Oncology Nursing Exam Review
Course Introduction
Oncology Nursing is a specialized course designed to equip students with the knowledge and skills necessary to care for individuals diagnosed with cancer. The course covers fundamentals of cancer biology, principles of cancer treatment and management, psychosocial aspects of care, and symptom management throughout the continuum of disease. Special emphasis is placed on effective communication, patient and family education, pain and symptom control, palliative care, and the nurses role in a multidisciplinary oncology team. Students will also explore ethical considerations, evidence-based practices, and the latest advances in oncology nursing to ensure holistic and compassionate care for cancer patients.
Recommended Textbook
Principles and Practice of Radiation Therapy 4th Edition by Washington
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954 Verified Questions
954 Flashcards
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Chapter 1: Cancer: An Overview
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Sample Questions
Q1) Which classification of chemotherapy agents was the first to be identified as having anticancer activities?
A) Alkylating agents
B) Antimetabolites
C) Antibiotics
D) Hormonal agents
E) Nitrosoureas
F) Vinca alkaloids
Answer: A
Q2) Which of the following biopsy methods results in the removal of the entire tumor?
A) Fine needle aspiration
B) Core needle
C) Incisional
D) Excisional
Answer: D
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Chapter 2: The Ethics and Legal Considerations of Cancer Management
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Sample Questions
Q1) Which doctrine contends that individuals are responsible for their own negligent conduct?
A) Doctrine of foreseeability
B) Doctrine of personal liability
C) Doctrine of res ipsa loquitur
D) Doctrine of respondeat superior
Answer: B
Q2) Which of the following is not a recognized exception to patient confidentiality?
A) Genetic disease
B) Abuse
C) Communicable disease
D) Automobile accident
Answer: A
Q3) Which of the following is not a source from which values are derived?
A) Money
B) Experience
C) Religion
D) Science
Answer: A
Page 4
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Chapter 3: Principles of Pathology
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Sample Questions
Q1) Hodgkin's disease is a neoplasm that typically involves the _________.
A) brain
B) lung
C) lymph nodes
D) liver
Answer: C
Q2) The purpose of the staging system for cancer is which of the following?
A) To evaluate the degree of differentiation of tumor
B) To estimate the prognosis of the patient
C) To evaluate the degrees of malignancy
D) To estimate the geographical extent of disease
Answer: D
Q3) A(n)______________ is a term used to describe a gene that accelerates growth.
A) oncogene
B) tumor-suppressor gene
C) nucleoside
D) nucleotide
Answer: A
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5
Chapter 4: Overview of Radiobiology
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Q1) How does oxygen retention affect radiosensitivity?
A) Increases
B) Decreases
C) No change
D) Varies by tissue
Q2) Fractionation of radiation dose administration to neoplastic tissues has which of the following effects? (Select three.)
A) Reoxygenation of hypoxic tumor cells, thus promotes their sensitivity to subsequent doses
B) Favors repair of radiation injury in normal cells over that of cancer cells
C) Favors repopulation of normal tissues slightly
D) Reduces or blunts the effects of the radiation injury in early responding normal tissues
Q3) Which of the following tissues is least radiosensitive?
A) Bone
B) Kidney
C) Ocular lens
D) Colon
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6
Chapter 5: Detection and Diagnosis
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Q1) Which of the following factors would not be observed when assessing respiration?
I.Rate
II.Rhythm
III.Character
A) I and II
B) II and III
C) I and III
D) I, II, and III
Q2) Which of the following indicates a hematocrit value within normal limits for a healthy 40-year-old woman?
A) 20%
B) 30%
C) 40%
D) 50%
Q3) Mass screening is based on all except which of the following?
A) Specific results obtained
B) Cost-effectiveness
C) Risk to the patient
D) Geographic location
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Page 7
Chapter 6: Medical Imaging
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Q1) The quantity of photons in an x-ray beam is directly proportional to _____________.
A) kVp
B) anode temperature rating
C) tube current
D) filtration
Q2) Which of the following is an advantage of the photostimulatable phosphor plate over conventional x-ray image production?
