea
D. Nausea
✅ Answer: A. Back pain and muscle weakness
💡 Rationale: Compression of spinal nerves causes pain, numbness, and loss of motor function.
69. What should the nurse do first if a chemotherapy spill occurs?
A. Call housekeeping
B. Cover with towels and continue care
C. Evacuate the area and use spill kit
D. Wipe the spill with tissue
✅ Answer: C. Evacuate the area and use spill kit
💡 Rationale: Cytotoxic agents are hazardous; proper cleanup prevents exposure.
70. Which type of isolation is used for a patient with neutropenia?
A. Contact isolation
B. Reverse isolation
C. Droplet isolation
D. Airborne isolation
✅ Answer: B. Reverse isolation
💡 Rationale: Reverse isolation protects immunocompromised patients from external infections.
71. A nurse is teaching a client receiving chemotherapy about infection prevention. Which statement indicates understanding?
A. “I’ll avoid crowds and sick people.”
B. “I’ll stop brushing my teeth.”
C. “I can eat raw seafood.”
D. “I’ll take herbal supplements.”
✅ Answer: A. “I’ll avoid crowds and sick people.”
💡 Rationale: Avoiding potential sources of infection is essential during immunosuppression.
72. Which symptom in a patient receiving cisplatin should be reported immediately?
A. Fatigue
B. Tinnitus
C. Mild nausea
D. Constipation
✅ Answer: B. Tinnitus
💡 Rationale: Cisplatin is ototoxic; early signs like ringing in the ears must be reported promptly.
73. Which is a common side effect of doxorubicin (Adriamycin)?
A. Cardiotoxicity
B. Hepatotoxicity
C. Nephrotoxicity
D. Ototoxicity
✅ Answer: A. Cardiotoxicity
💡 Rationale: Doxorubicin can cause irreversible heart damage; cardiac monitoring is necessary.
74. Which type of cancer commonly causes hypercalcemia?
A. Breast cancer with bone metastasis
B. Lung cancer
C. Colon cancer
D. Pancreatic cancer
✅ Answer: A. Breast cancer with bone metastasis
💡 Rationale: Bone breakdown releases calcium into the bloodstream.
75. A nurse notes bleeding gums and petechiae in a cancer patient. Which lab value is expected?
A. Platelet count 30,000/mm³
B. WBC 10,000/mm³
C. Hgb 13 g/dL
D. RBC 4.8 million/mm³
✅ Answer: A. Platelet count 30,000/mm³
💡 Rationale: Thrombocytopenia from chemotherapy leads to bleeding tendencies.
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NCLEX Oncology Nursing MCQs (76–100)
76. A patient receiving chemotherapy reports severe nausea and vomiting. Which nursing action is most effective?
A. Offer clear liquids only after meals
B. Administer prescribed antiemetic before chemotherapy
C. Encourage large meals to maintain nutrition
D. Suggest lying flat after meals
✅ Answer: B. Administer prescribed antiemetic before chemotherapy
💡 Rationale: Pre-treatment with antiemetics like ondansetron helps prevent chemotherapy-induced nausea and vomiting.
77. Which is a late sign of increased intracranial pressure in a patient with brain metastasis?
A. Headache
B. Projectile vomiting
C. Restlessness
D. Bradycardia and irregular respirations
✅ Answer: D. Bradycardia and irregular respirations
💡 Rationale: These are part of Cushing’s triad, indicating a dangerous rise in intracranial pressure.
78. What should the nurse include in discharge teaching for a patient with radiation therapy to the head and neck?
A. Use alcohol-based mouthwash for hygiene
B. Avoid spicy or acidic foods
C. Eat hard, crunchy foods for oral stimulation
D. Rinse with hydrogen peroxide
✅ Answer: B. Avoid spicy or acidic foods
💡 Rationale: Radiation can cause mucositis; soft, bland foods reduce irritation.
