CCTN Patient Education and Psychosocial Care in Transplantation 1 — Questions and Answers
Question 1: Which topic is most critical to include in discharge education for a new kidney transplant recipient?
- How to apply for disability benefits
- Signs and symptoms of rejection and when to seek immediate care (Correct answer)
- Exercise guidelines for returning to sports
- Dietary restrictions for cholesterol management
Correct answer: Signs and symptoms of rejection and when to seek immediate care
Teaching rejection warning signs (decreased urine output, fever, graft tenderness, rising creatinine) and when to seek care is the most critical discharge education topic.
Question 2: How should a transplant nurse counsel a patient about sun exposure after transplantation?
- Sun exposure is encouraged to increase vitamin D production
- Transplant recipients have significantly increased risk of skin cancer and must use high SPF sunscreen and protective clothing daily (Correct answer)
- Only melanoma risk is increased — other skin exposures are safe
- Sun protection is only needed in the first year post-transplant
Correct answer: Transplant recipients have significantly increased risk of skin cancer and must use high SPF sunscreen and protective clothing daily
Immunosuppression dramatically increases skin cancer risk (up to 100-fold for squamous cell carcinoma), requiring lifelong sun protection and regular dermatologic follow-up.
Question 3: A transplant recipient asks if they can get a flu shot. What is the most accurate nursing response?
- All vaccines are contraindicated after transplantation
- Inactivated influenza vaccines are recommended annually; live vaccines are contraindicated (Correct answer)
- Live attenuated vaccines are preferred for better immunity
- Vaccines are unnecessary because immunosuppression prevents flu
Correct answer: Inactivated influenza vaccines are recommended annually; live vaccines are contraindicated
Transplant recipients should receive inactivated vaccines (not live), including annual influenza vaccine, because live vaccines can cause disease in immunocompromised patients.
Question 4: What is the most common reason for graft loss in long-term kidney transplant recipients related to patient behavior?
- Excessive exercise damaging the graft
- Non-adherence to immunosuppressive medications (Correct answer)
- Dietary non-compliance causing metabolic syndrome
- Failure to attend annual follow-up appointments
Correct answer: Non-adherence to immunosuppressive medications
Non-adherence to immunosuppressive medications is the leading preventable cause of late graft loss, often resulting in chronic rejection.
Question 5: A transplant patient says they cannot afford their medications. What is the most appropriate nursing action?
- Advise the patient to skip non-critical medications to save money
- Connect the patient with social work, patient assistance programs, and transplant coordinators to address financial barriers (Correct answer)
- Document the concern and continue without intervention
- Advise the patient to use half doses to stretch their supply
Correct answer: Connect the patient with social work, patient assistance programs, and transplant coordinators to address financial barriers
Financial barriers to medication access are a major adherence threat — the transplant team's social worker and patient assistance programs must be engaged immediately.
Question 6: How long after transplantation should female recipients wait before attempting pregnancy?
- 6 months
- 12 months
- At least 1–2 years, when graft function is stable and immunosuppression is minimized (Correct answer)
- Pregnancy is permanently contraindicated after transplant
Correct answer: At least 1–2 years, when graft function is stable and immunosuppression is minimized
Transplant guidelines recommend waiting 1–2 years post-transplant until graft function is stable and immunosuppression is at maintenance levels before attempting pregnancy.
CCTN Patient Education and Psychosocial Care in Transplantation 1
Which topic is most critical to include in discharge education for a new kidney transplant recipient?