Certified Dialysis Nurse (CDN) Exam Review
The Certified Dialysis Nurse is a healthcare professional who has attained specialized education, along with meeting the certification requirements, to provide care to the dialysis patient. This includes monitoring the patient during dialysis and performing dialysis on the patient. Education is also a key part of the role of the Certified Dialysis Nurse and the patient is educated on their condition and the self-care and monitoring they can do on their own.
In order to become a Certified Dialysis Nurse, the applicant must be a licensed Registered Nurse and have worked at least 2,000 hours in providing care to renal patients over the past 2 years. At least 15 continuing education hours should have been completed at the time of application.
CDE exams are scheduled in various cities and states throughout the country and are hosted by local chapters of the American Nephrology Nurses' Association (ANNA). The CDE exam costs $250 the first time it is taken, but the price is reduced to $125 if it is taken a second time. ANNA members pay a discounted fee of $200 for the initial exam sitting and $100 if the CDE exam is repeated a second time.
Approximately one-half of the exam tests the RN's knowledge of hemodialysis. The physiology of renal failure makes up approximately one-third of the exam, with concepts in peritoneal dialysis and renal transplant making up the rest of the CDE exam. The CDE exam contains 200 questions total.
The Certified Dialysis Nurse credential lasts for 3 years before renewal. In order to renew the certification, the applicant must have spent at least 50% of their employment in providing direct patient care to the nephrology patient over the past 3 years, to equal at least 1,000 hours. At least 30 continuing education hours with a focus on nephrology should have been completed, also. Applicants may opt to retake the certification exam instead of maintaining the required number of continuing education credits. The fee is $200 for ANNA members and $225 for non-members.
Certified Dialysis Nurse Study Guide
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Certified Dialysis Nurse (CDN) Practice Questions
1. Some conditions that contribute to the development of CKD may include the following disease processes. Which of the following is least likely to be a direct cause of CKD?
- Chronic obstructive pulmonary disease (COPD)
- Diabetes mellitus (type 1 and 2)
- Systemic lupus
2. One of the negatives associated with peritoneal dialysis includes protein malnutrition. What are the causes of protein malnutrition?
- Loss of amino acids and protein in the dialysate
- Decreased appetite due to glucose load from dialysate
- Lack of protein intake due to high-carbohydrate diet
- a and b
3. Most aluminum is protein bound so the kidneys may not be able to filter it out of the blood. It is then stored in various tissues in the body, including the brain and bone. What are the symptoms of aluminum toxicity?
- Nausea, vomiting, diarrhea, fever, chills, upper respiratory tract infection, elevated white blood count, headache
- Behavioral changes, memory loss, slurred speech, lack of energy, loss of appetite bone disease, dementia, anemia, constipation
- Joint pain and redness, gangrene of fingers and toes, back pain, fractures, itching
- Nausea, vomiting, poor appetite, metallic taste, fetid breath, GI bleeding, diarrhea, functional constipation
4. Many factors affect the successful removal of toxins during dialysis. Which of the following is correct?
- Lower temperature of dialysate = higher amount of solutes removed
- Slower flow of dialysate = greater removal of solutes
- Lower molecular weight of solutes = more solutes removed
- Greater blood flow rate = lesser removal of solutes
5. Which of the following best defines concentration gradient?
- The difference in hydrostatic pressure between the blood and the dialysate solution
- The movement of solute particles from the side of higher concentration to the side of lower concentration through the dialysis membrane
- The rate of movement through a membrane
- The concentration of a certain type of particle is higher on one side of a membrane than on the other side
Certified Dialysis Nurse (CDN) Answer Key
1. Answer: A
Although many elderly patients may also suffer from chronic obstructive pulmonary disease it is not considered a direct cause of CKD. Diabetes mellitus (both type 1 and type 2), systemic lupus, and hypertension are all diseases that contribute to the development of CKD.
2. Answer: D
Some of the negatives associated with peritoneal dialysis (PD) include protein malnutrition and inadequate dialysis. The protein malnutrition results from the loss of amino acids and protein in the dialysate. The appetite is decreased because of the glucose load absorbed from the dialysis. This frequently results in hypertriglyceridemia, which causes weight gain from the caloric increase (not from a high-carbohydrate diet).
3. Answer: B
Since aluminum is usually stored in the brain or the bones, behavioral changes, memory loss, slurred speech, lack of energy, dementia, and bone disease are symptoms of aluminum toxicity. Anemia, constipation, and loss of appetite are also related to an excessive amount of aluminum in the body. Nausea, vomiting, diarrhea, fever, chills, upper respiratory tract infection, elevated WBC, and headache could be symptoms of influenza or multiple other infectious processes. Joint pain and redness, gangrene, back pain, fractures, and itching are classic symptoms of osteodystrophy. Nausea, vomiting, metallic taste, fetid breath, GI bleeding, diarrhea, and functional constipation are the GI effects of uremia.
4. Answer: C
The lower the molecular weight of the solutes, the greater the amount of solutes that will be removed. The higher the temperature, the greater the amount of solutes removed, the faster the flow rate of the dialysate, the greater the removal of solutes, and the faster the blood flow, the greater the amount of solutes removed.
5. Answer: D
Concentration gradient is the term used when the concentration of a certain particle is higher on one side of a membrane than on the other side. Transmembrane pressure (TMP) refers to the difference in hydrostatic pressure between the blood and the dialysate solution. Diffusive, or conductive transport, refers to the movement of solute particles from the side of higher concentration to the side of lower concentration through the dialysis membrane. Mass transfer rate, or solute flux, refers to the rate of movement through a membrane.
Last Updated: 12/29/2017