A) Less radiating per exposure
B) Postprocessing manipulation of density and contrast
C) No need for radiographic grids
D) Higher spatial resolution
Q3) Which of the following is responsible for transforming invisible x-rays into energy and then into visible light?
A) Grids
B) Glass envelop
C) Densitometer
D) Intensifying screens
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8
Chapter 7: Treatment Delivery Equipment
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Sample Questions
Q1) Of the following treatment units, which has the least amount of skin sparing?
A) Orthovoltage
B) Cobalt
C) 4 MV beam
D) 10 MV beam
Q2) The electron gun is similar to what part of an x-ray tube?
A) Anode
B) Rotating tungsten target
C) Cathode
D) Power supply
Q3) Some of the more common medical accelerator hazards include which of the following?
I.Incorrect dose delivered
II.Dose delivered to wrong area
III.Machine collision
IV.Emergency off malfunction
A) I, II, and IV
B) II, III, and IV
C) I, III, and IV
D) I, II, and III
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Chapter 8: Treatment Procedures
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Sample Questions
Q1) Increased skin doses may be seen on patients caused by the interaction of the photon beam with material used in beam-shaping or modifying devices.Therefore, to prevent electron contamination, all devices must be secured at a minimum of ______ cm from the surface of the patient.
A) 3
B) 5
C) 15
D) 20
Q2) Which of the following is a series of documentation and activities performed with the purpose of optimizing patient care?
A) Quality control
B) Quality auditing
C) Quality assurance (QA)program
D) Quality of life
Q3) Methods of matching abutting fields include all except which of the following?
A) Penumbra method
B) Gaps
C) Feathering
D) Use of nondivergent beam edges
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Page 10
Chapter 9: Infection Control in Radiation Oncology Facilities
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Sample Questions
Q1) Hepatitis B is a virus transmitted mainly through which of the following?
A) Contact with blood and body fluids
B) Indirect contact with airborne droplets
C) Direct contact with respiratory droplets
D) Common vehicle or fomite exposure
Q2) When should Standard Precautions be used?
A) When exposure to blood is likely
B) When exposure to saliva is likely
C) During all patient care procedures
D) During patient procedures requiring sterile asepsis
Q3) Following an accidental needle stick where exposure to human immunodeficiency virus (HIV)is possible, which of the following is the most appropriate first response?
A) Complete an incident report.
B) Apply bleach to the punctured area.
C) Squeeze the wound to make it bleed.
D) Decontaminate by using soap and water.
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Chapter 10: Patient Assessment
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Q1) A general health assessment can include all except which of the following?
A) An interview
B) Taking medical history past and present
C) A self-report
D) Asking when the person last attended church
Q2) Cachexia is the loss of which of the following?
A) Appetite
B) Self-esteem
C) Quality of life
D) Cognitive dimension
Q3) __________ pain is the persistence of pain for longer than 3 months with a less well-defined onset.Its cause may not be known.
A) Onset
B) Chronic
C) Sudden
D) Acute
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12
Chapter 11: Pharmacology and Drug Administration
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Q1) Radiolucent contrast agents are those that ______________________.
A) appear dark on x-ray
B) appear white on x-ray
C) have high atomic numbers
D) absorb x-ray photons easily
Q2) In which part of the body is barium sulfate used as a contrast agent?
A) Gastrointestinal tract
B) Bronchography
C) Myelography
D) Cardiovascular
Q3) Which of the following radioactive isotopes is used in radiation therapy?
A) Strontium 89
B) Technetium 99
C) Fluorine 18
D) Hydrogen 3
Q4) The abbreviation BID stands for which of the following?
A) After meals
B) Before meals
C) Twice daily
D) Once daily
Page 13
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Chapter 12: Applied Mathematics Review
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Sample Questions
Q1) Express log<sub>10</sub> 100 = 2 in exponential notation.
A) 1.0 × 10<sup>2</sup>
B) 102 = 100
C) 2<sup>10</sup> = 100
D) 10 = v100
Q2) Find the log of log453.
A) 2.656
B) 6.116
C) -19.08
D) 8.752
Q3) Which of the following numeric expressions is written in scientific notation?
