BMTCN Exam 2024/2025 with 100% Accurate Solutions, Exams of Nursing

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BMTCN EXAM 2024/2025 WITH 100%

ACCURATE SOLUTIONS

Which of the following is NOT an identified risk factor associated with infection? A. Personal history of infection B. Type of transplantation (autologous or allogeneic) C. Myeloablative Transplant D. None of the Above - Precise Answer ✔✔D. None of the above Clostridium difficile is not a common infection in the post-transplant setting A. True B. False - Precise Answer ✔✔B. False A cord blood transplantation is associated with all of the following except: A. Prolonged neutrophil and immune recovery B. Increase in viral infections C. Decrease in bacterial infections D. Decrease in graft-versus-host disease (GVHD) - Precise Answer ✔✔C. Decrease in bacterial infections

Which of the following is true when considering bacterial infections in patients after transplant? A. Patients are at a significant risk for encapsulated bacterial infections B. Multidrug-resistant organisms are not a major concern C. Streptococcus pneumoniae is not a common post-transplant bacterial infection D. Immunizations are not effective in controlling post-transplant bacterial or viral infections - Precise Answer ✔✔A. Patients are at a significant risk for encapsulated bacterial infections The following strategies should be considered in an effort to prevent post-transplant infectious complications:

1. Immunizations should begin immediately following transplant discharge
2. Antiviral and anti-fungal prophylaxis medications should be considered in the post-transplant setting
3. Lifestyle restrictions vary in each transplant center and often are enforced to decrease post-transplant infections. It is important to communicate lifestyle expectations and restrictions to patients and their families
4. Measles, mumps, and rubella immunization should be administered at 12 months A. 1, 2, 3, 4, B. 2 and 3 C. 2 and 4

D. 2, 3, 4 - Precise Answer ✔✔B. 2 and 3 Cardiovascular disease may be underreported in hematopoietic stem cell transplant (HSCT) recipients because symptoms may occur several months to several years following HSCT A. True B. False - Precise Answer ✔✔A. True Which risk factors are associated with post-HSCT cardiovascular disease? 1) Hypertension, 2)Gender, 3)Certain immunosuppressive medications, 4) Previous anthracycline chemotherapy A. 1, 2, 3, 4 B. 1, 3, 4 C. 2, 3, 4 D. 1, 2, 3 - Precise Answer ✔✔B. 1, 3, 4 The following strategies are used to manage cardiovascular disease in post HSCT patients EXCEPT: A. Antihypertensive medications B. Statin therapy C. Dietary counseling D. Prophylactic anti fungal medications - Precise Answer ✔✔D. Prophylactic anti-fungal medications

Patients should be monitored for the clinical signs and symptoms of cardiac disease post-HSCT by which of the following? A. Annual clinical assessment that includes baseline vital signs, review of symptoms, and physical examination B. Careful attention to travel over the last year C. Lifestyle counseling about smoking cessation, weight management, and stress reduction D. All of the above except B E. All of the above except C - Precise Answer ✔✔D. all of the above except B Which of the following chemotherapy agents is associated with patients cardiac disease in the post-HSCT setting? A. Bendamustine B. Melphalan C. Doxorubicin D. Methotrexate - Precise Answer ✔✔C. Doxorubicin Graft failure or graft rejection is associated with all of the following EXCEPT: A. Incidence of 1%-20% B. Favorable prognosis C. Loss of donor cells after initial engraftment D. Potential for marrow aplasia and pancytopenia - Precise Answer ✔✔B. Favorable prognosis

Graft failure may result from which of the following A. Type of primary disease B. Human leukocyte antigen (HLA) disparity C. Immunosuppression D. GVHD E. All of the above - Precise Answer ✔✔E. All of the above Strategies to prevent graft failure may include all of the following EXCEPT: A. Using a nonmyeloablative conditioning regimen B. Employing antithymocyte globulin in combination with cyclophosphamide for aplastic anemia C. Augmenting cell dose by giving donor buffy coat transfusion D. Administering granulocyte-colony-stimulating factor - mobilized peripheral blood stem cells as an alternative to bone marrow E. Reducing the frequency of pre-transplant blood transfusions - Precise Answer ✔✔A. Using a nonmyeloablative conditioning regimen Early and late transplant-related musculoskeletal complications include all of the following EXCEPT: A. Avascular necrosis (AVN) B. Improved exercise tolerance C. Osteoporosis D. Fracture

