CCTN Infection Prevention and Management in Transplant Recipients 3

Question 1

Which post-transplant complication is most strongly associated with Epstein-Barr virus (EBV) infection or reactivation in immunocompromised recipients?

Accepted Answer

Post-transplant lymphoproliferative disorder (PTLD)

Answer

EBV drives uncontrolled B-cell proliferation under immunosuppression, leading to PTLD, a spectrum of disorders ranging from benign lymphoid hyperplasia to aggressive lymphoma.

Question 2

A transplant recipient returning from a trip to the Ohio and Mississippi River valleys presents with fever, night sweats, and mediastinal lymphadenopathy. Which endemic fungal infection should be suspected?

Accepted Answer

Histoplasma capsulatum

Answer

Histoplasma capsulatum is endemic to the Ohio and Mississippi River valleys and can cause severe disseminated disease in immunocompromised transplant recipients following environmental exposure.

Question 3

What monitoring strategy is recommended for early detection of CMV infection in transplant recipients who are at intermediate risk (D+/R+ or D-/R+)?

Accepted Answer

Pre-emptive therapy guided by regular CMV quantitative PCR surveillance

Answer

Pre-emptive therapy uses quantitative PCR to detect rising CMV viremia before symptoms develop, allowing targeted antiviral treatment and avoiding unnecessary prolonged prophylaxis in intermediate-risk patients.

Question 4

Which infection control precaution is most critical for transplant nurses to implement when caring for a transplant recipient with suspected Clostridioides difficile (C. diff) infection?

Accepted Answer

Contact precautions with gown and gloves, using soap and water for hand hygiene (not alcohol gel)

Answer

C. difficile spores are not killed by alcohol-based hand sanitizers, so soap and water handwashing plus contact precautions (gown and gloves) are essential to prevent transmission.

Question 5

Which factor in the immunosuppression regimen most significantly increases the risk of invasive fungal infections, particularly Aspergillus, in transplant recipients?

Accepted Answer

High-dose corticosteroid use, especially pulse steroids for rejection treatment

Answer

High-dose corticosteroids impair neutrophil and macrophage function critical for containing Aspergillus hyphae, and pulse steroids given for rejection treatment markedly increase invasive aspergillosis risk.

CCTN - Certified Clinical Transplant Nurse Practice Test

CCTN - Certified Clinical Transplant Nurse Practice Test

CCTN Infection Prevention and Management in Transplant Recipients 3