The following sample questions are representative of actual test content, difficulty level, and question format. The answer key follows the set of questions.

Directions: Each question or incomplete statement below is followed by four suggested answers or completions. Select the one that is best in each case.

1. The nurse recognizes the need to postpone lutetium-177 dotatate treatment when they note:

(A) Long-acting octreotide was given two weeks prior to the scheduled treatment

(B) Long-acting octreotide was given six weeks prior to the scheduled treatment

(C) Short-acting octreotide was given 48 hours prior to the scheduled treatment

(D) Short-acting octreotide was given 72 hours prior to the scheduled treatment

2. Hypofractionated doses of radiation therapy are administered so that:

(A) the total radiation does is given in fewer large dose fractions.

(B) a greater effect can be achieved later in the treatment regimen.

(C) treatment can be administered more frequently than twice a day.

(D) the total radiation dose can be decreased.

3. Which factor negatively affects radiation treatment outcomes?

(A) Hemoglobin 6 g/dL 

(B) Platelet count 90,000/mm³

(C) Continued abstinence from tobacco

(D) Recent completion of an antibiotic course

4. A patient with a history of lung irradiation seven months ago notes dyspnea, a nonproductive cough, and fatigue for the past month despite finishing a course of antibiotics last week.  The nurse is suspicious of: 

(A) Post-infectious cough 

(B) Radiation pneumonitis 

(C) Tension pneumothorax 

(D) Pleural effusion

5. A patient with metastatic cancer to the bone finished radiation to the femur 48 hours ago and calls the office with a significant pain increase but is still able to walk despite the pain.  The nurse teaches the patient that this is an:

(A) unexpected outcome, and they should proceed to the emergency department. 

(B) unexpected outcome, and they should prepare for additional treatment. 

(C) expected outcome, and they should continue to take their dexamethasone.

(D) expected outcome, and they should continue to take their gabapentin.

Answer Key

1. A

Rationale: Long-acting octreotide should be discontinued 4 weeks prior to treatment initiation and short-acting octreotide should be discontinued 24 hours prior to treatment initiation.

Reference: McQuestion, M., Drapek, L.C., & Witt, M.E. (2021).  Manual for Radiation Oncology Nursing Practice and Education. Oncology Nursing Society, p. 423.

2. A

Rationale: Definition of hypofractionation is a higher daily dose given less often. 

Reference: McQuestion, M., Drapek, L.C., & Witt, M.E. (2021).  Manual for Radiation Oncology Nursing Practice and Education. Oncology Nursing Society, p. 9.

3. A

Rationale: Factors related to radiation-induced injury of healthy tissue include low hemoglobin, active smoking, and active infection.  There is no evidence that platelets affect radiation course. 

Reference: McQuestion, M., Drapek, L.C., & Witt, M.E. (2021).  Manual for Radiation Oncology Nursing Practice and Education. Oncology Nursing Society, p. 14-15.

4. B

Rationale: Radiation pneumonitis of the lungs can occur greater than 6 months after radiation in this area and can mimic pneumonia symptoms. 

Reference: McQuestion, M., Drapek, L.C., & Witt, M.E. (2021).  Manual for Radiation Oncology Nursing Practice and Education. Oncology Nursing Society, p. 447.

5. C

Rationale: Pain flairs after radiation to bony metastasis occurs between 24-48 hours following irradiation.  It is common in 40% of patients and treated with steroids. 

Reference: McQuestion, M., Drapek, L.C., & Witt, M.E. (2021).  Manual for Radiation Oncology Nursing Practice and Education. Oncology Nursing Society, p. 156.