OCN The Care Continuum Practice Questions (15 Free)
Published 2026-10-21 · Facts and text checked 2026-10-16 · Questions from our OCN study guide · Reviewed by Hana N., Quality Reviewer
These free OCN practice questions cover the Care Continuum, part of I. Care Continuum on the exam. Prevention, screening, navigation, survivorship, palliative and end-of-life care. Each question comes from a practice test in our OCN study guide and shows the correct answer with an explanation. The full exam has 165 questions (145 scored, 20 unscored).
Prevention, screening, navigation, survivorship, palliative and end-of-life care. On the exam this is part of I. Care Continuum (14%). Open each answer to read the explanation.
Question 1Easy
A new screening test for pancreatic cancer detects cases 2 years earlier than before, but the mortality rate from pancreatic cancer remains unchanged. Which bias most likely explains this finding?
- A.Recall bias
- B.Lead-time bias
- C.Length bias
- D.Selection bias
Show answer and explanation
Correct answer: B. Lead-time bias
Lead-time bias occurs when earlier diagnosis makes survival appear longer even if death occurs at the same time, because the time from diagnosis to death is extended without changing the actual course of disease. Length bias relates to detecting slower-growing tumors; selection and recall biases are not relevant.
From practice test 8 of our OCN study guide (question 122). Original question, not an official exam item.
Question 2Easy
In the TNM staging system, what does the 'M' category indicate?
- A.Presence or absence of distant metastasis
- B.Histologic grade of the tumor
- C.Spread to regional lymph nodes
- D.Size and extent of the primary tumor
Show answer and explanation
Correct answer: A. Presence or absence of distant metastasis
The M category specifically denotes the presence (M1) or absence (M0) of distant metastasis. The T category describes the primary tumor, and the N category describes regional lymph node involvement.
From practice test 2 of our OCN study guide (question 57). Original question, not an official exam item.
Question 3Easy
In the TNM staging system, which of the following is included in the T category?
- A.Presence of distant metastases.
- B.Tumor size and depth of invasion.
- C.Number of positive lymph nodes.
- D.Histologic grade.
Show answer and explanation
Correct answer: B. Tumor size and depth of invasion.
The T category describes the primary tumor, including size, depth of invasion, and involvement of adjacent structures. N describes nodes, M describes metastases, and grade is not part of TNM.
From practice test 5 of our OCN study guide (question 13). Original question, not an official exam item.
Question 4Easy
A nurse is preparing a lymph node biopsy specimen for flow cytometry. Which of the following actions is appropriate?
- A.Place the specimen in sterile water.
- B.Place the specimen in formalin.
- C.Place the specimen in saline.
- D.Freeze the specimen immediately.
Show answer and explanation
Correct answer: C. Place the specimen in saline.
Flow cytometry requires viable cells, so the specimen must be placed in a nutrient medium like saline or RPMI; formalin fixes and kills cells, making it unsuitable.
From practice test 5 of our OCN study guide (question 53). Original question, not an official exam item.
Question 5Easy
A 60-year-old asymptomatic man asks about prostate cancer screening. Which statement best reflects the USPSTF recommendation for men aged 55 to 69?
- A.The decision to screen should be based on shared decision-making acknowledging a small net benefit
- B.Annual DRE is recommended as an alternative to PSA
- C.Screening should be discouraged due to high risk of overdiagnosis
- D.Routine PSA screening is recommended for all men in this age group
Show answer and explanation
Correct answer: A. The decision to screen should be based on shared decision-making acknowledging a small net benefit
The USPSTF gives a C grade for men aged 55-69, meaning there is a small net benefit and screening should be offered only after shared decision-making considering individual values.
From practice test 4 of our OCN study guide (question 14). Original question, not an official exam item.
Question 6Hard
A patient with locally advanced breast cancer receives neoadjuvant chemotherapy. Pretreatment clinical stage was T3N1M0 (stage IIIA). After treatment, MRI shows a new 1 cm liver lesion not seen previously. Which best describes the current stage?
- A.Stage IIIB
- B.Pathologic stage is IIIA
- C.Clinical stage remains IIIA
- D.Stage IV
Show answer and explanation
Correct answer: D. Stage IV
The appearance of distant metastasis during neoadjuvant therapy indicates progression to stage IV disease. The stage shifts regardless of prior treatment.
From practice test 6 of our OCN study guide (question 100). Original question, not an official exam item.
Question 7Easy
In the TNM staging system, which component is defined by the size of the primary tumor and its invasion into surrounding structures?
- A.T category
- B.S category
- C.M category
- D.N category
Show answer and explanation
Correct answer: A. T category
The T descriptor in TNM describes the extent of the primary tumor, including size and depth of invasion. N describes regional lymph node involvement. M describes distant metastasis. There is no S category in standard AJCC staging.
From practice test 2 of our OCN study guide (question 129). Original question, not an official exam item.
Question 8Medium
A core needle biopsy is performed on a lymph node suspected of lymphoma. The specimen is placed in formalin. However, flow cytometry is also required. What is the most appropriate additional step?
- A.Request a repeat biopsy with a larger needle
- B.Request the laboratory to process the formalin-fixed specimen for flow cytometry
- C.Send a separate fresh specimen in saline for flow cytometry
- D.Place the entire specimen in RPMI medium
Show answer and explanation
Correct answer: C. Send a separate fresh specimen in saline for flow cytometry
Flow cytometry requires viable cells, which are destroyed by formalin fixation. A separate fresh specimen in saline or appropriate medium is needed.