79. Which nursing intervention helps manage fatigue in cancer patients?
A. Encourage short, frequent rest periods
B. Restrict physical activity completely
C. Encourage heavy exercise
D. Provide high-sugar snacks
✅ Answer: A. Encourage short, frequent rest periods
💡 Rationale: Fatigue is a common cancer symptom; pacing activities prevents exhaustion.
80. A patient with lymphedema after mastectomy should be instructed to:
A. Avoid using the affected arm for blood pressure and injections
B. Apply tight bandages
C. Massage the arm vigorously
D. Keep the arm hanging down
✅ Answer: A. Avoid using the affected arm for blood pressure and injections
💡 Rationale: Trauma to the arm can worsen lymphedema; protect it from injury or pressure.
81. Which is a common side effect of tamoxifen therapy?
A. Night sweats and hot flashes
B. Muscle cramps
C. Constipation
D. Skin rash
✅ Answer: A. Night sweats and hot flashes
💡 Rationale: Tamoxifen acts as an estrogen blocker, causing menopausal-like symptoms.
82. A nurse is assessing a patient with lung cancer and notes new onset of hoarseness. What could this indicate?
A. Metastasis to the brain
B. Laryngeal nerve involvement
C. Normal side effect of chemotherapy
D. Anemia
✅ Answer: B. Laryngeal nerve involvement
💡 Rationale: Tumor pressure on the recurrent laryngeal nerve causes hoarseness.
83. What is a priority intervention for a patient with superior vena cava syndrome?
A. Elevate the head of the bed
B. Apply abdominal binder
C. Encourage coughing exercises
D. Apply cold compress to chest
✅ Answer: A. Elevate the head of the bed
💡 Rationale: Elevation reduces venous congestion and improves breathing.
84. Which lab test best evaluates the effectiveness of erythropoietin therapy?
A. WBC count
B. Hemoglobin level
C. Platelet count
D. Serum calcium
✅ Answer: B. Hemoglobin level
💡 Rationale: Erythropoietin stimulates red blood cell production, raising hemoglobin.
85. A patient on chemotherapy reports burning during urination. What should the nurse do first?
A. Encourage fluids and assess for infection
B. Restrict fluid intake
C. Stop chemotherapy immediately
D. Apply heat to the abdomen
✅ Answer: A. Encourage fluids and assess for infection
💡 Rationale: Dysuria may indicate urinary tract irritation or infection; hydration helps.
86. A patient undergoing radiation develops dry, flaky skin. Which nursing action is most appropriate?
A. Use mild, unscented soap and pat dry
B. Apply heating pad to the area
C. Rub vigorously to remove flakes
D. Cover with tight clothing
✅ Answer: A. Use mild, unscented soap and pat dry
💡 Rationale: Gentle cleansing prevents further skin irritation and breakdown.
87. The nurse should monitor which electrolyte closely in a patient receiving cisplatin?
A. Sodium
B. Potassium
C. Calcium
D. Magnesium
✅ Answer: D. Magnesium
💡 Rationale: Cisplatin can cause hypomagnesemia due to renal toxicity.
88. A cancer patient receiving filgrastim (Neupogen) should be monitored for:
A. Bone pain
B. Hair loss
C. Constipation
D. Diarrhea
✅ Answer: A. Bone pain
💡 Rationale: Filgrastim stimulates bone marrow, which can cause bone pain as WBCs increase.
89. Which cancer treatment can directly alter DNA within cells?
A. Radiation therapy
B. Hormone therapy
C. Physical therapy
D. Nutritional therapy
✅ Answer: A. Radiation therapy
💡 Rationale: Radiation damages DNA, preventing tumor cell replication.
90. Which nursing action prevents stomatitis during chemotherapy?
A. Use a soft toothbrush and non-alcohol mouthwash
B. Eat hot, spicy food
C. Gargle with salt and lemon
D. Brush teeth vigorously
✅ Answer: A. Use a soft toothbrush and non-alcohol mouthwash
💡 Rationale: Gentle oral hygiene helps prevent mucosal injury and infection.
