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Exam Code : NNCC-CDN
Exam Name : NNCC Certified Dialysis Nurse
Vendor Name :
"Nursing"

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Question: 1

What is the primary purpose of hemodialysis in the treatment of renal failure?

1. To improve kidney function

2. To restore electrolyte balance

3. To remove excess fluid from the body

4. To provide a blood supply to the kidneys

Answer: C

Explanation: Hemodialysis is a process of removing waste products, excess fluid, and toxins from the blood when the kidneys are unable to perform these functions adequately. Its primary purpose is to remove excess fluid from the body.

Question: 2

Which of the following statements is true regarding the pre-dialysis education for a patient undergoing hemodialysis?

1. Pre-dialysis education helps patients understand the importance of medication adherence.

2. Pre-dialysis education primarily focuses on the technical aspects of the dialysis procedure.

3. Pre-dialysis education is not necessary for patients undergoing hemodialysis.

4. Pre-dialysis education is provided only to patients who will receive a kidney transplant.

Explanation: The true statement regarding the pre-dialysis education for a patient undergoing hemodialysis is that pre-dialysis education helps patients understand the importance of medication adherence. Pre-dialysis education is a critical component of the comprehensive care provided to patients with end- stage renal disease. It aims to empower patients with knowledge and skills to actively participate in their care. Education covers various aspects, including diet and fluid restrictions, vascular access care, recognizing and managing complications, and understanding the importance of medication adherence to optimize treatment outcomes.

Question: 3

Which of the following statements is true regarding the use of arteriovenous fistulas (AVFs) in hemodialysis?

1. AVFs provide immediate access for dialysis.

2. AVFs are primarily used for temporary vascular access.

3. AVFs have a higher risk of infection compared to central venous catheters.

4. AVFs are created by connecting an artery to a vein.
   
   Answer: D

Explanation: The correct statement regarding the use of arteriovenous fistulas (AVFs) in hemodialysis is that AVFs are created by connecting an artery to a vein. AVFs are the preferred type of vascular access for long-term hemodialysis treatment. They are surgically created by connecting an artery, usually in the forearm, with a nearby vein. AVFs require time to mature before they can be used for dialysis, but they offer several advantages over other vascular access options, including lower infection rates, improved long-term patency, and better preservation of veins.

Which of the following is an advantage of peritoneal dialysis compared to hemodialysis?

1. Requires fewer dietary restrictions

2. Suitable for patients with severe cardiovascular disease

3. Less risk of peritonitis

4. Provides better control of fluid balance
   
   Answer: D

Explanation: An advantage of peritoneal dialysis compared to hemodialysis is that it provides better control of fluid balance. Peritoneal dialysis involves the infusion of dialysis solution into the peritoneal cavity, where it dwells and allows the exchange of waste products and excess fluid. The continuous nature of peritoneal dialysis allows for more frequent exchanges throughout the day, providing better fluid removal and control. This is particularly beneficial for patients who have difficulty tolerating large fluid shifts, such as those with congestive heart failure.

Question: 5

Which immunosuppressive medication is commonly used to prevent graft rejection after kidney transplantation?

1. Prednisone

2. Lisinopril

3. Metformin

4. Cyclosporine
   
   Answer: D

Explanation: Cyclosporine is a commonly used immunosuppressive medication to prevent graft rejection after kidney transplantation. It works by suppressing

the immune system's response to the transplanted organ.

Question: 6

What is the leading cause of end-stage renal disease worldwide?

1. Glomerulonephritis

2. Hypertension

3. Diabetes mellitus

4. Polycystic kidney disease

Answer: C

Explanation: Diabetes mellitus is the leading cause of end-stage renal disease worldwide. Chronic uncontrolled diabetes can lead to kidney damage over time, resulting in the need for renal replacement therapy such as dialysis or transplantation.

Question: 7

Which of the following is a potential complication associated with kidney transplantation?

1. Gastrointestinal bleeding

2. Hyperthyroidism

3. Type 2 diabetes mellitus

4. Hypertension
   
   Answer: D

transplantation. Hypertension can develop or worsen after kidney transplantation due to various factors, including immunosuppressive medications, changes in renal function, and pre-existing cardiovascular risk factors. It is important to manage hypertension post-transplantation to reduce the risk of cardiovascular events and preserve the health and function of the transplanted kidney.

Question: 8

What is the most common type of kidney transplant?

1. Living-related donor transplant

2. ABO-incompatible transplant

3. Paired exchange transplant

4. Deceased donor transplant
   
   Answer: D

Explanation: Deceased donor transplant, where the kidney is obtained from a deceased individual, is the most common type of kidney transplant.

Question: 9

Which of the following is an immunosuppressant medication commonly used in kidney transplantation?

1. Metformin

2. Prednisone

3. Lisinopril

4. Atorvastatin

Explanation: Prednisone is an immunosuppressant medication commonly used in kidney transplantation. Kidney transplantation involves transplanting a healthy kidney from a donor into a recipient with end-stage renal disease. To prevent organ rejection, immunosuppressive drugs are prescribed. Prednisone is a corticosteroid that suppresses the immune system's response, reducing the risk of rejection. It is often used in combination with other immunosuppressant medications to achieve optimal outcomes in kidney transplantation.