A) 1222 × 10<sup>1</sup>
B) 122.2 × 10<sup>2</sup>
C) 12.22 × 10<sup>3</sup>
D) 1.222 × 10<sup>4</sup>
Q4) How many significant figures are there in 0.0068?
A) Two
B) Three
C) Four
D) Five
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Chapter 13: Introduction to Radiation Therapy Physics
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Sample Questions
Q1) Who proposed the first model of the atom?
A) Bohr
B) Thomson
C) Rutherford
D) Planck
Q2) A radioactive sample is measured to contain 1,000 mCi of radioactivity.If the decay constant of this isotope is 0.105 hr?¹, how much activity will remain after 48 hours?
A) 6.474 mCi
B) 7.368 mCi
C) 0.154 mCi
D) 15.445 mCi
Q3) AMU is an abbreviation for which of the following?
A) Atomic metric unit
B) Atomic measured unit
C) American metric unit
D) Atomic mass unit
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Chapter 14: Aspects of Brachytherapy
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Sample Questions
Q1) Regarding question 20, why is brachytherapy the treatment of choice?
A) It has a high energy.
B) It is more effective than stereotactic and proton therapy procedures.
C) Vision is spared due to a lack of radiation-induced changes.
D) It is less expensive for the patient.
Q2) Permanent implants involve which of the following?
I.Sources packaged as tiny seeds
II.Sources with long half-lives
III.Sources implanted with needles in surgery
IV.Tumors that cannot be reached surgically
A) I and II
B) I and III
C) II and III
D) I, II, and III
Q3) For brachytherapy to the cervix, where is point A located in relation to the cervical os?
A) 2 cm superior and 2 cm lateral
B) 1 cm superior and 2 cm lateral
C) 2 cm inferior and 2 cm lateral
D) 2 cm superior and 1 cm lateral
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Chapter 15: Special Procedures
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Sample Questions
Q1) A four-dimensional CT scan uses a(n)__________________.
A) oversampled spiral CT scan
B) pitch of 1.5
C) scanner rotation of 0.5 second
D) auditory respiratory signal
Q2) Devices that are on the linear accelerator for imaging include all except which of the following?
A) OBI
B) EPID
C) CT-on-rails
D) Cone beam CT (CBCT)
Q3) Image-guided radiation therapy is useful because it can ____________________.
I.result in a more focused treatment
II.account for interfraction and intrafraction motion
III.compare in-room image set with treatment planning image set
A) I and II
B) II and III
C) I and III
D) I, II, and III
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Chapter 16: Particle Therapy
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Sample Questions
Q1) Who discovered the Bragg peak phenomenon?
A) William Bragg
B) Ernest Lawrence
C) Ernest Rutherford
D) Robert Rathburn Wilson
Q2) The spread out Bragg peak (SOBP)is created by which of the following?
A) Nozzle
B) Aperture
C) Compensator
D) Modulator wheel
Q3) The water equivalent thickness (WET)of an immobilization device used during proton therapy can affect which of the following attributes of the beam?
A) Linear energy transfer
B) Symmetry
C) Range
D) Energy
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Chapter 17: Radiation Safety and Protection
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Sample Questions
Q1) What is the radiation weighting factor for alpha particles?
A) 1
B) 5
C) 10
D) 20
Q2) Thermoluminescent dosimeters are composed of ____.
A) Ra
B) Al<sub>2</sub>O<sub>3</sub>
C) Ce
D) LiF
Q3) The annual dose equivalent limit to the whole body for infrequent nonoccupationally exposed individuals is ____ mSv.
A) 0.5
B) 1
C) 5
D) 50
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Page 19
Chapter 18: Patient Safety in Radiation Oncology
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Q1) The step in the plan-do-study-act improvement cycle associated with making adjustments to address a problem is the ______________ step.
A) plan
B) do
C) study
D) act
Q2) Transactional-transformational leadership (TTL)focuses on which of the following?
A) Interactions between leaders and followers
B) Relationship between leaders and followers
C) Reward for positive behaviors and punishment for negative behaviors
D) Relationship and interactions between leaders and followers
Q3) According to Harold Freudenberger, physical signs of burnout would not include which of the following?
