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WorksheetsPeritoneal Dialysis
Total questions: 25
Worksheet time: 13mins
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
11. Which of the following best differentiates IPD from other PD modalities?
A. Long-term home dialysis with short dwells
B. Daily 24-hour exchanges
C. Hospital-based intermittent PD sessions
D. Use of glucose-free dialysate
12. Which feature makes the Tenckhoff catheter suitable for PD?
A. Single-lumen straight tube
B. Embedded antibacterial coating
C. Cuffed design minimizing infection risk
D. Disposable design for single use
13. A PD patient experiences poor ultrafiltration despite proper technique. Which dialysate modification is most appropriate?
A. Decrease dialysate volume
B. Use a lower dextrose concentration
C. Increase dextrose concentration
D. Add potassium to the fluid
14. Which of the following findings would most strongly indicate that a patient is not tolerating PD well?
A. Stable blood pressure
B. Daily weight gain of 0.5 kg
C. Signs of peritonitis
D. Controlled glucose levels
15. What role does the peritoneum play in PD?
A. Secretes dialysate
B. Filters large molecules only
C. Serves as a semipermeable membrane for exchange
D. Blocks glucose reabsorption
16. A patient has severe pulmonary disease. Why might PD be preferred over hemodialysis (HD)?
A. Faster clearance of toxins
B. Reduced respiratory compromise
C. Less fluid removal
D. Lower infection risk
17. Why is potassium typically not added to fresh PD fluid?
A. Risk of hypokalemia
B. Risk of hyperkalemia
C. PD fluid already contains potassium
D. Promotes acidosis
18. What is the most appropriate response if a Tenckhoff catheter exit site shows purulent drainage?
A. Cover with dry gauze
B. Increase dwell volume
C. Start empirical antibiotics
D. Remove the catheter immediately
19. A nurse notes that dialysate is draining slowly. What intervention would best address this issue?
A. Lower the drainage bag
B. Warm the dialysate
C. Reduce the dwell time
D. Add heparin to the fluid
20. Why might a diabetic patient experience challenges with PD?
A. Increased protein loss
B. Glucose in dialysate may affect glycemic control
C. PD causes hypoglycemia
D. Dialysate decreases insulin resistance
21. What is the best reason for using icodextrin-based dialysate in PD?
A. Short-term toxin removal
B. Improved protein binding
C. Long-dwell ultrafiltration without glucose
D. Enhanced potassium clearance
22. Why is the dwell time an important factor in PD efficiency?
A. Longer dwell always improves clearance
B. Short dwell prevents glucose absorption
C. It influences solute removal and fluid exchange
D. Dwell time determines catheter longevity
23. What is a key reason why PD may be favored in pediatric patients?
A. High blood volume
B. Reduced need for strict dietary control
C. Easier vascular access
D. Better psychosocial outcomes and growth
24. Which action best ensures long-term catheter function in PD?
A. Irrigate catheter daily
B. Avoid touching catheter
C. Educate patient on exit site care and hygiene
D. Replace catheter monthly
25. A patient reports abdominal bloating and incomplete drainage. What is the most likely cause?
A. Hypovolemia
B. Constipation
C. Catheter migration
D. Peritonitis
