Page 1 of 420
BMTCN Test Bank 2025/2026 – Complete 1200 Questions,
Answers, and Rationales for Blood and Marrow Transplant
Certified Nurses all chapters included
The administration of Epstein-Barr virus (EBV) cytotoxic T-lymphocytes has been found to be a feasible
therapeutic option in which EBV mediated-disease process?
a) Lymphoproliferative disease
b) Neuroblastoma
c) Nasopharyngeal rhabdomyosarcoma
d) Acute lymphocytic leukemia - Answer:A) Lymphoproliferative disease
Post-Transplant Lymphoproliferative Disorder PTLD is an aggressive, rare, and potentially fatal
proliferation of lymphoid cells of donor origin, usually occurring within the first four months after
allogeneic HSCT. PTLD is caused by the opportunistic expansion of Epstein-Barr virus (EBV)-transformed
donor B cells in a host with suppressed T-cell function
Donor leukocyte infusion is an appropriate treatment option for a patient who has relapsed post
allogeneic transplant with:
a) acute lymphocytic leukemia.
b) severe aplastic anemia.
c) chronic myelogenous leukemia.
d) acute lymphoblastic lymphoma. - Answer:C) chronic myelogenous leukemia
DLI has shown promising results for patients with CML in the chronic phase, with remission rates of 70%-
80%. Unfortunately, this approach is less effective in patients with CML in blast crisis or patients with
MM, myelodysplasias, lymphomas, and acute leukemias
The success of DLI for the treatment of post-transplant relapse of chronic myeloid leukemia has led
researchers to explore the role of combining T-cell depletion with a preplanned course of DLI post-
transplant
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It has been demonstrated clinically that graft-versus-tumor responses occur with DLI in 60%-80% of
patients with chronic myeloid leukemia and to a lesser extent with acute myeloid leukemia, chronic
lymphocytic leukemia, multiple myeloma, non-Hodgkin lymphoma, and renal cell carcinomas
Which of the following is most important prognostic element for a patient being treated for pulmonary
aspergillosis post-transplant?
a) Granulocyte recovery
b) Therapeutic serum fluconazole levels.
c) Serum IgG levels maintained greater than 400
d) Total number of CD34 positive cells in the donor's stem cells - Answer:A) Granulocyte recovery
The most conventional way to monitor immediate hematopoietic recovery is through granulocyte
recovery. Granulocyte recovery is more rapid with blood versus bone marrow autografts, regardless of
whether mobilization is achieved with chemotherapy or with hematopoietic growth factors
Patients who are most at risk for fungal infections are those who are neutropenic, are on prolonged
immunosuppression, or have chronic GVHD
Risk factors for an HSCT patient to develop aspergillosis include prolonged granulocytopenia, the
presence of GVHD, prolonged immunosuppression, human leukocyte antigen (HLA) mismatch,
construction near the hospital or a windy external environment, certain foods and plants, and high-dose
corticosteroid therapy
The Foundation for the Accreditation of Cellular Therapy requires notification of positive microbial
culture results on cellular therapy products to the:
a) recipient
b) donor
c) Food and Drug Administration.
d) American Association of Blood Banks - Answer:A) Recipient
The goal of this evaluation is to protect the safety of the donor and the recipient. The potential
transmission of communicable diseases from the donor to recipient is a serious concern. Therefore,
,Page 3 of 420
laboratory testing includes complete blood count, electrolytes, and renal, hepatic, and endocrine
testing. Infectious disease testing includes hepatitis B, hepatitis C, HIV, cytomegalovirus, herpes simplex
virus, syphilis, and human T-lymphotropic virus, as well as other infectious disease testing the transplant
center deems appropriate. The donor also will have blood and Rh typing, HLA testing, and pregnancy
testing if applicable. A thorough physical examination and medical history, including travel,
immunization, and transfusion histories, will be obtained
The potential transmission of communicable diseases from the donor to recipient is a serious concern.
Therefore, laboratory testing includes complete blood count, electrolytes, and renal, hepatic, and
endocrine testing. Infectious disease testing includes hepatitis B, hepatitis C, HIV, cytomegalovirus,
herpes simplex virus, syphilis, and human T-lymphotropic virus, as well as other infectious disease
testing the transplant center deems appropriate. The donor also will have blood and Rh typing, HLA
testing, and pregnancy testing if applicable. A thorough physical examination and medical history,
including travel, immunization, and transfusion histories, will be obtained
A patient is undergoing peripheral blood stem cell mobilization for an autologous transplant and starts
to experience fever, fatigue and bone pain. This is most likely due to:
a) a bacterial infection.
b) growth factors.
c) cytokine storm.
d) bone marrow hypoplasia. - Answer:B) growth factors
The most common side effects associated with growth factors used for mobilization include bone pain,
fever, and malaise
Daily nursing assessments should include a discussion of symptoms and an evaluation of the patient's
temperature, pulse, respirations, blood pressure, and weight. Patients may be instructed to take
acetaminophen for bone pain or headache. Occasionally, patients will request a stronger pain reliever,
such as acetaminophen with codeine. Other side effects should be assessed and treated
symptomatically. More serious side effects (e.g., pleural or pericardial effusions) may necessitate
stopping the growth factors
What is the best initial step in determining the evidence available to support a current nursing
intervention?
