CCTC Immediate Postoperative Care 4

Question 1

A pancreas transplant recipient develops hyperglycemia on postoperative day 1. What is the most important first step?

Accepted Answer

Assess graft perfusion with Doppler ultrasound

Answer

Sudden hyperglycemia after pancreas transplant may indicate graft thrombosis or failure, so vascular assessment with Doppler should precede insulin therapy.

Question 2

Which sign on physical examination is most concerning for intraabdominal hemorrhage in the immediate post-transplant period?

Accepted Answer

Increasing abdominal girth with hemodynamic instability

Answer

Expanding abdominal girth combined with tachycardia and hypotension indicates significant intraabdominal bleeding requiring urgent surgical evaluation.

Question 3

What is the recommended target blood pressure range for most kidney transplant recipients in the immediate postoperative period?

Accepted Answer

120/80 to 140/90 mmHg

Answer

Maintaining blood pressure in the normal range ensures adequate renal perfusion without risking anastomotic stress or hypertensive complications.

Question 4

A lung transplant patient on postoperative day 2 develops a fever of 38.9°C, purulent sputum, and worsening hypoxia. What is the most appropriate next step?

Accepted Answer

Obtain bronchoalveolar lavage (BAL) and start broad-spectrum antibiotics

Answer

Early post-transplant pneumonia requires BAL for culture-directed therapy and empiric broad-spectrum antibiotics given the immunocompromised state.

Question 5

In a liver transplant patient, which value best indicates early primary graft nonfunction (PNF)?

Accepted Answer

Absence of bile production with coagulopathy and encephalopathy within 24 hours

Answer

Primary graft nonfunction presents early with failure of all liver functions — absent bile, severe coagulopathy, and encephalopathy — requiring urgent re-listing.

CCTC - Certified Clinical Transplant Coordinator Practice Test

CCTC - Certified Clinical Transplant Coordinator Practice Test

CCTC Immediate Postoperative Care 4