ONCC Transplantation and Cellular Therapy Certified Nurse Examination Practice Test
Transplantation and cellular therapy nursing focuses on care before, during, and after hematopoietic cell transplantation and related cellular treatments. The question bank touches on donor matching, stem cell collection, immunosuppressive medication, nutrition during high-dose chemotherapy, and assessment for complications. These subjects call for careful monitoring, patient education, and prompt communication of changes that may signal treatment-related harm.
Exam overview
About the ONCC Transplantation and Cellular Therapy Certified Nurse Examination Exam
Nurses caring for transplant recipients track clinical changes against the patient’s baseline and recognize patterns that need rapid evaluation. Practice topics include using circulating CD34-positive cell counts in collection planning, understanding how HLA compatibility relates to allogeneic transplantation, and assessing fluid loss when watery stool output rises. New rash, diarrhea, or bilirubin elevation after an allogeneic transplant can raise concern for graft-versus-host disease; shortness of breath warrants focused assessment, including comparison of oxygenation with baseline. Safe care also involves teaching patients to take immunosuppressants as prescribed, screening over-the-counter products for potential interactions, supporting intake when appetite is poor, and reducing bleeding risk when platelet counts are low. These decisions connect transplant physiology with medication safety, symptom assessment, and practical discharge teaching.
Sample Practice Questions
Review a selection from this exam's published US Practice Tests practice bank.
A transplant recipient is discharged with prescribed immunosuppressive medication. Which patient statement indicates a need for further teaching?
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Correct answer: CPatients should not stop or alter immunosuppressive therapy without direction from the transplant team. Unplanned changes can increase the risk of graft-related complications. Medication schedules, missed-dose instructions, interaction checks, and prompt reporting of infection symptoms are important parts of safe care.
A patient receiving high-dose chemotherapy before transplantation has a markedly reduced appetite and early satiety. Which approach is most appropriate to support nutrition?
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Correct answer: ASmall, frequent, energy- and protein-dense meals may be easier to tolerate than large meals and can support intake. The team should assess weight and nutrition status and involve a dietitian when needed; specific food-safety instructions still apply during immune suppression.
A patient is scheduled for an allogeneic transplant from an HLA-matched sibling. Which explanation best describes the purpose of HLA matching?
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Correct answer: BHLA matching helps reduce immunologic incompatibility between donor and recipient, lowering—but not eliminating—the risk of complications such as graft-versus-host disease and graft rejection. HLA matching does not ensure blood-type identity or eliminate infection risk.
A patient is being considered for autologous hematopoietic cell collection. Which measure is commonly used to assess whether enough circulating CD34-positive cells are available to begin collection?
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Correct answer: APeripheral blood CD34-positive cell counts help the transplant team assess mobilization and determine when apheresis collection is likely to be productive. The other tests do not measure circulating hematopoietic progenitor-cell availability.
A patient after hematopoietic cell transplantation reports new shortness of breath when walking. Which assessment is most useful for identifying a change from the patient’s baseline oxygenation?
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Correct answer: AAssessing oxygen saturation at rest and with activity can help characterize exertional desaturation and guide further evaluation. New dyspnea after transplantation should be reported and assessed in clinical context rather than attributed to deconditioning without evaluation.
A patient several weeks after allogeneic transplantation develops a new maculopapular rash, watery diarrhea, and rising bilirubin. Which complication should the nurse promptly report as a concern?
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Correct answer: AAfter allogeneic transplantation, skin changes, gastrointestinal symptoms such as diarrhea, and liver dysfunction can be manifestations of acute graft-versus-host disease. These findings require prompt assessment and reporting because early evaluation and management are important.
A patient receiving an allogeneic transplant asks why the care team is monitoring for graft-versus-host disease. Which explanation is most accurate?
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Correct answer: AGraft-versus-host disease occurs when immunocompetent donor cells react against recipient tissues. The risk and severity depend on multiple factors, and monitoring helps identify possible manifestations for timely evaluation.
How to use this practice test
Access is free. Each session draws up to 20 random questions from the 50-question practice bank and displays results afterward. Use the questions to check how you apply transplant-care concepts to clinical situations, then revisit any missed topics, such as fluid assessment, medication teaching, or recognition of possible graft-versus-host disease.
Preparation tips
- Compare allogeneic and autologous transplantation, including the role of HLA matching and the purpose of CD34-positive cell assessment before collection.
- Practice distinguishing possible graft-versus-host disease findings—such as rash, watery diarrhea, and bilirubin elevation—from other post-transplant changes that need assessment.
- Review how to assess fluid balance with increased stool output and how to compare new respiratory symptoms with a patient’s baseline oxygenation.
- Prepare concise teaching on immunosuppressant adherence, checking supplements and over-the-counter products for interaction concerns, and bleeding precautions when platelet counts are low.
- Consider nutrition-support options for patients experiencing poor appetite or early satiety during high-dose chemotherapy, and connect recommendations to tolerance and intake.