, Page 4 of 420
a) Conduct a research study comparing two different processes to see which is better
b) Ask fellow nurses on the unit what their current practice is
c) Review current literature regarding the intervention, identify gaps or inconsistencies in nursing
practice
d) Evidence is not necessary to guide nursing practice - Answer:C) Review current literature regarding
the intervention, identify gaps or inconsistencies in nursing practice.
Managers should support introduction of new nursing interventions based on valid research findings
and encourage staff endeavors to implement new research findings when possible. Clinical staff should
be encouraged to review current journals for new, relevant research findings. Staff should also be
encouraged to question current nursing practices and look for gaps where there is a lack of research-
based practice (Haberman, 2007). Identifying gaps in the literature and inconsistencies in HSCT practices
is an important first step in designing evidence-based projects that can be used to standardize practice
and link best practices to improved patient outcomes (Bevans et al., 2009).
Microangiopathic hemolytic anemia can be a complication from which immunosuppressive therapy?
a) Tocilizumab
b) Antithymocyte globulin (ATG)
c) Cyclosporine
d) Alemtuzumab - Answer:C) Cyclosporine
Commonly encountered side effects of cyclosporine A include glucose intolerance, hirsutism,
hyperkalemia, hypertension, magnesium wasting, renal insufficiency, and tremor (Malat & Culkin, 2016).
Other side effects include confusion, cortical blindness, gingival hyperplasia, headache, hemolytic
uremic syndrome, hyperchloremic metabolic acidosis, hyperlipidemia, hyperuricemia, microangiopathic
hemolytic anemia, palmar-plantar dysesthesia, and seizures (Malat & Culkin, 2016
An 8-year old patient who received an HSCT develops a grade 2 acute GVHD skin rash. The nurse
anticipates which of the following orders for initial treatment?
a) Initiation of photophresis
b) Infliximab
BMTCN Test Bank 2025/2026 – Complete 1200 Questions,
Answers, and Rationales for Blood and Marrow Transplant
Certified Nurses all chapters included
The administration of Epstein-Barr virus (EBV) cytotoxic T-lymphocytes has been found to be a feasible
therapeutic option in which EBV mediated-disease process?
a) Lymphoproliferative disease
b) Neuroblastoma
c) Nasopharyngeal rhabdomyosarcoma
d) Acute lymphocytic leukemia - Answer:A) Lymphoproliferative disease
Post-Transplant Lymphoproliferative Disorder PTLD is an aggressive, rare, and potentially fatal
proliferation of lymphoid cells of donor origin, usually occurring within the first four months after
allogeneic HSCT. PTLD is caused by the opportunistic expansion of Epstein-Barr virus (EBV)-transformed
donor B cells in a host with suppressed T-cell function
Donor leukocyte infusion is an appropriate treatment option for a patient who has relapsed post
allogeneic transplant with:
a) acute lymphocytic leukemia.
b) severe aplastic anemia.
c) chronic myelogenous leukemia.
d) acute lymphoblastic lymphoma. - Answer:C) chronic myelogenous leukemia
DLI has shown promising results for patients with CML in the chronic phase, with remission rates of 70%-
80%. Unfortunately, this approach is less effective in patients with CML in blast crisis or patients with
MM, myelodysplasias, lymphomas, and acute leukemias
The success of DLI for the treatment of post-transplant relapse of chronic myeloid leukemia has led
researchers to explore the role of combining T-cell depletion with a preplanned course of DLI post-
transplant
,Page 2 of 420
It has been demonstrated clinically that graft-versus-tumor responses occur with DLI in 60%-80% of
patients with chronic myeloid leukemia and to a lesser extent with acute myeloid leukemia, chronic
lymphocytic leukemia, multiple myeloma, non-Hodgkin lymphoma, and renal cell carcinomas
Which of the following is most important prognostic element for a patient being treated for pulmonary
aspergillosis post-transplant?
a) Granulocyte recovery
b) Therapeutic serum fluconazole levels.
