CERTIFIED DIALYSIS NURSE EXAMS REVIEW
x x x x
WITH VERIFIED QUESTIONS AND ANSWERS
x x x x
- Ability xto xprogram xthe xcycler xfor xthe xcorrect xnumber xof xexchanges/night.
- Ability xto xset xthe xmachine xto xwarm xthe xdialysate xto xbody xtemperature.
- Ability xto xtime xthe xfrequency xof xexchanges xthroughout xthe xnight.
- Ability xto xensure xalarms xfor xinflow xfailure, xoverheating xand xinadequate xdrainage
xare xon xand x working.
- ANSWERS-Which xteaching xpoints xmust xbe xmastered xby xpatients xbefore xthey xcan
xperform xtheir x automated xperitoneal xdialysis xat xhome?
- Dialysis xdiscontinued xuntil xthe xcause xof xsymptoms xis xdetermined x& xthe xphysician xis
xnotified
- Do xnot xreturn xblood
- Administer xO2 xfor xbreathing xdifficulties
- Intravenous xantihistamines xor xepinephrine xmay xbe xordered xfor xanaphylaxis
- BP xsupport xmay xalso xbe xnecessary xfor xhypotension
- ANSWERS-Treatment xfor xdialyzer xreactions?
- Dry xpersistent xcough.
- Irregular xheart xrate xand xmuscle xweakness.
- Hypotension
- ANSWERS-When xassessing xa xCKD xpatient, xwhich xclinical xfindings xlead xthe xnurse
xto xsuspect xthe x patient xhas xdeveloped xa xside xeffect xto xlisinopril, xan xangiotensin-
converting xenzyme x(ACE) x inhibitor?
- Edema xnoted xin xabdomen xand xlower xlegs.
- Hypotension
- ANSWERS-Laboratory xvalues xreveal xthat xa xCKD xpatient's xalbumin xlevel xis xlow.
xThe xnurse xwill x likely xassess xwhich xsymptoms xof xhypoalbuminemia xin xthis
xpatient?
- Infusion xof xa xsmall xamount xof xheparinized xsaline xsolution xevery x4-8 xhours xfor xthe
xfirst x1-3 xdays x postoperatively.
- Low xvolume xin xand xout xexchanges xwith xheparinized xsaline xor xdialysate xuntil xthe
xeffluent xis xno x longer xbloody. xthen xdaily xfor x1 xto x2 xweeks, xand xweekly xthereafter
xuntil xthe xpatient xis xundergoing x PD. x- xA xsmall xvolume xof xheparinized xsolution
xshould xremain xin xthe xperitoneum xto xinhibit xthe x formation xof xfibrin
-immediate xdialysis xneed: xFrequent, xlow-volume xexchanges x(500-1000 xmL) xare
xperformed xusing xa x cycler xwith xthe xpatient xin xthe xsupine xposition.
,- xANSWERS-During xthe xperiod xcalled xcatheter xbreak-in, xwhen xthe xperitoneal xdialysis xcatheter
xis x placed xand xhealing xhas xbegun, xthe xnurse xshould xanticipate xwhich xprescribed xdialysis
xorders?
- It xensures xthe xteammate xhas xup xto xdate xcredentials xon xfile xthat xmeet xinternal
xand xexternal x regulatory xrequirements
- It xis xused xby xsurveyors xduring xCMS xaudits xto xverify xcredentials
- It xis xused xby xsurveyors xduring xCMS xaudits xto xverify xproper xtraining xand
xeducation xhad xbeen x completed
- It xprovides xa xpathway xfor xa xteammate xto xbe xpromoted
- ANSWERS-A xteammate's xfile xor xtranscript xmust xbe xkept xup xto xdate xby xthe xFacility
xAdministrator x or xdelegate xbecause x(select xall xthat xapply):
- less xthreatening xbut xmore xcommonly xseen xthan xType xA
- symptoms xusually xoccur xas xsoon xas xthe xpatient's xblood xis xexposed xto xthe xdialyzer
xand xreturned xto x the xpatient
-ANSWERS-What xis xa xType xB xdialyzer xreaction?
