TEST BANK| BLOOD & MARROW TRANSPLANT
CERTIFIED NURSE (BMTCN) EXAM PREP WITH
COMPLETE EXAM QUESTIONS AND CORRECT
DETAILED ANSWERS
When a patient senses a leaking in IV site during a chemotherapy infusion, what
does the nurse do first?
A. Place warning signs across the area to alert others to the spill
B. Restart the chemotherapy with a new order
C. Put on the right safety gear
D. Environmental programs should be contacted ......ANSWER......A. Place a
warning signs across the area to alert others to the spill
Explanation: People who treat or come into contact with chemotherapy drugs are
known to be at risk. This suggests that the medicines are powerful enough to
harm or destroy cancer cells, which is good news for patients. However, this
means that drugs could pose a risk to those who are exposed to them. This is why
chemo drug handlers must adhere to such safety guidelines and
recommendations. If IV chemo is spilled, powder or dust from a pill or tablet, or
liquid from oral or other types of chemo is present, it may be dangerous to others.
Which of the following is the leading cause of death after a cord blood transplant?
A. Infection
B. Bleeding
C. Malnutrition
pg. 1
,D. Renal Failure ......ANSWER......A. Infection
Explanation: Like bone marrow and peripheral blood, umbilical cord blood is risk
source of stem cells for transplantation. It does, however, come with a few risks.
"Infection" is one of the most serious risks that can lead to death. Infection is
thought to be responsible for 35-50% of non-relapse mortality in UCBT patients,
compared to 8-22% in allogeneic HCT patients. Following UCBT, viral infection,
particularly cytomegalovirus (CMV) and human herpesvirus 6 (HHV-6), have been
linked to an increase in morbidity and death.
Which of the following drugs will most likely lead to heart failure as being used in
the conditioning regimen?
A. Busulfan
B. Cytarabine
C. Fludarabine
D. Cyclophosphamide ......ANSWER......D. Cyclophosphamide
Explanation: Cardiac toxicity is the result of harmful chemicals causing damage to
the heart. Toxins (drugs) may be administered to you as part of your treatment to
destroy cancer cells. Normal cells in and around your heart can also be killed as a
side effect. Patients taking a cumulative dose of more than 150mg/kg
cyclophosphamide have a 7-33% chance of developing acute heart failure.
Depending on the dosing regimen and patient population, fatal cyclophosphamide
cardiomyopathy can range from 2 to 17%.
Daisy has leukemia. She will require HSCT treatment. In this situation, which of the
following is the most important thing for the nurse to consider while teaching her
caregiver?
A. Request that the teaching be done by a nurse who is not caring for the patient
B. Discuss the probability of transferring the details to someone other than the
caregiver
pg. 2
,C. Concentrate on details about the present stage of treatment
D. Keep track of the caregiver's emotional reaction ......ANSWER......C. Concentrate
on details about the present stage of treatment
Explanation: A successful caregiver must have the ability to develop adequate
coping strategies, solve problems, and prioritize. To be able to offer adequate
treatment for an HSCT recipient, the caregiver must preserve his or her own
quality of life -- including mental, physical, and emotional health -- during the
transplanting phase. Since the conditions of patients and their caregivers change
with each phase of treatment, it's critical to customize teaching to the particular
phase of treatment.
Under utilization for certain diseases occurs due to transplant-related toxicity. For
which of the following disease is transplant-related toxicity a barrier?
A. Neuroblastoma
B. Arrhythmia
C. Acute Myeloid Leukemia
D. Sickle Cell Disease ......ANSWER......D. Sickle Cell Disease
Explanation: While the clinical course of sickle cell disease (SCD) varies, many
patients experience end-organ complications that are associated with severe
morbidity and mortality. While myeloablative allogeneic HSCT (allo-HSCT) is
curative, it has traditionally been reserved for children under the age of 16. Sickle
cell disease (SCD) is triggered by a single nucleotide mutation in the -globin
protein, which replaces glutamate with valine in the 6th spot. The hemoglobin
protein is more likely to polymerize when deoxygenated as a result of this
transition, resulting in sickle-shaped red cells.
Identify which among the following electrolyte abnormalities, is not characterized
as an acute tumor lysis syndrome?
A. Hypocalcemia
pg. 3
, B. Hyperkalemia
C. Hyperuricermia
D. Hypophosphatemia ......ANSWER......D. Hypophosphatemia
Explanation: TLS is a situation in which a significant number of cancer cells die in a
short amount of time, releasing thier contents into the bloodstream.
Hypophosphatemia is defined as a phosphate level in the blood of an adult of less
than 2.5 (mg/dL). The typical amount of serum phosphate in children is much
greater, with children have a level of 7mg/dL. Hypophosphatemia is a fairly
common laboratory condition that is frequently discovered by chance.
A medical treatment that removed blood via machine and isolates white blood
cells has shown to reduce the severity of oral chronic GVHD. Identify the
treatment from below?
A. Methotrexate
B. Mercaptopruine
C. ECP
D. IBD ......ANSWER......C. ECP
Explanation: Photopheresis, also known as extracorporeal photopheresis (ECP), is
a medical procedure that involves the removal of blood and the isolation of white
blood cells using a computer. Until returning the blood to the patient, these white
cells are subjected to a drug called 8-mthoxypsoralen, accompanied by UVA
irradiation. There re several steps through which ECP is believed to reduce T-cell-
mediated immune responses in patients with GVHD are such as apoptosis of white
blood cells and phagocytosis of these apoptotic lymphocytes by APCs.
Non-squamous cell carcinoma has been diagnosed in a patient who obtained an
allogeneic HSCT twelve years ago. Which of the following factors does the nurse
believe contributed to the development of this secondary malignancy?
A. Effect of alkylating agents as part of the chemotherapy treatment previously
pg. 4