A) Headaches
B) Insomnia
C) Fatigue
D) Alopecia
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Chapter 19: Quality Improvement in Radiation Oncology
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Q1) Among continuous improvement methods, the system of Six Sigma focuses on improving processes by _______________________________.
A) emphasizing quality control procedures that are routinely performed, documented, and evaluated
B) emphasizing speed and efficiency
C) eliminating defects in the process through precision and accuracy
D) continuous statistical assessment of data being collected
Q2) In general, the major components of a QI plan include which of the following?
A) Evaluation of patterns
B) Assessment of individual clinical events
C) Action to be taken to resolve problems
D) Weekly meeting of QI committee
E) a, b, and d
F) a, b, and c
Q3) TJC's indicator measurement system (IM system)focuses primarily on which of the following?
A) Acute inpatient care
B) Quality indicators
C) Electronic data
D) Peer review
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Chapter 20: Surface and Sectional Anatomy
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Q1) If a cross section of the thorax is taken at about 10 cm inferior to the suprasternal notch (6 cm inferior to sternal angle), which structure(s)will not be visualized?
A) Trachea
B) Esophagus
C) Scapula
D) Both a and c
Q2) Which of the following anatomic landmarks is located in the head and neck area?
I.Superior orbital margin
II.Nasion
III.External occipital protuberance
IV.Mastoid process
A) I
B) II and III
C) III and IV
D) All of the above
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Chapter 21: Simulator Design
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Sample Questions
Q1) As the field of view increases and the matrix size remains constant, the spatial resolution ____________.
A) increases
B) decreases
C) stays the same
Q2) In the conventional simulator, the _____________ represent(s)the radiation field.
A) blades
B) wires
C) OID
D) collimator assembly
Q3) Which of the following represents the path of a photon when it enters the image intensifier?
A) Input phosphor, electrostatic lenses, photocathode, anode, output screen
B) Input phosphor, photocathode, electrostatic lenses, anode, output screen
C) Input phosphor, anode, electrostatic lenses, photocathode, output screen
D) Anode, input phosphor, electrostatic lenses, photocathode, output screen
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23
Chapter 22: Computed Tomography Simulation
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Sample Questions
Q1) A CT scanner specifically designed for use in the radiation therapy department should have which characteristics?
I.High performance scanner
II.Laser and patient marking system
III.Virtual simulation capabilities
A) I and II
B) I and III
C) II and III
D) I, II, and III
Q2) When using intravenous (IV)contrast to enhance the anatomy of the brain, the best interval for contrast administration should be before the scan by _____________.
A) 30 seconds
B) 60 seconds
C) 30 minutes
D) 60 minutes
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24
Chapter 23: Photon Dosimetry Concepts and Calculations
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Sample Questions
Q1) What is the depth from the PA if the SAD is 100 cm and the SSD is 89 cm?
A) 8 cm
B) 9 cm
C) 10 cm
D) 11 cm
Q2) A patient is treated using two superiorly/inferiorly adjacent fields.The collimator setting for the superior field is 10 cm wide by 13 cm long.The collimator setting for the inferior field is 20 cm wide by 35 cm long.Both fields are treated at 100 cm SSD.Calculate the gap at the skin surface if the fields abut at a depth of 5 cm.
A) 1.5
B) 1.2
C) 2.0
D) 1.0
Q3) Which of the following are adjacent fields that match on the surface and have an overlap at depth due to divergence?
A) Separated fields
B) Abutted fields
C) Half beam blocking fields
D) Geometric matching
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Page 25
Chapter 24: Photon Dose Distributions
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Q1) At what point does the treatment planning process begin?
A) Dose determination
B) Beam delineation
C) Organ segmentation
D) CT imaging
Q2) What determines the wedge angle?
A) The angle of the 100% isodose line with a line perpendicular to the central axis
B) The actual measurements of the wedge
C) The angle of the 80% isodose line with a line perpendicular to the central axis
D) Two times the hinge angle
Q3) During IMRT treatments, how is the intensity of the beam altered?
A) Insertions of a wedge
B) Movement of the collimators
C) Movement of the MLCs
D) Fluctuations in beam energy
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Chapter 25: Electron Beams in Radiation Therapy
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Q1) Which electron beam's diameter (field size)is most likely to have an effect on a 20-MeV beam's surface dose and percent depth dose?
