Deck 40: The Transplant Patient

Question 1

What time frame is provided for weaning of patients from mechanical ventilation after heart transplant surgery?

A) 12 to 24 hours
B) 24 to 36 hours
C) 12 to 36 hours
D) 24 to 48 hours

Answer 1

B
Weaning of patients from the mechanical ventilator may take several tries.Most patients are able to be alert during this time frame and are ready to resume more of the metabolic demands.Chest tubes and pacing wires are removed after 2 days.

Question 2

What is the cause of the ineffective cough and decrease in ciliary function after a lung transplant?

A) Impaired air flow
B) Hypertension
C) Denervation of the lung tissue
D) Increased cardiac output

Answer 2

C
Autonomic nervous system pathways do not operate correctly after transplant surgery because of the denervated tissue.Other associated complications of the denervated tissue are necrosis of the tissue and impaired airflow.

Question 3

When considering a single-lung transplant patient,which upper extremity motions should not be limited after surgery?

A) Overhead reaching
B) Abduction of the arms
C) External rotation of the upper extremity
D) All of the above

Answer 3

D
When considering the function of the latissimus dorsi,which often is taken down during surgery,abduction,flexion,and ER are the opposites of the muscle function,which should not be overstretched to allow for healing.

Question 4

Compensatory mechanisms of heart failure include which of the following?

A) Increased sympathetic nervous system activity and increased blood pressure
B) Increased fatigue and orthopnea
C) Appearance of third heart sound and jugular venous distention
D) Peripheral edema and hepatomegaly

Question 5

Psychological issues associated with transplant patients before surgery are limited to which of the following?

A) Stress from unknown waiting time and employment disruption
B) Moving from home to a new location
C) Staying hopeful and realization of terminal disease
D) Stresses are unlimited because each patient's case is different

Question 6

One of the major limitations of organ transplantation comes from which of the following?

A) The risk of disease that is inherent in all tissue
B) The increasing demand with limited supply
C) Lack of organization
D) All of the above

Question 7

What is the score the International Society for Heart and Lung Transplantation (ISHLT)guidelines requires for transplant?

A) 2 to 5
B) 5 to 8
C) 7 to 10
D) 10 to 13

Question 8

After a heart transplant surgery,what may cause the appearance of two P waves?

A) Two contractions of the ventricles
B) Repolarization of the atria
C) The atrial cuff left from the previous heart
D) The atrial depolarization after the ventricular depolarization

Question 9

What is the principle limitation to survival after a transplant?

A) Medication dosing
B) Graft rejection
C) Overexertion when trying to return to prior level of activity
D) Oversuppression of the immune system

Question 10

Which of the following is not a risk factor for idiopathic pulmonary fibrosis?

A) Respiratory failure
B) Pulmonary function results
C) Lung pathology
D) Development of COPD

Question 11

What change was made in 2005 to determine the priority of patients needing lung transplants?

A) Those on the waiting list the longest were considered first.
B) Those with greater medical emergency were considered first.
C) Those with the least possibility of rejection were considered first.
D) Those with the greatest number of comorbidities were considered first.

Question 12

Which of the following is not a phase of typical transplant rehabilitation?

A) Pretransplant
B) Surgery and postoperative acute rehabilitation
C) Postoperative inpatient rehabilitation
D) Community- and home-based rehabilitation

Question 13

What type of medication is often used after transplant surgery for the lung patient to ensure proper function of the lungs?

A) Vitamins and supplements
B) Diuretics
C) Antipsychotics
D) Paralytics

Question 14

The lung allocation score is based on which factors?

A) Posttransplant survival and wait list urgency
B) Posttransplant survival and transplant benefit measure
C) Wait list urgency, pretransplant health screening, and transplant benefit measure
D) None of the above

Question 15

Oxygen saturation during a 6-minute walk test must stay above what level for a patient with idiopathic pulmonary fibrosis?

A) 88%
B) 90%
C) 92%
D) 94%

Question 16

What is the most common diagnosis referred for lung transplant?

A) Idiopathic pulmonary fibrosis
B) COPD
C) Cystic fibrosis
D) Pulmonary arterial hypertension

Question 17

What is the role of the physical therapist before transplant surgery?

A) Establishing a baseline of function
B) Establishing a strengthening protocol after surgery
C) Determination of physical readiness
D) Organization of support groups

Question 18

Cardiac rehabilitation increases in aerobic capacity after heart transplant surgery can increase up to what percentage over pre-rehabilitation levels?

A) 20%
B) 30%
C) 40%
D) 50%

Question 19

What is important to know about heart rate transplant patients when sitting up these patient for the first time?

A) An overcompensation of the orthostatic hypertension response
B) No orthostatic hypotension response
C) Slower changes in heat rate and stroke volume
D) Faster changes in heart rate and stroke volume

Question 20

What is the primary need of heart transplant in children younger than the age of 1 year?

A) Coronary artery disease
B) Acute myocardial infarction
C) Mitral valve prolapse
D) Congenital abnormalities