FREE CMSRN Transplant Questions and Answers

Question 1

When a patient receives a kidney transplant and is sent home on maintenance medication, which procedure or intervention should come first?

Accepted Answer

Monitoring for bacterial and fungal infections

Answer

Patients who have received a kidney transplant are on lifelong immunosuppressive therapy to prevent organ rejection. This immunosuppression significantly compromises their immune system, making them highly susceptible to various bacterial, viral, and fungal infections. Therefore, monitoring for signs and symptoms of infection is the most critical and immediate post-discharge intervention to ensure patient safety and graft survival.

Question 2

A patient who had a kidney transplant two months prior experiences acute rejection and is admitted to the hospital. For this patient, which intervention is appropriate?

Accepted Answer

Organ biopsy to diagnose impaired function

Answer

When acute rejection of a transplanted kidney is suspected, the definitive diagnostic procedure is an organ biopsy. This allows for histological examination of kidney tissue to confirm the presence of immune-mediated damage, differentiate rejection from other causes of graft dysfunction, and guide appropriate immunosuppressive treatment to reverse the rejection episode. Immediate organ removal is not the first step, and imaging alone is usually not definitive.

Question 3

The kidney transplant patient, who was recently moved from the recovery unit, is being attended to by the intensive care nurse. Which of the following findings during the first 12 hours following surgery is the most dangerous and has to be reported to the transplant surgeon right away?

Accepted Answer

Abrupt decrease in urine

Answer

An abrupt decrease in urine output during the first 12 hours following a kidney transplant is a critical and dangerous finding. It can indicate serious complications such as acute tubular necrosis, vascular thrombosis (e.g., renal artery or vein thrombosis), or urinary obstruction, all of which can threaten the viability of the transplanted kidney. This requires immediate reporting to the transplant surgeon for urgent evaluation and intervention.

Question 4

When a transplant is rejected, how does the immune system react to a graft?

Accepted Answer

Host's immune system starts inflammation and immunologic actions to destroy nonself cells

Answer

Transplant rejection occurs when the recipient's (host's) immune system recognizes the transplanted organ (graft) as foreign, or 'non-self.' This triggers a complex and coordinated immune response involving various immune cells and antibodies, leading to inflammation and immunologic actions specifically aimed at destroying the foreign tissue. This is a normal function of the immune system, but it is detrimental in the context of transplantation.

Question 5

A patient receiving a heart transplant undergoes organ rejection during surgery. This is what kind of rejection?

Accepted Answer

Hyperacute

Answer

Hyperacute rejection is a severe and immediate form of transplant rejection that occurs within minutes to hours after transplantation, often while the patient is still in the operating room. It is caused by pre-existing antibodies in the recipient's blood that rapidly recognize and attack antigens on the donor organ, leading to widespread thrombosis within the graft and immediate organ destruction. This type of rejection makes the organ non-viable.

CMSRN - Medical-Surgical Nursing Practice Test

CMSRN - Medical-Surgical Nursing Practice Test

FREE CMSRN Transplant Questions and Answers