Download HSCT Practice Test: Questions and Answers for Hematopoietic Stem Cell Transplantation and more Exams Advanced Education in PDF only on Docsity!
BMTCN Practice Test B
Patients who have received an HSCT should receive which of the following annual immunizations? A. Yellow Fever B. Intranasal influenza C. Inactive influenza D. Live rotavirus - correct answer C. Inactive influenza is recommended yearly. What is an advantage of using umbilical cord blood for an HSCT? A. The cells exhibit an earlier time to engraftment. B. An unlimited supply of stem cells is available. C. The graft-versus-tumor effect is avoided. D. An HLA match with the recipient is not required. - correct answer D. A true HLA match is not required when using umbilical cord blood because the cells have not yet matured. Which of the following is most important for the nurse to remember when teaching the caregiver of a patient who will receive an HSCT? A. Focus on information related to the current phase of treatment. B. Discuss the possibility of identifying someone other than the caregiver to receive the information. C. Ask a nurse who is not caring for the patient to provide the teaching. D. Document the emotional response of the caregiver. - correct answer A. It is important to individualize teaching based on the specific phase of treatment since patients and their caregivers' needs vary with each phase of treatment. Which interpersonal relationship with the survivor of an HSCT has the strongest influence on social function and well-being? A. The extended family B. The partner
C. Another HSCT survivor D. The nurse - correct answer B. Although the survivor may have the medical team, extended family, and other HSCT survivors as resources, interpersonal relationships such as the relationship between the survivor and the partner has the strongest impact on social factors. Compared to adults, pediatric HSCT donors are at greater risk for which complication of apheresis? A. Infection B. Hypovolemia C. Thrombosis D. Hypercalcemia - correct answer B. Hypovolemia. The volume of the blood collected during the apheresis procedure must be based on the child's size. Tissue damage within target organs due to activated T-cells occurs in which phase of GVHD? A. Phase 1 B. Phase 2 C. Phase 3 D. Phase 4 - correct answer C. During phase 3, activated T lymphocytes either directly or indirectly produce or amplify tissue damage within the target organs. Which of the following organizations makes transplant outcome data and reporting an element of quality management standards? A. National Bone Marrow Donor Program B. Oncology Nursing Society C. Leukemia and Lymphoma Society D. Foundation for Accreditation of Cellular Therapies - correct answer D. As the FACT quality management standards make abundantly clear, data collection, analysis, and reporting is a pivotal element of quality management. The caregiver of a patient who had an HSCT is responsible for which of the following actions? A. Restarting pre-transplant herbal supplements
What is the most likely cause for the development of cataracts following an HSCT? A. Calcineurin inhibitors B. Steroids C. Direct result of GVHD D. Tacrolimus - correct answer B. Steroid use contributes to the development of cataracts. What is the treatment for a patient after an allogeneic transplant who is diagnosed with thrombotic microangiopathy? A. Discontinue calcineurin inhibitors B. Begin antifungal therapy C. Begin antibiotic treatment D. Receive a plasma exchange - correct answer A. Calcineurin inhibitors will be discontinued for patients who are diagnosed with thrombotic microangiopathy. The apheresis machine may be primed with irradiated red blood cells for patients weighing less than: A. 40kg B. 30kg C. 50kg D. 20kg - correct answer D. 20kg. In an effort to decrease the amount of blood lost during priming, the apheresis machine and tubing may be pre-primed with irradiated red blood cells if more than 10%-15%of the child. Which of the following is an advantage of using bone marrow as a source of stem cells? A. Takes less time to collect cells B. Cells are more mature C. Cells engraft more quickly D. Less risk of infection - correct answer A. Obtaining cells from the bone marrow is a much faster process than obtaining them from the peripheral blood.
A patient with graft-versus-host disease reports indigestion and diarrhea after eating cottage cheese and ice cream. Which of the following foods should the nurse encourage the patient to eat? A. Cheese B. Yogurt C. Custard D. Gelatin - correct answer D. Lactose intolerance is common with GVHD so dairy products should be avoided. Treatment with long-term corticosteroids increases the risk of which of the following complications? A. Pulmonary emboli B. Peripheral neuropathy C. Avascular necrosis D. Weight loss - correct answer C. Long-term use of corticosteroids such as in the treatment of GVHD is known to increase the risk of developing avascular necrosis through ischemic (non-traumatic) bone necrosis. A patient taking cyclosporine should be taught to A. Take the medication with grapefruit juice B. Avoid eating fresh fruits and vegetables C. Receive annual dental examinations D. Avoid switching brands of medication - correct answer D. Different oral preparations of cyclosporine may not be bioequivalent, so it is important not to switch brands of medication. A patient receiving a fresh hematopoietic stem cell infusion is at increased risk for which of the following complications? A. ABO incompatibility B. Anaphylaxis C. Pigment neuropathy D. Renal failure - correct answer A. The major risk associated with infusion of fresh stem cells is ABO incompatibility.
