Deck 80: Management of Clients Requiring Transplantation

Question 1

The nurse teaching a post-transplant client realizes that goals have been met when the client verbalizes understanding that the most common reason for rehospitalization in the post-transplant client is

A) acute rejection.
B) chronic rejection.
C) infection.
D) malignancy.

Answer 1

infection.

Question 2

A client is confused about Medicare coverage post-transplant. The nurse clarifies that in 1996 Medicare extended insurance coverage for

A) all organ transplants.
B) postoperative immunosuppressants.
C) preoperative immunosuppressive protocol.
D) relocation expenses.

Answer 2

postoperative immunosuppressants.

Question 3

The nurse warns a client who has been found to be an acceptable candidate for a kidney transplant, that now the greatest impediment to renal transplantation is

A) high potential for rejection.
B) high risk for infection.
C) insufficient financial resources.
D) lack of sufficient donor organs.

Answer 3

lack of sufficient donor organs.

Question 4

The nurse counseling a potential organ transplant candidate and his family explains that the evaluation process generally takes about

A) 1 to 2 days.
B) 3 to 5 days.
C) 7 to 10 days.
D) 1 to 2 weeks.

Question 5

The nurse on a team maintaining an organ donor before organ harvest makes the following assessment findings. Which finding must be addressed first?

A) Blood pressure of (100/40) mm Hg
B) Pulse of 120 beats/min
C) Respirations of 16/min
D) Urine output of 60 ml/hr

Question 6

Basing the assessment on knowledge of cultural customs and beliefs, the nurse would identify the client who would have the greatest conflict with heart transplantation as being from the faith of

A) Black Muslim.
B) Buddhism.
C) Friends (Quakers).
D) Russian Orthodox.

Question 7

A client who had a liver transplant 4 days ago has developed a fever and decreased biliary tube drainage. The nurse anticipates an order for the client to have a

A) liver biopsy.
B) set of blood cultures.
C) ultrasound.
D) white blood cell count.

Question 8

The nurse working with a client awaiting organ transplant would focus on dispelling the false belief that

A) medications used to prevent organ rejection have significant side effects.
B) the risk of organ rejection is an ongoing possibility post transplant.
C) transplantation will resolve the manifestations of end-stage organ disease.
D) transplantation will resolve most of the problems now faced by the family.

Question 9

The nurse explains that the law prohibiting the buying and selling of organs is the

A) National Transplant Act.
B) Organ Procurement and Transplant Network.
C) Uniform Anatomical Gift Act.
D) United Network of Organ Sharing.

Question 10

The nurse conducting community education on transplant options would teach that the client who would benefit most from kidney-pancreas transplantation is the client with

A) acute renal failure and pancreatitis.
B) end-stage renal disease and type 1diabetes.
C) glomerulonephritis and pancreatitis.
D) polycystic kidney disease and type 2 diabetes.

Question 11

The nurse working with clients who need organ transplant includes in the teaching plan that the primary responsibility of the transplantation team is to

A) determine the histocompatibility of the donor and the recipient.
B) find the best candidate with good immune function and appropriate insurance.
C) provide the greatest number of transplants possible because of the ongoing great need.
D) transplant organs into clients with the best chance of long-term success.

Question 12

The nurse working with the family of a potential organ donor informs them that the Uniform Determination of Death Act (UDDA) includes in its definition of death irreversible cessation of activity in the entire brain

A) except in the situation of an ancephalic infant.
B) in a person in an irreversible vegetative state.
C) including the brain stem.
D) unless a vegetative state has exceeded 2 years.

Question 13

A nurse in the intensive care unit is caring for a post-transplantation client. This client's first set of vital signs were temperature 94.4° F, pulse 110 beats/min, respirations ventilated at 20 breaths/min, blood pressure 108/64 mm Hg. After 2 hours, the vital signs are temperature 98.4° F, pulse 108 beats/min, respirations ventilated at 20 breaths/min, blood pressure 88/58 mm Hg. Which action by the nurse is most appropriate at this time?

A) Anticipate an order for arterial blood gasses (ABGs).
B) Call the physician to report that the client is still tachycardic.
C) Chart the findings and continue to monitor the client.
D) Prepare to administer vasoconstricting agents.

Question 14

The nurse working in an emergency department assesses that the client near death who would be the best candidate for organ donation is the client with

A) cancer.
B) cirrhosis.
C) coronary heart disease.
D) subarachnoid hemorrhage.

Question 15

Important health promotion measures for the client who has received an organ transplant include regularly-scheduled (select all that apply)

A) dental examinations.
B) mammograms.
C) Papanicolaou (Pap smears).
D) substance abuse screening.
E) vaccinations.

Question 16

The most important topic related to health promotion the nurse should teach a client before being discharged after an organ transplant is

A) housing options close to the transplant center for the next 1-2 months.
B) how to access funding to pay for lifelong immunosuppressant therapy.
C) primary prevention measures against common infectious diseases.
D) transplant team contact information for the client's primary health care provider.

Question 17

The nurse working with a post-transplant client tells the client that he should refrain from returning to his distant original home for up to

A) 1 week.
B) 8 weeks.
C) 3 months.
D) 6 months.

Question 18

To identify manifestations of rejection following kidney transplant, the nurse would instruct a client going home to monitor for

A) fatigue.
B) hypothermia.
C) recurrent nausea.
D) weight gain.

Question 19

A client who had a kidney transplant develops decreased urine output, increased serum creatinine level, and a slight elevation in temperature. The nurse anticipates providing which intervention?

A) Antibiotics
B) Extra IV fluids
C) High-dose steroids
D) Plasmapheresis

Question 20

A nurse working as part of a transplantation team is conducting a group education session. A client waiting for a heart transplant asks why he cannot stay in his rural home to wait. He knows someone who had a kidney transplant and stayed in the same local area waiting for his transplant. The best response by the nurse would be

A) "Because of confidentiality rules, I can't talk about your friend's experience."
B) "How long ago did that occur?"
C) "Different transplant centers have different requirements."
D) "Each organ's viability time is different. Kidneys can last longer than hearts."