CMSRN FREE CMSRN Transplant Questions and Answers 2 — Questions and Answers
Question 1: A patient is 48 hours post-kidney transplant and develops oliguria, fever, and tenderness over the graft site. Which complication should the nurse suspect first?
- Acute rejection (Correct answer)
- Hyperacute rejection
- Chronic rejection
- Urinary tract infection
Correct answer: Acute rejection
Acute rejection typically occurs days to weeks after transplant and presents with decreased urine output, fever, and graft tenderness.
Question 2: Which laboratory value is MOST important for the nurse to monitor in a patient receiving tacrolimus after a liver transplant?
- Serum creatinine (Correct answer)
- Serum sodium
- Hemoglobin
- Platelet count
Correct answer: Serum creatinine
Tacrolimus is nephrotoxic, so serum creatinine must be closely monitored to detect renal impairment early.
Question 3: A nurse is educating a heart transplant recipient about infection prevention. Which statement by the patient indicates a need for further teaching?
- I can eat fresh salads from any restaurant without worry (Correct answer)
- I should avoid crowds during flu season
- I need to wash my hands frequently
- I should report any fever to my transplant team immediately
Correct answer: I can eat fresh salads from any restaurant without worry
Immunosuppressed transplant recipients should avoid raw, unwashed produce from uncertain sources due to increased infection risk.
Question 4: During the immediate postoperative period after a lung transplant, which assessment finding requires the MOST urgent nursing intervention?
- Oxygen saturation dropping to 88% on 2L nasal cannula (Correct answer)
- Temperature of 99.2°F (37.3°C)
- Pain rating of 6 out of 10
- Urine output of 40 mL/hour
Correct answer: Oxygen saturation dropping to 88% on 2L nasal cannula
A significant drop in oxygen saturation in a new lung transplant patient may indicate primary graft dysfunction or airway complications requiring immediate intervention.
Question 5: Which immunosuppressive protocol is considered standard induction therapy to prevent early rejection in solid organ transplantation?
- Basiliximab with corticosteroids (Correct answer)
- Methotrexate alone
- Rituximab with plasmapheresis
- Intravenous immunoglobulin only
Correct answer: Basiliximab with corticosteroids
Basiliximab, an IL-2 receptor antagonist, combined with corticosteroids is a standard induction regimen to prevent early acute rejection.
Question 6: A pancreas transplant recipient reports persistent hyperglycemia despite a functioning graft confirmed by C-peptide levels. What should the nurse assess NEXT?
- Medication compliance with immunosuppressants (Correct answer)
- Dietary carbohydrate intake only
- Whether the patient needs insulin sliding scale
- Blood type compatibility records
Correct answer: Medication compliance with immunosuppressants
Certain immunosuppressants like tacrolimus can cause drug-induced diabetes, so medication compliance and drug levels should be assessed when hyperglycemia occurs despite a functioning graft.
CMSRN FREE CMSRN Transplant Questions and Answers 2
A patient is 48 hours post-kidney transplant and develops oliguria, fever, and tenderness over the graft site.
Which complication should the nurse suspect first?