CERTIFIED DIALYSIS NURSE (CDN)
EXAMINATION COMPLETE QUESTIONS AND
DETAILED SOLUTIONS LATEST UPDATE THIS
YEAR JUST RELEASED
1. A patient with end-stage kidney disease develops fatigue, pallor, and
decreased exercise tolerance. Which laboratory abnormality most directly
contributes to these findings?
A. Increased serum phosphate
B. Decreased hemoglobin
C. Increased serum sodium
D. Decreased serum potassium
Answer: B. Decreased hemoglobin
Rationale: Kidney failure reduces erythropoietin production, resulting in
decreased red blood cell production and anemia. Anemia commonly causes
fatigue, pallor, weakness, and reduced exercise tolerance.
2. Which hormone produced primarily by the kidneys stimulates red blood cell
production?
A. Renin
B. Aldosterone
C. Erythropoietin
D. Parathyroid hormone
Answer: C. Erythropoietin
,Rationale: Renal peritubular cells produce erythropoietin in response to hypoxia.
Reduced erythropoietin production is a major cause of anemia in chronic kidney
disease.
3. A patient with chronic kidney disease has persistent hyperphosphatemia.
Which complication is the nurse most concerned about?
A. Hypoglycemia
B. Renal bone disease
C. Respiratory alkalosis
D. Iron overload
Answer: B. Renal bone disease
Rationale: Phosphate retention contributes to secondary hyperparathyroidism
and disturbances in calcium-phosphate metabolism, increasing the risk of CKD-
mineral and bone disorder.
4. Which electrolyte abnormality is most immediately life-threatening in a
patient with severe kidney failure?
A. Hyperkalemia
B. Hyperphosphatemia
C. Mild hypocalcemia
D. Mild hypermagnesemia
Answer: A. Hyperkalemia
Rationale: Severe hyperkalemia can cause potentially fatal cardiac dysrhythmias.
It requires prompt assessment and treatment.
5. A patient with chronic kidney disease reports persistent pruritus. Which
factor is commonly associated with this symptom?
,A. Uremia and mineral imbalance
B. Hypoglycemia
C. Excess erythropoietin
D. Respiratory alkalosis
Answer: A. Uremia and mineral imbalance
Rationale: Uremia, disturbances in calcium-phosphate metabolism, and other
CKD-related factors may contribute to pruritus.
6. Which assessment finding is most consistent with fluid volume overload?
A. Dry mucous membranes
B. Orthostatic hypotension
C. Pulmonary crackles and peripheral edema
D. Decreased jugular venous pressure
Answer: C. Pulmonary crackles and peripheral edema
Rationale: Excess extracellular fluid can produce edema, elevated blood pressure,
jugular venous distention, weight gain, and pulmonary congestion.
7. Which intervention is most appropriate for a patient with significant fluid
overload related to kidney failure?
A. Encourage unlimited oral fluids
B. Restrict sodium and prescribed fluid intake
C. Increase dietary potassium
D. Avoid dialysis until edema resolves
Answer: B. Restrict sodium and prescribed fluid intake
Rationale: Sodium promotes water retention. Sodium and fluid restrictions, along
with prescribed dialysis and medications, help control extracellular fluid excess.
, 8. A patient with kidney failure has metabolic acidosis. Which finding would the
nurse expect?
A. Elevated serum bicarbonate
B. Decreased serum bicarbonate
C. Increased blood pH
D. Increased carbon dioxide elimination as the primary cause
Answer: B. Decreased serum bicarbonate
Rationale: Impaired renal acid excretion and reduced bicarbonate regeneration
contribute to metabolic acidosis.
9. Which finding is most concerning in a patient with severe uremia?
A. Mild dry skin
B. Pericardial friction rub
C. Increased appetite
D. Warm extremities
Answer: B. Pericardial friction rub
Rationale: Uremic pericarditis is a serious complication of advanced kidney failure
and requires immediate medical evaluation.
10. Which medication class commonly requires careful monitoring in patients
with kidney failure because renal clearance is reduced?
