TCTCN (Formerly BMTCN) Transplantation and Cellular Therapy Certified Nurse is a trademark of its owner, which is not affiliated with and does not endorse Test Treasure Publication or TTP Prep.
10 sample questions for the TCTCN (Formerly BMTCN) Transplantation and Cellular Therapy Certified Nurse, with the correct answer and an explanation for each. No account needed. Try each one before you open the answer.
Sections covered on the exam: Progenitor Cells, Match Probability, Lymphocyte Recovery, Unrelated Donor Matching Loci, Allogeneic Versus Autologous Choice, Of Autologous Rescue, Cells Recognize Tumor, Myeloma Consolidation, Aplastic Anemia Plan, Autologous Hsct For Immune Disease, As Donors, Twin Donor, Infusion, Bispecific Antibody Versus Car T, Therapy Product, Compared With Marrow, Blood Limitation, Material For Til, Pretransplant Organ Testing, Caregiver Plan, Pressured Sibling Donor, Symptom During G-Csf, Administration, Transplant Process and Infusion, Calcineurin Inhibitor Level, Prophylaxis Dose, Gvhd Grade, Before Engraftment, And Liver Pain, Rash At Count Recovery, Month Out, Second Week, Vision Change, Seizure, Neutrophil Recovery, Haploidentical Infusion, Mouth After Melphalan, After Antibiotics, Chronic Gvhd, Exertional Dyspnea, About Photopheresis, During Immunosuppression, About Fever, Cold Intolerance, With Walking, At Survivorship Visit, Donor Chimerism, Fever and Hypotension After Infusion, Oxygen Needs and Crs Grade, Early Fever With Neutropenia, Scoring A Neurologic Check, Confusion Without Fever, Sudden Neurologic Event, New Hypotension, No Fever, Laboratory Trend After Crs, Purpose of Small First Doses, Counts That Fall Again, Prophylaxis With Prolonged Steroids, Relapse After Cd19 Therapy, Crs Not Improving, Continuous Infusion Safety, Discharge Teaching Check, Recurrent Infections At 4 Months, New Movement Changes At Day 60, New Lymphoma After Therapy, Length of Follow-Up, Stopping A Prophylactic Drug, Monitoring B-Cell Counts, Protecting The Household, Quality of Life, Conditioning, Standards, Care, Lymphoid Lineage, Specific Antibodies, Depleted Graft, Hsct For Scid, Tapering Immunosuppression At Relapse, Costimulatory Domain, Relapse of Large B-Cell Lymphoma, Target In Myeloma, Hlh, Mismatched Unrelated Donor, Teaching After Dli, Cells Need Less Matching, Bispecific In Lung Cancer, Therapy Versus Sibling Hsct, Marrow Harvest, Cord Blood Units, Starting Material, Early Posttransplant Management and Education, Selecting Between Sibling Donors, Right To Withdraw, Planning Lodging For Car T, Pcr, Prophylaxis Candidate, After Engraftment, Diarrhea On Steroids, Diarrhea, Falling Counts, For A Drug-Level Draw, Transplant Cyclophosphamide Day, Platelet Unit, Lung Infiltrates, At Home, Transfusion Response, Fever With Nodules, Severity Score, Review For Cgvhd, Gritty Eyes, Live Vaccine, Pneumococcal Vaccines, Periods and Hot Flashes, Cytopenias Years Later, +180 Results, Steroid Survivor, Two Drugs For Blood Pressure, Grading Without Fever, Brief Seizure, Moderate Ice, Weight-Based Dose Check, Subtle Change In Writing, Fever Plus Confusion, Hyperinflammation As Crs Ends, Missed Treatment Week, Symptoms At Home After A Dose, Taste Change and Weight Loss, Special Blood Product Order, Hypotension In Week Three, Pre-Infusion Risk Factors, First Response Assessment, One-Sided Facial Weakness, Vaccine To Postpone, Counts Still Low At 3 Months, Foundations of Transplant, Driving Teaching Check, Boxed Warning Question, Exposure At Home, Moving To Another State, Professional Performance, Disagreement, After Discharge.
Question 1 · Progenitor Cells
The cell therapy laboratory reports the hematopoietic progenitor cell content of an autologous apheresis product. Which cell-surface marker is used for this count?
Answer: C. CD34
CD34 identifies hematopoietic stem and progenitor cells, and the CD34⁺ dose per kilogram predicts engraftment. CD3 marks T cells, CD19 B cells, and CD56 NK cells; none of these measures the stem cell dose.
Question 2 · Pressured Sibling Donor
A 16-year-old HLA-matched sibling tells the nurse, "My parents keep telling me I have to do this, but I'm scared of the needles and the surgery." Which action should the nurse take?
Answer: A. Involve the donor advocate who represents the donor's interests.
Donation must be voluntary and informed, and a minor donor needs an independent advocate (separate from the recipient's team) to protect the donor's interests and assent. False reassurance, parental pressure, or implying an obligation all undermine voluntariness.
