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Exam Code: CPDN
Exam Name: BONENT Certified Peritoneal Dialysis Nurse
Questions asked: 150 multiple-choice questions
Passing Marks: 70%
Time Allotted: 3 Hours
Exam Type: Computer-Based Testing (CBT)

DOMAIN I: Nursing Process (60%)
Collect- document and analyze patient information before- during- and after dialysis in order to maintain and/or Boost the quality of patient care through continuous evaluation and ongoing revision of interventions.
- Interviewing Techniques
- Physical Assessment
- Normal and abnormal patient signs and symptoms
- Nursing Assessment
- Patient- family- and significant others knowledge- skills- and self-care abilities
- Gross and fine motor coordination
- Hand strength
- Vision
- Human Anatomy and Physiology
- Anatomy and physiology of the kidney and urinary system
- Anatomy and physiology of the peritoneum
- Fluid balance
- Acid base balance
- Electrolyte balance
- Erythropoiesis
- Pathophysiology of the Kidney and Urinary System
- Etiologies of End Stage Renal Disease
- Laboratory Testing
- Patient preparation
- Nursing responsibilities
- Interpretation of results
- Diagnostic Testing
- Patient preparation
- Nursing responsibilities
- Interpretation of results
- Pharmacology
- General
- Alterations in drug excretion and metabolism in end stage renal disease
- Drugs used frequently in ESRD patients
- Alterations in drug metabolism and excretion in peritoneal dialysis
- Kinetics of intraperitoneally administered medications
- Antibiotics used in peritonitis
- Methods of administration
- Medical and Surgical Asepsis
- Clinical Manifestations of End Stage Renal Disease
- Dietary Prescriptions for End Stage Renal Disease Patients
- Predialysis
- Peritoneal dialysis
- Hemodialysis
- Transplantation
- General Principles of Dialysis
- Osmosis
- Diffusion
- Ultrafiltration
- Blood flow
- Membrane area
- Dialysis solution
- Kinetics of Peritoneal Dialysis
- Dialysate to plasma equilibration
- Ultrafiltration patterns
- Absorption of calcium- dextrose
- Obligatory losses of protein- water soluble vitamins- hormones
- Factors that influence ultrafiltration
- Factors that influence solute transport
- Drug transport
- Kt/V measurement
- Peritonal Membrane Characteristics
- Measurement of peritoneal membrane characteristics (PET)
- Types of Peritoneal Dialysis
- CAPD
- CCPD
- IPD or NPD
- Peritoneal Dialysis Systems
- (i.e.- Cyclers; CAPD systems – bag-spike- bag-spike with assist device; disconnect systems; sterile connections device)
- Dialysis Solutions
- Composition
- Dextrose concentrations
- Volumes
- Containers
- Access
- Types
- acute
- chronic
- Preoperative nursing management
- Insertion techniques
- Postoperative management
- Peritoneal Dialysis Prescription
- Type of dialysis (i.e.- IPD- CAPD- CCPD)
- Frequency of dialysis
- Exchange volume
- Number exchanges
- Type(s) solution
- System of equipment to be used
- Time (total exchange- fill time- dwell time- drain time- etc.)
- Additives
- Acute Peritoneal Dialysis (hospitalized- ill patients)
- Indications
- Predialysis patient assessment and education
- Initiating and terminating dialysis
- Monitoring
- Patient education- psychosocial support during treatment
- Procedures
- Chronic automated dialysis (IPD- CCPD)
- predialysis patient assessment
- machine set up
- initiation of dialysis
- technical problem solving- troubleshooting
- diagnosis and management of patient problems/complicaitons
- discontinuing dialysis
- post dialysis assessment
- documentation
- Chronic manual dialysis (CAPD)
- procedure for initiation of dialysis
- exchange procedure
- daily patient assessment- documentation
- diagnosis and management of patient problems/complications
- technical problems
- procedure to discontinue or interrupt dialysis
- Other procedures
- warming dialysis solutions
- adding medications for IP administration
- catheter fluoroscopy
- CT scan for diagnosis of internal leaks
- splicing damaged catheter
- changing catheter adapter
- transfer set change
- Complications
- Infectious: Etiology- signs and symptoms- diagnostic evaluation- nursing- medical and surgical intervention- sequelae of:
- peritonitis
- exit site infection
- subcutaneous tunnel infection
- intraperitoneal abscess
- systemic infection (septicemia)
- recurrent infections
- Noninfectious: Etiology- signs and symptoms- diagnostic evaluation- nursing- medical and surgical intervention- sequelae of:
- catheter related problems
- malfunction (i.e.- malposition- obstruction- air lock- other)
- pain
- cuff erosion
- cuff extrusion
- damage to catheter
- surgical complications
- bladder perforation
- bowel perforation
- incisional pain
- external leak
- subcutaneous leak
- hemorrhage
- ileus
- complications resulting from increased intraabdominal pressure
- hernia
- hemorrhage
- dialysate leaks
- problems related to peritoneal dialysis (inherent and due to less than optimal management)
- pain
- abdominal pain
- low pH
- solution infusion
- empty abdomen
- low back pain
- shoulder pain
- pneumoperitoneum
- fibrin production
- blood in dialysate
- pleural leak
- changes in pulmonary function
- changes in cardiovascular function
- inherent glucose load
- changes in glucose metabolism
- fluid overload
- hyperkalemia
- hypokalemia
- hypernatremia
- hyponatremia
- hyperphosphatemia
- hypertension
- hypotension
- hyperglycemia
- protein losses
- other losses
- peritoneal eosinophilia
- significant changes in membrane permeability
- Contraindications to Peritoneal Dialysis
- Hypercatabolism
- Pleural-peritoneal communication
- Inadequate membrane permeability
- Relative contraindications
- Outpatient Nursing Management of the Chronic Peritoneal Dialysis Patient
- Ongoing assessment- nursing diagnosis and intervention
- Anemia
- etiology
- management
- erythropoietin
- administration
- Diabetes mellitus
- pathophysiology
- glucose control
- insulin pharmacokinetics
- blood glucose monitoring
- urine testing
- systemic complications
- intraperitoneal and subcutaneous insulin administration
- Gerontology
- physiologic changes associated with aging
- interventions to facilitate vision
- interventions to facilitate hearing
- Other Treatment Modalities
- Principles of transplantation
- candidate selection criteria
- pre-transplant evaluation
- surgical proedure
- immunosuppressive therapy
- complications
- success/failure rates
- Principles of hemodialysis
- indications
- access
- components of the extracorporeal system
- solute and fluid removal
- treatment parameters
- complications

