Deck 37: Organ Donation and Transplantation

Question 1

A patient who has received a transplant is being taught about azathioprine.Which statement made by the patient would indicate the teaching was effective?

A) "I will notify my health care provider if my gums start to bleed."
B) "I will make sure to increase the amount of fiber in my diet."
C) "I realize I may have an increase in hair growth."
D) "I know the flulike symptoms will go away as I get used to the drug."

Answer 1

"I will notify my health care provider if my gums start to bleed."

Question 2

Which of the statements would indicate that a patient who has received an organ transplant understands the teaching about his or her immunosuppressive medications?

A) "My drug dosages will be lower because the medications enhance each other."
B) "I will be less prone to side effects because I will be taking more than one drug."
C) "Lower doses of these medications put me at greater risk for infection."
D) "Taking more than one medication will put me at risk for developing allergies."

Answer 2

"My drug dosages will be lower because the medications enhance each other."

Question 3

Which statement made by a patient who has had a urinary diversion pancreas transplant indicates the need for further teaching?

A) "I no longer need to monitor my blood glucose levels."
B) "I will need to have periodic pancreas biopsies."
C) "I may feel the urge to urinate frequently."
D) "I will give urine samples to monitor for rejection."

Answer 3

"I no longer need to monitor my blood glucose levels."

Question 4

Who determines the medical suitability of the patient for organ donation?

A) The organ procurement organization (OPO) coordinator
B) The patient's family
C) The admitting health care provider
D) The transplant team

Question 5

Which of the following nursing diagnoses would be appropriate for a patient who has received a kidney transplant?

A) Deficient fluid volume
B) Excess fluid volume
C) Urinary retention
D) Decreased cardiac output

Question 6

After a urinary diversion pancreatic transplant,the nurse must anticipate which order?

A) Continuous bladder irrigation
B) Intermittent insulin injections
C) Removal of the nasogastric tube as soon as the patient is alert
D) Daily hematocrit and hemoglobin levels.

Question 7

A nurse is caring for a patient who is receiving sirolimus.The nurse knows to monitor the patient for

A) bleeding.
B) diarrhea.
C) rigors.
D) hypotension.

Question 8

A patient is admitted to the critical care unit with the diagnosis of massive head trauma caused by a motor vehicle accident.The patient is unresponsive and on mechanical ventilation.The electroencephalogram is negative for brain waves.The family has agreed to organ donation.The organ donor would be classified as a

A) brain-dead donor.
B) donation after cardiac death.
C) living related donor.
D) living, unrelated donor.

Question 9

Which statement made by a patient who has received an organ transplant indicates that the teaching was effective?

A) "I will finally be able to eat a regular diet."
B) "I will establish a routine for checking any skin changes."
C) "I will check my blood pressure regularly to make sure it's not too high."
D) "After my drug regimen is established, I won't have to worry about rejection."

Question 10

The longest and most difficult part of the recipient hepatectomy is

A) stage 1.
B) stage 2.
C) stage 3.
D) grade 1.

Question 11

Because a patient who has received a lung transplant is at risk for ventilation/perfusion (V/Q)mismatch,it would be a priority for the nurse to monitor

A) blood gases.
B) cardiac output.
C) lung sounds.
D) blood pressure.

Question 12

Rejection that occurs within hours after the transplantation and results in immediate graft failure is known as

A) acute rejection.
B) intermediate rejection.
C) chronic rejection.
D) hyperacute rejection.

Question 13

Which of the following would indicate that a newly transplanted liver is not functioning properly?

A) Increased serum glucose
B) Low aspartate aminotransferase (AST) and alanine aminotransferase (ALT)
C) Elevated prothrombin time
D) Decreased blood urea nitrogen and creatinine

Question 14

Patients meeting criteria for imminent death and cardiac death are to be

A) immediately placed on life support and referred to the organ procurement organizations.
B) referred to the organ procurement organizations at the time of their death.
C) referred to the organ procurement organizations in a timely manner.
D) referred to physician to make the decision if they are a candidate for organ donation.

Question 15

Which of the following goals would be a priority after lung transplantation?

A) Wean the patient from the ventilator.
B) Maintain hypotensive levels.
C) Start corticosteroid therapy.
D) Initiate pulmonary function studies.

Question 16

A patient with liver failure manifested by portal hypertension and ascites is hospitalized and waiting for a liver transplant.Which of the following orders should the nurse question?