A patient with chronic GVHD is experiencing jaundice and abdominal pain, and has elevated liver function tests. The nurse should anticipate an order for which of the following? A. Beclomethasone B. Questran C. Ursodeoxycholic acid D. Psoralen ultraviolet irradiation (PUVA) - correct answer C. Bile acid displacement therapy with ursodeoxycholic acid may be indicated for a patient with these symptoms. Which of the following clinical findings is associated with calcineurin inhibitors? A. Elevated serum magnesium B. Hemiparesis C. Seizures D. Hypotension - correct answer C. Transient eye movement abnormalities are associated with calcineurin inhibitors. It is important to teach patients early in the transplant process to avoid contact with fresh plants to prevent infection with: A. Pneumocystis jiroveci B. Cytomegalovirus C. Aspergillus D. Respiratory Syncytial Virus - correct answer C. Aspergillosis is primarily contracted by inhalation of aspergillus spores from fresh plants, dried plants, and moss. Which of the following statements by a bone marrow donor indicates the need for further teaching? A. "I will avoid performing strenuous activities for a few days." B. "I can expect to have some bruising at the harvest sites." C. "I may require a blood transfusion during the harvest." D. "I should take a warm bath to alleviate the pain after the harvest." - correct answer D. Due to the risk of bleeding and infection, bone marrow donors need to avoid tub baths for several days.
Which of the following can increase the breakdown of cryopreserved hematopoietic stem cells for infusion? A. Prolonged exposure of cells to DMSO B. Washing thawed cells prior to infusion C. Infusing 2mL of DMSO per kilogram per day D. Length of time the cells have been stored - correct answer A. Once thawed, exposure of the cells to DMSO should be minimized to minimize cell breakdown. Infections that occur post-autologous transplant are often related to which of the following? A. The conditioning regimen B. Disease relapse C. The central venous catheter D. Chronic GVHD - correct answer A. Most autologous HSCT infections are related to the conditioning regimen. Which of the following risk factors leads to an increased incidence of chronic GVHD? A. Autologous transplants B. Recipients of bone marrow stem cells C. Female donors to male recipients D. Younger patients - correct answer C. Risk factors for chronic GVHD include previous acute GVHD, older recipients, female donors to male recipients. Risk is higher in recipients of peripheral blood stem cells versus recipients of bone marrow stem cells. Autologous transplant do not get chronic GVHD. Which of the following is a disadvantage of a syngeneic transplant? A. Prolonged immunosuppression is required B. Longer time to engraftment C. Limited supply of stem cells D. Lack of graft-versus-tumor effect - correct answer D. A syngeneic transplant lacks the graft-versus-tumor effect which is beneficial for the patient.
Which is an important predictive marker of T cell immune recovery following HSCT? A. CD4+ cell counts B. Serum IgG levels C. Presence of macrophages D. Absolute neutrophil count - correct answer A. CD4+ counts are one of the most predictive markers of immune recovery after HSCT. Which law requires federally funded school districts to provide accommodations for children who are perceived to have a learning disability, including pediatric cancer survivors? A. The Rehabilitation act of 1973 requires a 504 plan that provides accommodations to students who need them due to a perceived disability. B. The Individuals with Disabilities Education Act C. Family Medical Leave Act D. The American with Disabilities Act - correct answer A. The Rehabilitation Act of 1973 (Section 504) A patient reports weakness, fatigue, and a decreased desire to socialize with family and friends after transplant. What should the nurse do? A. Start patient on an antidepressant B. Instruct the patient to take frequent naps C. Decrease corticosteroid dose D. Encourage regular aerobic exercise - correct answer D. Studies have shown that regular aerobic exercise can help to decrease fatigue and improve overall well- being. A transplant center that uses data from audits to identify improvement opportunities is demonstrating: A. Quality management B. Data management C. Performance review
D. Policy development - correct answer A. Quality management includes program audits conducted on a regular basis. The results are used to recognize problems, identify trends and improvement opportunities. Performance review, policy development and data management are other aspects of a quality management plan. Which medication is routinely used for mobilization? A. Alemtuzumab B. IL- C. Filgrastim D. Cyclosporine - correct answer C. Filgrastim is used to mobilize circulating stem cells. Which medication is used as a pre-emptive treatment for a patient who had an HSCT and is now presenting with elevated EBV titres? A. Sorafenib B. Eriotinib C. Panitumumab D. Rituximab - correct answer D. Rituximab is used to as a pre-emptive treatment for PTLD. Which of the following is an example of providing safe, quality care based on the research process? A. Competency assessment B. Accreditation standards C. Evidence-based practice D. Regulatory requirements - correct answer C. It is not acceptable to provide patient care based on routine practice only. Cyclosporine can cause which of the following side effects? A. Oral mucositis B. Lichen planus C. Gingival hyperplasia
C. Referring physician D. Life expectancy of three months - correct answer A. Another frequent barrier to hospice eligibility is the desire to continue treatments such as blood transfusions, chemotherapy, total parenteral nutrition, and IV fluids because of the belief that these interventions will enhance the patient. Which of the following clinical findings is associated with polymyositis? A. Facial weakness B. Ptosis C. Proximal muscle weakness D. Sensory loss - correct answer C. Proximal muscle weakness is associated with polymyositis. Which of the following is a chemokine receptor that helps to regulate stem cell release into the peripheral circulation? A. CCR B. CXCR C. CD D. CD34 - correct answer B. CXCR4 has been identified as being important in the regulation of trafficking and homing of cells involved in hematopoiesis and the immune system.
