CDN Patient Education and Psychosocial Care 1 — Questions and Answers
Question 1: Which dietary restriction is MOST critical for end-stage renal disease (ESRD) patients on hemodialysis to prevent life-threatening complications?
- Limiting vitamin C intake
- Restricting potassium and phosphorus intake (Correct answer)
- Avoiding all dairy products
- Eliminating all dietary protein
Correct answer: Restricting potassium and phosphorus intake
Potassium restriction prevents fatal hyperkalemia, and phosphorus restriction prevents secondary hyperparathyroidism, vascular calcification, and bone disease in ESRD patients.
Question 2: What is the recommended fluid intake guideline for a hemodialysis patient with minimal residual urine output?
- Unrestricted — drink as much as desired
- Limit to 1000–1500 mL/day (Correct answer)
- Limit to 500 mL/day plus output
- No fluid restriction needed if on dialysis 3×/week
Correct answer: Limit to 1000–1500 mL/day
Hemodialysis patients with minimal urine output should generally restrict fluid intake to approximately 1000–1500 mL per day to prevent excessive interdialytic weight gain.
Question 3: When educating a dialysis patient about phosphorus restriction, which food group should be emphasized most strongly?
- Fresh fruits and vegetables
- Processed foods, dairy, and dark colas containing phosphate additives (Correct answer)
- Whole grain breads
- Fresh lean meats in all quantities
Correct answer: Processed foods, dairy, and dark colas containing phosphate additives
Processed foods contain phosphate additives that are nearly 100% absorbed, making them the highest-risk category for hyperphosphatemia in dialysis patients.
Question 4: A dialysis patient reports feeling hopeless and states 'I don't see the point in continuing treatment.' What is the nurse's priority action?
- Remind the patient of the importance of dialysis adherence
- Conduct a suicide risk assessment and notify the physician and social worker (Correct answer)
- Ask family members to monitor the patient at home
- Document the statement and continue with treatment
Correct answer: Conduct a suicide risk assessment and notify the physician and social worker
Statements of hopelessness in dialysis patients require immediate suicide risk assessment, as this population has significantly elevated rates of depression and suicidal ideation.
Question 5: Which teaching method is most effective for dialysis patients with low health literacy?
- Providing detailed written pamphlets with medical terminology
- Using teach-back method with simple language and visual aids (Correct answer)
- One-time group education sessions
- Online video modules only
Correct answer: Using teach-back method with simple language and visual aids
The teach-back method — asking patients to repeat information in their own words — combined with simple language and visuals is the most effective approach for low health literacy populations.
Question 6: What is the role of the dialysis social worker in the care of ESRD patients?
- Adjust dialysis prescriptions
- Provide psychosocial assessment, counseling, and help with financial/transportation barriers (Correct answer)
- Perform monthly lab draws
- Manage dialysis equipment maintenance
Correct answer: Provide psychosocial assessment, counseling, and help with financial/transportation barriers
The dialysis social worker addresses psychosocial needs, depression screening, financial assistance programs (Medicare/Medicaid), insurance issues, and transportation barriers to treatment.
CDN Patient Education and Psychosocial Care 1
Which dietary restriction is MOST critical for end-stage renal disease (ESRD) patients on hemodialysis to prevent life-threatening complications?