Free Transplantation and Cellular Therapy Certified Nurse (TCTCN™) Test Practice Questions

Sample Practice Questions

Try these 10 sample questions from the Transplantation and Cellular Therapy Certified Nurse (TCTCN™) Test practice bank. Each includes the answer and explanation. Continue with the interactive practice above to review the full question set.

1. 1A transplant nurse explains why one blood-forming stem cell population can restore several blood cell types. Which property makes this possible?

   1. A. Differentiation into several blood cell lineages
   2. B. Secretion of antibodies against specific antigens
   3. C. Phagocytosis of circulating microbial pathogens
   4. D. Direct destruction of antigen-bearing tumor cells

   Answer: A

   Explanation: NCI states, "Blood-forming stem cells are vital because they grow into different types of blood cells." Their differentiation restores multiple lineages; antibody secretion, phagocytosis, and cytotoxicity are mature immune-cell functions.

   Reference: Stem Cell Transplants in Cancer Treatment — Opening description of blood-forming stem cells

2. 2A nurse prepares a patient for leukapheresis to manufacture autologous CAR T cells. Which cell population must be separated for genetic modification?

   1. A. T lymphocytes
   2. B. B lymphocytes
   3. C. Natural killer cells
   4. D. Monocytes

   Answer: A

   Explanation: NIH states, "Patient undergoes apheresis to remove WBCs and separate T-cells". The T-cell population is collected and then engineered to express the CAR.

   Reference: Hematopoietic Stem Cell Transplantation & CAR T-cell Therapy: An Overview — How are CAR T-cells made?

3. 3A nurse assesses neutrophil engraftment after HSCT using the criterion described by NIH. What minimum absolute neutrophil count must be sustained for three consecutive days?

   1. A. 100 cells/mm³
   2. B. 500 cells/mm³
   3. C. 1,000 cells/mm³
   4. D. 1,500 cells/mm³

   Answer: B

   Explanation: NIH specifies "An absolute neutrophil count of ≥500/mm3 for 3 consecutive days". The minimum qualifying count is 500 cells/mm³.

   Reference: Hematopoietic Stem Cell Transplantation & CAR T-cell Therapy: An Overview — Engraftment

4. 4Three days after CAR T-cell infusion, a patient develops fever, myalgias, hypotension, and hypoxia. Cultures and other causes are being assessed. Which treatment-related syndrome best explains this inflammatory presentation?

   1. A. Immune effector cell-associated neurotoxicity syndrome
   2. B. Cytokine release syndrome
   3. C. Tumor lysis syndrome
   4. D. Immune effector cell-associated enterocolitis

   Answer: B

   Explanation: NCI states, "CRS presents as a sepsis-like situation, with fever, headache, myalgias, hypotension, capillary leak, hypoxia, and renal dysfunction." The systemic inflammatory presentation is characteristic of CRS; infection must still be evaluated.

   Reference: Pediatric Chimeric Antigen Receptor (CAR) T-Cell Therapy (PDQ®)–Health Professional Version — Toxicities of CAR T-Cell Therapy—Cytokine release syndrome

5. 5During transplantation follow-up, a patient reports skipping prescription refills because uncovered treatment costs have exhausted the family budget. Which problem should the nurse identify for navigation support?

   1. A. Decisional conflict
   2. B. Financial toxicity
   3. C. Anticipatory grief
   4. D. Caregiver burden

   Answer: B

   Explanation: NCI defines financial toxicity as "problems a patient has related to the cost of medical care." Cost-driven medication nonadherence illustrates this problem and warrants financial-navigation support.

   Reference: NCI Dictionary of Cancer Terms—Financial Toxicity — Financial toxicity—definition

6. 6A transplant nurse is preparing to administer an antineoplastic drug. In addition to chemotherapy gloves, which gown design matches NIOSH exposure-prevention guidance?

   1. A. An absorbent gown with a closed front and tight cuffs
   2. B. A nonabsorbent gown with a closed front and tight cuffs
   3. C. A nonabsorbent gown with an open front and tight cuffs
   4. D. A nonabsorbent gown with a closed front and loose cuffs

   Answer: B

   Explanation: NIOSH recommends "chemotherapy gloves and a nonabsorbent gown with a closed front and tight-fitting cuffs." This item tests the nurse's own safe handling during administration, within the outline's environmental health and safety scope.

   Reference: Chemical Hazards Risk Factors—Healthcare Workers — Antineoplastic agents—How employers and employees can reduce exposure

7. 7During allogeneic transplant evaluation, a patient asks what HLA typing compares between the recipient and prospective donors. What should the nurse identify?

   1. A. Concentrations of circulating serum immunoglobulins
   2. B. Inherited antigen markers on most body cells
   3. C. Numbers of circulating hematopoietic progenitors
   4. D. Proportions of circulating leukocyte subtypes

   Answer: B

   Explanation: NCI explains, "HLAs are sets of proteins, or markers, that you have on most cells in your body." HLA matching assesses these tissue markers, rather than immunoglobulin concentrations or blood cell counts.

   Reference: Stem Cell Transplants in Cancer Treatment — How blood-forming stem cells are matched

8. 8During TIL product preparation, which lymphocyte characteristic is tested to select cells for expansion?

   1. A. Reactivity against healthy recipient tissues
   2. B. Recognition of the patient's tumor cells
   3. C. Recognition of unrelated donor HLA antigens
   4. D. Reactivity against circulating viral antigens

   Answer: B

   Explanation: NCI states, "Doctors test these lymphocytes in the lab to find out which ones best recognize your tumor cells." Tumor recognition guides selection for TIL expansion; alloreactive, antiviral, or autoreactive specificity does not substitute.

   Reference: T-cell Transfer Therapy — How does T-cell transfer therapy work against cancer?, TIL preparation

9. 9Around neutrophil recovery after cord blood transplantation, a patient develops unexplained fever, rash, hypoxemia, and pulmonary infiltrates without cardiac disease or fluid overload. Which syndrome should the nurse suspect?

   1. A. Sinusoidal obstruction syndrome
   2. B. Transplant-associated thrombotic microangiopathy
   3. C. Engraftment syndrome
   4. D. Delayed hemolytic transfusion reaction

   Answer: C

   Explanation: FDA states, "Engraftment syndrome is manifested as unexplained fever and rash in the peri-engraftment period." Hypoxemia and noncardiogenic infiltrates further fit this inflammatory syndrome.

   Reference: FDA Prescribing Information: HPC, Cord Blood — 5.4 Engraftment Syndrome

10. 10A patient with clinically significant CAR T-cell-associated CRS is prescribed therapy directed against the interleukin-6 receptor. Which agent should the nurse anticipate?

    1. A. Ruxolitinib
    2. B. Rituximab
    3. C. Tocilizumab
    4. D. Blinatumomab

    Answer: C

    Explanation: NCI states, "CRS can be successfully treated with anti–interleukin-6 receptor (IL-6R) therapies (e.g., tocilizumab), often in combination with steroids." Tocilizumab targets IL-6R; the other agents have different molecular targets.

    Reference: Pediatric Chimeric Antigen Receptor (CAR) T-Cell Therapy (PDQ®)–Health Professional Version — Toxicities of CAR T-Cell Therapy—Cytokine release syndrome