From practice test 2 of our OCN study guide (question 15). Original question, not an official exam item.
Question 9Hard
A 48-year-old woman with a maternal aunt diagnosed with ovarian cancer at age 52, a maternal grandmother with breast cancer at age 70, and no personal history of breast disease is being evaluated for genetic counseling referral. Which breast cancer risk assessment model is most appropriate for this patient?
- A.Tyrer-Cuzick model
- B.Gail model
- C.PCPT risk calculator
- D.MMRpro model
Show answer and explanation
Correct answer: A. Tyrer-Cuzick model
The Tyrer-Cuzick model incorporates more detailed family history, including second-degree relatives and ovarian cancer, making it preferred for genetic counseling referrals. The Gail model underestimates risk in patients with strong family histories of ovarian cancer or BRCA mutations, while the PCPT and MMRpro models are designed for prostate and colorectal cancer risk, respectively.
From practice test 6 of our OCN study guide (question 7). Original question, not an official exam item.
Question 10Easy
During a CT-guided biopsy of a 2 cm lung lesion, the interventional radiologist obtains several core samples. How many cores are typically considered adequate for solid lesions?
- A.1-2 cores
- B.10-12 cores
- C.6-8 cores
- D.3-5 cores
Show answer and explanation
Correct answer: D. 3-5 cores
Standard practice for solid lesions is to obtain 3 to 5 core biopsies to ensure adequate tissue for histology and biomarker studies while minimizing risk. Fewer cores may lead to sampling error; more cores increase complication risk without proportional benefit.
From practice test 2 of our OCN study guide (question 161). Original question, not an official exam item.
Question 11Hard
A 50-year-old woman with average breast cancer risk expresses reluctance to schedule a screening mammogram, stating, 'I don't want to find cancer if I feel fine.' Which response best addresses her concern?
- A.Mammography can detect cancer at an early, more treatable stage even before symptoms appear.
- B.You are at low risk, so skipping screening is a reasonable choice.
- C.If you feel fine, you probably don't have cancer and don't need screening.
- D.Many women feel that way, but you need to follow the guidelines regardless.
Show answer and explanation
Correct answer: A. Mammography can detect cancer at an early, more treatable stage even before symptoms appear.
This response correctly explains the purpose of screening: finding cancer early to improve treatment outcomes. The other options either provide incorrect advice (B, D) or are dismissive without education (C).
From practice test 7 of our OCN study guide (question 76). Original question, not an official exam item.
Question 12Hard
A 30-year-old presents with a 2 cm supraclavicular lymph node. Lymphoma is suspected. Which biopsy technique is most appropriate for definitive diagnosis?
- A.Core needle biopsy with 3-5 cores
- B.Incisional biopsy of a portion of the node
- C.Excisional biopsy of the entire node
- D.Fine-needle aspiration for cytology
Show answer and explanation
Correct answer: C. Excisional biopsy of the entire node
Excisional biopsy provides the complete lymph node architecture necessary for accurate lymphoma classification. Core needle biopsy may not yield sufficient tissue; FNA provides only cytology. Incisional biopsy may compromise diagnosis.
From practice test 9 of our OCN study guide (question 157). Original question, not an official exam item.
Question 13Hard
A 62-year-old man is diagnosed with T2N2M0 non-small cell lung cancer (stage IIIA). After evaluation, which treatment approach is most appropriate?
- A.Chemotherapy alone
- B.Surgical resection alone
- C.Concurrent chemoradiation followed by durvalumab consolidation
- D.Stereotactic body radiation therapy (SBRT)
Show answer and explanation
Correct answer: C. Concurrent chemoradiation followed by durvalumab consolidation
For stage IIIA (T2N2M0) NSCLC with positive mediastinal nodes, standard treatment is concurrent chemoradiation followed by durvalumab consolidation, based on the PACIFIC trial. Surgery alone is insufficient due to nodal involvement.
From practice test 6 of our OCN study guide (question 71). Original question, not an official exam item.
Question 14Medium
A 28-year-old woman with a known BRCA1 mutation asks about breast cancer screening. According to high-risk guidelines, the nurse should recommend:
- A.Mammography alone starting at age 30
- B.Breast ultrasound every 6 months
- C.Annual mammography and clinical breast exam starting at age 40
- D.Breast MRI starting at age 25 alternating with mammography at age 30
Show answer and explanation
Correct answer: D. Breast MRI starting at age 25 alternating with mammography at age 30
High-risk guidelines recommend breast MRI starting at age 25, with mammography added at age 30, often alternating. Option A (mammography alone at 30) misses MRI, option B (ultrasound) is not standard, and option C (starting at 40) is for average risk.
From practice test 4 of our OCN study guide (question 30). Original question, not an official exam item.
Question 15Medium
A 50-year-old average-risk patient chooses the fecal immunochemical test (FIT) for colorectal cancer screening. The nurse instructs the patient that this test should be:
- A.Repeated every 2 years
- B.Done only once if negative
- C.Repeated annually
- D.Followed immediately by colonoscopy regardless of result
Show answer and explanation
Correct answer: C. Repeated annually
High-sensitivity stool tests such as FIT are recommended annually. A 2-year interval (option B) is too long, a one-time test (option C) is insufficient, and colonoscopy is indicated only if the FIT is positive (option D).
From practice test 4 of our OCN study guide (question 119). Original question, not an official exam item.
Want more mixed questions? Go back to the OCN practice test hub.
Want the full OCN preparation?
These questions come from our OCN study guide: full-length practice tests with every answer explained, flashcards, an AI study tutor and the audiobook.