- measure xthe xvolume xof xdialysate xto xbe xinfused,
- warm xthe xdialysate xto xbody xtemperature xbefore xinfusion,
- time xthe xfrequency xof xexchanges,
- count xthe xnumber xof xexchanges
- measure xUF.
- ANSWERS-Which xteaching xpoints xmust xbe xmastered xby xpatients xbefore xthey xcan
xperform xtheir x automated xperitoneal xdialysis xat xhome?
- PD xmay xcause xa xfull xfeeling xin xthe xabdomen, xresulting xin xa xlower xintake xof xcalories
- PD xpatients xmay xabsorb x150-1,000 xcalories/day xfrom xthe xdextrose xin xthe xdialysate
- ANSWERS-The xnurse xis xdiscussing xcaloric xneeds xwith xa xpatient xwho xis xon
xperitoneal xdialysis x(PD). x What xinformation xcan xthe xnurse xprovide xto xthe xpatient?
- Some xherbals xcan xbe xtoxic xto xthe xkidneys.
- Some xherbals xcan xaffect xblood xpressure xcontrol.
- Some xherbals xcan xaffect xanticoagulation.
- ANSWERS-A xdialysis xpatient xis xsharing xinformation xabout xher xfavorite xherbal
xremedies. xWhat x reminders xshould xthe xnurse xbe xprepared xto xprovide xthe
xpatient?
- Sometimes xreferred xto xas x"first-use xsyndrome" xbecause xsome xpatients xdevelop
xallergic-type x symptoms xwhen xexposed xto xthe xdialyzer xmembrane xfor xthe xfirst
xtime
- Often xpresent xwith xanaphylactic-type xsymptoms.
- Usually xoccur xwithin xthe xfirst x5 xminutes xof xtreatment
- ANSWERS-What xis xa xType xA xdialyzer xreaction?
- standardized xtest xof xperitoneal xmembrane xpermeability xused xto xestimate xthe
xsolute xtransport x characteristics, xglucose xabsorption, xand xnet xUF.
- done x1 xmonth xafter xinitiation xof xdialysis
-
- ANSWERS-What xis xa xperitoneal xequilibration xtest x(PET)
,- Standing xsystolic xBP xgreater xthan x140 xmm/Hg xor xless xthan x90 xmm/Hg
, - Standing xdiastolic xBP xgreater xthan x90 xmm/Hg xor xless xthan x50 xmm/Hg
- ANSWERS-Per xDaVita xpolicy, xa xstanding xpost xtreatment xblood xpressure xof
is x considered xan xabnormal xfinding xand xshould xbe xreported xto xa xlicensed xnurse
- Target xpostdialysis xweight
- How xmuch xfluid xthe xpatient xwill xreceive xorally xand/or xintravenously
- The xultrafiltration xcoefficient x(kUF)of xthe xdialyzer xthat xis xbeing xused.
- ANSWERS-What xinformation xwould xthe xnurse xneed xto xcalculate xthe xrate xof
xultrafiltration?
- The xpatient xis xin xfull xcharge xof xadministering xthe xperitoneal xdialysis,
xpreserving xtheir xusual x lifestyle.
- PD xpatients xdo xnot xsuffer xthe xeffects xof xrapid xbiochemical xand xfluid
xchanges xcommon xin x hemodialysis.
- There xis xless xrisk xof xdestabilizing xthe xfragile xmental xequilibrium xof xsome xolder xadult
xpatients.
- ANSWERS-While xproviding xpatient xeducation, xwhich xadvantages xof xperitoneal
xdialysis xcan xthe x nurse xshare xwith xan xolder xadult xCKD xpatient?
- tissues xare xoften xedematous xand xextremely xfriable.
