CCTC LATEST 2026 TEST PAPER QUESTIONS AND
SOLUTIONS RATED A+
✔✔You are caring for a 25 year old male who is admitted to CICU post heart transplant.
Within 12 hours, his heart rate drops to 50 beats per minute. You anticipate orders for
one or more of the following?
1. AV sequential pacing via temporary epicardial pacing wires
2. CXR
3. Endomyocardial biopsy
4. Initiation of isoproterenol (Isuprel)
a. 1 and 3
b. 2 and 4
c. 1 and 4
d. 3 and 4 - ✔✔c. 1 and 4
Patient is current bradycardic. Cannot give atropine, will need to use isoproterenol.
Want heart rate to be 100-120 post transplant
✔✔You are caring for a 25 year old male recipient who is post op day 1 from heart
transplant. You are taking over care on the night shift. Labs, hemodynamics and vitals
are as follows:
Hemoglobin of 6, HCT 18, systolic BP of 88, HR of 150 and chest tube output at 250
cc/hr. You notify the physician and anticipate orders for:
1. Endomyocardial biopsy
2. Immunosuppression medication
3. Blood products
4. Protamine
5. Preparation of patient returning to the OR
6. All of the above
a. 1, 2 and 3
b. 2, 3, and 5
c. 1, 3 and 4
d. 3, 4 and 5
e. All of the above - ✔✔d. 3, 4 and 5
3. Blood products
4. Protamine
5. Preparation of patient returning to the OR
✔✔You are mentoring a new transplant coordinator. The most common causes of
chronic kidney disease (CKD) include which of the following?
,1. Hypertension
2. Congestive heart failure
3. Diabetes
4. Glomerulonephritis
a. 1, 2, 3
b. 2, 3, 4
c. 1, 3, 4
d. All of the above - ✔✔c. 1, 3, 4
1. Hypertension
3. Diabetes
4. Glomerulonephritis
✔✔Which of the following risk factors requires frequent re-evaluation for patients on the
kidney transplant waitlist?
1. Females over 40
2. History of smoking 3 months ago
3. Receiving dialysis for less than 2 years
4. High-density lipoprotein (HDL) of less than 35
a. 1 and 2 only
b. 1 and 3 only
c. 2 and 4 only
d. 3 and 4 only - ✔✔c. 2 and 4 only
2. History of smoking 3 months ago
4. High-density lipoprotein (HDL) of less than 35
Good HDL level of >60
✔✔A sibling is scheduled for a left donor nephrectomy. The healthy kidney will be
transplanted into his sister who is blood type B negative. You are the coordinator
reviewing the final preoperative assessment. Which of the following donor findings
would make it necessary to potentially postpone the donation surgery?
1. Blood type is positive
2. BMI has increased
3. Urinalysis reveals microscopic hematuria
4. THC use is positive - ✔✔3. Urinalysis reveals microscopic hematuria
**could be associated with hereditary kidney diseases
✔✔A 21 year old female underwent kidney transplant for polycystic kidney disease. On
post op day #2, your patient asked if she still had her non-functioning kidney. You
,responded that her kidney was removed. With PKD, the removal of kidney can be done
for the following reasons except which statement?
1. Kidney had progressive cyst formation
2. Intractable pain
3. Hematuria
4. Infection
5. Enlargement
6. Patient preference - ✔✔6. Patient preference
✔✔When providing a new transplant coordinator education regarding early post-
operative complications post kidney transplant, you discuss ATN during the immediate
post operative phase. Donor factors that may affect the development of ATN in the
newly transplanted kidney include which of the following?
1. Hypotension during the donor management phase
2. Cardiac or respiratory arrest
3. Ventilator- associated pneumonia
4. Fluid overload during donor management
a. 1 and 3
b. 1 and 2
c. 2 and 3
d. 3 and 4 - ✔✔b. 1 and 2
1. Hypotension during the donor management phase
2. Cardiac or respiratory arrest
Drop in BP = Drop in perfusion to kidney
✔✔A 21 year old female kidney recipient is 5 years post kidney transplant and is seen
in your outpatient clinic. You take her blood pressure and it is 190/100 despite her
taking her antihypertension medications. Her creatinine is 2.0. There is bruit over the
anastomosis. What is most likely the patient's diagnosis?
