BONENT-CPDN MCQs
BONENT-CPDN TestPrep BONENT-CPDN Study Guide BONENT-CPDN Practice Test BONENT-CPDN Exam Questions
killexams.com
Certified Peritoneal Dialysis Nurse (CPDN) - 2026
https://killexams.com/pass4sure/exam-detail/BONENT-CPDN
A PD unit manager is addressing a fire hazard after a small electrical fire in the storage room. The unit???s fire safety protocol requires annual drills and compliance with NFPA 101 Life Safety Code. A patient on APD with a cycler reports smoke exposure, with a SpO2 of 92% and respiratory rate of 24 breaths/min. What should the manager include in the revised protocol to prevent future incidents?
Train staff to evacuate patients immediately upon any smoke detection
Limit cycler use to battery-powered models to reduce electrical risks
Require staff to store all electrical equipment in fireproof cabinets
Conduct fire drills biannually and install additional smoke detectors
Answer: D
Explanation: Conducting fire drills biannually and installing additional smoke detectors enhances fire safety per NFPA 101 while addressing the patient???s smoke exposure risk (SpO2 92%). Limiting cycler use to battery-powered models is impractical and not standard. Storing equipment in fireproof cabinets is insufficient to address broader fire risks. Immediate evacuation may be unsafe without assessing the situation, especially for PD patients mid-treatment.
A 55-year-old patient on CAPD develops severe abdominal pain and pneumoperitoneum on CT scan after a recent exchange. The patient is afebrile, and dialysate analysis shows no infection. The dialysate flow rate is 200 mL/min, and the patient uses 2.5% dextrose solution. What is the most likely cause of pneumoperitoneum, and how should it be managed?
Catheter introduction of air; reduce fill volume
Bowel perforation; urgent surgical consultation
Peritonitis; initiate intraperitoneal antibiotics
Visceral irritation; switch to 1.5% dextrose solution
Answer: A
Explanation: Pneumoperitoneum in peritoneal dialysis patients is often due to air introduced via the catheter during exchanges, especially in the absence of fever or infection. Reducing fill volume can minimize air entry and intra-abdominal pressure. Bowel perforation is unlikely without systemic signs or abnormal dialysate analysis. Peritonitis is ruled out by negative dialysate cultures. Switching to 1.5% dextrose solution addresses visceral irritation but not pneumoperitoneum.
During transfer set change, which step is critical to reduce the risk of bacterial contamination?
Following sterile technique and disinfecting catheter hub with antimicrobial solution before and after
change
Disconnecting old transfer set and immediately applying the new set without disinfection
Flushing the peritoneal cavity with saline before changing the transfer set
Changing the transfer set only when visible contamination is present
Answer: A
Explanation: Disinfecting the catheter hub with antimicrobial solution before and after transfer set change and strict sterile technique are essential to minimize peritonitis risk. Immediate connection without disinfection and waiting for visible contamination are unsafe.
What is the rationale for using 2.5% dextrose peritoneal dialysate solution compared to 1.5% in chronic PD patients?
To promote greater ultrafiltration in patients with fluid overload
To reduce glucose absorption and hyperglycemia risk
To decrease protein loss during dialysis
To enhance clearance of middle molecules
Answer: A
Explanation: Higher glucose concentration solutions like 2.5% provide greater osmotic gradient leading to increased ultrafiltration, useful in fluid overloaded patients. Higher glucose increases glucose absorption and hyperglycemia risk. Protein loss and middle molecule clearance are not significantly affected.
A peritoneal dialysis patient develops acute dyspnea and decreased ultrafiltration volume. Imaging reveals a pleural effusion on the right side. What parameter in the dialysate fluid is most consistent with a pleural leak?
Presence of pleural fibrin strands
Decreased dialysate sodium concentration
Elevated dialysate potassium concentration
Increased dialysate glucose concentration in pleural fluid
Answer: D
Explanation: A pleural leak in peritoneal dialysis is usually due to diaphragmatic defects permitting dialysate to migrate from the peritoneal cavity into the pleural space, commonly on the right side. The hallmark diagnostic finding is a pleural effusion with a high glucose concentration, similar to dialysate fluid glucose (which is higher than serum).
What is the most common route of transmission for biological agents causing peritoneal dialysis infections?
Vector-borne transmission via insects
Airborne particles in the dialysis unit
Touch contamination of catheter exit sites or connection systems
Waterborne transmission through dialysate solution
Answer: C
Explanation: Touch contamination during exchanges or poor exit site care mainly leads to infections. Airborne, vector, or waterborne routes are less common if proper procedures and solution manufacturing standards are followed.
