Chapter 38 Question 1 A patient being prepared for a heart transplant is concerned that the transplanted organ will not be accepted in his body. What should the nurse consider when formulating a response to this concern? 1. Heart transplants are very successful because of immunosuppressant medication. 2. Today it is more common to do heart–lung transplants. 3. Hearts were the first organs to be transplanted so the technique has been perfected. 4. There are no guarantees since transplants are more successful between twins. Question 2 A patient tells the nurse that chronic kidney disease is “in his family” and his father died within a few months after having a kidney transplant in the late 1940s. What information should the nurse provide? 1. “Your chances of a successful transplant depend upon finding a healthy family member who is a match and will agree to provide an organ.†2. “The most successful transplants have always been the heart and lungs.†3. “Many of the earlier failures of kidney transplants had to do with suturing technique.†4. “Medications to prevent problems associated with organ transplantation are now widely available.†Question 3 The older brother of a patient in renal failure has agreed to donate a kidney. Testing reveals that the brothers are a good match for this procedure. How would the nurse describe this treatment plan? 1. Heterograft living donor 2. Histograft living donor 3. Allograft living donor 4. Isograft living donor Question 4 A patient is scheduled to receive a liver for transplantation from a person who has died. The nurse anticipates that the donor has which characteristic? 1. Died of natural causes 2. Experienced cardiac death 3. Died in an automobile accident 4. Experienced brain death Question 5 A patient, identified as a potential organ donor, has been diagnosed as brain dead and is being maintained on ventilator support. The nurse is reviewing the patient’s hemodynamic parameters and is concerned about which findings? 1. Mean arterial pressure 50 mm Hg 2. Central venous pressure 5 mm Hg 3. Serum sodium 145 mEq/L 4. Serum glucose 170 mg/dL 5. Ejection fraction 30% Question 6 A patient, identified as an organ donor, is diagnosed as being brain dead. The organ procurement organization (OPO) rules that the patient is not a candidate for transplant. The nurse would attribute this decision to which patient history? 1. Experimented with intravenous heroin 20 years prior 2. Being treated for hepatitis B 3. Treated for prostate cancer one year ago 4. Treated for shock Question 7 The nurse is caring for a patient who will be an organ donor. Which nursing intervention is indicated to protect endocrine function? 1. Provide bolus of levothyroxine, Solu-Medrol, insulin, and 50 percent dextrose followed by continuous levothyroxine intravenous infusion. 2. Administer salt poor intravenous fluid. 3. Administer blood transfusion. 4. Provide intravenous dopamine. Question 8 A patient awaiting a kidney transplant has O blood type. The nurse would explain that the patient’s kidney can come from someone with which blood type? 1. Only O 2. B or O 3. A or O 4. A, B, or O Question 9 A patient who received a kidney transplant 2 years ago has been diagnosed with skin cancer. He tells the nurse that he cannot believe that he has cancer since he has already gone through “so much” with the kidney disease. How should the nurse respond to this patient’s statement? 1. “It is unusual for malignancies to develop this long after transplant.†2. “Patients on long-term medications to prevent organ rejection are at risk for developing cancer.†3. “At least this cancer will not affect the transplanted kidney.†4. “Everyone can develop cancer at any time.†Question 10 It has been determined that a patient who received hematopoietic stem cell transplantation is having poor functioning of the graft. The nurse would prepare the patient for which intervention? 1. Administration of high dose corticosteroids 2. A second stem cell infusion 3. Administration of platelets 4. Surgery to remove the graft