A
Chapter 54: Management of
Patients With Renal Disorders
NCLEX Questions and Answers
Updated 2026
(The nurse needs to assess the AV fistula for a bruit and thrill because if these findings aren't
present, the fistula isn't functioning. The AV fistula may get wet when the client isn't being
dialyzed. Immediately after a dialysis treatment, the access site should be covered with
adhesive bandages, not gauze. Blood pressure readings or venipunctures shouldn't be taken
in the arm with the AV fistula.) - Answer A client with a history of chronic renal failure
receives hemodialysis treatments three times per week through an arteriovenous (AV)
fistula in the left arm. Which intervention should the nurse include in the care plan?
a) Assess the AV fistula for a bruit and thrill.
b) Keep the AV fistula site dry.
c) Take the client's blood pressure in the left arm.
d) Keep the AV fistula wrapped in gauze.
D
(After a kidney transplant, rejection and failure can occur within 24 hours (hyperacute),
within 3 to 14 days (acute), or after many years. A hyperacute rejection is caused by an
immediate antibody-mediated reaction that leads to generalized glomerular capillary
thrombosis and necrosis. The term "simple" is not used in the categorization of types of
rejection of kidney transplants.) - Answer The nurse is caring for a patient who underwent a
kidney transplant. The nurse understands that rejection of a transplanted kidney within 24
hours after transplant is termed which of the following?
a) Acute rejection
b) Chronic rejection
,c) Simple rejection
d) Hyperacute rejection
A
(There is no cure for polycystic kidney disease. Medical management includes therapies to
control blood pressure, urinary tract infections, and pain. Renal replacement therapy is
indicated as the kidneys fail.) - Answer The client with polycystic kidney disease asks the
nurse, "Will my kidneys ever function normally again?" The best response by the nurse is:
a) "As the disease progresses, you will most likely require renal replacement therapy."
b) "Draining of the cysts and antibiotic therapy will cure your disease."
c) "Dietary changes can reverse the damage that has occurred in your kidneys."
d) "Genetic testing will determine the best treatment for your condition."
A
(The peritoneal dialysis catheter and regular exchanges of the dialysis bag provide a direct
portal for bacteria to enter the body. If the client experiences repeated peritoneal infections,
continuous ambulatory peritoneal dialysis may no longer be effective in clearing waste
products. Impaired urinary elimination, Toileting self-care deficit, and Activity intolerance
may be pertinent but are secondary to the risk of infection.) - Answer A client with renal
failure is undergoing continuous ambulatory peritoneal dialysis. Which nursing diagnosis is
the most appropriate for this client?
a) Risk for infection
b) Impaired urinary elimination
c) Toileting self-care deficit
d) Activity intolerance
D
, (Even a perfect match does not guarantee that a transplanted organ will not be rejected.
Immunosuppressive drugs are used in all organ transplants to decrease incidence of organ
rejection. To provide the client with the information needed to provide informed consent,
the treatment plan is reviewed and discussed prior to transplant.) - Answer A client with
end-stage renal disease is scheduled to undergo a kidney transplant using a sibling donated
kidney. The client asks if immunosuppressive drugs can be avoided. Which is the best
response by the nurse?
a) "Let's wait until after the surgery to discuss your treatment plan."
b) "The doctor may decide to delay the use of immunosuppressant drugs."
c) "Immunosuppressive drugs guarantee organ success."
d) "Even a perfect match does not guarantee organ rejection."
A
(If bleeding goes undetected or is not detected promptly, the patient may lose significant
amounts of blood and may experience hypoxemia. In addition to hypovolemic shock due to
hemorrhage, this type of blood loss may precipitate a myocardial infarction or transient
ischemic attack.) - Answer The nurse is caring for a patient after kidney surgery. What major
danger should the nurse closely monitor for?
a) Hypovolemic shock caused by hemorrhage
b) Abdominal distention owing to reflex cessation of intestinal peristalsis
c) Paralytic ileus caused by manipulation of the colon during surgery
d) Pneumonia caused by shallow breathing because of severe incisional pain
D
(Fever is an indicator of infection or transplant rejection.) - Answer Which nursing
assessment finding indicates that the client who has undergone renal transplant has not met
expected outcomes?