- Patients xwith xinfections xand xrejection xare xalmost xalways xcatabolic,
xedematous, xand x hypoproteinemic.
-Cardiopulmonary xand xcardiovascular xsystems xoften xlabile, xand xhypotension xor
xcardiac x dysrhythmias xand xpulmonary xcongestion xshould xbe xanticipated.
- ANSWERS-When xcaring xfor xa xpatient xwho xis xexperiencing xa xsevere xtransplant
xrejection, xwhat x complications xshould xthe xnurse xanticipate?
- When xmandated xby xstate xlaw x(pre-treatment xinitiation xvs xwithin x1 xhour xafter xstart xof
xtreatment)
- When xthe xPCT xperforming xa xdata xcollection xnotices xabnormal xfindings xor xwhen
xthe xnurse xor xPCT x observe xunusual xbehaviors
- When xthe xpatient xreports xunusual xsymptoms xto xthe xnurse xor xPCT xbefore xtreatment
xinitiation
- ANSWERS-When xis xa xpre-treatment xassessment xby xthe xlicensed xnurse xrequired?
-bleeding xulcers
High xlevels xof xurea xbreak xdown xin xthe xgastrointestinal x(GI) xtract xand xrelease
xammonia, xcausing x irritation xof xthe xGI xmucosa. xAltered xcapillary xpermeability xand
xplatelet xdysfunction xin xuremia xalso x contribute xto xGI xbleeding.
- ANSWERS-A xpatient xwho xhas xlong-standing, xuntreated xchronic xkidney xdisease xis
xadmitted xvia x the xemergency xdepartment xwith xuremia. xAcute xdialysis xis
xinitiated. xBecause xof xthe xhistory xof x untreated xkidney xdisease, xthe xpatient xis xat
xrisk xfor xwhich xof xthese xgastrointestinal xconditions?
-polyps
-giardiasis
-paralytic xileus
-bleeding xulcers
"Control xyour xblood xglucose xlevels xif xyou xare xa
x x x x
WITH VERIFIED QUESTIONS AND ANSWERS
x x x x
- Ability xto xprogram xthe xcycler xfor xthe xcorrect xnumber xof xexchanges/night.
- Ability xto xset xthe xmachine xto xwarm xthe xdialysate xto xbody xtemperature.
- Ability xto xtime xthe xfrequency xof xexchanges xthroughout xthe xnight.
- Ability xto xensure xalarms xfor xinflow xfailure, xoverheating xand xinadequate xdrainage
xare xon xand x working.
- ANSWERS-Which xteaching xpoints xmust xbe xmastered xby xpatients xbefore xthey xcan
xperform xtheir x automated xperitoneal xdialysis xat xhome?
- Dialysis xdiscontinued xuntil xthe xcause xof xsymptoms xis xdetermined x& xthe xphysician xis
xnotified
- Do xnot xreturn xblood
- Administer xO2 xfor xbreathing xdifficulties
- Intravenous xantihistamines xor xepinephrine xmay xbe xordered xfor xanaphylaxis
- BP xsupport xmay xalso xbe xnecessary xfor xhypotension
- ANSWERS-Treatment xfor xdialyzer xreactions?
- Dry xpersistent xcough.
- Irregular xheart xrate xand xmuscle xweakness.
- Hypotension
- ANSWERS-When xassessing xa xCKD xpatient, xwhich xclinical xfindings xlead xthe xnurse
xto xsuspect xthe x patient xhas xdeveloped xa xside xeffect xto xlisinopril, xan xangiotensin-
converting xenzyme x(ACE) x inhibitor?
- Edema xnoted xin xabdomen xand xlower xlegs.
- Hypotension
- ANSWERS-Laboratory xvalues xreveal xthat xa xCKD xpatient's xalbumin xlevel xis xlow.
xThe xnurse xwill x likely xassess xwhich xsymptoms xof xhypoalbuminemia xin xthis
xpatient?
