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June 2022

Question Title

* A patient hospitalized with AKI has a central venous catheter that is locked with heparin. On day three of his admission, the patient’s platelet count drops from 110,000/mm3 to 50,000/mm3. Which of these plans of action would most effectively address his thrombocytopenia?

The correct answer is d. Discontinue all heparin, including lock, and monitor for thromboembolism.

Rationale: If heparin-induced thrombocytopenia (HIT) is suspected, all heparin use must be stopped, even before laboratory tests are available confirming the presence of antibodies. Within 2-3 days of heparin therapy, direct heparin-induced degradation of platelets can result in a modest reduction of platelet count.

Reference: Counts, C. (Ed.) Core Curriculum for Nephrology Nursing, 7th ed., page 1013.
January 2022

Question Title

* By regulating the renin-angiotensin-aldosterone system (RAAS), healthy kidneys control which of these functions?

The correct answer is b. blood pressure. 

Rationale: A healthy kidney can contribute to blood pressure control via the renin-angiotensin-aldosterone system (RAAS).  RAAS activation leads to blood vessel constriction, as well as salt and fluid retention, which raise blood pressure.

Reference: Bodin, S. (Ed.) Comprehensive Nephrology Nursing, 3rd ed., pages 426-427; Kallenbach, J.Z. (2021). Review of Hemodialysis for Nurses and Dialysis Personnel, 10th ed., page 34

August 2021

Question Title

* In patients who have CKD Stage 5 and are on kidney replacement therapy, a major risk factor linked to acquiring infection with the hepatitis C virus (HCV) is the

The correct answer is d. number of years receiving hemodialysis treatments.

Rationale: The number of years on hemodialysis is the major risk factor independently associated with higher rates of HCV infection in patients with CKD Stage 5 who are receiving kidney replacement therapy.  

Reference: Bodin, S.M. (2017). Contemporary Nephrology Nursing, 3rd ed., p. 884
March 2021

Question Title

* A patient who has been taking cinacalcet (Sensipar) is being switched to etelcalcetide (Parsabiv). When initiating treatment with Parsabiv, the Sensipar must be

The correct answer is a. discontinued for 7 days prior to administering Parsabiv.

Rationale: Sensipar should be discontinued for at least 7 days prior to starting Parsabiv, which should then be initiated at a starting dose of 5 mg.  Also, a corrected serum calcium level at or above the lower limit of normal must be ensured prior to Parsabiv initiation.

Reference: Amgen package insert for etelcalcetide (Parsabiv), 2017, p. 3
October 2020

Question Title

* One helpful patient education technique is the Teach-Back method, which allows the nurse to

The correct answer is d. confirm that the patient understands the content.

Rationale: Teach Back is a way to confirm that the nurse has explained to the patient and/or family what they need to know in a manner that was understood. The understanding is confirmed when they explain the information back (Teach Back) to the nurse.

Reference: Bodin, S.M. (2017). Contemporary Nephrology Nursing, 3rd ed., pp. 145-146.
May 2020

Question Title

* Water softeners in dialysis water treatment systems are used to

The correct answer is b. increase the life‑span of the reverse osmosis membrane.

Rationale: If feed water contains calcium and/or magnesium, these elements must be removed to prevent scaling of the reverse osmosis (RO) membrane. The softened water increases the life span of the RO membrane.

 Reference:  Bodin, S.M. (2017). Contemporary Nephrology Nursing, 3rd ed., p. 176
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