E. Osteomyelitis - Precise Answer ✔✔B. Improved exercise tolerance Which of the following is a risk factor for AVN? A. Steroid therapy B. Younger age C. Absence of GVHD D. Primary diagnosis of multiple myeloma - Precise Answer ✔✔A. Steroid therapy Which of the following is treatment for diminished bone mineral density? A. Nutritional supplementation with calcium and VitD B. Correction of possible endocrinopathies C. Correction of renal dysfunction D. Use of biophosphonates E. All of the above - Precise Answer ✔✔E. All of the above Which of the following is true of post-HSCT ocular damage? A. It can involve all the parts of the eye B. It may be a consequence of immunosuppression C. It may be influenced by conditioning regimens (chemotherapy, radiation, or both) D. It may be the result of underlying disease E. All of the above - Precise Answer ✔✔E. All of the above

Manifestations of ocular GVHD include all of the following EXCEPT: A. Dry, gritty, or painful eyes B. Cicatricial conjunctivitis C. Keratoconjunctivitis D. Absence of early morning mucoid secretions E. Confluent areas of punctate keratopathy - Precise Answer ✔✔D. Abscence of early morning mucoid secretions Which of the following is true cataract formation? A. It can be attributed to radiation and steroid therapy and is not a direct result of GVHD itself B. It isn't uncommon cause a visual acuity loss C. The risk is decreased with total body irradiation D. It does not lead to increased incidence of cataract surgery - Precise Answer ✔✔A. It can be attributed to radiation and steroid therapy and is not a direct result of GVHD itself Risk factors that can predict a poorer overall psychological outcome include all of the following EXCEPT: A. Prior psychiatric morbidity or history B. Pre-transplant nonadherence C. Lack of stable social support D. History of considerable regimen -related toxicity E. Male Sex - Precise Answer ✔✔E. Male Sex

What effect might higher levels of depression have on transplant patients? A. Influence post-transplant physical health system B. Increased symptom-related distress C. Contribute to a higher suicide rate D. Decreased survival E. All of the above - Precise Answer ✔✔E. All of the above In a study by Windows et al. (2005), patients who exhibited higher incidences of posttraumatic stress disorder symptoms had all of the following EXCEPT: A. Positive assessment of the transplant experience B. Larger use of avoidance based coping strategies C. Decreased social support D. Increased social constraint E. Decreased assessment of general well-being - Precise Answer ✔✔A. Positive assessment of the transplant experience An HSCT recipient diagnosed with herpes simplex virus (HSV) is scheduled to receive foscarnet intravenously. The nurse anticipates an order for which of the following? A. Echo B. urine sodium C. pulmonary function tests

D. Pre-hydration fluids - Precise Answer ✔✔D. Pre-hydration fluids Which of the following is a major cause of electrolyte imbalances in HSCT recipients? A. Decreased oral intake B. Fluctuation in bodyweight C. Altered gastrointestinal absorption D. Restriction of fresh fruits - Precise Answer ✔✔A. Decreased oral intake An HSCT recipient is complaining of increased weakness and numbness around the mouth. This symptom may be related to which of the following? A. Hyperkalemia B. Hypocalcemia C. Hyperphosphatemia D. Hyponatremia - Precise Answer ✔✔B. Hypocalcemia A patient with acute myeloid leukemia is receiving myeloablative conditioning regimen with cyclophosphamide. The nurse would closely monitor for which electrolyte imbalance? A. Hypercalcemia B. Hypokalemia C. Hyperphosphatemia D. Hyponatremia - Precise Answer ✔✔D. Hyponatremia

Amphotericin B and corticosteroids can result in which of the following electrolyte imbalance? A. Hypernatremia B. Hypokalemia C. Hypocalcemia D. Hypercalcemia - Precise Answer ✔✔B. Hypokalemia The nurse is caring for a HSCT recipient with acute lymphoblastic leukemia and has drawn and sent laboratory samples for the morning. The recipient's lab report shows a corrected calcium level of 7.6 mg/dl and the patient is symptomatic. The nurse would anticipate an order to administer? A. Calcium gluconate IV B. Zoledronate acid IV C. Sodium Bicarbonate IV D. Insulin/glucose IV - Precise Answer ✔✔A. Calcium gluconate IV The patient is receiving tacrolimus IV following an allogenic HSCT. The patient is at greatest risk for developing which electrolyte imbalance? A. Hyponatremia B. Hyperkalemia C. Hypomagnesemia D. Hypernatremia - Precise Answer ✔✔C. Hypomagnesemia

