CCTN Certified Clinical Transplant Nurse 2

Question 1

A kidney transplant recipient on tacrolimus develops a serum creatinine rise from 1.2 to 2.8 mg/dL on post-op day 5. The most appropriate next step is:

Accepted Answer

Obtain a renal biopsy to differentiate rejection from tacrolimus nephrotoxicity

Answer

A renal biopsy is the gold standard to distinguish acute rejection from calcineurin inhibitor nephrotoxicity, as treatment differs significantly.

Question 2

Which of the following cytomegalovirus (CMV) serostatus combinations carries the HIGHEST risk for CMV disease post-transplant?

Accepted Answer

Donor positive / Recipient negative (D+/R-)

Answer

A CMV-seropositive donor transplanted into a seronegative recipient (D+/R-) poses the highest risk because the recipient has no pre-existing immunity.

Question 3

A liver transplant patient on mycophenolate mofetil (MMF) reports persistent diarrhea. The nurse should first:

Accepted Answer

Switch to enteric-coated mycophenolate sodium to reduce GI side effects

Answer

Enteric-coated mycophenolate sodium delivers the drug to the small intestine, reducing upper GI side effects including diarrhea.

Question 4

During a living donor kidney evaluation, the potential donor is found to have a glomerular filtration rate (GFR) of 72 mL/min/1.73 m². The transplant team should:

Accepted Answer

Evaluate further with a 24-hour urine collection and repeat measurement

Answer

A borderline GFR requires further evaluation including 24-hour urine for creatinine clearance and protein to ensure safe residual function post-donation.

Question 5

Post-liver transplant, a patient develops fever, right upper quadrant pain, and elevated liver enzymes on day 10. Doppler ultrasound shows absent hepatic artery flow. This finding is MOST consistent with:

Accepted Answer

Hepatic artery thrombosis

Answer

Hepatic artery thrombosis typically presents with fever, elevated enzymes, and absent arterial flow on Doppler in the early post-operative period.

CCTN - Certified Clinical Transplant Nurse Practice Test

CCTN - Certified Clinical Transplant Nurse Practice Test

CCTN Certified Clinical Transplant Nurse 2