CCTC Immediate Postoperative Care 5

Question 1

Which immunosuppressive drug used in the immediate post-transplant period is most associated with hyperglycemia requiring insulin therapy?

Accepted Answer

Tacrolimus and corticosteroids

Answer

Tacrolimus impairs insulin secretion from beta cells, and corticosteroids cause insulin resistance, together producing significant post-transplant hyperglycemia.

Question 2

A kidney transplant patient's morning labs show a tacrolimus trough level of 24 ng/mL (target 8-12 ng/mL). What is the most appropriate action?

Accepted Answer

Hold next dose and notify the transplant physician

Answer

A supratherapeutic tacrolimus level increases nephrotoxicity and neurotoxicity risk; the dose should be held and the physician notified for dose adjustment.

Question 3

What is the significance of pink or red-tinged drain output following a liver transplant in the immediate postoperative period?

Accepted Answer

Possible arterial or venous bleeding requiring immediate assessment

Answer

Bloody drain output suggests intraabdominal hemorrhage, which is a surgical emergency requiring urgent evaluation and possible re-exploration.

Question 4

In the immediate postoperative period after heart transplant, pulmonary hypertension in the recipient increases the risk of which complication?

Accepted Answer

Right ventricular failure of the donor heart

Answer

The donor right ventricle is unaccustomed to high pulmonary pressures in the recipient and can fail acutely when exposed to pre-existing pulmonary hypertension.

Question 5

A nurse reports that a post-renal transplant patient has not produced any urine for 2 hours. After ruling out catheter obstruction, what is the next step?

Accepted Answer

Administer a fluid bolus and reassess

Answer

A fluid bolus is the first step to optimize intravascular volume and perfusion before escalating to other interventions for post-transplant oliguria.

CCTC - Certified Clinical Transplant Coordinator Practice Test

CCTC - Certified Clinical Transplant Coordinator Practice Test

CCTC Immediate Postoperative Care 5