CDN Renal Pharmacology for Dialysis Nurses 2

Question 1

Heparin is administered at the start of hemodialysis primarily to prevent:

Accepted Answer

Clotting in the extracorporeal circuit

Answer

Heparin prevents thrombus formation in the blood tubing, dialyzer, and needle during passage of blood through the extracorporeal circuit.

Question 2

A dialysis patient is prescribed active vitamin D therapy. Which laboratory values must be monitored to prevent complications?

Accepted Answer

Serum calcium and phosphorus

Answer

Active vitamin D (calcitriol or paricalcitol) can cause hypercalcemia and hyperphosphatemia, which must be monitored to prevent vascular calcification.

Question 3

Which medication requires dose adjustment or avoidance in dialysis patients due to accumulation of active metabolites that can cause neurological toxicity?

Accepted Answer

Meperidine (Demerol)

Answer

Meperidine's active metabolite normeperidine accumulates in renal failure and can cause seizures, making it contraindicated in dialysis patients.

Question 4

When should phosphate binders be administered to achieve maximum effectiveness?

Accepted Answer

With or immediately after meals

Answer

Phosphate binders must be taken with meals to bind dietary phosphate in the gut before it is absorbed, reducing serum phosphorus levels.

Question 5

A dialysis patient on warfarin for atrial fibrillation requires more frequent INR monitoring. Why?

Accepted Answer

Altered protein binding and volume of distribution affect drug levels

Answer

Uremia alters plasma protein binding and drug metabolism, making anticoagulation levels unpredictable and requiring more frequent INR monitoring.

CDN - Certified Dialysis Nurse Practice Test

CDN - Certified Dialysis Nurse Practice Test

CDN Renal Pharmacology for Dialysis Nurses 2