A patient with multiple myeloma is complaining of increased weakness seven days following HCST. Morning lab results reveal the following: K+ 3.8, Mg 2.2, Ph 1.9, and corrected Cl 10.2mg/dl. The nursing priority would be to obtain an order to administer which of the following medications? A. Sodium Bicarb IV B. Potassium phosphate IV C. Magnesium sulfate IV D. Calcium gluconate IV - Precise Answer ✔✔B. Potassium Phosphate IV A patient receiving cisplatin as a part of the conditioning regimen prior to HSCT. Which of the following metabolic alterations will the nurse expect? A. hypomagnesemia B. Hypokalemia C. Hyperkalemia D. Hypocalcemia - Precise Answer ✔✔A. Hypomagnesemia A recipient is being admitted for an allogenic HSCT. One of the most important assessments during admission is to establish which of the following? A. favorite foods B. anxiety level C. baseline weight

D. learning preference - Precise Answer ✔✔C. baseline weight A recipient has received an auto HSCT. When does the nurse anticipate neutrophil engraftment? A. 26-28 days post transplant B. 14-21 days post transplant C. 7-9 days post transplant D. 30-42 days post transplant - Precise Answer ✔✔B. 14-21 days post transplant A recipient is 15 days post an allo HSCT with high-dose chemo and is complaining of mouth sores. On assessment, the nurse observes erythema and ulcerations in the oral cavity. History includes seropositivity for HSV, cytomegalovirus (CMV), and Epstein-barr virus (EBV). What is the possible reactivation? A. EBV B. CMV C. HSV D. Varicella-zoster virus - Precise Answer ✔✔C. HSV Which of the following is a common fungal pathogen in the late transplant phase? A. Aspergillus B. HSV C. CMV

D. Streptococcus - Precise Answer ✔✔A. Aspergillus A post transplant recipient has a decreased platelet count of 32,000/mm3. Which grade of thrombocytopenia is the patient experiencing? A. Grade 1 B. Grade C. Grade 3 D. Grade4 - Precise Answer ✔✔C. Grade 3 A recipient is more than 100 days post auto transplant and is relocating to another state. What is the most important nursing intervention in this situation? A. Provider care planning B. Monitor current medications C. Ensure adequate diet D. Assess dry weight - Precise Answer ✔✔A. provider care planning Late transplant infections are directly related to which of the following? A. Radiation therapy B. Neutrophil engraftment C. Hepatitis B infection D. T cell impairment - Precise Answer ✔✔D. T. cell impairment

A recipient is seven days post auto HSCT and is complaining of chills, rash, and difficulty breathing. Current temp is 38.5c, rash is noted on anterior and posterior torso, and oxygen sat is 89% on room air. The nurse should expect which of the following? A. Community -acquired pneumonia B. DVT C. Acute GVHD D. engraftment syndrome - Precise Answer ✔✔D. engraftment syndrome A patient is 28 days post allo HSCT with the following lab results: WBC 2,100, HCT 25.9, neutrophils (polys) 22% and bands 4%. What is the patient's ANC? A. 546 B. 795 C. 1, D. 378 - Precise Answer ✔✔A. 546 (%bands + % neutrophils) x WBC = ANC An HSCT recipient is more likely to have a febrile nonhemolytic reaction from which of the following transfusions? A. RBCs B. FFP C. Platelets D. Cryoprecipitate - Precise Answer ✔✔A. Platelets

A recipient is 14 days post auto HSCT and is experiencing pallor, SOB with exertion, fatigue, tachycardia, and dizziness. Which of the following could the symptoms be indicating? A. Anemia B. Thrombocytopenia C. Pulmonary edema D. Acute cutaneous GVHD - Precise Answer ✔✔A. Anemia A patient is on day 14 after undergoing an allo HSCT and has continued to experience poor appetite and severe, watery diarrhea. A several -day history includes neutropenic fever with antibiotics and antiemetics. A priority nursing intervention would include which of the following? A. obtaining stool sample for culture B. applying a barrier cream to rectal area C. planning a diet with bland foods D. Providing small, frequent meals - Precise Answer ✔✔A. obtaining stool sample for culture On day nine following the conditioning regimen, a transplant recipient reports inability to swallow with dry mouth. On exam of the oral mucosa, the nurse observes debris on the teeth and gums. What is the most likely complication? A. Candida B. Dysphagia C. Mucositis

