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Transplant Flashcards

7 cards from real CMSRN practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.

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  1. A patient with end-stage liver disease secondary to hepatitis C is being evaluated for liver transplant. Which score is used to prioritize liver allocation in the United States?

    Answer: MELD score

    The Model for End-Stage Liver Disease (MELD) score, based on creatinine, bilirubin, and INR, determines priority for liver transplant allocation in the US.

  2. A renal transplant patient is noted to have a rising creatinine 3 weeks post-op along with a urine cytology showing decoy cells. Which complication should the nurse suspect?

    Answer: BK virus nephropathy

    BK virus nephropathy presents with rising creatinine and decoy cells (virally infected tubular cells) on urine cytology and is managed by reducing immunosuppression.

  3. Post-transplant hypertension is most commonly caused by which of the following?

    Answer: Calcineurin inhibitor toxicity (vasoconstriction)

    Calcineurin inhibitors (tacrolimus, cyclosporine) cause renal afferent arteriolar vasoconstriction leading to hypertension and nephrotoxicity.

  4. Which type of allograft rejection occurs within minutes to hours after reperfusion and is caused by preformed donor-specific antibodies?

    Answer: Hyperacute rejection

    Hyperacute rejection is mediated by preformed anti-donor antibodies that activate complement immediately upon reperfusion, causing irreversible thrombosis.

  5. A nurse is teaching a kidney transplant recipient about signs of rejection to report. Which symptom cluster should prompt immediate notification?

    Answer: Decreased urine output, flank pain, and low-grade fever

    Decreased urine output, graft site pain, and fever are classic signs of acute renal transplant rejection and require urgent evaluation.

  6. Sirolimus (rapamycin) differs from tacrolimus in its mechanism of action because it:

    Answer: Blocks the mTOR pathway to inhibit T-cell proliferation

    Sirolimus binds FKBP12 but inhibits mTOR rather than calcineurin, blocking T-cell proliferation in response to IL-2 signaling.

  7. A transplant coordinator is discussing organ preservation with a new nurse. Which solution is most commonly used for cold storage of kidneys during transport?

    Answer: University of Wisconsin (UW) solution

    University of Wisconsin solution is the standard cold storage solution for kidney preservation, maintaining cellular integrity for up to 30–36 hours.