TCTCN exam guide
About the Transplantation and Cellular Therapy Certified Nurse (TCTCN) exam
TCTCN assesses specialized nursing across hematopoietic stem-cell transplantation and cellular therapy, from donor and recipient selection through collection, conditioning, administration, early and late complications, survivorship, quality of life, and professional performance. Preparation must distinguish HSCT-specific risks from cellular-therapy toxicities while preserving infection prevention, education, and rapid escalation.
MedPorium is an independent education platform and is not affiliated with or endorsed by Oncology Nursing Certification Corporation (ONCC). Exam details can change; confirm them with the official source before applying.
TCTCN exam format at a glance
- Questions
- 165
- 125 scored; 40 unscored
- Time
- 3 hours, including the tutorial and post-test survey
- Delivery
- Computer-based testing through PSI
Knowledge to review for the TCTCN exam
These foundations support the practical tasks in the official examination matrix.
Foundations and treatment process
- Hematopoiesis, immune function, HLA and histocompatibility, graft-versus-tumor effect, reconstitution, indications, autologous and allogeneic HSCT
- Related, unrelated, mismatched, cord, and haploidentical donors; peripheral blood, marrow, cord, and tumor sources
- CAR-T, TIL, NK, bispecific antibodies, gene therapy, DLI, recipient and donor evaluation, mobilization, collection, storage, conditioning, and administration
Post-HSCT and cellular therapy care
- Engraftment, pancytopenia, transfusion support, infection, sepsis, graft failure, chimerism, acute and chronic GVHD, VOD, GI effects, and immunosuppression
- CRS, ICANS or neurotoxicity, HLH, engraftment syndrome, hypogammaglobulinemia, relapse, progression, and treatment failure
- Pain, nausea, fatigue, nutrition, mobility, pulmonary, ocular, reproductive, cognitive, and other early and late effects
Long-term and professional care
- Vaccination, antimicrobial prophylaxis, milestone visits, subsequent malignancy, survivorship, health promotion, sexuality, and follow-up
- Navigation, caregiver support, coping, culture, spirituality, palliation, hospice, end-of-life care, and legacy building
- Scope, evidence, quality, teamwork, safety, ethics, consent, directives, advocacy, FACT, Joint Commission, REMS, and self-care
TCTCN examination matrix
The percentages below are the approximate exam-score weights published by Oncology Nursing Certification Corporation (ONCC). Use them to allocate study time, then adjust for your own weak areas.
22%
Foundations of HSCT and Cellular Therapy
Apply hematopoietic, immunologic, histocompatibility, indication, donor, source, therapy, evaluation, and education principles.
- Differentiate autologous and allogeneic HSCT, donor options, sources, indications, and therapeutic goals
- Understand CAR-T and other cellular, immune, gene, and donor-lymphocyte approaches
- Support recipient suitability, donor selection, informed education, caregiver preparation, and risk recognition
22%
HSCT and Cellular Therapy Process and Administration
Apply nursing principles for product collection, mobilization, harvest, storage, conditioning, acute toxicity, and administration.
- Support collection, mobilization, harvest, processing, transport, and storage
- Monitor chemotherapy, radiation, biotherapy, immunotherapy, targeted, and intensity-based conditioning
- Prepare for and manage fresh or cryopreserved product administration, compatibility, infusion reactions, and acute complications
22%
Post-HSCT Management and Education
Manage early and late HSCT complications, symptoms, infection risk, graft outcomes, relapse, and follow-up education.
- Monitor engraftment, pancytopenia, infection, sepsis, immunosuppression, acute GVHD, VOD, graft failure, rejection, and chimerism
- Recognize engraftment syndrome, CRS, HLH, GI and other organ complications and support symptoms and function
- Address chronic GVHD, BOS, cataracts, infertility, cognition, vaccines, prophylaxis, relapse, malignancy, and milestone care
22%
Post-Cellular Therapy Management and Education
Manage early and late infection, hematologic, immune, neurologic, symptom, failure, relapse, and follow-up issues after cellular therapy.
