CCTN Patient Education and Psychosocial Care in Transplantation 2 — Questions and Answers
Question 1: Which psychological condition is most commonly seen in transplant recipients awaiting an organ on the waiting list?
- Schizophrenia
- Depression and anxiety (Correct answer)
- Mania
- Obsessive-compulsive disorder
Correct answer: Depression and anxiety
Depression and anxiety are highly prevalent in transplant candidates and recipients, driven by uncertainty, health burden, and life disruption, requiring regular psychosocial screening.
Question 2: A kidney transplant recipient expresses guilt about their donor's death. What is the most therapeutic nursing response?
- Tell the patient they should feel grateful, not guilty
- Acknowledge the patient's feelings, normalize them, and offer connection to counseling or donor family support programs (Correct answer)
- Redirect the patient to focus on their recovery
- Explain to the patient that guilt is irrational
Correct answer: Acknowledge the patient's feelings, normalize them, and offer connection to counseling or donor family support programs
Survivor guilt is a recognized psychological response in transplant recipients; acknowledging feelings, normalizing them, and offering support resources is the therapeutic approach.
Question 3: Which lifestyle modification is most important to counsel a transplant recipient about for long-term cardiovascular health?
- Bed rest to protect the graft
- Smoking cessation, regular exercise, and blood pressure management (Correct answer)
- Low-protein diet to reduce graft workload
- Avoiding all physical activity for the first year
Correct answer: Smoking cessation, regular exercise, and blood pressure management
Cardiovascular disease is the leading cause of death in transplant recipients, so smoking cessation, exercise, and BP management are paramount lifestyle counseling topics.
Question 4: What dietary counseling should a transplant nurse provide to a patient taking tacrolimus about grapefruit?
- Grapefruit is encouraged to boost immune function
- Grapefruit and grapefruit juice must be avoided because they inhibit CYP3A4 and can dramatically increase tacrolimus levels (Correct answer)
- Grapefruit only affects cyclosporine, not tacrolimus
- One glass of grapefruit juice per day is acceptable
Correct answer: Grapefruit and grapefruit juice must be avoided because they inhibit CYP3A4 and can dramatically increase tacrolimus levels
Grapefruit inhibits intestinal CYP3A4 enzymes, unpredictably elevating tacrolimus blood levels and risking toxicity — it must be completely avoided.
Question 5: A liver transplant recipient reports drinking alcohol occasionally. What is the most appropriate nursing response?
- Moderate alcohol is acceptable after liver transplantation
- Alcohol is absolutely contraindicated after liver transplantation due to risk of graft injury and recurrence of alcoholic liver disease (Correct answer)
- Occasional alcohol is only concerning if liver enzymes are elevated
- Advise the patient to limit to one drink per week
Correct answer: Alcohol is absolutely contraindicated after liver transplantation due to risk of graft injury and recurrence of alcoholic liver disease
Alcohol is contraindicated after liver transplantation because it can damage the graft and cause recurrence of alcoholic liver disease, threatening graft survival.
Question 6: Which transplant patient situation requires mandatory referral to social work?
- Patient asks questions about medication side effects
- Patient expresses inability to afford medications or housing instability (Correct answer)
- Patient requests a second medical opinion
- Patient has questions about returning to work
Correct answer: Patient expresses inability to afford medications or housing instability
Financial instability and housing insecurity are social determinants that directly threaten medication adherence and graft survival, requiring urgent social work intervention.
CCTN Patient Education and Psychosocial Care in Transplantation 2
Which psychological condition is most commonly seen in transplant recipients awaiting an organ on the waiting list?