These CDN practice questions target assessment — including AVF. The complete CDN deck holds 1050 flashcards, 41 of them dedicated to this topic. Study the free samples below, then unlock the whole collection for a one-time $7.
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What are the four clinical parameters defined by the Rule of 6s used to determine if a newly created arteriovenous fistula (AVF) is mature enough for cannulation?
Show answer →The Rule of 6s includes: 1. Depth: < 0.6 cm (6 mm) from the skin surface. 2. Diameter: > 0.6 cm (6 mm) vessel body diameter. 3. Flow: Blood flow rate (BFR) > 600 mL/min via duplex ultrasound. 4. Timing: Evaluation occurs at 6 weeks post-op. Exam Tip: NNCC often tests these specific numbers. If any parameter is not met, the AVF is considered not mature and requires further intervention (e.g., superficialization or angioplasty) before routine cannulation.
A new AVF meets Rule of 6s criteria. During the first treatment, the nurse notes high arterial pre-pump pressures (-250 mmHg) at a Qb of 200 mL/min. What is the likely cause?
Show answer →This suggests Inflow Stenosis (at or near the anastomosis). Even if the vessel met the 6mm diameter rule, a focal narrowing can limit the volume of blood available to the pump. Exam Logic: High negative arterial pressure = The pump is pulling against resistance or lack of supply. High venous pressure = Downstream resistance/outflow stenosis. Rule of 6s ensures the vessel is large enough, but it doesn't guarantee the absence of focal stenotic lesions that appear under the stress of hemodialysis flow.
During the Look portion of your assessment, you see redness and warmth over an AVG. How do you clinically differentiate between simple needle track irritation and a true access infection?
Show answer →True infection signs include localized fluctuance, purulent drainage, or systemic symptoms (fever). Look for tracking redness along the vein (lymphangitis) or skin erosion. For AVGs, any area of skin breakdown or scabbing not related to a recent needle site is considered an infection until proven otherwise. Exam Tip: Biofilm on grafts can present subtly; persistent pimple-like lesions are high-risk indicators.
A patient has an exit site score of 2 (slight redness, no drainage). However, the nurse notes tenderness and induration 3cm away from the exit site along the catheter track. What is the suspected complication and the priority assessment technique?
Show answer →Suspected Complication: Tunnel Infection. This can occur with or without an active exit-site infection. Priority Assessment: The milking technique. The nurse should palpate the subcutaneous tunnel, starting from the internal cuff and moving toward the exit site, to see if purulent drainage can be expressed. Clinical Reasoning: Tunnel infections are often more serious than ESI and frequently involve Biofilms on the catheter. They are a common reason for catheter replacement. Exam Strategy: If the exit site looks okay but the patient has pain along the track, think Tunnel Infection. Ultrasound may be used to confirm fluid collections along the tunnel.
A patient reports persistent fatigue, poor appetite, and insomnia. How does the CDN distinguish between uremic symptoms and clinical depression during a psychosocial assessment?
Show answer →Overlap is high. Key differentiator: Cognitive/affective symptoms (hopelessness, worthlessness, anhedonia, suicidal ideation) are specific to depression, whereas physical symptoms (fatigue, anorexia) can be uremic. Exam Strategy: If symptoms improve post-dialysis or with better clearance (Kt/V), they are likely uremic. If they persist despite adequate dialysis, prioritize depression screening using the PHQ-9.
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Try 30 free CDN cards firstThe full CDN deck contains 1050 flashcards, and 41 of them focus on assessment. This page shows 5 free samples.
Our CDN deck dedicates 41 of 1050 cards (4%) to assessment — always cross-check the official NNCC exam outline for the current blueprint weighting.
Yes — the samples on this page are free, and the CDN preview page has 30 more free cards. Full access to all 1050 cards is a one-time $7.
Basics
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