D. Xerostomia - Precise Answer ✔✔D. Xerostomia A recipient reports a decrease in taste sensation with decreased intake of breakfast and lunch. What is the symptom called? A. Stomatitis B. Xerostomia C. Hypogeusia D. Infection - Precise Answer ✔✔C. Hypogeusia An HSCT recipient is complaining of diarrhea for the past three days consisting of five episodes in the last 24 hours. According to the National Cancer Common Terminology Criteria for Adverse Events, this indicates which grade of diarrhea? A. grade 2 B. grade 3 C. grade 4 D. grade 5 - Precise Answer ✔✔A. grade 2 A transplant recipient has received a myeloablative conditioning regimen over the past two days, which is now complete. In the beginning of day 4, the recipient develops nausea and vomiting. The recipient is experiencing which type of chemo induced nausea and vomiting? A. Acute B. Delayed

C. Chronic D. Anticipatory - Precise Answer ✔✔B. delayed A recipient has developed oral mucositis following the start of an intense conditioning regimen. When does oral mucositis peak? A. 8-10 days B. 3-5 days C. 1-2 days D. 12-14 days - Precise Answer ✔✔D.12-14 days What is the mainstay for treatment of severe oral mucositis? A. Pain management B. Magic mouthwash C. viscous lidocaine D. bland rinses - Precise Answer ✔✔A. pain management Which of the following is a chemotherapy agent with a high emetic risk? A. Paclitaxel B. cyclophosphamide C. bleomycin D. vinorelbine - Precise Answer ✔✔B. cyclophosphamide A recipient is experiencing signs and symptoms of xerostomia. The rexcipient is at highest risk to develop what infection?

A. EBV

B. HSV

C. Candidiasis D. CMV - Precise Answer ✔✔C. Candidiasis A recipient who has diarrhea over the past two days is complaining of discomfort and itching in the perineal-rectal area. On assessment, the nurse observes dry, flaking, and peeling skin. This symptoms is a result of which of the following? A. chronic dryness B. dry desquamation C. vesicle formation D. soughing presentation - Precise Answer ✔✔B. dry desquamation What treatment strategy might be included for relapsed disease? A. withdrawal of immunosuppression to elicit a Graft versus tumor effect B. Donor lymphocyte infusion C. second myeloablative or reduced-intensity HSCT followed by second Allo HSCT outside the setting of a clinical trial D. exploration of clinical trials examining cellular adoptive immunotherapy, ex vivo-activated T cells, cytokine-induced killer cells, natural killer cells, and antigen specific cytotoxic T lymphocytes E. none of the above - Precise Answer ✔✔C. second myeloablative or reduced-intensity HSCT followed by second Allo HSCT outside the setting of a clinical trial

Patient characteristics that may predict benefit from a reduced-intensity Allo HSCT include all of the following except? A. Availability of a donor who is HLA compatible B. Good performance status C. Large tumor burden D. chemo-sensitive disease E. none of the above - Precise Answer ✔✔C. large tumor burden Post transplant lymphoproliferative disorders are strongly associated with which of the following? A. HSV B. VZV C. EBV D. BK virus E. CMV - Precise Answer ✔✔C. EBV What is a fundamental component of advanced care planning? A. Designation of a healthcare proxy B. Completion of a living will C. Preparation of an estate will D. Conversations with loved ones and healthcare providers regarding the patients wishes in a variety of situations E. All of the above - Precise Answer ✔✔E. all of the above

Which of the following is a barrier to palliative care? A. Unpredictability of the illness trajectory with acute exacerbation requiring highly technical therapies B. The patient and family asking for information regarding palliative care services C. Social work D. Discussing options with the patient and family at a time when the patient can make an informed, autonomous decision - Precise Answer ✔✔A. Unpredictability of the illness trajectory with acute exacerbation requiring highly technical therapies Self care approaches for patients with terminal illness should include all of the following EXCEPT? A. Symptoms and pain management that affects quality of life B. Psychological and emotional adaptation to their illness C. Stress relief with symptoms that cannot easily be altered D. Self-titration of pain medication by patients - Precise Answer ✔✔D. self-titration of pain medication by patients Which of the following is an example of a myeloid cell? A. Thymus-derived cells (T cells) B. Bone marrow-derived cells (B cells) C. Monocytes D. Natural killer cells - Precise Answer ✔✔C. monocytes

