CCTC STUDY GUIDE 2026 EXAM QUESTIONS AND
SOLUTIONS RATED A+
✔✔You are reviewing medications with your kidney transplant patient how is 2 days
post transplant. His inpatient course has been uneventful ad his kidney is functioning
well and his creatinine is 2.0. He wants to know when he can return to his job as a
trainer and continue his dietary and herbal supplements. One of his pre-transplant
supplements was St. John's Wort which he took on a daily basis. You should explain tat
he should not take this because:
a. It will increase his anxiety and desire for sugar
b. It can contribute to the development of diabetes
c. It can decrease calcineurin levels
d. It can increase calcineurin levels - ✔✔c. It can decrease calcineurin levels
✔✔You are educating your potential kidney recipient during his evaluation. His kidney
disease is secondary to membranoproliferative glomerulonephritis type 3 (MPGN3). You
know that this disease can reoccur in the transplanted kidney. You explain that the
following kidney donor options would be offered to him:
a. Only deceased donor kidney according to UNOS policy
b. Deceased donor or living donor kidney transplant according to the individual
transplant center policy
c. Only living donor transplant according to UNOS policy
d. He is not eligible for a kidney transplant - ✔✔b. Deceased donor or living donor
kidney transplant according to the individual transplant center policy
**No UNOS policy that dictates medical disease and eligibility on getting transplant.
High reoccurrence rate with MPGN3
✔✔Your patient is waiting for a deceased donor kidney transplant called you and asked
how long he would have to wait for a kidney as he has been listed for 3 years. You
explain that there are a number of factors that influence how kidneys are allocated. The
most important factors in determining kidney allocation are:
a. BMI, cPRA, and age of recipient
b. cPRA and EPTS of recipient and KDPI of donor
c. length of time on waitlist, medical co-morbidities of recipient and diabetes
d. recipient serum albumin and Karnofsky score - ✔✔b. cPRA and EPTS of recipient
and KDPI of donor
**asking which ones directly influence allocation (cPRA, EPTS, KDPI and length of time
on waitlist)
,✔✔You are very excited to hear that your patient was transplanted with a deceased
donor kidney. He is a 43 year old man with ESRD secondary to HTN. He also has a
history of Hepatitis C, anti-phospholipid syndrome and thrombocytopenia. On post-op
day 2, you review his inpatient progress. His lab values indicate creatinine of 11.6,
which is unchanged from the day prior, potassium of 5.6, platelet count of 41 and Hgb of
8.0. His urine output over the past 8 hours is 65 ml. His transplant ultrasound showed
slight increase in resistive index of the artery and a patent vein and slight peri-nephric
fluid. You expect your patient is experiencing:
a. Dehydration
b. Bleeding
c. Acute tubular necrosis (ATN)
d. Acute rejection - ✔✔c. Acute tubular necrosis (ATN)
Symptoms of ATN include - creatinine not improving, UOP is oliguric, not quality urine,
Increased resistive index of artery, peri-nephric fluid
✔✔You are caring for a 73 year old female patient who is 36 hours post-kidney
transplant, has systolic BP of 90-100 mmHg over the past 2 hours. Urine output is
25cc/hr. Her only complaint is being very tired. Your initial assessment is that the patient
may be all of the following except:
a. Hypovolemic
b. Comfortable and pain free
c. Overly sedated
d. Stable with a satisfactory urine output - ✔✔d. Stable with a satisfactory urine output
UOP of 25 cc/hr is not satisfactory
✔✔Health screening for patients being evaluated for a kidney transplant would include:
a. Pap smear, PSA, ECG and CXR
b. Troponin, CK, ESR and CA-125
c. Cystoscopy, Colposcopy, colonoscopy and barium swallow
d. EGD, upper GI, MRI and 6 minute walk - ✔✔a. Pap smear, PSA, ECG and CXR
**general health screenings
✔✔As a transplant coordinator, you manage your liver waitlist. You have a 21 year old
male liver candidate with a history of hepatocellular carcinoma with a MELD score of 26.