- Infusion xof xa xsmall xamount xof xheparinized xsaline xsolution xevery x4-8 xhours xfor xthe
xfirst x1-3 xdays x postoperatively.
- Low xvolume xin xand xout xexchanges xwith xheparinized xsaline xor xdialysate xuntil xthe
xeffluent xis xno x longer xbloody. xthen xdaily xfor x1 xto x2 xweeks, xand xweekly xthereafter
xuntil xthe xpatient xis xundergoing x PD. x- xA xsmall xvolume xof xheparinized xsolution
xshould xremain xin xthe xperitoneum xto xinhibit xthe x formation xof xfibrin
-immediate xdialysis xneed: xFrequent, xlow-volume xexchanges x(500-1000 xmL) xare
xperformed xusing xa x cycler xwith xthe xpatient xin xthe xsupine xposition.
,- xANSWERS-During xthe xperiod xcalled xcatheter xbreak-in, xwhen xthe xperitoneal xdialysis xcatheter
xis x placed xand xhealing xhas xbegun, xthe xnurse xshould xanticipate xwhich xprescribed xdialysis
xorders?
- It xensures xthe xteammate xhas xup xto xdate xcredentials xon xfile xthat xmeet xinternal
xand xexternal x regulatory xrequirements
- It xis xused xby xsurveyors xduring xCMS xaudits xto xverify xcredentials
- It xis xused xby xsurveyors xduring xCMS xaudits xto xverify xproper xtraining xand
xeducation xhad xbeen x completed
- It xprovides xa xpathway xfor xa xteammate xto xbe xpromoted
- ANSWERS-A xteammate's xfile xor xtranscript xmust xbe xkept xup xto xdate xby xthe xFacility
xAdministrator x or xdelegate xbecause x(select xall xthat xapply):
- less xthreatening xbut xmore xcommonly xseen xthan xType xA
- symptoms xusually xoccur xas xsoon xas xthe xpatient's xblood xis xexposed xto xthe xdialyzer
xand xreturned xto x the xpatient
-ANSWERS-What xis xa xType xB xdialyzer xreaction?
- measure xthe xvolume xof xdialysate xto xbe xinfused,
- warm xthe xdialysate xto xbody xtemperature xbefore xinfusion,
- time xthe xfrequency xof xexchanges,
- count xthe xnumber xof xexchanges
- measure xUF.
- ANSWERS-Which xteaching xpoints xmust xbe xmastered xby xpatients xbefore xthey xcan
xperform xtheir x automated xperitoneal xdialysis xat xhome?
- PD xmay xcause xa xfull xfeeling xin xthe xabdomen, xresulting xin xa xlower xintake xof xcalories
- PD xpatients xmay xabsorb x150-1,000 xcalories/day xfrom xthe xdextrose xin xthe xdialysate
- ANSWERS-The xnurse xis xdiscussing xcaloric xneeds xwith xa xpatient xwho xis xon
xperitoneal xdialysis x(PD). x What xinformation xcan xthe xnurse xprovide xto xthe xpatient?
- Some xherbals xcan xbe xtoxic xto xthe xkidneys.
- Some xherbals xcan xaffect xblood xpressure xcontrol.
- Some xherbals xcan xaffect xanticoagulation.
- ANSWERS-A xdialysis xpatient xis xsharing xinformation xabout xher xfavorite xherbal
xremedies. xWhat x reminders xshould xthe xnurse xbe xprepared xto xprovide xthe
xpatient?
- Sometimes xreferred xto xas x"first-use xsyndrome" xbecause xsome xpatients xdevelop
xallergic-type x symptoms xwhen xexposed xto xthe xdialyzer xmembrane xfor xthe xfirst
xtime
- Often xpresent xwith xanaphylactic-type xsymptoms.
- Usually xoccur xwithin xthe xfirst x5 xminutes xof xtreatment
- ANSWERS-What xis xa xType xA xdialyzer xreaction?