1. Ureteral obstruction
2. Renal artery stenosis
3. Lymphocele
4. Graft thrombosis
5. Urine Leak
6. Rejection - ✔✔2. Renal artery stenosis
Increased uncontrolled BP, increased creatinine, months-years post transplant, bruit
over kidney blood flow area
, ✔✔A 21 year old female kidney transplant recipient is 1 month post right iliac fossa
kidney transplant and is seen in your outpatient clinic. She reports fever of 39 for the
past 24 hours, decreased urine output and right leg swelling. Labs result with a BUN of
60 and creatinine of 2.1. What do you suspect?
1. Acute cellular rejection
2. Thrombophlebitis
3. Lymphocele
4. Antibody mediated rejection - ✔✔3. Lymphocele
Lymph fluid over kidney, increased creatinine, leg edema on same side as kidney
transplant, fever
✔✔The transplant coordinator should anticipate which of the following in this patient...
ATN present as renal failure after rejection and obstruction were ruled out. Signs and
symptoms of ATN including which of the following?
1. Increased BUN and creatinine
2. Anuria or oliguria
3. Pulmonary edema
4. Elevated potassium and magnesium levels
5. Decreased weight
a. 1, 2, 3
b. 1, 2, 4
c. 1, 2, and 5
d. 1, 2, 3, and 4
e. All of the above - ✔✔d. 1, 2, 3, and 4
1. Increased BUN and creatinine
2. Anuria or oliguria
3. Pulmonary edema
4. Elevated potassium and magnesium levels
**will gain weight
✔✔A 45 year old female kidney recipient is 1 month post kidney transplant and will be
undergoing a renal biopsy. Prior to biopsy, which lab tests should you be ordering?
a. Platelet count
b. Pt/INR
c. WBC
d. a and b
e. a and c
f. all of the above - ✔✔d. a and b
SOLUTIONS RATED A+
✔✔You are caring for a 25 year old male who is admitted to CICU post heart transplant.
Within 12 hours, his heart rate drops to 50 beats per minute. You anticipate orders for
one or more of the following?
1. AV sequential pacing via temporary epicardial pacing wires
2. CXR
3. Endomyocardial biopsy
4. Initiation of isoproterenol (Isuprel)
a. 1 and 3
b. 2 and 4
c. 1 and 4
d. 3 and 4 - ✔✔c. 1 and 4
Patient is current bradycardic. Cannot give atropine, will need to use isoproterenol.
Want heart rate to be 100-120 post transplant
✔✔You are caring for a 25 year old male recipient who is post op day 1 from heart
transplant. You are taking over care on the night shift. Labs, hemodynamics and vitals
are as follows:
Hemoglobin of 6, HCT 18, systolic BP of 88, HR of 150 and chest tube output at 250
cc/hr. You notify the physician and anticipate orders for:
1. Endomyocardial biopsy
2. Immunosuppression medication
3. Blood products
4. Protamine
5. Preparation of patient returning to the OR
6. All of the above
a. 1, 2 and 3
b. 2, 3, and 5
c. 1, 3 and 4
d. 3, 4 and 5
e. All of the above - ✔✔d. 3, 4 and 5
3. Blood products
4. Protamine
5. Preparation of patient returning to the OR
✔✔You are mentoring a new transplant coordinator. The most common causes of
chronic kidney disease (CKD) include which of the following?
,1. Hypertension
2. Congestive heart failure
3. Diabetes
4. Glomerulonephritis
a. 1, 2, 3
b. 2, 3, 4
c. 1, 3, 4
d. All of the above - ✔✔c. 1, 3, 4
1. Hypertension
3. Diabetes
4. Glomerulonephritis
✔✔Which of the following risk factors requires frequent re-evaluation for patients on the
kidney transplant waitlist?