A 57-year-old patient on APD reports weight gain and shortness of breath. The nurse notes 1 L of ultrafiltration with 2.5% dextrose and a dwell time of 2 hours. What factor is most likely limiting ultrafiltration?
High peritoneal membrane permeability
Inadequate dwell time
Low dextrose concentration
Reduced membrane surface area
Answer: B
Explanation: Inadequate dwell time (2 hours) limits ultrafiltration in APD, as the osmotic gradient dissipates before optimal fluid removal (Inadequate dwell time). High permeability (High peritoneal membrane permeability) enhances, not limits, ultrafiltration. Low dextrose (Low dextrose concentration) is less likely with 2.5% dextrose. Reduced membrane area (Reduced membrane surface area) is uncommon without surgical history.
A patient on peritoneal dialysis has a low serum albumin of 2.8 g/dL and is noted to have protein losses in dialysate of 7 g/day. Which nutritional intervention is most appropriate?
Restrict protein intake to reduce losses
Limit fluid intake to prevent dilution
Supplement dialysate with albumin
Increase dietary protein intake to 1.2-1.3 g/kg/day
Answer: D
Explanation: PD patients lose protein daily via dialysate, requiring increased dietary protein intake (1.2???
1.3 g/kg/day) to maintain adequate nutrition and prevent malnutrition. Restriction worsens catabolism. Albumin supplementation in dialysate is ineffective. Fluid restriction does not address protein loss.
A transplant candidate with a BMI of 34 kg/m?? is undergoing evaluation. Which criterion is most likely to exclude them from transplantation?
Recent myocardial infarction within 3 months
History of non-compliance with dialysis
BMI alone if controlled with diet
Type 2 diabetes with HbA1c of 7.5%
Answer: A
Explanation: A recent myocardial infarction (within 3???6 months) is a contraindication to transplantation due to high perioperative cardiac risk. BMI of 34 may require optimization but is not an absolute exclusion. Non-compliance is a concern but not an automatic exclusion. Controlled diabetes is not a contraindication.
Which lab value is most critical for evaluating peritoneal dialysis adequacy and should be monitored regularly?
Serum potassium level
Hemoglobin A1c
Serum albumin
Blood urea nitrogen (BUN) and creatinine clearance
Answer: D
Explanation: BUN and creatinine clearance are indicators of solute removal efficacy, vital for dialysis adequacy.
A patient with ESRD from polycystic kidney disease is on PD. Which systemic complication is most frequently associated with this condition?
Intracranial aneurysms
Hyperkalemia
Pulmonary hypertension
Bone fractures
Answer: A
Explanation: Polycystic kidney disease is associated with increased risk of intracranial aneurysms due to vascular abnormalities.
A chronic PD patient demonstrates inadequate dialysis clearance with a D/P creatinine ratio of 0.45 on the peritoneal equilibration test. What does this indicate?
Low transporter status with slow solute equilibration
High transporter status with rapid solute equilibration
Normal peritoneal membrane permeability
Dialysis catheter malfunction
Answer: A
Explanation: A D/P creatinine ratio below 0.5 indicates low transporter status, meaning slow equilibration of solutes and possibly reduced dialysis adequacy. High transporter status usually shows D/P >0.8.
A 54-year-old patient on CAPD has a dialysate effluent with a WBC count of 200/mm?? and reports abdominal pain. The nurse is teaching the patient to recognize peritonitis. Which teaching activity should the nurse prioritize?
Demonstrate catheter site cleaning
Explain the significance of WBC counts >100/mm??
Provide a written guide on antibiotic therapy
Review the patient???s exchange schedule
Answer: B
Explanation: Explaining the significance of WBC counts >100/mm?? directly addresses the cognitive need to recognize peritonitis, as the patient???s effluent (200/mm??) indicates infection. Demonstrating cleaning is psychomotor, providing a guide is cognitive but less urgent, and reviewing the schedule is unrelated.
A 60-year-old patient on automated peritoneal dialysis (APD) reports difficulty performing exchanges due to recent hand tremors. During the nursing assessment, the patient struggles to manipulate a syringe, dropping it twice. Which assessment tool should the nurse use to quantify the patient???s fine motor coordination?
Visual Acuity Chart
Tinetti Balance Assessment
Nine-Hole Peg Test
Wong-Baker Pain Scale
Answer: C
Explanation: The Nine-Hole Peg Test is a standardized tool to assess fine motor coordination and dexterity, ideal for evaluating the patient???s ability to handle dialysis equipment. The Tinetti Balance Assessment evaluates gait and balance, not fine motor skills. The Visual Acuity Chart tests vision, and the Wong-Baker Pain Scale assesses pain, neither of which address motor coordination.
