Exam (elaborations)
BMTCN STUDY GUIDE QUESTIONS AND ANSWERS
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- Oxford University (OX)
BMTCN STUDY GUIDE QUESTIONS AND ANSWERS
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BMTCN EXAM PRACTICE QUESTIONSAND ANSWERS 2023
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
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
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
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
B. Record of previous condition regimen with radiation-therapy
C. Attack of EBV
D. Gender and age of the patient - answer B. Record of previous condition regimen with
radiation-therapy
Explanation: Secondary malignancies are tumors that develop as a result of radiation or
chemotherapy treatment. One of the most serious late side effects of radiation therapy is
radiation-induced second malignancies (RISM), which has an influence on treatment decision-
making. Age at radiation, exposure and volume of irradiated region, type of irradiated organ and
tissue, radiation technique, and personal and family history of cancer are all factors that
contribute to the development of RISM.
Alex underwent an HSCT couple of weeks back. His wife Emma is the caregiver for him. She
noticed some behavior changes in Alex like agitation, severe anxiety, insomnia, depression, and
hypervigilance recently and reported to the staff nurse. What will be the primary suspect of the
nurse?
A. Emma is under stress and exaggerating
B. Alexi is trying to be self-pity
C. Emma is having PTSD
D. Alex is having PTSD - answer D. Alex is having PTSD
Explanation: It's natural to experience exhausted or stressed after a transplant. Adding to this
there will be drugs cause anxiety and stress. But when you observe excessive insomnia,
aggressive behavior, and self-isolation it is highly suspect for Post Traumatic Stress Disorder
(PTSD). These symptoms are to be reported and get the assistance of a psychologist as early as
possible.
What immunosuppressive medication can result in serum sickness?
A. Calcineurin inhibitors
B. ATG
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