c) Serum IgG levels maintained greater than 400
d) Total number of CD34 positive cells in the donor's stem cells - Answer:A) Granulocyte recovery
The most conventional way to monitor immediate hematopoietic recovery is through granulocyte
recovery. Granulocyte recovery is more rapid with blood versus bone marrow autografts, regardless of
whether mobilization is achieved with chemotherapy or with hematopoietic growth factors
Patients who are most at risk for fungal infections are those who are neutropenic, are on prolonged
immunosuppression, or have chronic GVHD
Risk factors for an HSCT patient to develop aspergillosis include prolonged granulocytopenia, the
presence of GVHD, prolonged immunosuppression, human leukocyte antigen (HLA) mismatch,
construction near the hospital or a windy external environment, certain foods and plants, and high-dose
corticosteroid therapy
The Foundation for the Accreditation of Cellular Therapy requires notification of positive microbial
culture results on cellular therapy products to the:
a) recipient
b) donor
c) Food and Drug Administration.
d) American Association of Blood Banks - Answer:A) Recipient
The goal of this evaluation is to protect the safety of the donor and the recipient. The potential
transmission of communicable diseases from the donor to recipient is a serious concern. Therefore,
,Page 3 of 420
laboratory testing includes complete blood count, electrolytes, and renal, hepatic, and endocrine
testing. Infectious disease testing includes hepatitis B, hepatitis C, HIV, cytomegalovirus, herpes simplex
virus, syphilis, and human T-lymphotropic virus, as well as other infectious disease testing the transplant
center deems appropriate. The donor also will have blood and Rh typing, HLA testing, and pregnancy
testing if applicable. A thorough physical examination and medical history, including travel,
immunization, and transfusion histories, will be obtained
The potential transmission of communicable diseases from the donor to recipient is a serious concern.
Therefore, laboratory testing includes complete blood count, electrolytes, and renal, hepatic, and
endocrine testing. Infectious disease testing includes hepatitis B, hepatitis C, HIV, cytomegalovirus,
herpes simplex virus, syphilis, and human T-lymphotropic virus, as well as other infectious disease
testing the transplant center deems appropriate. The donor also will have blood and Rh typing, HLA
testing, and pregnancy testing if applicable. A thorough physical examination and medical history,
including travel, immunization, and transfusion histories, will be obtained
A patient is undergoing peripheral blood stem cell mobilization for an autologous transplant and starts
to experience fever, fatigue and bone pain. This is most likely due to:
a) a bacterial infection.
b) growth factors.
c) cytokine storm.
d) bone marrow hypoplasia. - Answer:B) growth factors
The most common side effects associated with growth factors used for mobilization include bone pain,
fever, and malaise
Daily nursing assessments should include a discussion of symptoms and an evaluation of the patient's
temperature, pulse, respirations, blood pressure, and weight. Patients may be instructed to take
acetaminophen for bone pain or headache. Occasionally, patients will request a stronger pain reliever,
such as acetaminophen with codeine. Other side effects should be assessed and treated
symptomatically. More serious side effects (e.g., pleural or pericardial effusions) may necessitate
stopping the growth factors
What is the best initial step in determining the evidence available to support a current nursing
intervention?
, Page 4 of 420
a) Conduct a research study comparing two different processes to see which is better
b) Ask fellow nurses on the unit what their current practice is
c) Review current literature regarding the intervention, identify gaps or inconsistencies in nursing
practice
d) Evidence is not necessary to guide nursing practice - Answer:C) Review current literature regarding
the intervention, identify gaps or inconsistencies in nursing practice.
Managers should support introduction of new nursing interventions based on valid research findings
and encourage staff endeavors to implement new research findings when possible. Clinical staff should
be encouraged to review current journals for new, relevant research findings. Staff should also be
encouraged to question current nursing practices and look for gaps where there is a lack of research-
based practice (Haberman, 2007). Identifying gaps in the literature and inconsistencies in HSCT practices
is an important first step in designing evidence-based projects that can be used to standardize practice
and link best practices to improved patient outcomes (Bevans et al., 2009).
Microangiopathic hemolytic anemia can be a complication from which immunosuppressive therapy?
a) Tocilizumab
b) Antithymocyte globulin (ATG)
c) Cyclosporine
d) Alemtuzumab - Answer:C) Cyclosporine
Commonly encountered side effects of cyclosporine A include glucose intolerance, hirsutism,
hyperkalemia, hypertension, magnesium wasting, renal insufficiency, and tremor (Malat & Culkin, 2016).
Other side effects include confusion, cortical blindness, gingival hyperplasia, headache, hemolytic
uremic syndrome, hyperchloremic metabolic acidosis, hyperlipidemia, hyperuricemia, microangiopathic
hemolytic anemia, palmar-plantar dysesthesia, and seizures (Malat & Culkin, 2016
An 8-year old patient who received an HSCT develops a grade 2 acute GVHD skin rash. The nurse
anticipates which of the following orders for initial treatment?
a) Initiation of photophresis
b) Infliximab
