Peritoneal Dialysis

1. A nurse is preparing a patient for Tenckhoff catheter insertion. What is the primary reason for selecting the lower abdomen as the insertion site?

• A. It's easier to access the bladder
  

• B. It avoids respiratory interference
  

• C. It promotes better dialysate inflow/outflow
  

• D. It enhances patient comfort during dialysis

2. A patient with multiple prior abdominal surgeries is being considered for PD. Which factor is most relevant in the decision?

• A. Fluid overload
  

• B. Peritoneal adhesions
  

• C. Age >65
  

• D. History of hypertension

3. Which of the following clinical conditions is an absolute contraindication to PD?

• A. Diabetes mellitus
  

• B. Polycystic kidney disease
  

• C. Active abdominal infection
  

• D. Congestive heart failure

4. Which principle best explains how solute removal occurs during PD?

• A. Diffusion across a pressure gradient
  

• B. Ultrafiltration via arterial pressure
  

• C. Osmosis across the peritoneal membrane
  

• D. Convection through vascular shunting

5. A patient is prescribed APD. What distinguishes this modality from CAPD?

• A. Manual exchanges are performed daily
  

• B. Dialysate is exchanged overnight using a machine
  

• C. It requires less patient training
  

• D. It avoids catheter use

6. Which goal is most consistent with the initiation of peritoneal dialysis?

• A. Rapid correction of hypernatremia
  

• B. Immediate cure of end-stage renal disease
  

• C. Maintenance of fluid, electrolyte, and toxin balance
  

• D. Permanent replacement of kidney structure

7. During PD, a patient has decreased outflow with abdominal discomfort. What is the priority action?

• A. Increase dwell time
  

• B. Flush the catheter with heparin
  

• C. Reposition the patient
  

• D. Stop dialysis and call surgery

8. Which patient is the most appropriate candidate for CAPD?

• A. Blind patient with no caregiver
  

• B. Patient with limited dexterity from arthritis
  

• C. Active adult preferring home-based dialysis
  

• D. Patient with recurrent hernias

9. Why is dextrose commonly used in PD dialysate?

• A. To enhance electrolyte balance
  

• B. To create an osmotic gradient for ultrafiltration
  

• C. To improve protein retention
  

• D. To buffer acidic pH

10. A patient on CAPD develops cloudy effluent and abdominal pain. What is the nurse’s immediate priority?

• A. Notify the nephrologist and send effluent for culture
  

• B. Increase the frequency of dialysis exchanges
  

• C. Stop dialysis until symptoms resolve
  

• D. Administer IV fluids