DOMAIN II: Administration (10%)
- Management
- Establish and implement policies/procedures/standards relating to personnel management of patient care staff in order to deliver
- Patient needs and staffing patterns
- Staff abilities and limitations
- Standards of dialysis care
- Unit policies and procedures relating to personnel management
- Medical-ethical issues involved with patient care
- Staff Training and Development
- Environmental Control
- Biological agents
- potential hazards
- effects of biological agents
- routes of transmission
- Infection control
- CDC recommendations
- OSHA Standards
- Hazards Prevention and Control
- i.e.- fire- bomb threats- power failures- etc.
- EPA requirements
- Equipment and Supplies
Develop and implement policies and procedures for evaluation- use and maintenance of equipment and supplies in order to deliver safe- effective- and economical care.
- status of dialysis technology
- Critical elements for evaluation of dialysis equipment and supplies
- Budgeting/Financial Planning
Determine short and long term operational and financial goals and strategies in order to achieve efficient management of the peritoneal dialysis program.
- Budget/financial/operational planning
- Reimbursement structure
- Regulations/options
- Institutions financial strategies and billing system
- Quality Assurance
Establish and implement a quality assurance program that ensures compliance with established standards in order to provide optimal patient care.
- Continuous quality improvement


DOMAIN III: Education (20%)
Instruction and guidance for the patient and/or family
and significant others in peritoneal dialysis theory and procedures based on the principles of adult learning- to achieve optimal health status.
- Principles of Learning
- Learning styles
- Teaching methods
- Learning domains
- i.e.- cognitive- psychomotor- affective
- Activities and Teaching
- Comparison to nursing process
- Assessment/diagnosis phase
- assessment of learning needs
- assessment of readiness and ability to learn
- Planning phase
- teaching activities
- purpose
- developing the teaching plan
- behavioral objectives
- content and outline
- learning activities
- alternative teaching strategies
- evaluation
- Implementation phase
- Evaluation phase


DOMAIN IV: Professional Development (10%)
- Information Sharing
Share information with colleagues to stimulate professional growth by participating in and/or organizing formal inservice programs- disseminating professional literature and attending professional meetings.
- Professional literature
- Professional organizations
- Research
Participate in and/or conduct research designed to analyze and validate current practice and procedures and generate new knowledge. Communicate the information obtained to clarify- revise- and strengthen nursing practice.
- Scientific method and its application
- Research design and implementation
- Ethics
Adhere to the professional code of ethics (e.g.- patient confidentiality- patients rights- informed consent- allocation of resources) and intervene- if necessary- when violations of practice standards- institutional policies- codes of ethics- or legal standards have been identified in order to protect the peritoneal dialysis patient and the public.
- Nursing Code of Ethics
- State Nurse Practice Act
- Patients Bill of Rights
- Nursing Practice Standards
- Patient Care Standards
- Legislative process
- legal standards
- legal ramifications