BMTCN® Sample Test Questions

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 administration of Epstein-Barr virus (EBV) cytotoxic T-lymphocytes has been found to be a feasible therapeutic option in which EBV mediated-disease process? 
     
    1. Lymphoproliferative disease
    2. Neuroblastoma
    3. Nasopharyngeal rhabdomyosarcoma
    4. Acute lymphocytic leukemia

       
  2. Donor leukocyte infusion is an appropriate treatment option for a patient who has relapsed post allogeneic transplant with:
     
    1. acute lymphocytic leukemia.
    2. severe aplastic anemia.
    3. chronic myelogenous leukemia.
    4. acute lymphoblastic lymphoma.

       
  3. Which of the following is most important prognostic element for a patient being treated for pulmonary aspergillosis post-transplant?
    1. Granulocyte recovery
    2. Therapeutic serum fluconazole levels.
    3. Serum IgG levels maintained greater than 400
    4. Total number of CD34 positive cells in the donor’s stem cells

       
  4. The Foundation for the Accreditation of Cellular Therapy requires notification of positive microbial culture results on cellular therapy products to the: 
     
    1. recipient
    2. donor
    3. Food and Drug Administration.
    4. American Association of Blood Banks

       
  5. 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: 
     
    1. a bacterial infection.
    2. growth factors.
    3. cytokine storm.
    4. bone marrow hypoplasia.

       

Answer Key

1. A


Rationale: Clinical studies have demonstrated the feasibility and safety of administering Epstein-Barr virus (EBV) cytotoxic T-lymphocytes (CTL) to prevent and treat EBV lymphoproliferative disease in post allogeneic transplant patient. The use of EBV-specific CTLs has been evaluated in pediatric patients with EBV associated lymphoproliferative disease after hematopoietic stem cell transplantation and solid organ transplant, EBV-positive Hodgkin disease, and nasopharyngeal carcinoma.

Reference: Appelbaum, F.R., Blume, K.G., Forman, S.J. & Negrin, R.S. (Eds.) (2009). Thomas' hematopoietic cell transplantation: Stem cell transplantation (4th ed.).  Wiley, John & Sons, Inc., p. 1414.


2. C

Rationale: An effective therapeutic option for patients with chronic myelogenous leukemia (CML) in chronic phase with molecular relapse following allogeneic hematopoietic stem cell transplantation is withdrawal of immunosuppression followed by G-CSF primed T -lymphocyte infusions from the original donor. Donor leukocyte infusion has minimal effectiveness in relapsed acute myelogenous leukemia post allogeneic transplant. Responses in acute lymphocytic leukemia are rare and often short in duration.

Reference: Appelbaum, F.R., Blume, K.G., Forman, S.J. & Negrin, R.S. (Eds.) (2009). Thomas' hematopoietic cell transplantation: Stem cell transplantation (4th ed.).  Wiley, John & Sons, Inc., pp. 1059-1061. 

Baggott, C.R., Fochtman, D., Foley, G.V., & Kelly, K.P. (Eds.). (2011). Nursing care of children and adolescents with cancer and blood disorders (4th ed.).  Association of Pediatric Hematology/Oncology Nurses, p. 458.

3. A


Rationale: Graft count does not aid in antifungal effects. Neither fluconazole nor nystatin is indicated for this fungi. Granulocyte recovery is important in helping the body fight a fungal infection.

Reference: Ezzone, S. (Ed.). (2013). Hematopoietic stem cell transplantation: A manual for nursing practice (2nd ed.). Pittsburgh: Oncology Nursing Society, p. 194.

4. A
Rationale: At minimum FACT requires the recipient be notified of the positive microbial product.

Reference: Ezzone, S. (Ed.). (2013). Hematopoietic stem cell transplantation: A manual for nursing practice (2nd ed.).  Oncology Nursing Society, page 92.

5. B
Rationale: Growth Factors are administered at higher doses of 10-15 mcg/Kg for mobilization of stem cells for peripheral collection. Common side effects of these products are mild to moderate bone pain, fever, myalgia, and malaise. Bacterial infection is a possible cause but less likely. Bone marrow hypoplasia on its own would not cause fever or pain, but more likely to cause fatigue. Cytokine storm though associated with the use of growth factors post transplant does not present with the same side-effects.

Reference: Baggott, C.R., Fochtman, D., Foley, G.V., & Kelly, K.P. (Eds.). (2011). Nursing care of children and adolescents with cancer and blood disorders (4th ed.). Association of Pediatric Hematology/Oncology Nurses, pp. 387-388. 


Ezzone, S. (Ed.). (2013). Hematopoietic stem cell transplantation: A manual for nursing practice (2nd ed.). Oncology Nursing Society, p. 28.