91. What finding in a patient receiving methotrexate is most concerning?
A. Mouth ulcers
B. Hair loss
C. Mild fatigue
D. Loss of appetite
✅ Answer: A. Mouth ulcers
💡 Rationale: Methotrexate causes mucosal toxicity; mouth ulcers indicate potential overdose or toxicity.
92. The nurse observes that a patient on chemotherapy has reddened, painful veins. This finding suggests:
A. Phlebitis
B. Cellulitis
C. Thrombosis
D. Hypotension
✅ Answer: A. Phlebitis
💡 Rationale: IV chemotherapy can irritate veins, leading to inflammation and discomfort.
93. A patient receiving palliative care for terminal cancer asks about the goal of care. The nurse should respond:
A. “To cure your illness.”
B. “To improve your comfort and quality of life.”
C. “To prepare you for surgery.”
D. “To reverse your condition.”
✅ Answer: B. “To improve your comfort and quality of life.”
💡 Rationale: Palliative care focuses on relief of symptoms, not cure.
94. Which nursing intervention prevents oral thrush in immunocompromised patients?
A. Encourage frequent mouth rinsing
B. Restrict fluid intake
C. Brush teeth once daily
D. Use shared utensils
✅ Answer: A. Encourage frequent mouth rinsing
💡 Rationale: Good oral hygiene prevents fungal infections like candidiasis.
95. Which symptom of hypercalcemia should the nurse monitor in cancer patients?
A. Muscle weakness and confusion
B. Tremors
C. Increased reflexes
D. Diarrhea
✅ Answer: A. Muscle weakness and confusion
💡 Rationale: High calcium levels affect neuromuscular and cognitive function.
96. A nurse is caring for a patient with multiple myeloma. Which lab value is expected?
A. Elevated calcium
B. Low BUN
C. Low uric acid
D. Elevated platelets
✅ Answer: A. Elevated calcium
💡 Rationale: Bone destruction in multiple myeloma releases calcium into the blood.
97. A patient receiving chemotherapy develops a fever of 101°F (38.3°C). What is the priority action?
A. Administer antipyretics
B. Notify the healthcare provider immediately
C. Encourage fluid intake only
D. Monitor temperature again in 4 hours
✅ Answer: B. Notify the healthcare provider immediately
💡 Rationale: Fever may indicate infection in neutropenic patients, requiring urgent treatment.
98. Which is an expected outcome of colony-stimulating factor therapy?
A. Increased white blood cell count
B. Decreased red blood cell count
C. Increased platelet destruction
D. Decreased immune response
✅ Answer: A. Increased white blood cell count
💡 Rationale: Colony-stimulating factors promote neutrophil production to prevent infection.
99. A patient with pancreatic cancer reports jaundice and dark urine. This indicates:
A. Biliary obstruction
B. Dehydration
C. Kidney failure
D. Hyperglycemia
✅ Answer: A. Biliary obstruction
💡 Rationale: Tumor compression of bile ducts causes jaundice and dark urine due to bilirubin buildup.
100. A cancer patient expresses hopelessness and says, “I can’t fight anymore.” The best nursing response is:
A. “You must stay positive.”
B. “Tell me more about how you’re feeling.”
C. “Try to focus on your recovery.”
D. “Don’t think negatively.”
✅ Answer: B. “Tell me more about how you’re feeling.”
💡 Rationale: Open communication supports emotional expression and builds trust in end-of-life care.
💊 NCLEX Pharmacology Practice Questions
🩺 NCLEX Psychiatric and Mental Health Nursing MCQs
✅ Conclusion
Oncology nursing is one of the most critical areas in NCLEX preparation. These 100 NCLEX Oncology Nursing MCQs with rationales aim to enhance your understanding of cancer care, from chemotherapy and radiation safety to psychological and palliative support. Remember — mastering these concepts not only improves your exam performance but also shapes you into a more compassionate, skilled nurse ready to care for cancer patients in the U.S. healthcare system.