CDN Certified Dialysis Nursing 4

Question 1

A patient on hemodialysis develops sudden onset of back and chest pain with pink-tinged plasma and falling hematocrit during treatment. What complication is occurring?

Accepted Answer

Hemolysis

Answer

Hemolysis causes destruction of red blood cells, releasing hemoglobin that turns plasma pink; it is a dialysis emergency caused by heat, kinking, or hypotonic dialysate.

Question 2

Which secondary hyperparathyroidism finding is a consequence of chronic kidney disease and impacts dialysis nursing care?

Accepted Answer

Elevated PTH driving bone disease, hypercalcemia, and vascular calcification

Answer

CKD-MBD involves elevated PTH due to reduced vitamin D activation and hyperphosphatemia, leading to renal osteodystrophy and cardiovascular calcification.

Question 3

A peritoneal dialysis patient's drain effluent is consistently brown or feculent. What does this MOST likely indicate?

Accepted Answer

Bowel perforation with fecal contamination of the peritoneum

Answer

Brown or feculent effluent strongly suggests bowel perforation with intestinal contents contaminating the peritoneal cavity, requiring emergency surgical evaluation.

Question 4

When assessing for adequate anticoagulation during hemodialysis with heparin, which test is MOST commonly used bedside?

Accepted Answer

Activated Clotting Time (ACT)

Answer

The Activated Clotting Time (ACT) is a rapid bedside test used to monitor heparin anticoagulation during hemodialysis, with target typically 150–250 seconds.

Question 5

A dialysis nurse notes the patient's interdialytic weight gain is consistently 4–5 kg between sessions. What is the PRIORITY patient education topic?

Accepted Answer

Fluid and sodium restriction

Answer

Excessive interdialytic weight gain (>2–3 kg) reflects fluid and sodium excess, requiring education on fluid restriction and limiting high-sodium foods.

CDN - Certified Dialysis Nurse Practice Test

CDN - Certified Dialysis Nurse Practice Test

CDN Certified Dialysis Nursing 4