- standardized xtest xof xperitoneal xmembrane xpermeability xused xto xestimate xthe
xsolute xtransport x characteristics, xglucose xabsorption, xand xnet xUF.
- done x1 xmonth xafter xinitiation xof xdialysis
-
- ANSWERS-What xis xa xperitoneal xequilibration xtest x(PET)
,- Standing xsystolic xBP xgreater xthan x140 xmm/Hg xor xless xthan x90 xmm/Hg
, - Standing xdiastolic xBP xgreater xthan x90 xmm/Hg xor xless xthan x50 xmm/Hg
- ANSWERS-Per xDaVita xpolicy, xa xstanding xpost xtreatment xblood xpressure xof
is x considered xan xabnormal xfinding xand xshould xbe xreported xto xa xlicensed xnurse
- Target xpostdialysis xweight
- How xmuch xfluid xthe xpatient xwill xreceive xorally xand/or xintravenously
- The xultrafiltration xcoefficient x(kUF)of xthe xdialyzer xthat xis xbeing xused.
- ANSWERS-What xinformation xwould xthe xnurse xneed xto xcalculate xthe xrate xof
xultrafiltration?
- The xpatient xis xin xfull xcharge xof xadministering xthe xperitoneal xdialysis,
xpreserving xtheir xusual x lifestyle.
- PD xpatients xdo xnot xsuffer xthe xeffects xof xrapid xbiochemical xand xfluid
xchanges xcommon xin x hemodialysis.
- There xis xless xrisk xof xdestabilizing xthe xfragile xmental xequilibrium xof xsome xolder xadult
xpatients.
- ANSWERS-While xproviding xpatient xeducation, xwhich xadvantages xof xperitoneal
xdialysis xcan xthe x nurse xshare xwith xan xolder xadult xCKD xpatient?
- tissues xare xoften xedematous xand xextremely xfriable.
- Patients xwith xinfections xand xrejection xare xalmost xalways xcatabolic,
xedematous, xand x hypoproteinemic.
-Cardiopulmonary xand xcardiovascular xsystems xoften xlabile, xand xhypotension xor
xcardiac x dysrhythmias xand xpulmonary xcongestion xshould xbe xanticipated.
- ANSWERS-When xcaring xfor xa xpatient xwho xis xexperiencing xa xsevere xtransplant
xrejection, xwhat x complications xshould xthe xnurse xanticipate?
- When xmandated xby xstate xlaw x(pre-treatment xinitiation xvs xwithin x1 xhour xafter xstart xof
xtreatment)
- When xthe xPCT xperforming xa xdata xcollection xnotices xabnormal xfindings xor xwhen
xthe xnurse xor xPCT x observe xunusual xbehaviors
- When xthe xpatient xreports xunusual xsymptoms xto xthe xnurse xor xPCT xbefore xtreatment
xinitiation
- ANSWERS-When xis xa xpre-treatment xassessment xby xthe xlicensed xnurse xrequired?
-bleeding xulcers
High xlevels xof xurea xbreak xdown xin xthe xgastrointestinal x(GI) xtract xand xrelease
xammonia, xcausing x irritation xof xthe xGI xmucosa. xAltered xcapillary xpermeability xand
xplatelet xdysfunction xin xuremia xalso x contribute xto xGI xbleeding.
- ANSWERS-A xpatient xwho xhas xlong-standing, xuntreated xchronic xkidney xdisease xis
xadmitted xvia x the xemergency xdepartment xwith xuremia. xAcute xdialysis xis
xinitiated. xBecause xof xthe xhistory xof x untreated xkidney xdisease, xthe xpatient xis xat
xrisk xfor xwhich xof xthese xgastrointestinal xconditions?
-polyps
-giardiasis
-paralytic xileus
-bleeding xulcers
"Control xyour xblood xglucose xlevels xif xyou xare xa
