CCTN Infection Prevention and Management in Transplant Recipients 2

Question 1

A kidney transplant recipient is found to have rising BK viremia on routine surveillance. What is the most appropriate initial intervention?

Accepted Answer

Reduce immunosuppression, particularly the antimetabolite dose

Answer

The primary treatment for BK viremia in kidney transplant recipients is reduction of immunosuppression, which allows the host immune system to control viral replication, though this must be balanced against rejection risk.

Question 2

Which antifungal agent is most commonly used for prophylaxis against Candida infections in high-risk solid organ transplant recipients during the early post-transplant period?

Accepted Answer

Fluconazole

Answer

Fluconazole is the standard prophylactic antifungal in high-risk transplant recipients (e.g., liver, small bowel) due to its established efficacy, oral bioavailability, and favorable safety profile.

Question 3

A lung transplant recipient develops bronchiolitis obliterans syndrome (BOS). How does BOS increase infection risk?

Accepted Answer

Impaired mucociliary clearance and airway structural changes create a favorable environment for bacterial colonization

Answer

BOS damages the airway epithelium and mucociliary apparatus, impairing pathogen clearance and promoting chronic bacterial colonization with organisms like Pseudomonas aeruginosa.

Question 4

Which screening test should be performed on all transplant candidates to detect latent tuberculosis prior to transplantation?

Accepted Answer

Tuberculin skin test (TST) or interferon-gamma release assay (IGRA)

Answer

Both TST and IGRA (QuantiFERON-TB Gold) are recommended for pre-transplant latent TB screening, as immunosuppression post-transplant carries a significant risk of reactivating latent infection.

Question 5

A transplant nurse is educating a recipient about food safety. Which food should be specifically avoided to prevent Listeria monocytogenes infection?

Accepted Answer

Unpasteurized soft cheeses and ready-to-eat deli meats

Answer

Listeria thrives in refrigerated, ready-to-eat foods such as deli meats and soft cheeses made from unpasteurized milk, and causes severe invasive disease in immunocompromised transplant recipients.

CCTN - Certified Clinical Transplant Nurse Practice Test

CCTN - Certified Clinical Transplant Nurse Practice Test

CCTN Infection Prevention and Management in Transplant Recipients 2