CCTN Certified Clinical Transplant Nurse MCQ 2

Question 1

A kidney transplant recipient is on tacrolimus and develops a trough level of 18 ng/mL in the first week post-transplant. What is the most appropriate nursing action?

Accepted Answer

Notify the transplant team for dose reduction

Answer

A tacrolimus trough of 18 ng/mL exceeds typical early post-transplant targets (10–15 ng/mL) and raises the risk of nephrotoxicity, requiring prompt notification of the transplant team for dose adjustment.

Question 2

Which finding in a liver transplant recipient at post-operative day 3 would be MOST concerning for primary non-function (PNF)?

Accepted Answer

AST >5,000 IU/L with coagulopathy and rising creatinine

Answer

Markedly elevated transaminases (>5,000 IU/L) combined with coagulopathy and renal failure in the early post-transplant period are hallmarks of primary non-function, a graft-threatening emergency.

Question 3

A heart transplant patient develops a new resting heart rate of 58 bpm with fatigue and dyspnea on post-operative day 10. What etiology should the nurse prioritize?

Accepted Answer

Acute cellular rejection

Answer

New fatigue and dyspnea with hemodynamic changes in the first weeks post-heart transplant are classic signs of acute cellular rejection until proven otherwise and require urgent endomyocardial biopsy.

Question 4

When educating a renal transplant recipient about food safety, which instruction is MOST important due to immunosuppression?

Accepted Answer

Consume only pasteurized dairy products and avoid raw shellfish

Answer

Immunosuppressed transplant recipients are at high risk for Listeria and other foodborne pathogens, making avoidance of unpasteurized dairy and raw shellfish a critical safety measure.

Question 5

A pancreas transplant recipient's fasting blood glucose rises from 90 to 210 mg/dL on post-operative day 14. What should the nurse suspect FIRST?

Accepted Answer

Graft rejection or thrombosis

Answer

A sudden rise in glucose in a pancreas transplant recipient signals potential graft rejection or vascular thrombosis, both of which impair insulin secretion and require immediate investigation.

CCTN - Certified Clinical Transplant Nurse Practice Test

CCTN - Certified Clinical Transplant Nurse Practice Test

CCTN Certified Clinical Transplant Nurse MCQ 2