CMSRN Transplant 4

Question 1

A patient with end-stage liver disease secondary to hepatitis C is being evaluated for liver transplant. Which score is used to prioritize liver allocation in the United States?

Accepted Answer

MELD score

Answer

The Model for End-Stage Liver Disease (MELD) score, based on creatinine, bilirubin, and INR, determines priority for liver transplant allocation in the US.

Question 2

A renal transplant patient is noted to have a rising creatinine 3 weeks post-op along with a urine cytology showing decoy cells. Which complication should the nurse suspect?

Accepted Answer

BK virus nephropathy

Answer

BK virus nephropathy presents with rising creatinine and decoy cells (virally infected tubular cells) on urine cytology and is managed by reducing immunosuppression.

Question 3

Post-transplant hypertension is most commonly caused by which of the following?

Accepted Answer

Calcineurin inhibitor toxicity (vasoconstriction)

Answer

Calcineurin inhibitors (tacrolimus, cyclosporine) cause renal afferent arteriolar vasoconstriction leading to hypertension and nephrotoxicity.

Question 4

Which type of allograft rejection occurs within minutes to hours after reperfusion and is caused by preformed donor-specific antibodies?

Accepted Answer

Hyperacute rejection

Answer

Hyperacute rejection is mediated by preformed anti-donor antibodies that activate complement immediately upon reperfusion, causing irreversible thrombosis.

Question 5

A nurse is teaching a kidney transplant recipient about signs of rejection to report. Which symptom cluster should prompt immediate notification?

Accepted Answer

Decreased urine output, flank pain, and low-grade fever

Answer

Decreased urine output, graft site pain, and fever are classic signs of acute renal transplant rejection and require urgent evaluation.

CMSRN - Medical-Surgical Nursing Practice Test

CMSRN - Medical-Surgical Nursing Practice Test

CMSRN Transplant 4