A) 5 cm
B) 10 cm
C) 15 cm
D) 20 cm
Q2) What thickness of lead is necessary to adequately shield a 9-MeV electron beam?
A) 3 cm
B) 3.6 cm
C) 4.5 cm
D) 5.4 cm
Q3) Which electron beam energy is most likely to under-dose at the surface?
A) 9 MeV
B) 12 MeV
C) 16 MeV
D) 20 MeV
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Page 27
Chapter 26: Electronic Charting and Image Management
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Q1) _______ is a computer network covering a small geographic area.
A) A local area network (LAN)
B) WAN
C) PACS
D) DICOM
Q2) All of the following except which personnel provide support for EMRs?
A) System analyst
B) Network specialist
C) Engineers
D) Information systems specialist
Q3) Which medical personnel are interested in records and verify systems for the transfer of information between the treatment planning and treatment delivery systems?
A) Physicists
B) Radiation therapists
C) Radiation oncologists
D) Nurses
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Chapter 27: Bone, Cartilage, and Soft Tissue Sarcomas
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Q1) Preoperative radiation therapy for STS is performed to _________________.
I.kill the reactive rim of tumor cells before they are cut into
II.decrease the risk of implantation
III.attempt to preserve as much normal function as possible
A) I and II
B) I and III
C) II and III
D) I, II, and III
Q2) Which of the following has the highest incidence of bone tumors?
A) Ewing sarcoma
B) Chondrosarcoma
C) Metastatic bone lesions
D) Multiple myeloma
Q3) Which of the following is the most common primary site that leads to bone metastasis?
A) Breast
B) Prostate
C) Kidney
D) Lung
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Page 29
Chapter 28: Lymphoreticular System Tumors
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Q1) Which treatment field for HD includes the para-aortic lymph node chain?
A) Mantle
B) Inverted-Y (abdominal portion)
C) Inverted-Y (pelvic portion)
D) All of the above
Q2) Which treatment field for HD includes the mediastinal lymph node chain?
A) Mantle
B) Inverted-Y (abdominal portion)
C) Inverted-Y (pelvic portion)
D) All of the above
Q3) Which pathologic type of Hodgkin lymphoma is the least common in the United States?
A) Nodular sclerosing
B) Mixed cellularity
C) Lymphocyte depleted
D) Lymphocyte rich
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Chapter 29: Endocrine System Tumors
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Q1) In which gland is ACTH produced?
A) Pancreas
B) Pituitary
C) Thyroid
D) Adrenal
Q2) Survivors of the atomic bombs developed which type of endocrine gland cancer most frequently?
A) Pancreas
B) Pituitary
C) Thyroid
D) Adrenal
Q3) Radioactive iodine is used to treat cancers of which of the following endocrine glands?
A) Pancreas
B) Pituitary
C) Thyroid
D) Adrenal
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Page 31
Chapter 30: Respiratory System Tumors
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Q1) Which of the following symptoms is not associated with Horner syndrome?
A) Ipsilateral miosis
B) Ptosis
C) Exophthalmos
D) Anhidrosis
Q2) Which of the following terms is used to describe the surgical removal of an entire lung?
A) Lobectomy
B) Segmentectomy
C) Pneumonectomy
D) Wedge resection
Q3) Cancer in which lobe of the lung will typically never include treatment of the contralateral hilar lymph nodes unless proved positive?
A) Upper
B) Middle
C) Lower
D) None of the above
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32
Chapter 31: Head and Neck Cancers
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Q1) What defines the superior radiation field border for the treatment of a low-staged larynx cancer?
A) Superior aspect of the hyoid
B) Cricoid cartilage
C) Inferior aspect of the mandible
D) Roof of the mouth
Q2) Radiation therapy of which of the following cancers does not include regional lymph nodes?
A) Early staged parotid
B) Early staged larynx
C) Early staged nasopharynx
D) All of the above include regional lymph nodes
Q3) What is the name of the leaf-shaped cartilage that protects the larynx?
A) Glottis
B) Epiglottis
C) Pharynx
D) Larynx
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Chapter 32: Central Nervous System Tumors
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Q1) What is the most common CNS tumor in children?