A patient on CAPD with a known catheter fracture undergoes splicing of the damaged catheter. Which is the most important step to prevent infection during this procedure?
Use of local anesthesia at the splice site
Flushing catheter with heparinized saline post-splice
Clamping of catheter proximal and distal before splicing
Strict sterile technique with prophylactic antibiotics administration
Answer: D
Explanation: Strict sterile technique and prophylactic antibiotics are crucial to prevent peritonitis during catheter splicing because this procedure exposes the sterile catheter lumen and peritoneal cavity to infection risks.
In the peritoneum, which layer acts as the primary barrier to solute and fluid transport in PD?
Visceral peritoneum
Parietal peritoneum
Endothelium of peritoneal capillaries
Submesothelial interstitium
Answer: C
Explanation: The endothelium of peritoneal capillaries is the primary barrier regulating solute and fluid transport during PD. Both visceral and parietal peritoneum contribute, but the capillary endothelium is key in the transport process.
Which of the following changes in pulmonary function are typically seen in patients undergoing chronic
peritoneal dialysis with large dialysate volumes?
Elevated diffusion capacity for carbon monoxide
Increased forced expiratory volume in 1 second (FEV1)
Decreased total lung capacity and reduced functional residual capacity
Bronchodilation due to metabolic alkalosis
Answer: C
Explanation: Large volumes of dialysate increase intra-abdominal pressure, impeding diaphragmatic excursion, resulting in decreased total lung capacity (TLC) and functional residual capacity (FRC). FEV1 usually does not increase. Diffusion capacity is not typically elevated. Bronchodilation due to metabolic alkalosis is not a known feature in PD patients.
A PD nurse manager is revising staff training to address OSHA standards for biological hazard exposure. A patient???s dialysate bag leaks during an exchange, and the fluid tests positive for Staphylococcus epidermidis. What should the training emphasize for handling this incident?
Use PPE and dispose of contaminated materials in a biohazard container
Clean the spill with an alcohol-based disinfectant
Neutralize the spill with a 1:100 bleach solution
Restrict the area and call an environmental safety team
Answer: A
Explanation: Using PPE and disposing of contaminated materials in a biohazard container aligns with OSHA standards for handling infectious fluids like dialysate with Staphylococcus epidermidis. Alcohol- based disinfectants are ineffective against certain pathogens. A 1:100 bleach solution is too dilute for biohazards. Calling a safety team is unnecessary for a routine spill.
During a PD exchange, a 47-year-old patient reports poor dialysate outflow. The nurse confirms constipation via patient history and notes a dwell time of 4 hours with 1.5% dextrose. What is the most likely cause of poor outflow, and what should the nurse do next?
Catheter kinking; reposition the patient
Peritonitis; obtain effluent culture
Fibrin buildup; add heparin to dialysate
Constipation; administer a laxative
Answer: D
Explanation: Constipation is a common cause of poor dialysate outflow in PD, as fecal mass can obstruct
catheter flow (Constipation; administer a laxative). Administering a laxative addresses this issue. Catheter kinking (Catheter kinking; reposition the patient) is less likely without positional changes. Fibrin buildup (Fibrin buildup; add heparin to dialysate) typically causes cloudy effluent, not mentioned here. Peritonitis (Peritonitis; obtain effluent culture) is unlikely without cloudy effluent or fever.
A patient on CAPD presents with fatigue and muscle weakness. Laboratory results show a serum potassium of 3.2 mEq/L. What should the nurse suspect?
Hyperkalemia from inadequate dialysis
Metabolic acidosis from dialysate pH
Hypokalemia from excessive potassium removal
Uremic neuropathy
Answer: C
Explanation: A serum potassium of 3.2 mEq/L indicates hypokalemia, likely due to excessive potassium removal during CAPD exchanges. Fatigue and muscle weakness are classic symptoms. Hyperkalemia is incorrect, as the potassium level is low. Metabolic acidosis is unrelated to these symptoms or potassium levels. Uremic neuropathy causes sensory changes, not primarily muscle weakness.
A nurse presents a study at a CNNT meeting on the effect of patient education on ultrafiltration failure. The study reports a relative risk of 0.75 for educated versus non-educated patients. What does this relative risk indicate?
Educated patients have a 25% lower risk of ultrafiltration failure
Educated patients have a 25% higher risk of ultrafiltration failure
Non-educated patients have a 75% lower risk of ultrafiltration failure
No significant difference in ultrafiltration failure risk
Answer: A
Explanation: A relative risk of 0.75 indicates that educated patients have a 25% lower risk of ultrafiltration failure (1 - 0.75 = 0.25) compared to non-educated patients. A higher risk would have a relative risk >1. Non-educated patients are the reference group, so the reduction applies to educated patients. No difference would have a relative risk near 1 with a non-significant p-value.