You continue to update his listing status in UNET. How often do you recertify his listing?
A. Every 30 days with labs within 7 days
B. Every 7 days with labs within 48 hours
C. Every 90 days with labs within 14 days
,D. Every 12 month with labs within 30 days - ✔✔B. Every 7 days with labs within 48
hours
✔✔Laboratory studies which are required for recertification in UNET for this liver patient
with hepatocellular carcinoma and a MELD score of 26 includes the following?
A. INR, C-peptide, bilirubin, creatinine
B. INR, bilirubin, creatinine, albumin
C. INR , C-peptide, bilirubin, albumin
D. Bilirubin, creatinine, sodium, C-peptide
E. INR, bilirubin, creatinine, sodium - ✔✔E. INR, bilirubin, creatinine, sodium
✔✔You just completed the evaluation for a 2 year old liver transplant candidate in the
ICU. The committee agreed to move forward with listing and you have met with the
family and completed all the necessary paperwork. You will be listing this patient today.
The patient has a history of a fulminant liver failure, blood type O, labs showing ALT >
2000, INR 2, total bilirubin of 12. How will you list this patient?
1. PELD status 1A
2. PELD status 1B
3. PELD exception
4. MELD status 1
5. MELD >25 - ✔✔1. PELD status 1A
** Patient is under 2 and has fulminant liver failure
Labs that qualify for status 1A:
ALT >2000
INR > 2.0
Total bili >10
✔✔You are a transplant coordinator working in ICU taking care of a fresh transplant
liver recipient. Which of the following is a false statement about a Blakemore tube?
A. Used in management of upper GI hemorrhage
B. Is always used post transplant
C. Used to control esophageal varices
D. Is rarely used at present
E. Is a device inserted through the mouth or nose - ✔✔B. Is always used post transplant
✔✔As a transplant coordinator, you manage your liver waitlist. You have a 21 year old
male liver candidate who will be going to the OR for the transjugular intrahepatic
portosystemic shunt (TIPS) procedure. All of the following statements are true regarding
the TIPS procedure except for which one statement?
A. Can be used to treat complications of portal hypertension
, B. Can be used to treat variceal bleeding or bleeding from any veins that normally drain
the stomach, esophagus or intestine into the liver
C. Creates a new connection between two blood vessels in your liver
D. Catheter is inserted into your jugular vein and guided into your hepatic bein into your
liver
E. TIPS procedure can reverse liver cirrhosis and avoid transplantation
F. 88% of people with cirrhosis and variceal bleeding who received the TIPS procedure
survived for 2 years and 61% survived for at least 5 years - ✔✔E. TIPS procedure can
reverse liver cirrhosis and avoid transplantation
**Used a bridge to transplant
✔✔A father was the living donor liver for his 6 month old son. He initially asked how his
liver will be divided. The transplant coordinator informed the father that the surgeon will
perform a:
1. Right lobectomy
2. Left lobectomy
3. Left lateral segmentectomy
4. Right lateral segmentectomy - ✔✔3. Left lateral segmentectomy
Typically used for recipients of small size
✔✔The father that donated liver to his 6 month old son then asks how long will it take
for his liver to grow back? The transplant coordinator should inform that the remaining
organ will continue to regenerate for how many months?
1. 3
2. 6
3. 12
4. 18 - ✔✔3. 12
Majority of regeneration takes place in 2-3 months, however, the process continues up
to 1 year.
✔✔A 21 year old liver transplant is 3 days post transplant. His PT is 25 sec, AST >2000
and ALT > 5000. He will be going for a liver biopsy. It is thought he has primary graft
non-function. Factors related to primary nonfunction of new liver include which of the
following
A. Prolonged ischemic time
B. Donor age
C. Prolonged donor management/hospital stay
D. A and C only
E. B and C only
SOLUTIONS RATED A+
✔✔You are reviewing medications with your kidney transplant patient how is 2 days
post transplant. His inpatient course has been uneventful ad his kidney is functioning
well and his creatinine is 2.0. He wants to know when he can return to his job as a
trainer and continue his dietary and herbal supplements. One of his pre-transplant
supplements was St. John's Wort which he took on a daily basis. You should explain tat
he should not take this because:
a. It will increase his anxiety and desire for sugar
b. It can contribute to the development of diabetes
c. It can decrease calcineurin levels
d. It can increase calcineurin levels - ✔✔c. It can decrease calcineurin levels
✔✔You are educating your potential kidney recipient during his evaluation. His kidney
disease is secondary to membranoproliferative glomerulonephritis type 3 (MPGN3). You
know that this disease can reoccur in the transplanted kidney. You explain that the
following kidney donor options would be offered to him:
a. Only deceased donor kidney according to UNOS policy
b. Deceased donor or living donor kidney transplant according to the individual
transplant center policy
c. Only living donor transplant according to UNOS policy
d. He is not eligible for a kidney transplant - ✔✔b. Deceased donor or living donor
kidney transplant according to the individual transplant center policy
**No UNOS policy that dictates medical disease and eligibility on getting transplant.
High reoccurrence rate with MPGN3
✔✔Your patient is waiting for a deceased donor kidney transplant called you and asked
how long he would have to wait for a kidney as he has been listed for 3 years. You
explain that there are a number of factors that influence how kidneys are allocated. The
most important factors in determining kidney allocation are:
a. BMI, cPRA, and age of recipient
b. cPRA and EPTS of recipient and KDPI of donor
c. length of time on waitlist, medical co-morbidities of recipient and diabetes
d. recipient serum albumin and Karnofsky score - ✔✔b. cPRA and EPTS of recipient
and KDPI of donor
**asking which ones directly influence allocation (cPRA, EPTS, KDPI and length of time
on waitlist)
,✔✔You are very excited to hear that your patient was transplanted with a deceased
donor kidney. He is a 43 year old man with ESRD secondary to HTN. He also has a
history of Hepatitis C, anti-phospholipid syndrome and thrombocytopenia. On post-op
day 2, you review his inpatient progress. His lab values indicate creatinine of 11.6,
which is unchanged from the day prior, potassium of 5.6, platelet count of 41 and Hgb of
8.0. His urine output over the past 8 hours is 65 ml. His transplant ultrasound showed
slight increase in resistive index of the artery and a patent vein and slight peri-nephric
fluid. You expect your patient is experiencing:
a. Dehydration
b. Bleeding
c. Acute tubular necrosis (ATN)
d. Acute rejection - ✔✔c. Acute tubular necrosis (ATN)
Symptoms of ATN include - creatinine not improving, UOP is oliguric, not quality urine,
Increased resistive index of artery, peri-nephric fluid
✔✔You are caring for a 73 year old female patient who is 36 hours post-kidney
transplant, has systolic BP of 90-100 mmHg over the past 2 hours. Urine output is
25cc/hr. Her only complaint is being very tired. Your initial assessment is that the patient
may be all of the following except:
a. Hypovolemic
b. Comfortable and pain free
c. Overly sedated
d. Stable with a satisfactory urine output - ✔✔d. Stable with a satisfactory urine output
UOP of 25 cc/hr is not satisfactory
✔✔Health screening for patients being evaluated for a kidney transplant would include:
a. Pap smear, PSA, ECG and CXR
b. Troponin, CK, ESR and CA-125
c. Cystoscopy, Colposcopy, colonoscopy and barium swallow
d. EGD, upper GI, MRI and 6 minute walk - ✔✔a. Pap smear, PSA, ECG and CXR
**general health screenings
✔✔As a transplant coordinator, you manage your liver waitlist. You have a 21 year old
male liver candidate with a history of hepatocellular carcinoma with a MELD score of 26.
You continue to update his listing status in UNET. How often do you recertify his listing?
A. Every 30 days with labs within 7 days
B. Every 7 days with labs within 48 hours
C. Every 90 days with labs within 14 days
,D. Every 12 month with labs within 30 days - ✔✔B. Every 7 days with labs within 48
hours
✔✔Laboratory studies which are required for recertification in UNET for this liver patient
with hepatocellular carcinoma and a MELD score of 26 includes the following?
A. INR, C-peptide, bilirubin, creatinine
B. INR, bilirubin, creatinine, albumin
C. INR , C-peptide, bilirubin, albumin
D. Bilirubin, creatinine, sodium, C-peptide
E. INR, bilirubin, creatinine, sodium - ✔✔E. INR, bilirubin, creatinine, sodium
✔✔You just completed the evaluation for a 2 year old liver transplant candidate in the
ICU. The committee agreed to move forward with listing and you have met with the
family and completed all the necessary paperwork. You will be listing this patient today.
The patient has a history of a fulminant liver failure, blood type O, labs showing ALT >
2000, INR 2, total bilirubin of 12. How will you list this patient?
1. PELD status 1A
2. PELD status 1B
3. PELD exception
4. MELD status 1
5. MELD >25 - ✔✔1. PELD status 1A
** Patient is under 2 and has fulminant liver failure
Labs that qualify for status 1A:
ALT >2000
INR > 2.0
Total bili >10
✔✔You are a transplant coordinator working in ICU taking care of a fresh transplant
liver recipient. Which of the following is a false statement about a Blakemore tube?
A. Used in management of upper GI hemorrhage
B. Is always used post transplant
C. Used to control esophageal varices
D. Is rarely used at present
E. Is a device inserted through the mouth or nose - ✔✔B. Is always used post transplant
✔✔As a transplant coordinator, you manage your liver waitlist. You have a 21 year old
male liver candidate who will be going to the OR for the transjugular intrahepatic
portosystemic shunt (TIPS) procedure. All of the following statements are true regarding
the TIPS procedure except for which one statement?
A. Can be used to treat complications of portal hypertension
, B. Can be used to treat variceal bleeding or bleeding from any veins that normally drain
the stomach, esophagus or intestine into the liver
C. Creates a new connection between two blood vessels in your liver
D. Catheter is inserted into your jugular vein and guided into your hepatic bein into your
liver
E. TIPS procedure can reverse liver cirrhosis and avoid transplantation
F. 88% of people with cirrhosis and variceal bleeding who received the TIPS procedure
survived for 2 years and 61% survived for at least 5 years - ✔✔E. TIPS procedure can
reverse liver cirrhosis and avoid transplantation
**Used a bridge to transplant
✔✔A father was the living donor liver for his 6 month old son. He initially asked how his
liver will be divided. The transplant coordinator informed the father that the surgeon will
perform a:
1. Right lobectomy
2. Left lobectomy
3. Left lateral segmentectomy
4. Right lateral segmentectomy - ✔✔3. Left lateral segmentectomy
Typically used for recipients of small size
✔✔The father that donated liver to his 6 month old son then asks how long will it take
for his liver to grow back? The transplant coordinator should inform that the remaining
organ will continue to regenerate for how many months?
1. 3
2. 6
3. 12
4. 18 - ✔✔3. 12
Majority of regeneration takes place in 2-3 months, however, the process continues up
to 1 year.
✔✔A 21 year old liver transplant is 3 days post transplant. His PT is 25 sec, AST >2000
and ALT > 5000. He will be going for a liver biopsy. It is thought he has primary graft
non-function. Factors related to primary nonfunction of new liver include which of the
following
A. Prolonged ischemic time
B. Donor age
C. Prolonged donor management/hospital stay
D. A and C only
E. B and C only