1. Females over 40
2. History of smoking 3 months ago
3. Receiving dialysis for less than 2 years
4. High-density lipoprotein (HDL) of less than 35
a. 1 and 2 only
b. 1 and 3 only
c. 2 and 4 only
d. 3 and 4 only - ✔✔c. 2 and 4 only
2. History of smoking 3 months ago
4. High-density lipoprotein (HDL) of less than 35
Good HDL level of >60
✔✔A sibling is scheduled for a left donor nephrectomy. The healthy kidney will be
transplanted into his sister who is blood type B negative. You are the coordinator
reviewing the final preoperative assessment. Which of the following donor findings
would make it necessary to potentially postpone the donation surgery?
1. Blood type is positive
2. BMI has increased
3. Urinalysis reveals microscopic hematuria
4. THC use is positive - ✔✔3. Urinalysis reveals microscopic hematuria
**could be associated with hereditary kidney diseases
✔✔A 21 year old female underwent kidney transplant for polycystic kidney disease. On
post op day #2, your patient asked if she still had her non-functioning kidney. You
,responded that her kidney was removed. With PKD, the removal of kidney can be done
for the following reasons except which statement?
1. Kidney had progressive cyst formation
2. Intractable pain
3. Hematuria
4. Infection
5. Enlargement
6. Patient preference - ✔✔6. Patient preference
✔✔When providing a new transplant coordinator education regarding early post-
operative complications post kidney transplant, you discuss ATN during the immediate
post operative phase. Donor factors that may affect the development of ATN in the
newly transplanted kidney include which of the following?
1. Hypotension during the donor management phase
2. Cardiac or respiratory arrest
3. Ventilator- associated pneumonia
4. Fluid overload during donor management
a. 1 and 3
b. 1 and 2
c. 2 and 3
d. 3 and 4 - ✔✔b. 1 and 2
1. Hypotension during the donor management phase
2. Cardiac or respiratory arrest
Drop in BP = Drop in perfusion to kidney
✔✔A 21 year old female kidney recipient is 5 years post kidney transplant and is seen
in your outpatient clinic. You take her blood pressure and it is 190/100 despite her
taking her antihypertension medications. Her creatinine is 2.0. There is bruit over the
anastomosis. What is most likely the patient's diagnosis?
1. Ureteral obstruction
2. Renal artery stenosis
3. Lymphocele
4. Graft thrombosis
5. Urine Leak
6. Rejection - ✔✔2. Renal artery stenosis
Increased uncontrolled BP, increased creatinine, months-years post transplant, bruit
over kidney blood flow area
, ✔✔A 21 year old female kidney transplant recipient is 1 month post right iliac fossa
kidney transplant and is seen in your outpatient clinic. She reports fever of 39 for the
past 24 hours, decreased urine output and right leg swelling. Labs result with a BUN of
60 and creatinine of 2.1. What do you suspect?
1. Acute cellular rejection
2. Thrombophlebitis
3. Lymphocele
4. Antibody mediated rejection - ✔✔3. Lymphocele
Lymph fluid over kidney, increased creatinine, leg edema on same side as kidney
transplant, fever
✔✔The transplant coordinator should anticipate which of the following in this patient...
ATN present as renal failure after rejection and obstruction were ruled out. Signs and
symptoms of ATN including which of the following?
1. Increased BUN and creatinine
2. Anuria or oliguria
3. Pulmonary edema
4. Elevated potassium and magnesium levels
5. Decreased weight
a. 1, 2, 3
b. 1, 2, 4
c. 1, 2, and 5
d. 1, 2, 3, and 4
e. All of the above - ✔✔d. 1, 2, 3, and 4
1. Increased BUN and creatinine
2. Anuria or oliguria
3. Pulmonary edema
4. Elevated potassium and magnesium levels
**will gain weight
✔✔A 45 year old female kidney recipient is 1 month post kidney transplant and will be
undergoing a renal biopsy. Prior to biopsy, which lab tests should you be ordering?
a. Platelet count
b. Pt/INR
c. WBC
d. a and b
e. a and c
f. all of the above - ✔✔d. a and b