A PD nurse is evaluating a 56-year-old patient???s understanding of fluid balance after a teaching session. The patient calculates an ultrafiltration volume of 300 mL from a 2000 mL inflow and 2300 mL outflow. Which evaluation method should the nurse use to confirm cognitive learning?
Review the patient???s fluid intake records
Observe the patient measuring outflow
Provide a quiz on fluid balance principles
Ask the patient to repeat the calculation
Answer: D
Explanation: Asking the patient to repeat the calculation confirms cognitive learning by verifying the understanding of ultrafiltration (2300 mL - 2000 mL = 300 mL). Observing measurement is psychomotor, a quiz is broader, and reviewing records is unrelated to cognitive confirmation.
A 60-year-old patient on CCPD using a cycler with a 2 L fill volume, 2.5% dextrose, and 5 cycles/night has a Kt/V of 1.4 and ultrafiltration (UF) of 600 mL/day. The PET shows a low transporter (D/P creatinine 0.48). Lab results indicate serum albumin of 3.0 g/dL and effluent protein loss of 8 g/day. Which prescription adjustment would best improve Kt/V and UF?
Use icodextrin for a long daytime dwell
Increase fill volume to 2.5 L, maintaining 2.5% dextrose and 5 cycles
Switch to CAPD with 2 L, 4.25% dextrose, 4 exchanges/day
Add a daytime exchange with 2 L, 1.5% dextrose
Answer: A
Explanation: A low transporter (D/P creatinine 0.48) benefits from longer dwell times for optimal solute clearance and UF. Icodextrin, a glucose polymer, provides sustained ultrafiltration over long dwells (e.g., 8???12 hours), improving UF and Kt/V (target ???1.7). Low UF (600 mL/day) and hypoalbuminemia (3.0 g/dL) suggest protein loss contributes to reduced oncotic pressure, making icodextrin???s sustained UF effective. Adding a 1.5% dextrose daytime exchange may not sufficiently improve UF for a low transporter. Increasing fill volume without changing dwell time may not optimize clearance. Switching to CAPD with 4.25% dextrose is less effective due to shorter dwells unsuitable for low transporters.
During ongoing assessment, a nurse notices a PD patient with unexplained weight loss, muscle wasting, and serum albumin 2.7 g/dL. What is the most likely contributing factor?
Iron deficiency anemia
Excessive fluid removal by dialysis
Protein-energy wasting from hypercatabolism
Peritoneal membrane infection
Answer: C
Explanation: Weight loss, muscle wasting, and low serum albumin suggest protein-energy wasting, a catabolic state common in dialysis patients due to inflammation and metabolic imbalance. Excessive fluid removal causes dehydration but not muscle wasting. Iron deficiency impacts anemia, and infection would cause systemic signs.
A patient's dialysate analysis shows significant protein loss. What is the expected impact and nursing consideration?
Decrease dialysis solution volume
Monitor nutritional status and consider dietary protein supplementation
Increase dwell time to improve protein retention
Limit oral protein intake to reduce losses
Answer: B
Explanation: Protein loss through peritoneal dialysis can lead to malnutrition; monitoring and dietary adjustments are critical. Reducing solution volume or increasing dwell time does not affect protein losses. Limiting protein intake worsens nutritional status.
KILLEXAMS.COM
Killexams.com is a leading online platform specializing in high-quality certification exam preparation. Offering a robust suite of tools, including MCQs, practice tests, and advanced test engines, Killexams.com empowers candidates to excel in their certification exams. Discover the key features that make Killexams.com the go-to choice for exam success.
Killexams.com provides exam questions that are experienced in test centers. These questions are updated regularly to ensure they are up-to-date and relevant to the latest exam syllabus. By studying these questions, candidates can familiarize themselves with the content and format of the real exam.
Killexams.com offers exam MCQs in PDF format. These questions contain a comprehensive
collection of questions and answers that cover the exam topics. By using these MCQs, candidate can enhance their knowledge and improve their chances of success in the certification exam.
Killexams.com provides practice test through their desktop test engine and online test engine. These practice tests simulate the real exam environment and help candidates assess their readiness for the actual exam. The practice test cover a wide range of questions and enable candidates to identify their strengths and weaknesses.
Killexams.com offers a success guarantee with the exam MCQs. Killexams claim that by using this materials, candidates will pass their exams on the first attempt or they will get refund for the purchase price. This guarantee provides assurance and confidence to individuals preparing for certification exam.
Killexams.com regularly updates its question bank of MCQs to ensure that they are current and reflect the latest changes in the exam syllabus. This helps candidates stay up-to-date with the exam content and increases their chances of success.