Several factors affect immune reconstitution following hematopoietic stem cell transplant. These include all of the following EXCEPT: A. Recipients response to conditioning treatment B. Viral infections C. Chronic graft-versus host disease D. Longevity of mature lymphocytes present at the time of transplant - Precise Answer ✔✔B. viral infections Hematopoiesis occurs primarily in which area? A. bone marrow B. Spleen C. Thymus gland D. lymph nodes - Precise Answer ✔✔A. bone marrow Which of the following statements is true about innate immunity? A. It occurs in response to T-cell activation B. It occurs in response to B-cell activation C. It is a natural process that uses phagocytes that release inflammatory mediators in response to infections or illness D. It is a natural process that occurs primarily in the spleen - Precise Answer ✔✔C. It is a natural process that uses phagocytes that release inflammatory mediators in response to infections or illness Which is NOT a common indication for allo transplantation?

A. Acute myeloid leukemia B. Myelodysplastic Syndrome C. Chronic Myeloid leukemia D. Breast cancer - Precise Answer ✔✔D. Breast cancer Graft-versus-tumor effect is promoted by which of the following? A. withdrawal of immunosuppressive therapy B. Administration of donor lymphocyte infusion C. A and B D. Increased dose of immunosuppressive therapy - Precise Answer ✔✔C. A and B Which of the following is NOT a role of the caregiver? A. Provide physical and emotional support B. Assist with the recovery following HSCT C. Assist with medication administration D. Recommend over the counter medications for management of post HSCT symptoms - Precise Answer ✔✔D. Recommend over the counter medications for management of post HSCT symptoms MJ is to undergo and auto transplant. From whom will he receive his stem cells? A. Matched related donor B. matched unrelated donor

C. umbilical cord blood donor D. Himself - Precise Answer ✔✔D. Himself PF had undergone an allo transplant using umbilical cord blood as the stem cell source. This makes her at higher risk for which of the following post-transplant complications? A. Graft failure B. GVHD C. N/V D. complications of surgery - Precise Answer ✔✔A. Graft failure E. N. is worried about the post transplant complication of GVHD. Which stem cell sources have recently been shown to have decreased incidence of this serious and often debilitating problem? A. umbilical cord blood and bone marrow B. peripheral blood stem cells and bone marrow C. bone marrow and peripheral blood stem cells D. none of the above - Precise Answer ✔✔A. umbilical cord blood and bone marrow What is the most important rationale for giving TBI in multiple fractions? A. It is easier for the patients B. It decreases short term side effects C. It decreases long term side effects

D. It is easier for radiation itself - Precise Answer ✔✔C. It decreases long term side effects What change can decrease side effects of busulfan? A. using oral busulfan B. basing the busulfan dose on blood levels C. giving busulfan intravenously D. B and C - Precise Answer ✔✔D. B and C Which regimen is the most appropriate for a 70-year old patient with multiple myeloma undergoing auto stem cell transplant? A. Myeloablative busulfan and cyclophosphamide B. reduced intensity mel C. reduced intensity TBI and flu D. myeloablative mel - Precise Answer ✔✔D. Myeloablative mel Why would a reduced-intensity conditioning regimen be chosen for a patient with low-risk disease and multiple co-morbidities who has been determined to be a high-risk transplant patient? A. Transplant-related mortality would decrease with the lower-intensity conditioning regimens B. relapsing rate would decrease with the lower-intensity conditioning regimens C. conditioning regimens are easier to administer

D. organ toxicities would increase with lower-intensity conditioning regimens - Precise Answer ✔✔A. transplant-related mortality would decrease with the lower-intensity conditioning regimens What is NOT a rationale for using a myeloablative transplant conditioning regimen? A. increased tumor kill B. decreased risk of graft rejection C. increased graft vs tumor effect D. increased immunosuppression - Precise Answer ✔✔C. increased graft vs tumor effect PJ is a 58 year old woman who is receiving a reduced intensity allo stem cell transplant for acute myeloid leukemia. During allo stem cell infusion, P.J. begins to feel short of breath and appears pale and diaphoretic. The nurse notes bronchospasm and wheezing upon auscultation of the. lungs. PJ is most likely experiencing what type of reaction? A. acute hemolytic reaction B. anaphylactic reaction C. urticarial reaction D. dimethyl sulfoxide toxicity - Precise Answer ✔✔B. anaphylactic reaction Acute tumor lysis syndrome is characterized by all of the following electrolyte abnormalities EXCEPT: