Deck 36: Organ Donation and Transplantation

Question 1

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

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

Answer 1

Human leukocyte antigen tissue typing

Question 2

A nurse is preparing a patient for a liver transplant.The patient asks which stage of the procedure is the longest and most difficult.What would the nurse tell the patient?

A) Stage 1-recipient hepatectomy
B) Stage 2-vascular anastomoses
C) Stage 3-biliary anastomosis
D) Stage 4-induction therapy

Answer 2

Stage 1-recipient hepatectomy

Question 3

A patient is admitted with a massive head trauma.The patient is unresponsive and on mechanical ventilation.The electroencephalogram is negative for brain waves.The family has agreed to organ donation.How would the nurse check for the absence of cerebral motor reflexes?

A) Performing a sternal rub
B) Applying needle pricks to fingers and toes
C) Clapping hands near the ears
D) Applying pressure to the nail beds or supraorbital ridge

Answer 3

Applying pressure to the nail beds or supraorbital ridge

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 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 6

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

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

Question 7

The nurse is caring for a patient after a liver transplant.Which finding would be of most concern to the nurse?

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 8

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 9

Rejection that occurs within hours after the transplantation and results in immediate graft failure is referred to as what type of rejection?

A) Acute
B) Intermediate
C) Chronic
D) Hyperacute

Question 10

What happens to patients that meet criteria for imminent death?

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

Question 11

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."

Question 12

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

A) Bleeding
B) Diarrhea
C) Rigors
D) Hypotension

Question 13

The nurse is caring for a patient after a lung transplant.Which intervention would be a priority for the nurse?

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

Question 14

The nurse is caring for a patient after a heart transplant.Which finding would the nurse anticipate 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 15

Which nursing problem 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 16

The nurse is caring for a patient with a pancreas transplant.Which statement made by the patient 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."

Question 17

A patient is admitted after a lung transplant.The nurse knows the patient is at risk for developing pneumonia.What parameter would be a priority for the nurse to monitor?

A) Oxygen saturation
B) Chest tube output
C) Intake and output
D) Blood pressure

Question 18

After a pancreatic transplant with bladder exocrine drainage,the nurse would 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 19

Which statement would indicate that a patient who has received an organ transplant understands the teaching about 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."

Question 20

A patient is admitted with a massive head trauma.The patient is unresponsive and on mechanical ventilation.The electroencephalogram (EEG)is negative for brain waves.The family has agreed to organ donation.How would this organ donor be classified?

A) Brain-dead donor
B) Donation after cardiac death
C) Living related donor
D) Living unrelated donor

Question 21

Many barriers exist to increasing the number of organ donors to meet today's growing need.Which barriers are 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 22

Potential recipients are matched with donors based on what factors?

A) Blood type
B) Human leukocyte antigen
C) Race
D) Socioeconomic status
E) Severity of illness
F) Location of recipient
G) Waiting time on the list

Question 23

A patient is admitted with massive head trauma.The patient is unresponsive and on mechanical ventilation.The electroencephalogram (EEG)is negative for brain waves.The family has agreed to organ donation.Which organs would not be considered for transplant?

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

Question 24

A patient is admitted with massive head trauma.The patient is unresponsive and on mechanical ventilation.The electroencephalogram (EEG)is negative for brain waves.The family has agreed to organ donation.When the nurse turns the patient's head quickly from side to side,the patient's eyes do not move.The nurse knows this is the result of the loss of what reflex?

A) Oculovestibular
B) Corneal
C) Oculocephalic
D) Pupillary

Question 25

The nurse is caring for a patient who has had a recent heart transplant.Which signs and symptoms would alert the nurse that the patient is rejecting the transplant?

A) Shortness of breath
B) Tolerance of exercise
C) Disturbance in mood
D) Decreased weight
E) Pulmonary crackles
F) Onset of hypertension
G) Sudden onset of edema

Question 26

Not every patient with end-stage liver disease is a candidate for receiving a transplant.Which 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 27

Which 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

The organ procurement organization coordinator writes orders to initiate standard donor care.Which interventions are parts of standard donor care?

A) Continue administration of osmotic agents and diuretics.
B) Maintain head of bed at 30 to 40 degrees elevation.
C) Continue routine pulmonary suctioning and side-to-side body positioning.
D) Warming blanket to maintain body temperature above 36.5° C.
E) Maintain mean arterial pressure less than 70 mm Hg.

Question 29

The nurse is teaching a patient about antiviral medications.The patient asks what is the most common viral infection in transplant recipients.What should the nurse tell the patient?

A) Influenza
B) Respiratory syncytial virus
C) Cytomegalovirus (CMV)
D) Parainfluenza

Question 30

The Model for End-Stage Liver Disease (MELD)formula is used to calculate risk of 3-month mortality in patients 12 years old or older.What criteria is part of the MELD formula?

A) Whether the patient has undergone hemodialysis at least twice in the past 2 weeks
B) The number of organs in which metastasis has occurred following hepatocellular carcinoma
C) The presence or absence of intractable pruritus
D) The number of hours the patient is expected to live without a transplant