Question: 10

Which of the following is considered to be the most significant side effect of recombinant human erythropoietin (rHuEPO)?

1. Hypertension

2. Headaches

3. Nausea/vomiting

4. Edema

Answer: A

Explanation: The most significant side effect of recombinant human erythropoietin (rHuEPO) is hypertension. rHuEPO is commonly used to stimulate red blood cell production in patients with renal failure. However, one of its adverse effects is an increase in blood pressure. This occurs due to the erythropoietin-induced expansion of blood volume and increased viscosity. Hypertension is a concern in dialysis patients as it can lead to cardiovascular complications and worsen the progression of renal failure.

Question: 11

1. Obstruction of the renal pelvis

2. Renal artery stenosis

3. Acute tubular necrosis

4. Polycystic kidney disease

Answer: C

Explanation: Acute tubular necrosis refers to damage to the tubular cells of the kidneys, which can result from ischemia, toxins, or sepsis. It is an example of an intrinsic cause of renal failure.

Question: 12

During hemodialysis, which of the following parameters is monitored to assess the adequacy of dialysis?

1. Serum creatinine level

2. Blood urea nitrogen (BUN) level

3. Blood pressure

4. Serum albumin level

Answer: B

Explanation: The adequacy of dialysis during hemodialysis is commonly assessed by monitoring the blood urea nitrogen (BUN) level. BUN is a waste product that is filtered by the kidneys. Elevated levels of BUN indicate that an adequate clearance of waste products is not occurring during dialysis, suggesting inadequate dialysis. Monitoring the BUN level helps evaluate the effectiveness of dialysis treatment and determine if adjustments are needed to optimize clearance.

Question: 13

Which of the following is a potential complication of peritoneal dialysis?

1. Hypokalemia

2. Peritonitis

3. Hypoglycemia

4. Respiratory alkalosis

Answer: B

Explanation: Peritonitis, or inflammation of the peritoneum, is a potential complication of peritoneal dialysis. It can occur due to infection or contamination of the dialysis fluid.

Question: 14

Which of the following laboratory findings is commonly observed in a patient with chronic renal failure?

1. Hypercalcemia

2. Hypokalemia

3. Hyponatremia

4. Hyperphosphatemia
   
   Answer: D

Explanation: Hyperphosphatemia is commonly observed in a patient with chronic renal failure. In chronic renal failure, the kidneys are unable to effectively excrete phosphorus, leading to its accumulation in the blood. Elevated levels of phosphorus can have several adverse effects, including the

formation of calcium-phosphate deposits in various tissues, such as blood vessels and joints. Hyperphosphatemia is managed through dietary restrictions, phosphate binders, and dialysis to maintain phosphorus levels within the target range.

Question: 15

Which of the following is a characteristic of peritoneal dialysis?

1. It requires the use of a dialysis machine.

2. It utilizes the peritoneum as a dialyzing membrane.

3. It involves the insertion of a catheter into the bladder.

4. It is primarily used for long-term dialysis treatment.

Answer: B

Explanation: Peritoneal dialysis involves the use of the peritoneum, a thin membrane lining the abdominal cavity, as a dialyzing membrane. Dialysis fluid is introduced into the peritoneal cavity, and waste products and excess fluid pass through the peritoneum into the dialysis fluid.

Question: 16

Which of the following is a potential complication of hemodialysis?

1. Metabolic alkalosis

2. Hyperkalemia

3. Hypotension

4. Hyperglycemia

Answer: C

Explanation: Hypotension, or low blood pressure, is a common complication of hemodialysis. The rapid removal of fluid during the procedure can cause a drop in blood pressure.

Question: 17

Which of the following is a potential complication associated with peritoneal dialysis?

1. Hypotension

2. Hemolysis

3. Hyperkalemia

4. Peritonitis
   
   Answer: D

Explanation: A potential complication associated with peritoneal dialysis is peritonitis. Peritonitis refers to an infection of the peritoneal cavity, which is the space where the dialysis solution is infused and dwell during peritoneal dialysis. It can occur due to contamination during the dialysis procedure or from exit site or tunnel infections. Peritonitis is a serious complication that requires prompt medical attention and appropriate antibiotic therapy to prevent further complications and preserve peritoneal membrane function.

Question: 18

Which of the following is a potential complication of kidney transplantation?

1. Graft rejection

2. Hypercalcemia

3. Acute tubular necrosis

4. Metabolic acidosis

Answer: A

Explanation: Graft rejection is a potential complication of kidney transplantation. The recipient's immune system may recognize the transplanted kidney as foreign and mount an immune response, leading to rejection of the organ.

Question: 19

Which of the following is a contraindication for peritoneal dialysis?

1. Uncontrolled hypertension

2. End-stage renal disease

3. Diabetes mellitus

4. Previous abdominal surgery
   
   Answer: D

Explanation: Previous abdominal surgery can be a contraindication for peritoneal dialysis. Adhesions or scarring from the surgery may interfere with the effectiveness of the procedure or increase the risk of complications.

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