Chapter 54: Management of
Patients With Renal Disorders
NCLEX Questions and Answers
Updated 2026
(The nurse needs to assess the AV fistula for a bruit and thrill because if these findings aren't
present, the fistula isn't functioning. The AV fistula may get wet when the client isn't being
dialyzed. Immediately after a dialysis treatment, the access site should be covered with
adhesive bandages, not gauze. Blood pressure readings or venipunctures shouldn't be taken
in the arm with the AV fistula.) - Answer A client with a history of chronic renal failure
receives hemodialysis treatments three times per week through an arteriovenous (AV)
fistula in the left arm. Which intervention should the nurse include in the care plan?
a) Assess the AV fistula for a bruit and thrill.
b) Keep the AV fistula site dry.
c) Take the client's blood pressure in the left arm.
d) Keep the AV fistula wrapped in gauze.
D
(After a kidney transplant, rejection and failure can occur within 24 hours (hyperacute),
within 3 to 14 days (acute), or after many years. A hyperacute rejection is caused by an
immediate antibody-mediated reaction that leads to generalized glomerular capillary
thrombosis and necrosis. The term "simple" is not used in the categorization of types of
rejection of kidney transplants.) - Answer The nurse is caring for a patient who underwent a
kidney transplant. The nurse understands that rejection of a transplanted kidney within 24
hours after transplant is termed which of the following?
a) Acute rejection
b) Chronic rejection
,c) Simple rejection
d) Hyperacute rejection
A
(There is no cure for polycystic kidney disease. Medical management includes therapies to
control blood pressure, urinary tract infections, and pain. Renal replacement therapy is
indicated as the kidneys fail.) - Answer The client with polycystic kidney disease asks the
nurse, "Will my kidneys ever function normally again?" The best response by the nurse is:
a) "As the disease progresses, you will most likely require renal replacement therapy."
b) "Draining of the cysts and antibiotic therapy will cure your disease."
c) "Dietary changes can reverse the damage that has occurred in your kidneys."
d) "Genetic testing will determine the best treatment for your condition."
A
(The peritoneal dialysis catheter and regular exchanges of the dialysis bag provide a direct
portal for bacteria to enter the body. If the client experiences repeated peritoneal infections,
continuous ambulatory peritoneal dialysis may no longer be effective in clearing waste
products. Impaired urinary elimination, Toileting self-care deficit, and Activity intolerance
may be pertinent but are secondary to the risk of infection.) - Answer A client with renal
failure is undergoing continuous ambulatory peritoneal dialysis. Which nursing diagnosis is
the most appropriate for this client?
a) Risk for infection
b) Impaired urinary elimination
c) Toileting self-care deficit
d) Activity intolerance
D
, (Even a perfect match does not guarantee that a transplanted organ will not be rejected.
Immunosuppressive drugs are used in all organ transplants to decrease incidence of organ
rejection. To provide the client with the information needed to provide informed consent,
the treatment plan is reviewed and discussed prior to transplant.) - Answer A client with
end-stage renal disease is scheduled to undergo a kidney transplant using a sibling donated
kidney. The client asks if immunosuppressive drugs can be avoided. Which is the best
response by the nurse?
a) "Let's wait until after the surgery to discuss your treatment plan."
b) "The doctor may decide to delay the use of immunosuppressant drugs."
c) "Immunosuppressive drugs guarantee organ success."
d) "Even a perfect match does not guarantee organ rejection."
A
(If bleeding goes undetected or is not detected promptly, the patient may lose significant
amounts of blood and may experience hypoxemia. In addition to hypovolemic shock due to
hemorrhage, this type of blood loss may precipitate a myocardial infarction or transient
ischemic attack.) - Answer The nurse is caring for a patient after kidney surgery. What major
danger should the nurse closely monitor for?
a) Hypovolemic shock caused by hemorrhage
b) Abdominal distention owing to reflex cessation of intestinal peristalsis
c) Paralytic ileus caused by manipulation of the colon during surgery
d) Pneumonia caused by shallow breathing because of severe incisional pain
D
(Fever is an indicator of infection or transplant rejection.) - Answer Which nursing
assessment finding indicates that the client who has undergone renal transplant has not met
expected outcomes?
