BMTCN EXAM AND PRACTICE EXAM
NEWEST 2026 TEST BANK| BLOOD &
MARROW TRANSPLANT CERTIFIED
NURSE (BMTCN) EXAM PREP WITH
COMPLETE 300 REAL EXAM QUESTIONS
AND CORRECT DETAILED ANSWERS
(VERIFIED ANSWERS) ALREADY GRADED
A+ (BRAND NEW!!)
1. Which cell lineage gives rise to erythrocytes, platelets, and most
leukocytes?
B) Myeloid stem cells
Explanation: Myeloid stem cells differentiate into erythrocytes,
megakaryocytes (platelets), granulocytes, and monocytes, whereas lymphoid
stem cells give rise to T-cells, B-cells, and NK cells
2. Which cell surface complex is primarily responsible for presenting
endogenous peptide antigens to CD8+ T-cells?
C) HLA-A, -B, -C (Class I)
*Explanation: Class I HLA molecules (HLA-A, -B, -C) present intracellular
peptides to CD8+ cytotoxic T-cells, whereas Class II molecules present to
CD4+ helper cells*
3. The primary goal of graft-versus-tumor (GVT) effect in allogeneic
transplantation is to:
, B) Eliminate residual malignant cells
Explanation: GVT is the immunologic attack by donor immune cells on
residual host tumor cells, improving disease control
4. In HLA typing, which locus is most critical for matching unrelated
donors?
C) HLA-DRB1
*Explanation: HLA-DRB1 matching is strongly associated with reduced risk
of acute GVHD and improved survival in unrelated donor transplants*
5. A patient receives a myeloablative conditioning regimen that
includes total body irradiation (TBI). Which acute toxicity is most
closely associated with this component?
D) Severe mucositis
Explanation: High-dose TBI contributes significantly to mucosal injury,
resulting in severe oral and gastrointestinal mucositis
6. Which of the following is a contraindication to proceeding with an
allogeneic hematopoietic stem cell transplant?
B) Active uncontrolled infection
Explanation: Active uncontrolled infection poses a high risk of mortality
during the profound immunosuppression of transplant
7. The graft-versus-leukemia (GVL) effect is primarily mediated by
which cell type?
B) Donor T-lymphocytes
Explanation: Donor-derived T-cells recognize residual malignant cells and
mediate the GVL effect, which is a key therapeutic benefit of allogeneic
transplantation
8. Which malignant disease is an absolute indication for autologous
stem cell transplant in first remission?
, B) Diffuse large B-cell lymphoma
Explanation: Autologous transplant is standard for aggressive non-Hodgkin
lymphomas such as diffuse large B-cell lymphoma
9. Which immunosuppressive agent works by inhibiting calcineurin,
thereby preventing IL-2 transcription?
B) Cyclosporine
*Explanation: Cyclosporine is a calcineurin inhibitor. It binds to cyclophilin,
which inhibits calcineurin, preventing the transcription of IL-2 and other
cytokines and thereby suppressing T-cell activation*
10. In the context of stem cell sources, which statement is true
regarding peripheral blood stem cell (PBSC) collection?
B) Mobilization is typically achieved with G-CSF alone or G-CSF plus
chemotherapy.
*Explanation: PBSC mobilization utilizes granulocyte-colony stimulating
factor (G-CSF) alone or with chemotherapy to increase circulating CD34+
cells for apheresis*
11. Immunoglobulins are secreted by which type of cell?
A) B-lymphocyte
Explanation: B lymphocytes synthesize and secrete immunoglobulins
(antibodies) as part of the humoral immune response
12. Which portion of the immunoglobulin activates the complement
pathway?
C) Fc
Explanation: The Fc (Fragment crystallizable) region of an antibody is
responsible for activating the classical complement pathway
13. Which of the following is a class II HLA antigen?
B) DR
, Explanation: HLA DR, DQ, and DP are Class II antigens, which are primarily
expressed on antigen-presenting cells
14. 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?
B) Topical steroids
Explanation: Topical steroid cream should be used as first line therapy for
grade 1 and 2 skin GVHD
15. Cataract development post transplant is linked to which of the
following treatment regimens?
C) TBI
Explanation: Total Body Irradiation (TBI) is a significant risk factor for the
development of cataracts after transplant
16. Prior to engraftment, a patient has a fever greater than 38.3°C
(100.4°F) on more than two occasions lasting more than three days
and is not responding to treatment. This is indicative of:
A) Hyperacute GVHD
*Explanation: Diagnosis of hyperacute GVHD includes fever >38.3°C on two
occasions for >3 days before engraftment, with no response to
antibiotics/antifungals*
17. How should the healthcare team address the psychosocial needs of
transplant patients and caregivers?