Question 3 · Administration
During infusion of the third bag of a thawed autologous PBSC product, the patient becomes nauseated and flushed. The nurse notes a strong garlic-like odor. Vital sign Before infusion Now Heart rate 84/min 48/min Blood pressure 128/76 mm Hg 172/98 mm Hg SpO₂ 98% 97% Which action should the nurse take FIRST?
Answer: C. Slow or pause the infusion and notify the provider.
Bradycardia, hypertension, nausea, flushing and a garlic odor are classic DMSO reactions; slowing or pausing the infusion and treating symptoms per protocol usually resolves them, and the product is then completed because it is irreplaceable. There is no hypotension, wheezing or hypoxia to suggest anaphylaxis or fluid overload.
Question 4 · During Immunosuppression
A patient is 14 months after allogeneic HSCT and still takes tacrolimus for active mild chronic GVHD. It is influenza season, and the patient asks which vaccine can be given at today's visit. Which vaccine is appropriate today?
Answer: A. Inactivated influenza vaccine
Inactivated vaccines are safe during immunosuppression, and inactivated influenza vaccine is given yearly starting about 6 months after HSCT (as early as 4 months in an outbreak). Live vaccines, including MMR, varicella and intranasal influenza, are contraindicated with active GVHD or ongoing immunosuppression and before 24 months.
Question 5 · Discharge Teaching Check
A patient is being discharged 10 days after CD19-directed CAR T- cell infusion. The nurse reviews current labeling requirements with the patient and caregiver. Which statement by the patient shows correct understanding?
Answer: B. I will stay within 2 hours of the center and not drive for 2 weeks after infusion
Current labeling for the approved autologous CAR T products requires staying within about 2 hours of the treating center for at least 2 weeks and avoiding driving or hazardous machinery for 2 weeks after infusion. The older 4-week proximity and 8-week driving limits and the REMS programs were removed.
Question 6 · Lymphoid Lineage
Which cell develops from the common lymphoid progenitor rather than the common myeloid progenitor?
Answer: B. Natural killer cell
The lymphoid progenitor gives rise to T cells, B cells and NK cells. Monocytes, megakaryocytes (platelets), granulocytes such as eosinophils, and red cells come from the myeloid progenitor.
Question 7 · Right To Withdraw
An unrelated PBSC donor asks whether she can change her mind about donating. Which response by the nurse is accurate?
Answer: A. "You may withdraw at any time, but stopping after the recipient's conditioning starts could be life-threatening for the recipient."
Donation is voluntary and the donor may withdraw at any point, but donors are taught that the most critical time is after the recipient begins conditioning, when the recipient's marrow has been destroyed. Consent does not create a binding obligation, and a backup donor is not guaranteed.
Question 8 · Administration
A group A recipient received a G-CSF–mobilized PBSC graft from a group O donor. Day Hemoglobin Total bilirubin LDH +5 9.6 g/dL 0.9 mg/dL 240 units/L +9 7.2 g/dL 3.4 mg/dL 720 units/L Direct antiglobulin test: positive (anti-A) No signs of bleeding These findings are most consistent with which complication?
Answer: A. Passenger lymphocyte syndrome
In a minor ABO mismatch (group O donor to group A recipient), donor B lymphocytes in the graft make anti-A that hemolyzes the recipient's red cells, typically between days 5 and 15. Major-mismatch hemolysis occurs at infusion and requires recipient antibodies against donor red cells, and pure red cell aplasia is a later, nonhemolytic complication of major mismatch.
Question 9 · Live Vaccine
SURVIVOR AT CLINIC VISIT Item Status Time since allogeneic HSCT 30 months Immunosuppression Stopped 13 months ago Active GVHD None Last IVIG dose 5 months ago The patient asks about the MMR vaccine. Which response is accurate?
Answer: B. Defer it until at least 8 months after the last IVIG
Live vaccines follow the 2-1-8 rule: at least 2 years after HSCT, at least 1 year off immunosuppression, and at least 8 months since the last IVIG, with no active GVHD. This patient meets the first two criteria, but IVIG 5 months ago can neutralize the vaccine, so MMR is deferred about 3 more months.
Question 10 · One-Sided Facial Weakness
On day 23 after ciltacabtagene autoleucel infusion, a patient notices that the left side of his face droops and he cannot fully close his left eye. Limb strength, speech and orientation are normal, and his ICE score is 10. Which action should the nurse take?
Answer: B. Report it promptly as possible delayed neurotoxicity and protect the eye
Cranial nerve palsies, most often facial nerve palsy, are a recognized delayed neurologic toxicity after BCMA CAR T-cell therapy and need prompt evaluation to exclude stroke or infection and to start treatment (often corticosteroids). The ICE score is normal, so this is not ICANS, and eye lubrication and taping protect the cornea.
TTP Prep has 200 TCTCN (Formerly BMTCN) practice questions with explanations, timed and mock-exam modes, 180 flashcards, interactive lessons, a printable cheat sheet and a readiness score. Start free, no card needed.
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