Preparing for the CDN (Certified Dialysis Nurse) exam? Management is one of the areas our deck drills hardest: 284 of its 1050 flashcards focus on management, covering topics like EDW, IDWG, Estimated Dry Weight, Interdialytic Weight Gain. Try the sample questions below — every card is a real question-and-answer pair from the full deck.
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A dialysis patient's K+ is 6.8 mEq/L. What is the earliest ECG change expected, and what progression should the nurse monitor for if levels continue to rise?
Show answer →Earliest change: Tall, peaked T waves. Progression: PR interval prolongation, loss of P wave, QRS widening, and finally the sine wave pattern leading to V-fib/asystole. Exam Tip: NNCC often tests the sequence of ECG changes. Peaked T waves are the classic first sign, but QRS widening indicates imminent cardiac arrest risk. Distinguish between peaked T waves and the hyperacute T waves seen in early MI.
For a completely occluded CVC lumen where a standard dwell is impossible because the lumen cannot be filled, which advanced tPA administration technique is recommended by current standards?
Show answer →Technique: Rapid Push-Pull or Oscillation technique. Using a 10mL syringe, small amounts of tPA are pulsed into the lumen to increase surface area contact with the clot. Rationale: This breaks up the head of the thrombus to allow penetration. Clinical Pearl: Never use a syringe smaller than 10mL to avoid excessive intraluminal pressure which could rupture the catheter.
What does the mnemonic COLT stand for in the emergency management of a suspected air embolism during hemodialysis?
Show answer →C: Clamp the venous line (prevents further air entry). O: Off (turn off the blood pump). L: Left side (place patient in left lateral decubitus position). T: Trendelenburg (head down position). Clinical Pearl: Clamping and stopping the pump must happen simultaneously to prevent the air bolus from reaching the heart. NNCC exams prioritize the Clamp and Off steps as the absolute first actions.
A patient on PD requires 1000 U/L of IP Heparin for fibrin. The patient is also on systemic Warfarin for AFib. What is the risk of systemic anticoagulation from the IP Heparin?
Show answer →There is negligible risk of systemic anticoagulation. Heparin is a large molecular weight molecule (approx. 15,000 Daltons) and does not significantly cross the peritoneal membrane into the bloodstream. Rationale: IP Heparin acts locally within the dialysate and catheter lumen. Systemic coagulation parameters (PT/INR/aPTT) are generally unaffected by standard IP Heparin doses.
A patient with an Estimated Dry Weight (EDW) of 70kg presents with a pre-dialysis weight of 74.5kg. Based on KDOQI benchmarks, how should the nurse categorize this Interdialytic Weight Gain (IDWG)?
Show answer →This IDWG is 4.5kg, which is 6.4% of the patient's EDW (4.5/70). Standard clinical goals for IDWG are generally <3-5% of EDW. A gain >5% is considered high and significantly increases the risk for cardiovascular stress and intradialytic complications. \n\nExam Strategy: The NNCC often tests the ability to calculate percentages rather than just identifying the raw weight. Always use EDW as the denominator, not the current weight. Educating patients to stay under 1kg to 1.5kg per day is a common rule of thumb, but the percentage of EDW is the clinical standard for risk assessment.
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The full CDN deck contains 1050 flashcards, and 284 of them focus on management. This page shows 5 free samples.
Our CDN deck dedicates 284 of 1050 cards (27%) to management — 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.