Certified Clinical Transplant Nurse MCQ Flashcards

A CMV-seronegative kidney recipient receives an organ from a CMV-seropositive donor (D+/R−). What is the standard prophylaxis approach?

Answer: Valganciclovir prophylaxis for 3–6 months post-transplant

D+/R− is the highest-risk CMV mismatch, and universal prophylaxis with valganciclovir for 3–6 months is the standard of care to prevent primary CMV disease.

Which clinical finding differentiates hepatic artery thrombosis (HAT) from biliary stricture in a liver transplant recipient?

Answer: HAT causes dramatically elevated transaminases and can cause fulminant graft failure; biliary strictures cause cholestatic LFT pattern

HAT presents acutely with ischemic hepatocyte injury (high AST/ALT) and can precipitate graft necrosis, while biliary strictures cause a more insidious cholestatic pattern with elevated bilirubin and alkaline phosphatase.

A renal transplant recipient at 3 years post-transplant develops a skin lesion diagnosed as squamous cell carcinoma. What education should the transplant nurse prioritize?

Answer: Sun protection, annual full-body skin exams, and awareness that immunosuppression significantly elevates skin cancer risk

Transplant recipients have a 65–250 times higher risk of squamous cell carcinoma due to chronic immunosuppression, and lifelong sun protection plus annual dermatology screening is essential.

A pediatric liver transplant patient is transitioning to adult care. Which nursing intervention is MOST critical for successful transition?

Answer: Structured transition program teaching self-management, medication adherence, and adult healthcare navigation starting at age 12–14

Early, structured transition programs that gradually transfer self-management responsibility are evidence-based and reduce the high rate of graft loss seen during adolescent transition to adult care.

Which electrolyte abnormality is a well-known side effect of tacrolimus in kidney transplant recipients?

Answer: Hyperkalemia and hypomagnesemia

Tacrolimus causes hyperkalemia through impaired renal potassium excretion and hypomagnesemia through urinary magnesium wasting, both of which require monitoring and dietary management.

A nurse is caring for a deceased-donor liver recipient whose family asks about brain death. Which explanation is MOST accurate?

Answer: Brain death is the irreversible cessation of all brain and brainstem function, meeting legal and medical criteria for death

Brain death is legally and medically defined as the irreversible cessation of all functions of the entire brain, including the brainstem, and is determined by standardized clinical criteria.

Post-transplant lymphoproliferative disorder (PTLD) is MOST strongly associated with which viral infection?

Answer: Epstein-Barr virus (EBV)

PTLD is strongly associated with EBV-driven B-cell proliferation occurring under immunosuppression, particularly in EBV-seronegative recipients of EBV-seropositive donors.