- Recognize CRS, ICANS or neurotoxicity, HLH, sepsis, pancytopenia, and transfusion needs
- Support pain, nausea, fatigue, nutrition, mobility, and patient-caregiver education
- Monitor late neurotoxicity, cytopenias, hypogammaglobulinemia, infection, relapse, subsequent malignancy, and milestone follow-up
8%
Quality of Life
Coordinate psychosocial, caregiver, cultural, sexual, survivorship, palliative, and end-of-life support across the continuum.
- Navigate services and coordinate longitudinal care
- Assess coping, caregiver burden, family support, sexuality, culture, spirituality, and health maintenance
- Support survivorship, palliation, hospice, end-of-life care, and legacy goals
4%
Professional Performance
Apply scope, evidence, quality, safety, ethics, law, accreditation, collaboration, advocacy, development, and self-care.
- Practise within transplantation and cellular-therapy nursing scope and evidence
- Apply safe handling, PPE, consent, directives, boundaries, donor and patient advocacy
- Use research, quality improvement, teamwork, FACT, Joint Commission, REMS, development, and clinician self-care
How to use this TCTCN diagnostic
The diagnostic samples all six official domains, including the four equally weighted 22% clinical domains. Classify each gap by therapy type, phase, product, donor or recipient issue, complication timing, immune or organ effect, symptom management, education, quality of life, or professional standard.
High-yield TCTCN study priorities
Priority 1
Build a phase-based timeline
Organize study around evaluation, collection, conditioning, infusion, aplasia, engraftment, early recovery, late recovery, survivorship, relapse, and long-term follow-up.
Priority 2
Separate HSCT from cellular therapy toxicities
Compare GVHD, graft failure, VOD, and engraftment issues with CRS, ICANS, HLH, cytopenias, hypogammaglobulinemia, and cellular-treatment failure.
Priority 3
Rehearse immune emergencies
Use timed cases for fever, sepsis, CRS grade changes, new neurologic findings, HLH, respiratory decline, and rapidly evolving organ dysfunction.
Priority 4
Treat education as longitudinal
Cover infection prevention, medicines, vaccines, nutrition, activity, caregivers, warning signs, milestones, fertility, sexuality, psychosocial recovery, and when to call.
TCTCN exam FAQ
How many questions are on the TCTCN exam?
ONCC currently lists 165 multiple-choice questions. Of these, 125 count toward the score and 40 are unscored pretest questions that cannot be identified during the examination.
How long is the TCTCN exam?
The test session is three hours, including 15 minutes for the computer-based testing tutorial before the exam and a post-test survey. There are no scheduled breaks, and the timer continues during an unscheduled break.
How is the TCTCN content outline weighted?
The 2026 outline is weighted Foundations of HSCT and Cellular Therapy 22%, HSCT and Cellular Therapy Process and Administration 22%, Post-HSCT Management and Education 22%, Post-Cellular Therapy Management and Education 22%, Quality of Life 8%, Professional Performance 4%. The percentages apply to the 125 scored questions.
How long is the TCTCN testing window?
ONCC currently provides a 90-day testing window after authorization to test. Candidates should confirm processing times, authorization dates, and scheduling instructions directly with ONCC.
Who should verify eligibility for TCTCN?
Candidates should confirm the current license, education, experience, practice-hour, and continuing-education requirements on the official ONCC page before applying. This study page does not determine eligibility.
Does this diagnostic predict whether I will pass?
No. A 15-question diagnostic is a low-confidence baseline, not a validated pass prediction. Review every rationale, then use larger mixed and domain-specific sets to build a more stable readiness estimate.
Is MedPorium affiliated with ONCC?
No. MedPorium is an independent education platform and is not affiliated with or endorsed by the Oncology Nursing Certification Corporation.
Review and official source
Clinical reviewer: G. D. Davis
Exam format and matrix information were checked against the ONCC Transplantation and Cellular Therapy Certified Nurse certification page. Source reviewed October 12, 2026.
Ready to check your TCTCN knowledge?
Take the free 15-question practice test to identify strengths and topics that need more review.