Certified Nephrology Nurse Test Questions Fully Solved
You are assessing the nutrition of a 67 y.o. individual with chronic kidney disease G4 with a eGFR of 22
and are reviewing his lab results drawn four days ago. You note that his serum albumin is decreased.
Which information in the patients history would MOST likely result in a decreased albumin level?
A. Follows a mediterranean diet
B. Does not take prescribed phosphate binders
C. Hospitalized three weeks ago due to sepsis
D. Dehydrated at the time the specimen was obtained - Answers Answer
C. Hospitalized three weeks ago due to sepsis
Rationale
Elements of a nutritional risk assessment include recent Hospitalization and metabolic needs related to
sepsis, Fever and infection. Serum albumin levels may be decreased secondary to infection and
inflammation; Increased levels may be secondary to dehydration
Which Physical Examination finding indicates poor nutrition status?
A. Dental Caries
B. Loss of balance
C. Shortness of breath
D. Skeletal muscle Wasting - Answers Answer
D Skeletal muscle wasting
Rational
Physical examination findings that indicate poor nutrition include general muscle wasting, loss of
adipose tissue, decreased alertness, and dry/scaling skin.
Volume of distribution is an important concept in understanding plasma concentration of drugs given to
individuals with CKD. Which of the following is accurate regarding volume of distribution in CKD?
A. The larger the volume of distribution, the lower the amount of drug required for therapeutic effect
B. Drugs with a high volume of distribution are found more in the extravascular spaces.
, C. The lower the volume of distribution, the longer the half-life of elimination
D. Drugs with a low volume of distribution are more likely to result in toxic effects - Answers Answer
B. Drugs with a high volume of distribution are found more in the extravascular spaces.
Rational
The volume of distribution indicates which body compartment to which a drug is distributed. Drugs with
a high volume of distribution are found more readily in the extracellular spaces as opposed to the
intracellular spaces
Following a teaching session, which statement by an individual with worsening kidney function due to
high blood pressure indicates an understanding of the effects of hypertension on kidney function:
A. " I'll get my blood pressure under control so my kidneys will heal and go back to normal"
B. "No matter what i do, my kidneys are going to continue to get worse"
C. "I know i couldn't avoid high blood pressure problems because both of my parents have high blood
pressure "
D. "If i take my medicine and watch my diet, I can slow down what's happening to my kidneys" -
Answers Answer
"If i take my medicine and watch my diet, I can slow down what's happening to my kidneys"
Rational
Principles of learning that guide patient education include correcting wrong information immediately in
order to facilitate learning. Kidney damage from hypertension may be slowed but not reversed and is an
important aspect of helping patients understand the importance of blood pressure control. Activate
listening to patient feedback or comments assist in determining if understanding and information
processing has occurred
Which statement is accurate regarding the etiology of metabolic acidosis associated with CKD?
A. Metabolic acidosis occurs due to decreased tubular reabsorption of bicarbonate
B. Metabolic acidosis occurs due to increased tubular reabsorption of sodium and fluid
C. Metabolic acidosis occurs due to increased tubular secretion of hydrogen ion
You are assessing the nutrition of a 67 y.o. individual with chronic kidney disease G4 with a eGFR of 22
and are reviewing his lab results drawn four days ago. You note that his serum albumin is decreased.
Which information in the patients history would MOST likely result in a decreased albumin level?
A. Follows a mediterranean diet
B. Does not take prescribed phosphate binders
C. Hospitalized three weeks ago due to sepsis
D. Dehydrated at the time the specimen was obtained - Answers Answer
C. Hospitalized three weeks ago due to sepsis
Rationale
Elements of a nutritional risk assessment include recent Hospitalization and metabolic needs related to
sepsis, Fever and infection. Serum albumin levels may be decreased secondary to infection and
inflammation; Increased levels may be secondary to dehydration
Which Physical Examination finding indicates poor nutrition status?
A. Dental Caries
B. Loss of balance
C. Shortness of breath
D. Skeletal muscle Wasting - Answers Answer
D Skeletal muscle wasting
Rational
Physical examination findings that indicate poor nutrition include general muscle wasting, loss of
adipose tissue, decreased alertness, and dry/scaling skin.
Volume of distribution is an important concept in understanding plasma concentration of drugs given to
individuals with CKD. Which of the following is accurate regarding volume of distribution in CKD?
A. The larger the volume of distribution, the lower the amount of drug required for therapeutic effect
B. Drugs with a high volume of distribution are found more in the extravascular spaces.
, C. The lower the volume of distribution, the longer the half-life of elimination
D. Drugs with a low volume of distribution are more likely to result in toxic effects - Answers Answer
B. Drugs with a high volume of distribution are found more in the extravascular spaces.
Rational
The volume of distribution indicates which body compartment to which a drug is distributed. Drugs with
a high volume of distribution are found more readily in the extracellular spaces as opposed to the
intracellular spaces
Following a teaching session, which statement by an individual with worsening kidney function due to
high blood pressure indicates an understanding of the effects of hypertension on kidney function:
A. " I'll get my blood pressure under control so my kidneys will heal and go back to normal"
B. "No matter what i do, my kidneys are going to continue to get worse"
C. "I know i couldn't avoid high blood pressure problems because both of my parents have high blood
pressure "
D. "If i take my medicine and watch my diet, I can slow down what's happening to my kidneys" -
Answers Answer
"If i take my medicine and watch my diet, I can slow down what's happening to my kidneys"
Rational
Principles of learning that guide patient education include correcting wrong information immediately in
order to facilitate learning. Kidney damage from hypertension may be slowed but not reversed and is an
important aspect of helping patients understand the importance of blood pressure control. Activate
listening to patient feedback or comments assist in determining if understanding and information
processing has occurred
Which statement is accurate regarding the etiology of metabolic acidosis associated with CKD?
A. Metabolic acidosis occurs due to decreased tubular reabsorption of bicarbonate
B. Metabolic acidosis occurs due to increased tubular reabsorption of sodium and fluid
C. Metabolic acidosis occurs due to increased tubular secretion of hydrogen ion