B) Develop a comprehensive educational program
Explanation: Members of the team must work together to educate the patient,
family, and caregiver through each step of the transplant to address
psychosocial needs
18. A pre-transplant patient asks about ABO compatibility with the
donor. The nurse explains that:
NEWEST 2026 TEST BANK| BLOOD &
MARROW TRANSPLANT CERTIFIED
NURSE (BMTCN) EXAM PREP WITH
COMPLETE 300 REAL EXAM QUESTIONS
AND CORRECT DETAILED ANSWERS
(VERIFIED ANSWERS) ALREADY GRADED
A+ (BRAND NEW!!)
1. Which cell lineage gives rise to erythrocytes, platelets, and most
leukocytes?
B) Myeloid stem cells
Explanation: Myeloid stem cells differentiate into erythrocytes,
megakaryocytes (platelets), granulocytes, and monocytes, whereas lymphoid
stem cells give rise to T-cells, B-cells, and NK cells
2. Which cell surface complex is primarily responsible for presenting
endogenous peptide antigens to CD8+ T-cells?
C) HLA-A, -B, -C (Class I)
*Explanation: Class I HLA molecules (HLA-A, -B, -C) present intracellular
peptides to CD8+ cytotoxic T-cells, whereas Class II molecules present to
CD4+ helper cells*
3. The primary goal of graft-versus-tumor (GVT) effect in allogeneic
transplantation is to:
, B) Eliminate residual malignant cells
Explanation: GVT is the immunologic attack by donor immune cells on
residual host tumor cells, improving disease control
4. In HLA typing, which locus is most critical for matching unrelated
donors?
C) HLA-DRB1
*Explanation: HLA-DRB1 matching is strongly associated with reduced risk
of acute GVHD and improved survival in unrelated donor transplants*
5. A patient receives a myeloablative conditioning regimen that
includes total body irradiation (TBI). Which acute toxicity is most
closely associated with this component?
D) Severe mucositis
Explanation: High-dose TBI contributes significantly to mucosal injury,
resulting in severe oral and gastrointestinal mucositis
6. Which of the following is a contraindication to proceeding with an
allogeneic hematopoietic stem cell transplant?
B) Active uncontrolled infection
Explanation: Active uncontrolled infection poses a high risk of mortality
during the profound immunosuppression of transplant
7. The graft-versus-leukemia (GVL) effect is primarily mediated by
which cell type?
B) Donor T-lymphocytes
Explanation: Donor-derived T-cells recognize residual malignant cells and
mediate the GVL effect, which is a key therapeutic benefit of allogeneic
transplantation
8. Which malignant disease is an absolute indication for autologous
stem cell transplant in first remission?
, B) Diffuse large B-cell lymphoma
Explanation: Autologous transplant is standard for aggressive non-Hodgkin
lymphomas such as diffuse large B-cell lymphoma
9. Which immunosuppressive agent works by inhibiting calcineurin,
thereby preventing IL-2 transcription?
B) Cyclosporine
*Explanation: Cyclosporine is a calcineurin inhibitor. It binds to cyclophilin,
which inhibits calcineurin, preventing the transcription of IL-2 and other
cytokines and thereby suppressing T-cell activation*
10. In the context of stem cell sources, which statement is true
regarding peripheral blood stem cell (PBSC) collection?
B) Mobilization is typically achieved with G-CSF alone or G-CSF plus
chemotherapy.
*Explanation: PBSC mobilization utilizes granulocyte-colony stimulating
factor (G-CSF) alone or with chemotherapy to increase circulating CD34+
cells for apheresis*
11. Immunoglobulins are secreted by which type of cell?
A) B-lymphocyte
Explanation: B lymphocytes synthesize and secrete immunoglobulins
(antibodies) as part of the humoral immune response
12. Which portion of the immunoglobulin activates the complement
pathway?
C) Fc
Explanation: The Fc (Fragment crystallizable) region of an antibody is
responsible for activating the classical complement pathway
13. Which of the following is a class II HLA antigen?
B) DR
, Explanation: HLA DR, DQ, and DP are Class II antigens, which are primarily
expressed on antigen-presenting cells
14. 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?
B) Topical steroids
Explanation: Topical steroid cream should be used as first line therapy for
grade 1 and 2 skin GVHD
15. Cataract development post transplant is linked to which of the
following treatment regimens?
C) TBI
Explanation: Total Body Irradiation (TBI) is a significant risk factor for the
development of cataracts after transplant
16. Prior to engraftment, a patient has a fever greater than 38.3°C
(100.4°F) on more than two occasions lasting more than three days
and is not responding to treatment. This is indicative of:
A) Hyperacute GVHD
*Explanation: Diagnosis of hyperacute GVHD includes fever >38.3°C on two
occasions for >3 days before engraftment, with no response to
antibiotics/antifungals*
17. How should the healthcare team address the psychosocial needs of
transplant patients and caregivers?
B) Develop a comprehensive educational program
Explanation: Members of the team must work together to educate the patient,
family, and caregiver through each step of the transplant to address
psychosocial needs
18. A pre-transplant patient asks about ABO compatibility with the
donor. The nurse explains that:
