Chapter 11: Organ Donation

Chapter 11: Organ Donation

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

MULTIPLE CHOICE

 

1. The nurse is caring for a patient who has a Glasgow Coma Scale (GCS) score of 3. Discussions have been held with the family about withdrawing life support. Which statement by the nurse best describes requirements that must be met to sustain Centers for Medicare and Medicaid Services (CMS) Conditions of Participation?

a.	“I need to notify the local Organ Procurement Organization of my patient’s impending death.”
b.	“I will contact the provider to obtain informed consent for organ donation.”
c.	“The charge nurse will notify the local Organ Procurement Organization once the patient has been pronounced brain dead.”
d.	“I need the physician to evaluate my patient’s suitability for organ donation.”

 

 

ANS:  A

Hospitals that receive Medicare or Medicaid reimbursement must notify the local OPO in cases of impending death. It is the responsibility of the organ procurement organization, not the provider, to obtain family consent for organ donation and to evaluate the patient for potential suitability as a donor. Notification of the organ procurement organization must occur before death, not after the patient has been pronounced dead.

 

DIF:    Cognitive Level: Understand/Comprehension                    REF:   p. 233

OBJ:   Discuss processes associated with organ donation.

TOP:   Nursing Process Step: Implementation

MSC:  NCLEX Client Needs Category: Safe and Effective Care Environment

 

2. The nurse is managing a donor patient six hours before the scheduled harvesting of the patient’s organs. Which assessment finding requires immediate action by the nurse?

a.	Morning serum blood glucose of 128 mg/dL
b.	pH 7.30; PaCO2 38 mm Hg; HCO3 16 mEq/L
c.	Pulmonary artery temperature of 97.8° F
d.	Central venous pressure of 8 mm Hg

 

 

ANS:  B

Donor management focuses on maintaining hemodynamic stability and normal

laboratory parameters. Standardized order sets are usually used, and they focus on preserving organ function and viability. Immediate action is required for an arterial blood gas value of pH 7.30; PaCO₂ 38 mmHg; HCO₃ 16 mEq/L. The finding indicates metabolic acidosis. All other values are within normal limits.

 

DIF:    Cognitive Level: Analyze/Analysis                                   REF:   p. 239

OBJ:   Describe clinical triggers associated with brain death.

TOP:   Nursing Process Step: Implementation

MSC:  NCLEX Client Needs Category: Safe and Effective Care Environment

 

3. 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?

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

 

 

ANS:  A

A patient with a GCS score of 3 and no activity on EEG is facing impending death. The OPO should be notified. There are no indications of impending death in any of the other patient scenarios.

 

DIF:    Cognitive Level: Apply/Application                                  REF:   Table 11-4

OBJ:   Discuss processes associated with organ donation.

TOP:   Nursing Process Step: Assessment

MSC:  NCLEX Client Needs Category: Safe and Effective Care Environment

 

4. The transplant clinic coordinator is evaluating relatives of a patient with end-stage renal disease, whose blood type is A positive, for suitability as a living donor for kidney transplantation. Which family member best qualifies for evaluation?

a.	A 65-year-old brother with a history of hypertension; blood type A positive
b.	A 35-year-old female with a history of food allergies; blood type O negative
c.	A 14-year-old son, otherwise healthy with no history; blood type B negative
d.	A 70-year-old mother, with a history of sinus infections; blood type A positive

 

 

ANS:  B

To qualify as a living donor, an individual must be free from hypertension, diabetes, cancer, kidney disease, and heart disease and generally between 18 and 60 years of age. A 35-year-old female with a history of food allergies and a blood type of O negative (universal donor) best qualifies for evaluation. The brother and mother, although blood-type compatible, are outside acceptable age ranges for living donation. The minor son does not qualify based on blood type.

 

DIF:    Cognitive Level: Apply/Application                                  REF:   p. 239

OBJ:   Discuss processes associated with organ donation.

TOP:   Nursing Process Step: Assessment

MSC:  NCLEX Client Needs Category: Physiological Adaptation