CCTN Trivia 5 — Questions and Answers
Question 1: Which criterion is part of the standard brain death determination process?
- EEG showing delta waves
- Absence of all brain stem reflexes with a known irreversible cause (Correct answer)
- Absence of cortical activity only
- Flat EEG alone is sufficient
Correct answer: Absence of all brain stem reflexes with a known irreversible cause
Brain death requires demonstration of coma, absence of all brainstem reflexes, and apnea, with a known irreversible etiology confirmed by clinical exam.
Question 2: What is 'delayed graft function' (DGF) in kidney transplantation?
- Rejection occurring within 24 hours
- Need for dialysis within the first week post-transplant due to ATN (Correct answer)
- Gradual improvement of creatinine over 3 months
- Failure to urinate intraoperatively
Correct answer: Need for dialysis within the first week post-transplant due to ATN
DGF is defined as the need for dialysis in the first week post-transplant and is most commonly caused by ischemia-reperfusion injury leading to ATN.
Question 3: Which of the following is a common gastrointestinal side effect of mycophenolate mofetil (MMF)?
- Constipation and bloating
- Diarrhea, nausea, and abdominal cramping (Correct answer)
- Peptic ulcer disease
- Esophageal stricture
Correct answer: Diarrhea, nausea, and abdominal cramping
MMF commonly causes GI side effects including diarrhea, nausea, and cramping, which may be reduced by switching to enteric-coated mycophenolate sodium.
Question 4: What is the nurse's priority action when a kidney transplant patient reports no urine output 2 hours post-operatively?
- Wait and reassess in 2 hours
- Assess catheter patency, check vitals, and notify the surgeon immediately (Correct answer)
- Administer furosemide IV without orders
- Encourage oral fluid intake
Correct answer: Assess catheter patency, check vitals, and notify the surgeon immediately
Anuria post-kidney transplant may indicate surgical complications, vascular thrombosis, or urinary obstruction — all require immediate evaluation.
Question 5: Which electrolyte abnormality is a well-known adverse effect of tacrolimus and cyclosporine?
- Hyponatremia
- Hypocalcemia
- Hyperkalemia
- Hypomagnesemia and hyperkalemia (Correct answer)
Correct answer: Hypomagnesemia and hyperkalemia
Calcineurin inhibitors commonly cause both hyperkalemia (via reduced renal potassium excretion) and hypomagnesemia (via renal wasting).
Question 6: Which vaccine type is generally contraindicated in solid organ transplant recipients on immunosuppression?
- Inactivated influenza vaccine
- Pneumococcal polysaccharide vaccine
- Live attenuated vaccines (e.g., MMR, live varicella) (Correct answer)
- Recombinant zoster vaccine
Correct answer: Live attenuated vaccines (e.g., MMR, live varicella)
Live attenuated vaccines are contraindicated post-transplant because immunosuppression may allow the attenuated organism to cause disease.
Question 7: A patient awaiting a liver transplant has a MELD score of 38. What does this indicate?
- Low disease severity with stable liver function
- Very high 90-day mortality risk and high urgency for transplant (Correct answer)
- Candidate is not yet sick enough for transplant
- Score has no role in organ allocation
Correct answer: Very high 90-day mortality risk and high urgency for transplant
The MELD (Model for End-Stage Liver Disease) score predicts 90-day mortality; a score of 38 indicates very high urgency and priority on the waitlist.
CCTN Trivia 5
Which criterion is part of the standard brain death determination process?