Question 1

The nurse is caring for a patient who is being evaluated clinically for brain death.Which assessment finding supports brain death?

Accepted Answer

A)   Absence of a corneal reflex
B)   Unequal, reactive pupils
C)   Withdrawal from painful stimuli
D)   Core temperature of 100.8° F A

Question 2

Which statement best represents appropriate donor-to-recipient criteria for liver transplantation?

Accepted Answer

A)   Blood type and HLA tissue type
B)   HLA tissue type and body type
C)   Blood type and body size
D)   Blood type and donor history C

Question 3

A nurse is preparing to admit a post-heart transplant patient for a second myocardial biopsy in 3 weeks.What conclusion does the nurse draw from this admission information?

Accepted Answer

A)   The patient is having rejection.
B)   The patient is being monitored for rejection.
C)   The new heart is functioning poorly.
D)   The patient is being evaluated for a repeat transplant. B

Question 4

The postanesthesia care unit receives handoff communication from the CRNA indicating that the renal transplant recipient received induction therapy in the operating room with antithymocyte globulin (ATG).What is the best understanding of the administration of this drug by the nurse?

Accepted Answer

A)   The drug is administered for recipients of CMV-positive donor organs.
B)   Administration of the drug decreases initial postoperative rejection rates.
C)   Antiproliferative agents are recommended for routine induction therapy.
D)   Antithymocyte globulin (ATG)  is given as a single dose in the OR.

Question 5

The charge nurse is reviewing the status of patients in the critical care unit.Regarding which patient should the nurse notify the organ procurement organization to evaluate for possible organ donation?

Accepted Answer

A)   A 36-year-old patient with a Glasgow Coma Scale score of 3 with no activity on electroencephalogram
B)   A 68-year-old patient admitted with unstable atrial fibrillation who has suffered a stroke
C)   A 40-year-old brain-injured patient with a history of ovarian cancer and a Glasgow Coma Scale score of 7
D)   A 53-year-old diabetic with a history of unstable angina status postresuscitation

Question 6

The family of a critically ill patient has asked to discuss organ donation with the patient's nurse.When preparing to answer the family's questions,the nurse understands which concern(s)most often influence a family's decision to donate?

Accepted Answer

A)   Donor disfigurement influences on funeral care
B)   Fear of inferior medical care provided to donor
C)   Age and location of all possible organ recipients
D)   Concern that donated organs will not be used
E)   Fear that the potential donor may not be deceasedF)  Concern over financial costs associated with donation

Question 7

The nurse is educating a renal transplant patient about his immunosuppressant medication therapy.Which statement by the patient best indicates an appropriate understanding?

Accepted Answer

A)   "I will be gradually weaned off my medications during my lifetime."
B)   "After 6 months, I will be down to taking one medication for life."
C)   "Complications of these medications include diabetes, infection, hypertension, and bone loss."
D)   "I will only need to take my mediations every other day for life."

Question 8

A patient being cared for in the ICU before organ donation shows increased PVCs on the cardiac monitor What medication does the nurse prepare to administer first?

Accepted Answer

A)   Nitroprusside
B)   Esmolol
C)   Dobutamine
D)   Normal saline

Question 9

The nurse is caring for a renal transplant recipient in the postanesthesia care unit.Blood pressure is 125/70 mm Hg; heart rate is 115 beats/min; respiratory rate is 24 breaths/min; oxygen saturation (SpO2)is 95% on 3 L/min of oxygen via nasal cannula; temperature is 97.8° F; and the central venous pressure (CVP/RAP)is 2 mm Hg.What is the best action by the nurse?

Accepted Answer

A)   Administer fluid replacement therapy; monitor intake and output closely.
B)   Increase supplemental oxygen to 100% non-rebreather mask; notify physician.
C)   Apply thermal warming blanket; administer all fluids through warming device.
D)   Assess the patient for pain; administer pain medications as ordered.

Question 10

A renal transplant recipient presents to the outpatient transplant clinic with blood glucose values for the past 3 days exceeding 250 mg/dL.The patient takes prednisone 5 mg daily and tacrolimus (Prograf)2 mg twice daily.Hemoglobin A1C level drawn the day of the clinic appointment was 8.5%.What is the best interpretation of this finding by the nurse?

