Chapter 38 High Acuity Nursing 6th Edition by Kathleen Dorman Wagner

Chapter 38 High Acuity Nursing 6th Edition by Kathleen Dorman Wagner

Complete Chapter Questions With Answers

Sample Questions Are Posted Below

Question 1

Type: MCSA

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.

Correct Answer: 1

Rationale 1: Cardiac transplantation is highly successful today, in part because of tissue typing and improved immunosuppressant therapy.

Rationale 2: Both heart and heart–lung transplants are successful today.

Rationale 3: The first transplants were done in the 1950s and were kidney transplants. Heart transplants were first successful in the mid-to-late 1960s.

Rationale 4: Identical twin transplants are the most successful, but much success has also been demonstrated with non-twin transplants.

Global Rationale:

Cognitive Level: Applying

Client Need: Physiological Integrity

Client Need Sub: Physiological Adaptation

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 38-1

Question 2

Type: MCSA

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.”

Correct Answer: 4

Rationale 1: Many non-family transplants are performed and are successful.

Rationale 2: Transplanting the heart and lungs did not receive the focus of transplantable organs until the 1980s. There is no evidence that transplant of these organs is more successful than transplant of other organs.

Rationale 3: The major problem associated with transplant has always been rejection.

Rationale 4: Cyclosporine and other antirejection drugs are now available and have made transplant surgeries much more successful.

Global Rationale:

Cognitive Level: Applying

Client Need: Physiological Integrity

Client Need Sub: Physiological Adaptation

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 38-1

Question 3

Type: MCSA

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

Correct Answer: 3

Rationale 1: Heterograft is the transplantation of tissue between two different species.

Rationale 2: Histograft is not a term used to describe status of the donor. Histocompatible refers to the compatibility between donor and recipient.

Rationale 3: An allograft refers to tissue that is transplanted within the same species. A living donor is someone who agrees to have body parts transplanted into another person while alive. The patient’s brother is an allograft living donor.

Rationale 4: Isograft refers to tissue transplanted between twins.

Global Rationale:

Cognitive Level: Applying

Client Need: Physiological Integrity

Client Need Sub: Physiological Adaptation

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 38-2

Question 4

Type: MCSA

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

Correct Answer: 4

Rationale 1: It is not possible for the nurse to know if the donor died from natural causes.

Rationale 2: Cardiac death refers to death by cessation of cardiac and respiratory function. This type of death limits the kinds of tissues that can be donated and typically excludes organ donation.

Rationale 3: The method of death is not predictable.

Rationale 4: There are two types of cadaver donors. Organ donors from cadavers who have died from brain death comprise the largest number of implantable organs.

Global Rationale:

Cognitive Level: Applying

Client Need: Physiological Integrity

Client Need Sub: Physiological Adaptation

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 38-2