CDN Fluid and Electrolyte Balance in Dialysis 2

Question 1

Which acid-base disorder is most commonly observed in patients with end-stage renal disease prior to dialysis?

Accepted Answer

Metabolic acidosis

Answer

Failed kidneys cannot excrete fixed acids or regenerate bicarbonate, leading to chronic metabolic acidosis in ESRD patients.

Question 2

What interdialytic weight gain is generally considered the maximum acceptable limit for a hemodialysis patient?

Accepted Answer

3–5% of dry body weight

Answer

Interdialytic weight gain up to 3–5% of dry body weight is generally considered acceptable, though lower gains are associated with better outcomes.

Question 3

Which sign/symptom is associated with hyponatremia in a dialysis patient?

Accepted Answer

Confusion, seizures, and muscle weakness

Answer

Severe or rapidly developing hyponatremia causes neurological symptoms including confusion, seizures, and weakness due to cerebral edema.

Question 4

A dialysis patient develops peaked T-waves and widened QRS on ECG. Which electrolyte abnormality is most likely responsible?

Accepted Answer

Hyperkalemia

Answer

Hyperkalemia produces sequential ECG changes including peaked T-waves, PR prolongation, widened QRS, and ultimately sine-wave pattern with cardiac arrest.

Question 5

What role does aluminum toxicity play in dialysis patients?

Accepted Answer

Leads to adynamic bone disease and encephalopathy

Answer

Aluminum accumulation in dialysis patients, historically from aluminum-containing phosphate binders and contaminated water, causes adynamic bone disease, anemia, and encephalopathy.

CDN - Certified Dialysis Nurse Practice Test

CDN - Certified Dialysis Nurse Practice Test

CDN Fluid and Electrolyte Balance in Dialysis 2