Accepted Answer

A)   The patient is at increased risk for infection.
B)   The patient has developed posttransplant diabetes.
C)   Temporary elevations in blood sugars are normal.
D)   Discontinuation of steroids will normalize values.

Question 11

A nurse is caring for a patient declared brain dead following a car crash in preparation for the harvesting of organs.The patient's urine output was 1050 mL in the last hour.What medication does the nurse prepare to administer?

Accepted Answer

A)   Vasopressin
B)   Methylprednisolone
C)   Desmopressin acetate
D)   Esmolol

Question 12

A patient presents to the outpatient transplant clinic stating,"I would like to donate one of my kidneys." What is the best response by the nurse?

Accepted Answer

A)   "To be a living donor, you must be related to the recipient."
B)   "You must be over the age of 30 to be a living donor."
C)   "Living donor donation is coordinated by UNOS."
D)   "Let us orient you to the process required to become a donor."

Question 13

The nurse is caring for a renal transplant patient admitted with an acute rejection episode.The patient asks the nurse how the doctors will know if the kidney has been rejected.What is the best response by the nurse?

Accepted Answer

A)   "Your admission lab results will determine whether your kidney is being rejected."
B)   "A procedure called a renal biopsy will be the best way to confirm rejection."
C)   "Monitoring over the next few days will determine whether your kidney is failing."
D)   "An ultrasound of your kidney will determine whether your kidney has failed."

Question 14

The transplant clinic nurse is educating a patient about the renal criteria that must be met in order to be placed on the transplant waiting list.Which statement by the patient best indicates an understanding of the criteria?

Accepted Answer

A)   "I qualify if I have end-stage renal disease."
B)   "I will not qualify until I have to go on regular hemodialysis treatments."
C)   "My blood type does not have to be a match with the donor blood type."
D)   "The national waiting list is based on the ability to pay for medications."

Question 15

The transplant clinic nurse is conducting a pretransplant education session for patients being evaluated for liver transplantation.Which statement by the nurse provides the best explanation of the numeric system used to classify the severity of a patient's liver disease?

Accepted Answer

A)   "A score is calculated based upon kidney function, clotting time, and bilirubin levels."
B)   "A score is calculated that ranges between 6 and 40, with the lower score being more serious."
C)   "There are currently no exceptions to the MELD score calculation for severity of disease."
D)   "The calculated score represents the patient's risk of death within 1 year of diagnosis."

Question 16

The transplant clinic social worker is completing a social history on a patient with end-stage renal disease who is being evaluated for transplant.Which statement by the patient warrants further action?

Accepted Answer

A)   "I only smoke marijuana on an occasional basis."
B)   "I have two sisters who live within two hours of me."
C)   "I have attended all of my scheduled dialysis sessions."
D)   "My mother's side of the family has a history of cancer."

Question 17

A family member of a gravely ill child approaches the child's nurse and states,"We want to donate our child's organs." What is the best action by the nurse?

Accepted Answer

A)   Arrange a multidisciplinary meeting with physicians.
B)   Consult the hospital's ethics committee for a ruling.
C)   Notify the organ procurement organization (OPO) .
D)   Obtain family consent to withdraw life support.

Question 18

The charge nurse of a transplant unit is reviewing the clinical course of several transplant patients being cared for in the unit.Which patient assessed by the charge nurse requires immediate action?

Accepted Answer

A)   Renal transplant recipient, 1 day post-op with a 3/10 pain level
B)   Lung transplant recipient, 1 day post-op with a productive cough
C)   Heart transplant recipient, 1 day post-op with a cardiac output of 4 L/min
D)   Liver transplant recipient, 2 days post-op with a serum creatinine of 3.7 mg/dL

Question 19

Which statement best describes the lung allocation score (LAS)used to prioritize lung transplant recipients?

Accepted Answer

A)   The LAS estimates the probability of survival and benefits from transplantation.
B)   Lungs from children and adolescents are offered to adults first.
C)   The LAS is limited to candidates under the age of 65 years.
D)   The score was developed to estimate 5-year survival rates.

Question 20

The nurse is caring for a mechanically ventilated patient following bilateral lung transplantation.When planning the care of this patient,what is the priority nursing intervention?

Accepted Answer

A)   Thirty-degree elevation of head of bed
B)   Endotracheal suctioning as needed
C)   Frequent side to side repositioning
D)   Sequential compression stockings

Exam 11: Organ Donation