NCLEX Review Questions (Wagner) - Chapter (38)

Chapter 38: Solid Organ and Hematopoietic Stem Cell Transplantation NCLEX® Review This activity contains 10 questions. A patient who was injured in a motor vehicle accident is a potential organ donor. Before the nurse contacts the organ procurement organization for a referral, which information should be collected? Select all that apply. Details of the accident Height and weight Past social history Past medical history Age, sex, and race A patient is scheduled for an isograft kidney transplant tomorrow. Which nursing statement is indicated? "How many years older than you is your sister who is donating her kidney?" "You are so lucky to have an identical twin." "It is good that your mother is healthy and can donate an organ to you." "Your donor also provided a heart and lungs for transplant." The manner in which a potential organ donor's family is approached is important. It is strongly suggested that family be approached only after what has occurred? The family has acknowledged that their loved one is brain-dead. The family has approached the physician or nurse about possible donation. The patient has been pronounced legally dead. It is determined whether the potential donor has signed a uniform donor card. The transplant team has just recovered a heart for transplant. The nurse caring for the intended recipient should plan for the transplant to occur in what time frame? Within 8 hours Within 4 hours Within 12 hours Within 18 hours A patient with end-stage renal disease is being evaluated for possible kidney transplant. The nurse prepares this patient for which testing for this procedure? Select all that apply. Tissue typing Cross-matching Electrolytes ABO typing BUN and creatinine A patient who is in need of a transplant is scheduled for psychosocial evaluation. The patient says, "I don't think this is necessary." How should the nurse respond? "It is necessary even if you don't think so." "You shouldn't be worried unless there is a problem you haven't told us about already." "Psychosocial status has been proven to have direct bearing on the success of transplant." "Not only will you need testing, but so will your family." A patient developed a cytomegalovirus infection following kidney transplant surgery. What is the most common source of this infection? A wound infection developed and infiltrated the circulatory system. The patient had a pre-existing CMV infection that was reactivated. The patient was incorrectly suctioned during recovery. The patient's blood was contaminated through invasive devices. A patient is being "conditioned" for a hematopoietic stem cell transplant (HSCT). Which statements would the nurse interpret as indicating the patient understands this procedure? Select all that apply. "One of the goals of conditioning is to get rid of my disease." "I will start on medications to suppress my immune system." "Conditioning will help to ensure that the HSCT graft works." "I will be completing several sets of exercises each day to strengthen my body." "I will get small doses of radiation every day to get rid of my bone marrow." A patient has been started on muromonab-CD3 (OKT3) therapy. The nurse plans specific assessment for which adverse effect in the first 48 hours of treatment? Cytokine-release syndrome Infection Renal failure Nausea and vomiting A patient is being discharged after kidney transplant. The nurse should educate the patient that periodic re-evaluation of kidney function will be necessary. Which test will the nurse specifically mention to this patient? Kidney ultrasound A 24-hour urine sample Complete blood cell count Needle biopsy of the grafted kidney