CMSRN FREE CMSRN Transplant Questions and Answers 3

Question 1

A patient awaiting a liver transplant has a MELD score of 32. The nurse understands this score primarily reflects which factors?

Accepted Answer

Bilirubin, INR, and serum creatinine

Answer

The MELD score is calculated using serum bilirubin, INR, and creatinine to predict 90-day mortality and prioritize organ allocation.

Question 2

A renal transplant patient on mycophenolate mofetil presents with severe diarrhea and a white blood cell count of 2,800/mm³. What is the priority nursing action?

Accepted Answer

Hold the medication and notify the transplant team

Answer

Mycophenolate commonly causes GI side effects and bone marrow suppression; leukopenia with severe diarrhea warrants holding the drug and notifying the provider.

Question 3

Which clinical finding in a cardiac transplant recipient should alert the nurse to possible chronic rejection?

Accepted Answer

Progressive exercise intolerance and coronary artery vasculopathy on angiography

Answer

Cardiac allograft vasculopathy is the hallmark of chronic rejection in heart transplants, presenting as gradual exercise intolerance rather than typical angina.

Question 4

A nurse is caring for a patient who received a living-donor liver transplant. Which postoperative complication is UNIQUE to living-donor liver recipients compared to deceased-donor recipients?

Accepted Answer

Small-for-size syndrome

Answer

Small-for-size syndrome occurs when the transplanted partial graft is insufficient for the recipient's metabolic demands, a complication specific to living-donor and split-liver transplants.

Question 5

A nurse notes that a kidney transplant patient's cyclosporine trough level is 450 ng/mL (therapeutic range: 100-300 ng/mL). Which symptom should the nurse monitor for MOST closely?

Accepted Answer

Tremors and elevated serum creatinine

Answer

Supratherapeutic cyclosporine levels cause nephrotoxicity (elevated creatinine) and neurotoxicity (tremors), which are the most clinically significant adverse effects.

CMSRN - Medical-Surgical Nursing Practice Test

CMSRN - Medical-Surgical Nursing Practice Test

CMSRN FREE CMSRN Transplant Questions and Answers 3