CCTN Certified Clinical Transplant Nurse MCQ 4

Question 1

A CMV-seronegative kidney recipient receives an organ from a CMV-seropositive donor (D+/R−). What is the standard prophylaxis approach?

Accepted Answer

Valganciclovir prophylaxis for 3–6 months post-transplant

Answer

D+/R− is the highest-risk CMV mismatch, and universal prophylaxis with valganciclovir for 3–6 months is the standard of care to prevent primary CMV disease.

Question 2

Which clinical finding differentiates hepatic artery thrombosis (HAT) from biliary stricture in a liver transplant recipient?

Accepted Answer

HAT causes dramatically elevated transaminases and can cause fulminant graft failure; biliary strictures cause cholestatic LFT pattern

Answer

HAT presents acutely with ischemic hepatocyte injury (high AST/ALT) and can precipitate graft necrosis, while biliary strictures cause a more insidious cholestatic pattern with elevated bilirubin and alkaline phosphatase.

Question 3

A renal transplant recipient at 3 years post-transplant develops a skin lesion diagnosed as squamous cell carcinoma. What education should the transplant nurse prioritize?

Accepted Answer

Sun protection, annual full-body skin exams, and awareness that immunosuppression significantly elevates skin cancer risk

Answer

Transplant recipients have a 65–250 times higher risk of squamous cell carcinoma due to chronic immunosuppression, and lifelong sun protection plus annual dermatology screening is essential.

Question 4

A pediatric liver transplant patient is transitioning to adult care. Which nursing intervention is MOST critical for successful transition?

Accepted Answer

Structured transition program teaching self-management, medication adherence, and adult healthcare navigation starting at age 12–14

Answer

Early, structured transition programs that gradually transfer self-management responsibility are evidence-based and reduce the high rate of graft loss seen during adolescent transition to adult care.

Question 5

Which electrolyte abnormality is a well-known side effect of tacrolimus in kidney transplant recipients?

Accepted Answer

Hyperkalemia and hypomagnesemia

Answer

Tacrolimus causes hyperkalemia through impaired renal potassium excretion and hypomagnesemia through urinary magnesium wasting, both of which require monitoring and dietary management.

CCTN - Certified Clinical Transplant Nurse Practice Test

CCTN - Certified Clinical Transplant Nurse Practice Test

CCTN Certified Clinical Transplant Nurse MCQ 4