A) Low-sodium diet
B) Low-protein diet
C) ABO typing
D) Human leukocytic antigen tissue typing

Question 17

A patient is admitted to the critical care unit with the diagnosis of massive head trauma caused by a motor vehicle accident.The patient is unresponsive and on mechanical ventilation.The electroencephalogram is negative for brain waves.The family has agreed to organ donation.The nurse will check for the absence of cerebral motor reflexes by

A) performing a sternal rub.
B) needle pricks to fingers and toes.
C) clapping hands near the ears.
D) applying pressure to the nail beds or supraorbital ridge.

Question 18

Which of the following is an anticipated finding after cardiac transplantation?

A) Two P waves on the electrocardiogram (ECG)
B) High cardiac output
C) Anginal pain
D) Resting heart rate of 60 to 70 beats/min

Question 19

A patient who has received a transplant is being taught about cyclosporine.Which statement made by the patient would indicate the teaching was effective?

A) "I know this drug prevents my immune system from working."
B) "If I find the capsules are hard to swallow, I'll take the liquid."
C) "I will need to watch for bruising."
D) "I will need to monitor my blood pressure."

Question 20

A patient has had a kidney transplant.The nurse knows that monitoring which of the following would have the highest priority?

A) Fluid volume
B) Electrolytes
C) Complete blood count
D) Temperature

Question 21

The most common viral infection in transplant recipients is

A) Aspergillus.
B) Candida.
C) cytomegalovirus (CMV).
D) Pneumocystis jiroveci.

Question 22

Signs and symptoms of heart transplant rejection include

A) SOB.
B) tolerance of exercise.
C) disturbance in mood.
D) decreased weight.
E) pulmonary crackles, wheezes.
F) onset of hypertension.
G) sudden onset of edema.

Question 23

Many barriers exist to increasing the number of organ donors to meet today's growing need.Which of the following are barriers related to hospital factors?

A) Limited resources
B) Lack of interest
C) Failure to approve protocols
D) Nurses' attitudes
E) Delay in termination of life support

Question 24

Not every patient with end-stage liver disease is a candidate for receiving a transplant.Which of the following conditions are contraindications to a kidney transplant?

A) Malignancy during the past 5 years
B) Active infectious process
C) Advanced cardiopulmonary disease
D) Recreational drug use
E) Nonadherence to current medical regimen

Question 25

According to the critical pathway developed by United Network for Organ Sharing,which of the following should be carried out by the critical care nurse?

A) Complete the operating room checklist.
B) Document the date and time of brain death.
C) Insert two large-bore IV catheters.
D) Maintain patient temperature between 36.5° and 37.5° C.
E) Notify the supervisor of pending donation.

Question 26

A patient is admitted to the critical care unit with the diagnosis of massive head trauma caused by an MVA.The patient is unresponsive and on mechanical ventilation.EEG is negative for brain waves.The family has agreed to organ donation.Which of the following organs would not be considered for transplant?

A) Heart
B) Lung
C) Liver
D) Kidney

Question 27

Which of the following federal laws regulate the medical and surgical therapy involved with organ transplantation?

A) Omnibus Budget Reconciliation Act
B) Uniform Anatomical Gift Act
C) Hospital Conditions of Participation-Organ Donations
D) Medical Examiner Laws
E) Uniform Determination of Death Act

Question 28

Potential recipients are matched with donors based on

A) blood type.
B) human leukocytic antigen.
C) race.
D) socioeconomic status.
E) severity of illness.
F) location of recipient.
G) waiting time on the list.

Question 29

A patient is admitted to the critical care unit with the diagnosis of massive head trauma caused by an MVA.The patient is unresponsive and on mechanical ventilation.EEG is negative for brain waves.The family has agreed to organ donation.The nurse turns the patient's head quickly from side to side.The eyes do not move.The nurse knows this is the result of a loss in the

A) oculovestibular reflex.
B) corneal and jaw reflexes.
C) oculocephalic reflex.
D) pupillary reflexes.

Question 30

The Model for End-Stage Liver Disease (MELD)formula is used to

A) calculate risk of 3-month mortality in patients 12 years old or older.
B) calculate risk of 3-month mortality in patients 11 years or younger.
C) calculate risk of 6-month mortality in patient 18 years or older.
D) calculate risk of 6-month mortality in patient 17 years or younger.