A. Renally eliminated medications
B. Topical emollients
C. Inhaled saline only
D. Most topical antibiotics
EXAMINATION COMPLETE QUESTIONS AND
DETAILED SOLUTIONS LATEST UPDATE THIS
YEAR JUST RELEASED
1. A patient with end-stage kidney disease develops fatigue, pallor, and
decreased exercise tolerance. Which laboratory abnormality most directly
contributes to these findings?
A. Increased serum phosphate
B. Decreased hemoglobin
C. Increased serum sodium
D. Decreased serum potassium
Answer: B. Decreased hemoglobin
Rationale: Kidney failure reduces erythropoietin production, resulting in
decreased red blood cell production and anemia. Anemia commonly causes
fatigue, pallor, weakness, and reduced exercise tolerance.
2. Which hormone produced primarily by the kidneys stimulates red blood cell
production?
A. Renin
B. Aldosterone
C. Erythropoietin
D. Parathyroid hormone
Answer: C. Erythropoietin
,Rationale: Renal peritubular cells produce erythropoietin in response to hypoxia.
Reduced erythropoietin production is a major cause of anemia in chronic kidney
disease.
3. A patient with chronic kidney disease has persistent hyperphosphatemia.
Which complication is the nurse most concerned about?
A. Hypoglycemia
B. Renal bone disease
C. Respiratory alkalosis
D. Iron overload
Answer: B. Renal bone disease
Rationale: Phosphate retention contributes to secondary hyperparathyroidism
and disturbances in calcium-phosphate metabolism, increasing the risk of CKD-
mineral and bone disorder.
4. Which electrolyte abnormality is most immediately life-threatening in a
patient with severe kidney failure?
A. Hyperkalemia
B. Hyperphosphatemia
C. Mild hypocalcemia
D. Mild hypermagnesemia
Answer: A. Hyperkalemia
Rationale: Severe hyperkalemia can cause potentially fatal cardiac dysrhythmias.
It requires prompt assessment and treatment.
5. A patient with chronic kidney disease reports persistent pruritus. Which
factor is commonly associated with this symptom?
,A. Uremia and mineral imbalance
B. Hypoglycemia
C. Excess erythropoietin
D. Respiratory alkalosis
Answer: A. Uremia and mineral imbalance
Rationale: Uremia, disturbances in calcium-phosphate metabolism, and other
CKD-related factors may contribute to pruritus.
6. Which assessment finding is most consistent with fluid volume overload?
A. Dry mucous membranes
B. Orthostatic hypotension
C. Pulmonary crackles and peripheral edema
D. Decreased jugular venous pressure
Answer: C. Pulmonary crackles and peripheral edema
Rationale: Excess extracellular fluid can produce edema, elevated blood pressure,
jugular venous distention, weight gain, and pulmonary congestion.
7. Which intervention is most appropriate for a patient with significant fluid
overload related to kidney failure?
A. Encourage unlimited oral fluids
B. Restrict sodium and prescribed fluid intake
C. Increase dietary potassium
D. Avoid dialysis until edema resolves
Answer: B. Restrict sodium and prescribed fluid intake
Rationale: Sodium promotes water retention. Sodium and fluid restrictions, along
with prescribed dialysis and medications, help control extracellular fluid excess.
, 8. A patient with kidney failure has metabolic acidosis. Which finding would the
nurse expect?
A. Elevated serum bicarbonate
B. Decreased serum bicarbonate
C. Increased blood pH
D. Increased carbon dioxide elimination as the primary cause
Answer: B. Decreased serum bicarbonate
Rationale: Impaired renal acid excretion and reduced bicarbonate regeneration
contribute to metabolic acidosis.
9. Which finding is most concerning in a patient with severe uremia?
A. Mild dry skin
B. Pericardial friction rub
C. Increased appetite
D. Warm extremities
Answer: B. Pericardial friction rub
Rationale: Uremic pericarditis is a serious complication of advanced kidney failure
and requires immediate medical evaluation.
10. Which medication class commonly requires careful monitoring in patients
with kidney failure because renal clearance is reduced?
A. Renally eliminated medications
B. Topical emollients
C. Inhaled saline only
D. Most topical antibiotics
