CCTN Certified Clinical Transplant Nurse MCQ 3

Question 1

A deceased-donor organ allocation nurse receives a kidney offer for a highly sensitized patient with a panel reactive antibody (PRA) of 98%. What is the MOST critical pre-transplant test to perform?

Accepted Answer

Virtual or prospective crossmatch

Answer

In highly sensitized recipients, a virtual or prospective crossmatch is critical to detect donor-specific antibodies (DSA) that could cause hyperacute rejection.

Question 2

Which laboratory trend is MOST consistent with calcineurin inhibitor (CNI) nephrotoxicity in a stable kidney transplant recipient?

Accepted Answer

Gradual creatinine rise with supratherapeutic CNI trough levels and no proteinuria

Answer

CNI nephrotoxicity typically presents as a gradual, dose-dependent rise in creatinine associated with elevated drug troughs, without the systemic signs of rejection.

Question 3

Which opportunistic infection prophylaxis is standard for ALL solid organ transplant recipients in the first 3–6 months post-transplant?

Accepted Answer

Trimethoprim-sulfamethoxazole (TMP-SMX) for Pneumocystis jirovecii

Answer

TMP-SMX is universally recommended for PCP prophylaxis in all solid organ transplant recipients during the high-immunosuppression period, and also provides coverage for Toxoplasma and Nocardia.

Question 4

A renal transplant nurse notes a recipient's urine output drops from 200 mL/hr to 20 mL/hr at post-operative hour 6. What is the PRIORITY intervention?

Accepted Answer

Check for Foley catheter kinking or obstruction first

Answer

The first step in evaluating sudden oliguria post-transplant is to rule out a mechanical cause such as Foley catheter obstruction, which is common and easily correctable.

Question 5

A liver transplant recipient on tacrolimus is started on fluconazole for a fungal infection. What does the nurse anticipate?

Accepted Answer

Tacrolimus levels will increase due to CYP3A4 inhibition

Answer

Fluconazole is a potent CYP3A4 inhibitor that markedly reduces tacrolimus metabolism, causing drug levels to rise and increasing the risk of toxicity.

CCTN - Certified Clinical Transplant Nurse Practice Test

CCTN - Certified Clinical Transplant Nurse Practice Test

CCTN Certified Clinical Transplant Nurse MCQ 3