Oncology Certified Nurse (OCN) Test Review
The Oncology Certified Nurse has achieved the specialized requirements to obtain credentialing in a specific field of nursing. This specialized healthcare professional is frequently employed to fulfill the role of providing patient care to cancer patients, as well as serve in educational and administrative positions.
In order to take the Oncology Certified Nurse exam, the applicant must be a licensed Registered Nurse who has been working at least 1 year within the past 3 years. At least 1,000 hours should have been spent in Oncology Nursing within the past 2 ½ years. In addition, at least 10 continuing education hours in the field of Oncology Nursing should have been completed over the past 3 years.
The Oncology Certified Nurse exam is offered as a computer-based exam during a 2-week window in January, April, July, and October. It is only offered once a year in paper and pencil format. The fee to take the exam is $260 for members of the Oncology Nursing Society (ONS) or Association of Pediatric Oncology Nurses (APON) or $38 for non-members.
The exam consists of 165 multiple-choice questions with 20 of those questions used for pretesting purposes for possible use on future exams. Over one-third of the exam consists of questions testing the RN's knowledge in quality of life issues. The remainder of the exam consists of questions pertaining to specific disease processes and nursing interventions to treat potential complications.
The Oncology Certified Nurse certification is valid for 3 years. At the end of that time period, the licensed RN should have work at least 1 year as an RN within the past 3 years. At least 1,000 hours of these employment hours should be in providing care to oncology patients over the past 2 ½ years. In addition, at least 100 continuing education hours should have been completed over the past 3 years with at least 65 of those hours in Oncology Nursing.
OCN Study Guide
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OCN Certification Exam
Oncology Certified Nurse (OCN) Practice Questions
1. Which of the following is most recommended for early detection of colorectal cancer in normal-risk persons?
- Fecal occult blood test (FOBT) every five years
- Virtual colonoscopy every 5 years
- Colonoscopy every 10 years
- Double-contrast barium enema (DCBE) every 10 years
2. According to a current theory of carcinogenesis, which of the following are required to transform normal cells into malignant ones?
- A carcinogenic initiating agent
- A promoter
- Both A and B
- Neither A nor B
3. The granulocyte colony-stimulating factor (G-CSF) filgrastim (Neupogen):
- May be given as a single dose before chemotherapy
- Stimulates both neutrophil and monocyte/macrophage production
- Is not indicated for patients receiving bone marrow transplants
- May be given by subcutaneous injection or short intravenous (IV) infusion
4. Ondansetron is:
- A chemotherapy drug
- A steroid
- An antiemetic
- An antibiotic
5. An elderly cancer patient presents with abdominal pain. He appears dehydrated with abnormal vital signs. Emergency operation for a bowel obstruction is recommended by the attending surgeon. The patient seems somewhat confused and is unable to give a rational understanding and approval of informed consent. Which of the following would be the best first course of action?
- Delay the surgery until the patient is more rational
- Contact a relative or other valid representative to obtain permission
- Cancel surgery and attempt medical treatment
- Declare this an emergency and proceed with the surgery
Oncology Certified Nurse (OCN) Answer Key
1. Answer: C
For many years, annual fecal occult blood testing was the only routine method of screening for early colon cancer. Unfortunately, there are many false-positives and false-negatives with this technique, although it still has a role in the detection of bowel neoplasia with annual testing. Virtual colonoscopy using computerized tomography and bowel contrast media is still under evaluation as a screening tool but is associated with high radiation exposure and the discomfort of a contrast enema. Colonoscopy every 10 years is the currently the most favored method for both sexes starting at age 50. It has the advantages of being performed under anesthesia, routine examination of the entire colon is possible, and the immediate excision of polyps or other premalignant lesions. Double-contrast barium enema has largely been replaced by colonoscopy, but when used (ex. those with tortuous colons that are hard to colonoscope) it should be done every five years.
2. Answer: C
According to the three-stage theory of carcinogenesis, malignant transformation of normal cells involves three distinct mechanisms. An initiator substance, which may be a chemical, physical, or biologiccarcinogen, damages DNA that affects a genetic change. The damaged DNA may then undergo repair and no initiation occurs. However if the damage is permanent (mutation) it may be subject to further modification of the cell physiology by a promoter substance that can lead to alterations in the cell's proliferative capacity or inhibit apoptosis (genetically programmed cell death). Some substances such as asbestos, tobacco smoke, or alcohol have both initiator and promoter properties. It is believed there is a threshold dose for a promoter substance to alter cell physiology that in turn depends on the nature, dose, and duration of exposure.
3. Answer: D
Filgrastim (Neupogen) is a granulocyte colony-stimulating factor that raises the absolute circulating granulocyte count by stimulating a committed marrow precursor. It has been very useful in avoiding severe neutropenia (absolute count less than 500/mm3) and subsequent fever and infection in cancer or some leukemia patients receiving cytotoxic chemotherapy. It is also indicated for bone marrow transplant recipients and for recruiting neutrophil precursor cells into the blood for harvesting by leukapheresis. It does not stimulate monocyte/macrophage production. It is given in multiple doses daily by subcutaneous or IV administration and should not be started earlier than 24 hours after the administration of cytotoxic chemotherapy. A pegylated (covalently bound to polyethylene glycol) form named pegfilgrastim (Neulasta) is longer acting and may be given as a single dose. Bone pain is a side effect of both forms.
4. Answer: C
Ondansetron (Zofran) is an antiemetic drug used to prevent or treat nausea and vomiting during or after chemotherapy. It may also be used to control postoperative and postradiation therapy nausea and vomiting and perhaps for gastrointestinal disease induced as well. It is thought to reduce the activity of the vagus nerve that connects to and activates the vomiting center in the brainstem as well as block serotonin in the chemoreceptor trigger zone. Interestingly, it has little effect on vomiting caused by motion sickness. It may be given orally and is sometimes combined with dexamethasone to enhance the antiemetic effect. The drug is usually well tolerated with constipation, headache, and dizziness the most common side effects. It has no significant drug interactions.
5. Answer: B
This is an admittedly difficult situation but one that comes up often. If the patient is disoriented and judged unable to give permission for informed consent, much depends on how emergent the situation is and how promptly must treatment be given. If the patient has signed a power of attorney for health care and appointed someone specific as his medical representative, that person (usually a family member or occasionally a lawyer) should be contacted. If not, a close family member may be adequate. If no one is reachable and the situation is grave, then an emergency may be declared and the surgery begun without informed consent. This should be well documented in the medical record, preferably by two staff members. If the situation is such that medical treatment may be employed temporarily, an appropriate representative may be contacted or the patient's mental state may improve enough to sign an informed consent document.
Oncology Nurse Exam Review
Last Updated: 04/18/2018