CNN Basics Practice Questions (110 Flashcards)

A score of 3 or higher on the PHQ-2 is considered a positive screen. The nurse must immediately administer the PHQ-9 (Patient Health Questionnaire-9) to further evaluate the severity of depressive symptoms. A PHQ-9 score ≥10 typically indicates moderate to severe depression requiring intervention. NNCC Strategy: CMS mandates annual depression screening for all ESRD patients. Distractor: Do not wait for the social worker to initiate the PHQ-9; the nurse can and should perform this initial tool escalation to ensure timely IDT (Interdisciplinary Team) referral.

This is an anaphylactoid reaction caused by the accumulation of bradykinin. The AN69 membrane is negatively charged, which activates the Hageman factor (Factor XII), leading to bradykinin production. Normally, ACE (Angiotensin-Converting Enzyme) breaks down bradykinin. However, ACE inhibitors block this degradation, leading to systemic vasodilation and increased capillary permeability. NNCC Tip: This is a classic exam favorite. If a patient is on an ACE inhibitor, avoid AN69 membranes or ensure the membrane is pre-treated/rinsed according to specific protocols to neutralize the charge.

High Transmembrane Pressure (TMP) in the NxStage cartridge often results from clumping or fiber clotting due to a high filtration fraction. Filtration fraction is the ratio of UF rate to plasma flow; if it exceeds 20-25%, the blood becomes too viscous (hemoconcentration), increasing pressure across the membrane. Strategy: To resolve, the nurse should instruct the patient to decrease the UF rate or increase the blood flow (if possible). NNCC Distractor: Do not confuse high TMP (filter issue) with high Venous Pressure (access/kink issue).

DBD: Organs are perfused until recovery; brain death is declared. DCD: Life support is withdrawn; organ recovery begins after cardiac arrest. DCD kidneys have higher DGF rates due to warm ischemia time (the period between withdrawal of support and organ flushing). NNCC Focus: DCD kidneys are a vital part of the donor pool in 2026, but the CNN must monitor these recipients closely for slow graft function and the potential need for temporary dialysis.

The limitation is UF Intensity. To remove 12L in 8 hours, the UF rate must be 1.5 L/hr, which a hemodynamically fragile patient may not tolerate. CRRT could remove that same 12L at a steady 0.5 L/hr over 24 hours. If the patient is severely fluid overloaded and requires high-volume removal but has a low mean arterial pressure (MAP), the high UF rate required by the shorter SLED duration might cause profound hypotension, making CRRT the safer choice for fluid-heavy goals.