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Free BCOP Practice Questions

10 free, exam-style Board Certified Oncology Pharmacist (BCOP) practice questions with answers and explanations. No signup required. Work through them below, then take the full free BCOP practice test to study every exam domain.

Question 1

A 58-year-old woman with ovarian cancer is to receive single-agent carboplatin at a target AUC of 5. Her estimated GFR is 60 mL/min. Using the Calvert formula, what is the most appropriate total carboplatin dose?

  1. 300 mg
  2. 510 mg
  3. 425 mg
  4. 325 mg
Show answer & explanation

Correct answer: C - 425 mg

Question 2

A patient is scheduled to begin cisplatin 75 mg/m² for a head and neck cancer. Which antiemetic regimen is most appropriate for prevention of acute and delayed chemotherapy-induced nausea and vomiting?

  1. Palonosetron plus dexamethasone administered on day 1 of treatment only
  2. An NK1 antagonist, a 5-HT3 antagonist, dexamethasone, and olanzapine
  3. Ondansetron taken only as needed for breakthrough symptoms
  4. Olanzapine plus dexamethasone, with the 5-HT3 antagonist omitted
Show answer & explanation

Correct answer: B - An NK1 antagonist, a 5-HT3 antagonist, dexamethasone, and olanzapine

Question 3

A patient is starting a chemotherapy regimen associated with an approximately 25% risk of febrile neutropenia, and no equally effective lower-risk regimen is available. According to ASCO guidelines, which intervention is most appropriate?

  1. Start prophylactic oral levofloxacin with each chemotherapy cycle
  2. Reduce the chemotherapy dose by 25% before the first cycle is given
  3. Reserve all growth-factor support until after a first febrile episode occurs
  4. Administer primary prophylaxis with a granulocyte colony-stimulating factor
Show answer & explanation

Correct answer: D - Administer primary prophylaxis with a granulocyte colony-stimulating factor

Question 4

A patient receiving pembrolizumab develops increased stool frequency with abdominal cramping, confirmed as grade 2 immune-mediated colitis after infection is excluded. What is the most appropriate management?

  1. Hold pembrolizumab and initiate systemic corticosteroids
  2. Continue pembrolizumab and start scheduled loperamide therapy
  3. Permanently discontinue pembrolizumab and begin infliximab now
  4. Continue pembrolizumab at full dose and add oral budesonide alone
Show answer & explanation

Correct answer: A - Hold pembrolizumab and initiate systemic corticosteroids

Question 5

A patient with bulky, high-grade non-Hodgkin lymphoma is admitted for treatment and is at high risk for tumor lysis syndrome. The team plans to give rasburicase. Which finding in this patient would make rasburicase contraindicated?

  1. A baseline serum uric acid level measured at 11 mg/dL
  2. An estimated creatinine clearance of 45 mL/min on admission
  3. Known glucose-6-phosphate dehydrogenase (G6PD) deficiency
  4. Concurrent treatment with oral allopurinol
Show answer & explanation

Correct answer: C - Known glucose-6-phosphate dehydrogenase (G6PD) deficiency

Question 6

A patient with metastatic colorectal cancer has tumor testing reported as mismatch repair deficient (dMMR) / microsatellite instability-high (MSI-H). Beyond its prognostic value, what is the primary clinical significance of this result?

  1. It predicts likely benefit from immune checkpoint inhibitor therapy
  2. It confirms eligibility for anti-EGFR monoclonal antibody therapy
  3. It indicates resistance to all fluoropyrimidine-based chemotherapy
  4. It establishes a clear need for HER2-directed targeted therapy
Show answer & explanation

Correct answer: A - It predicts likely benefit from immune checkpoint inhibitor therapy

Question 7

Before starting capecitabine, a patient is found to be a DPYD intermediate metabolizer. Based on Clinical Pharmacogenetics Implementation Consortium (CPIC) guidance, what is the most appropriate action?

  1. Proceed with the standard full starting dose while monitoring closely
  2. Add leucovorin to chemically counteract the reduced enzyme activity
  3. Avoid all fluoropyrimidines and select an entirely different regimen
  4. Reduce the starting dose of capecitabine
Show answer & explanation

Correct answer: D - Reduce the starting dose of capecitabine

Question 8

A phase III oncology trial reports an overall survival hazard ratio of 0.70 (95% CI, 0.55-0.89) favoring the experimental arm. Which statement best interprets this result?

  1. Exactly 70% of patients treated in the experimental arm were still alive at analysis
  2. The therapy lowered the relative hazard of death by about 30%, a significant result
  3. The result is not statistically significant because the confidence interval is too wide
  4. Median overall survival was improved by precisely 30% in the experimental arm
Show answer & explanation

Correct answer: B - The therapy lowered the relative hazard of death by about 30%, a significant result

Question 9

An oncology pharmacist is preparing a hazardous antineoplastic agent for compounding. Which USP General Chapter specifically governs the safe handling of hazardous drugs to protect personnel and the environment?

  1. USP <800>
  2. USP <797>
  3. USP <795>
  4. USP <825>
Show answer & explanation

Correct answer: A - USP <800>

Question 10

During order verification, a pharmacist receives an order for vincristine to be administered by the intrathecal route together with the patient's scheduled intrathecal methotrexate. What is the correct action?

  1. Permit intrathecal vincristine provided that the dose is appropriately reduced first
  2. Permit intrathecal vincristine only when it is diluted in preservative-free saline
  3. Reject the order; intrathecal vincristine is contraindicated and fatal
  4. Permit intrathecal vincristine as long as it is administered after the methotrexate
Show answer & explanation

Correct answer: C - Reject the order; intrathecal vincristine is contraindicated and fatal

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