CCTN Post-Transplant Immunosuppressive Medications

Question 1

Tacrolimus exerts its immunosuppressive effect by inhibiting which enzyme?

Accepted Answer

Calcineurin

Answer

Tacrolimus inhibits calcineurin, preventing IL-2 transcription and thereby blocking T-cell activation and proliferation.

Question 2

Which side effect is most associated with long-term tacrolimus use in transplant recipients?

Accepted Answer

Hypertension and nephrotoxicity

Answer

Long-term tacrolimus use commonly causes nephrotoxicity and hypertension, both of which require ongoing monitoring in transplant recipients.

Question 3

Mycophenolate mofetil (MMF) inhibits which enzyme to suppress lymphocyte proliferation?

Accepted Answer

Inosine monophosphate dehydrogenase (IMPDH)

Answer

MMF inhibits IMPDH, blocking de novo purine synthesis which lymphocytes rely on exclusively for proliferation, making it lymphocyte-selective.

Question 4

A transplant nurse notes a tacrolimus trough level of 22 ng/mL in a 3-month post-kidney-transplant patient. What is the most appropriate action?

Accepted Answer

Notify the provider because the level is supratherapeutic

Answer

At 3 months post-transplant, tacrolimus trough targets are typically 8–12 ng/mL; a level of 22 ng/mL is supratherapeutic and requires physician notification.

Question 5

Which immunosuppressant is an mTOR inhibitor used in transplantation?

Accepted Answer

Sirolimus

Answer

Sirolimus (rapamycin) is an mTOR inhibitor that blocks the intracellular signaling pathway required for T-cell proliferation after IL-2 stimulation.

CCTN - Certified Clinical Transplant Nurse Practice Test

CCTN - Certified Clinical Transplant Nurse Practice Test

CCTN Post-Transplant Immunosuppressive Medications