A) Medulloblastoma
B) Metastatic lesion
C) Astrocytoma
D) Craniopharyngioma
Q2) Which of the following is a late effect of brain irradiation in children?
A) Leukemia
B) Decreased IQ
C) Gigantism
D) Chronic fatigue
Q3) Which of the following is the dose at which radiation necrosis of brain tissue is most likely to occur?
A) 6000 cGy
B) 4500 cGy
C) 4000 cGy
D) 2000 cGy
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Chapter 33: Digestive System Tumors
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Sample Questions
Q1) What condition is most closely associated with adenomatous polyposis?
A) Barrett esophagus
B) Gardner syndrome
C) Plummer-Vinson syndrome
D) Tenesmus
Q2) What is the most common histologic type of cancers that occur in the lower third of the esophagus?
A) Adenocarcinoma
B) Transitional cell carcinoma
C) Squamous cell carcinoma
D) Renal cell carcinoma
Q3) Which of the following cancers is most common in the United States?
A) Esophagus
B) Stomach
C) Liver
D) Colorectal
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Page 35
Chapter 34: Gynecological Tumors
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Q1) Overall, cervical cancer occurs most frequently with those associated with which of the following factors?
I.Women of lower socioeconomic status
II.Early sexual activity and multiple partners
III.Multiple instances of pelvic infection
A) I and II
B) I and III
C) II and III
D) I, II, and III
Q2) Intraperitoneal radiopharmaceuticals can be used to treat which of the following female reproductive organs?
A) Ovarian
B) Uterus (endometrium)
C) Vaginal
D) Vulvar
Q3) Treating ovarian cancer with radiation blocks which of the following organs?
A) Ovaries
B) Kidneys
C) Small bowel
D) Spinal cord
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Chapter 35: Male Reproductive and Genitourinary Tumors
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Q1) A total dose of 2500 cGy in fractions of 160 cGy is used to treat which male reproductive cancer?
A) Penis
B) Testicle
C) Prostate
D) Bladder
Q2) Which of the following treatment techniques can be used to treat the prostate?
A) 4-field box
B) IMRT
C) Brachytherapy
D) All of the above
Q3) Which of the following cancers is most likely to occur in a 27-year-old male?
A) Penis
B) Testicle
C) Prostate
D) Urethra
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Chapter 36: Breast Cancer
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Q1) What T stage is a breast cancer that is a 1-cm tumor in the upper outer quadrant?
A) Tis
B) T1
C) T2
D) T3
E) T4
Q2) Inflammatory breast cancer is always classified as which T stage?
A) T4a
B) T4b
C) T4c
D) T4d
Q3) What T stage is a breast cancer that is a 3-cm tumor invading the chest wall?
A) Tis
B) T1
C) T2
D) T3
E) T4
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Page 38
Chapter 37: Pediatric Solid Tumors
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Q1) Successful treatment of Langerhans cell histiocytosis requires what dose?
A) 200 to 400 cGy
B) 400 to 1200 cGy
C) 1500 to 2500 cGy
D) Greater than 4000 cGy
Q2) Which pediatric cancer occurs in the sympathetic nervous system ganglia?
A) Medulloblastoma
B) Neuroblastoma
C) Primary brain lesions
D) Retinoblastoma
Q3) Ewing sarcomas are cancers of which organ?
A) Kidney
B) Bone
C) Skeletal muscle
D) Smooth muscle
Q4) Children are most likely to develop which type of leukemia?
A) ALL
B) AML
C) CLL
D) CML
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Chapter 38: Skin Cancers and Melanoma
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Q1) What is the medical term for a mole?
A) Actinic keratosis
B) Nevus
C) Telangiectasia
D) Xeroderma pigmentosum
Q2) What primary skin cancer (other than malignant melanoma)is aggressive and has a tendency to spread through the lymphatics and bloodstream?
A) Adenocarcinoma
B) Basal cell
C) Squamous cell
D) Merkel cell
Q3) What form of skin cancer has the highest mortality rate?
A) Basal cell carcinoma
B) Squamous cell carcinoma
C) Melanoma
D) Kaposi sarcoma
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