OCN Surgical and Radiation Oncology Questions (15 Free)
Published 2026-10-22 · Facts and text checked 2026-10-16 · Questions from our OCN study guide · Reviewed by Hana N., Quality Reviewer
These free OCN surgical and radiation oncology questions come from our OCN study guide, each with the answer explained. They cover preoperative risk, infection and lung-complication prevention, recovery after surgery, fractionation, SBRT, brachytherapy and dose limits. On the 2026 ONCC outline, surgery and radiation sit in Treatment Modalities, 20% of the exam.
Surgery and radiation therapy, with their nursing care and side effects. On the exam this is part of III. Treatment Modalities (20%). Open each answer to read the explanation.
Question 1Easy
What does a preoperative serum albumin level of 2.7 g/dL indicate?
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Correct answer: C. Increased risk for wound healing problems.
An albumin level below 3.0 g/dL is a marker of malnutrition and is associated with higher risk of wound healing complications and infections postoperatively.
From practice test 9 of our OCN study guide (question 112). Original question, not an official exam item.
Question 2Easy
A nurse is preparing a patient for a scheduled colorectal resection. The surgeon orders cefazolin 2 g IV. According to evidence-based guidelines, at what time should this antibiotic be administered?
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Correct answer: A. Within 60 minutes before incision
The evidence-based standard for preoperative antibiotic prophylaxis is administration within 60 minutes of incision to ensure adequate tissue levels. Options within 30 minutes are earlier but not the recommended window; later administration reduces efficacy.
From practice test 6 of our OCN study guide (question 14). Original question, not an official exam item.
Question 3Easy
What is the approximate tolerance dose of the spinal cord when using conventional fractionation of 1.8-2.0 Gy per day?
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Correct answer: A. 45 Gy
The spinal cord tolerance dose is approximately 45 Gy in 1.8-2.0 Gy fractions. Above this threshold, the risk of radiation myelopathy increases significantly. This is a standard fact in radiation oncology.
From practice test 7 of our OCN study guide (question 29). Original question, not an official exam item.
Question 4Easy
According to published data, what is the approximate incidence of incisional surgical site infection in clean-contaminated colorectal cancer resections?
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Correct answer: C. 5% to 15%
Incisional infections occur in 5% to 15% of clean-contaminated cases like colorectal resections. The 1% to 3% figure applies to symptomatic venous thromboembolism with routine prophylaxis, not surgical site infections.
From practice test 8 of our OCN study guide (question 18). Original question, not an official exam item.
Question 5Easy
Stereotactic body radiotherapy (SBRT) is characterized by:
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Correct answer: B. Delivery of a high dose of radiation to an extracranial tumor in one to five fractions
SBRT delivers high-dose radiation in a few fractions to extracranial tumors. Option A describes brachytherapy, Option C is conventional fractionation, and Option D is typical palliative radiation.
From practice test 6 of our OCN study guide (question 9). Original question, not an official exam item.
Question 6Hard
A 72-year-old woman with stage III colon cancer is scheduled for an open right hemicolectomy. Preoperative labs show albumin 3.2 g/dL and total weight loss of 8% over 6 months. The nurse identifies which finding as the clearest indicator of malnutrition that increases infection risk?
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Correct answer: D. Albumin 3.2 g/dL
An albumin level below 3.5 g/dL is a marker of malnutrition that increases infection risk after surgery. Weight loss of 8% does not meet the >10% threshold; therefore the albumin level alone is the clearest indicator.
From practice test 4 of our OCN study guide (question 50). Original question, not an official exam item.
Question 7Medium
A malnourished patient is scheduled for a major abdominal cancer resection in 10 days. The surgeon orders preoperative oral nutritional supplements with arginine and omega-3 fatty acids. When should the nurse instruct the patient to start taking these supplements?
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Correct answer: C. Starting 5 to 7 days before surgery
Evidence-based guidelines recommend administration of oral nutritional supplements containing arginine and omega-3 fatty acids for 5 to 7 days before major abdominal surgery to reduce infectious complications.
From practice test 7 of our OCN study guide (question 40). Original question, not an official exam item.
