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Nursing

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Certified Nephrology Nurse

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Question: 1

Diabetic nephropathy results from an elevation of blood pressure, increasing the workload of the glomeruli. The glomeruli thicken and allow serum albumin to pass into the urine. Which of the following signs and symptoms indicate diabetic nephropathy?

1. Edema around the eyes upon awakening, progressing to general swelling of the legs and body

2. Weight gain, malaise, fatigue, and frothy urine

3. Rust-colored urine, weight loss, and back pain

4. A and C

5. A and B

Answer: E

Question: 2

What steps need to be taken to diagnose and eliminate the problem of dialysate leakage during peritoneal dialysis?

1. Use a Dextrostick to ascertain the presence of glucose.

2. Resuture the exit site, and stabilize or replace the catheter.

3. LDiscontinue peritoneal dialysis to allow for healing, or decrease the infusion time with the patient lying on the left side.

4. Both A and B are true.

5. Both B and C are true.

Answer: D

Question: 3

Certain precautions must be followed when performing dialysis on a recent transplant recipient. All of the following statements regarding dialysis for the post-transplant patient are true EXCEPT:

1. Close observation is necessary for hypotension because of the risk of internal bleeding in first 24 hours postsurgery; a physician must be alerted if hypotension occurs.

2. Hypotension must be avoided to prevent ischemia of the newly transplanted kidney, even if fluid removal during dialysis is compromised.

3. High-dose heparin must be used to prevent postoperative clotting;

4. Observation is necessary for electrolyte imbalance, especially hyperkalemia.

Answer: C

Question: 4

A patient is admitted with the following signs and symptoms: edema around the eyes upon awakening, progressing to general swelling of the legs and body; weight gain; fatigue; headache; nausea; vomiting; frequent hiccoughs; and itching. A urine specimen is obtained, and the urine is frothy. The patient has a history of insulin-dependent diabetes (type 1 diabetes), which is poorly controlled, and high blood pressure, and his blood work comes back showing an elevated cholesterol level. Which of the following disease processes would you suspect?

1. Nephrosclerosis

2. Diabetic nephropathy

3. Polycystic kidney disease

4. Amyloidosis

Answer: B

Question: 5

Damaged kidneys lose their ability to produce erythropoietin, a hormone that stimulates the formation of red blood cells. What is usually prescribed to stimulate erythropoiesis in patients with chronic kidney disease?

1. Epoetin alfa (Epogen, Procrit)

2. Cinacalcet HCl (Sensipar)

3. Furosemide (Lasix) or bumetanide (Bumex)

4. Sevelamer hydrochloride (Renagel)

Answer: A