Question 8Hard
A 74-year-old woman with ECOG performance status 2 is scheduled for a total gastrectomy for gastric cancer. Her nurse is planning postoperative pulmonary care. Which of the following interventions is most important to include based on her performance status?
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Correct answer: A. Prepare for possible need for aggressive pulmonary toileting and early mobilization
Patients with ECOG 2 or higher have reduced functional reserve and are at higher risk for pulmonary complications. The nurse should anticipate the need for aggressive pulmonary interventions such as frequent incentive spirometry, deep breathing exercises, and early mobilization.
From practice test 4 of our OCN study guide (question 82). Original question, not an official exam item.
Question 9Easy
Brachytherapy is commonly used to treat which of the following cancer types?
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Correct answer: A. Cervical, prostate, and breast
Common brachytherapy sites include cervical, prostate, and breast (accelerated partial breast irradiation). The other options list cancers that are typically treated with external beam or systemic therapy.
From practice test 4 of our OCN study guide (question 59). Original question, not an official exam item.
Question 10Easy
The ECOG performance status scale is used to assess a patient's functional ability. Which of the following correctly describes the ECOG performance status score range and its meaning?
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Correct answer: C. 0 (fully active) to 5 (dead)
The ECOG performance status scale ranges from 0 (fully active, able to carry on all pre-disease activities without restriction) to 5 (dead). The other options either omit the dead category or misstate the range.
From practice test 5 of our OCN study guide (question 20). Original question, not an official exam item.
Question 11Easy
A nurse is explaining radiation therapy to a patient. How should fractionation be defined?
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Correct answer: D. The total dose of radiation divided by the number of treatment days
Fractionation is the division of the total prescribed radiation dose into smaller daily doses (fractions) delivered over multiple days. This spares normal tissues by allowing repair of sublethal damage between fractions while maintaining tumor control.
From practice test 7 of our OCN study guide (question 65). Original question, not an official exam item.
Question 12Medium
A 65-year-old patient undergoes open right hemicolectomy. The nurse implements enhanced recovery after surgery (ERAS) interventions. Which nonpharmacologic measure should the nurse encourage to stimulate vagal activity and reduce postoperative ileus?
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Correct answer: D. Gum chewing for 30 minutes three times daily
Gum chewing is an ERAS intervention that stimulates vagal activity, reducing time to first flatus and stool. Incentive spirometry prevents pulmonary complications, not ileus; early ambulation helps but is less specific for vagal stimulation; PCA pump is an analgesic method, not for ileus.
From practice test 3 of our OCN study guide (question 85). Original question, not an official exam item.
Question 13Easy
Which nursing intervention is most effective in preventing postoperative pulmonary complications after major cancer surgery?
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Correct answer: C. Incentive spirometry used hourly while awake
Incentive spirometry set to 10-15 mL/kg ideal body weight and used hourly while awake is the single most effective intervention for preventing pulmonary complications. Deep breathing is a weaker substitute, and mobilization is important but not the primary pulmonary prevention.
From practice test 4 of our OCN study guide (question 69). Original question, not an official exam item.
Question 14Medium
Incentive spirometry target volume is based on ideal body weight. What is the recommended target volume range per breath?
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Correct answer: B. 10-15 mL/kg of ideal body weight
The recommended incentive spirometry target is 10-15 mL/kg of ideal body weight. Lower volumes are insufficient for pulmonary expansion, and higher volumes are not evidence-based.
From practice test 5 of our OCN study guide (question 107). Original question, not an official exam item.
Question 15Medium
An oncology nurse is implementing an evidence-based bundle to prevent surgical site infection (SSI) in a patient undergoing an open colectomy. Which of the following interventions is NOT part of the recommended SSI prevention bundle?
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Correct answer: A. Applying a wound vacuum device postoperatively
The SSI prevention bundle includes preoperative antibiotic within 60 minutes, normothermia (core >36°C), and supplemental oxygen at FiO2 0.8. Wound vacuum devices are not part of this bundle; they are used for specific wound management but not as routine prophylaxis.
From practice test 9 of our OCN study guide (question 13). Original question, not an official exam item.
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