Nursing 354 Dialysis Nursing Exam
Questions And Correct Answers (Verified
Answers) Plus Rationales 2026 Q&A
Instant Download Pdf
1. A nurse is caring for a patient receiving hemodialysis. Which assessment
finding requires immediate attention?
A. Mild fatigue after treatment
B. Blood pressure of 118/72 mmHg
C. Chest pain and difficulty breathing
D. Mild thirst
Answer: Chest pain and difficulty breathing
Rationale: Chest pain and dyspnea may indicate a serious complication such as
an air embolism, myocardial ischemia, or significant fluid-related complication
and require immediate assessment and intervention.
2. Which vascular access is considered the preferred permanent access for
many patients requiring long-term hemodialysis?
A. Tunneled central venous catheter
B. Arteriovenous fistula
C. Temporary femoral catheter
D. Peripheral intravenous catheter
Answer: Arteriovenous fistula
,Rationale: An arteriovenous fistula generally provides durable vascular access
with lower infection and thrombosis rates than central venous catheters.
3. Which finding indicates that an arteriovenous fistula is functioning
properly?
A. Absence of a pulse
B. Coolness of the extremity
C. Severe pain at the access site
D. Palpable thrill over the fistula
Answer: Palpable thrill over the fistula
Rationale: A palpable thrill reflects blood flow through the fistula. The nurse
should assess the access regularly for both a thrill and bruit.
4. Which action should the nurse avoid in an extremity containing an
arteriovenous fistula?
A. Assessing the thrill
B. Listening for a bruit
C. Obtaining a blood pressure measurement
D. Inspecting the access site
Answer: Obtaining a blood pressure measurement
Rationale: Blood pressure measurements can compress the vascular access and
compromise circulation. Venipuncture and constrictive devices should also
generally be avoided in the access extremity.
5. Which electrolyte imbalance is particularly dangerous in a patient with
advanced kidney failure?
A. Hypernatremia
B. Hypochloremia
C. Hyperkalemia
D. Hypocalcemia
Answer: Hyperkalemia
,Rationale: Impaired renal potassium excretion can cause hyperkalemia, which
may produce life-threatening cardiac dysrhythmias.
6. A patient with chronic kidney disease is scheduled for hemodialysis. Which
medication class may require special consideration because dialysis can
remove some medications from the bloodstream?
A. Topical moisturizers
B. Certain antimicrobial medications
C. Eye lubricants
D. Skin emollients
Answer: Certain antimicrobial medications
Rationale: Some medications are dialyzable and may require dose or timing
adjustments. Medication reconciliation is important before and after dialysis.
7. Which symptom is commonly associated with intradialytic hypotension?
A. Hypertension
B. Dizziness
C. Bradycardia with hypertension
D. Increased urine output
Answer: Dizziness
Rationale: Excessive fluid removal during hemodialysis can cause hypotension,
resulting in dizziness, weakness, nausea, cramping, or altered mental status.
8. What is the primary purpose of ultrafiltration during hemodialysis?
A. Increase red blood cell production
B. Remove bacteria from the bloodstream
C. Remove excess fluid from the blood
D. Increase serum albumin
Answer: Remove excess fluid from the blood
Rationale: Ultrafiltration removes plasma water across the dialysis membrane
and is used to reduce fluid overload.
, 9. Which laboratory value is especially important when monitoring a patient
receiving hemodialysis?
A. Hemoglobin A1c only
B. Serum potassium
C. Amylase only
D. Bilirubin only
Answer: Serum potassium
Rationale: Kidney failure commonly impairs potassium excretion. Both pre- and
post-dialysis potassium levels may be important in evaluating treatment and
safety.
10.A patient develops painful muscle cramps during hemodialysis. What is a
common contributing factor?
A. Excessive dietary protein
B. Hyperglycemia
C. Rapid fluid removal
D. Increased hemoglobin
Answer: Rapid fluid removal
Rationale: Rapid ultrafiltration can decrease intravascular volume and
contribute to muscle cramping, hypotension, and discomfort.
11.Which finding should the nurse report immediately when assessing an
arteriovenous fistula?
A. Audible bruit
B. Palpable thrill
C. Warm skin
D. Absent thrill
Answer: Absent thrill
Rationale: An absent thrill may indicate thrombosis or loss of blood flow
through the fistula and requires prompt evaluation.
Questions And Correct Answers (Verified
Answers) Plus Rationales 2026 Q&A
Instant Download Pdf
1. A nurse is caring for a patient receiving hemodialysis. Which assessment
finding requires immediate attention?
A. Mild fatigue after treatment
B. Blood pressure of 118/72 mmHg
C. Chest pain and difficulty breathing
D. Mild thirst
Answer: Chest pain and difficulty breathing
Rationale: Chest pain and dyspnea may indicate a serious complication such as
an air embolism, myocardial ischemia, or significant fluid-related complication
and require immediate assessment and intervention.
2. Which vascular access is considered the preferred permanent access for
many patients requiring long-term hemodialysis?
A. Tunneled central venous catheter
B. Arteriovenous fistula
C. Temporary femoral catheter
D. Peripheral intravenous catheter
Answer: Arteriovenous fistula
,Rationale: An arteriovenous fistula generally provides durable vascular access
with lower infection and thrombosis rates than central venous catheters.
3. Which finding indicates that an arteriovenous fistula is functioning
properly?
A. Absence of a pulse
B. Coolness of the extremity
C. Severe pain at the access site
D. Palpable thrill over the fistula
Answer: Palpable thrill over the fistula
Rationale: A palpable thrill reflects blood flow through the fistula. The nurse
should assess the access regularly for both a thrill and bruit.
4. Which action should the nurse avoid in an extremity containing an
arteriovenous fistula?
A. Assessing the thrill
B. Listening for a bruit
C. Obtaining a blood pressure measurement
D. Inspecting the access site
Answer: Obtaining a blood pressure measurement
Rationale: Blood pressure measurements can compress the vascular access and
compromise circulation. Venipuncture and constrictive devices should also
generally be avoided in the access extremity.
5. Which electrolyte imbalance is particularly dangerous in a patient with
advanced kidney failure?
A. Hypernatremia
B. Hypochloremia
C. Hyperkalemia
D. Hypocalcemia
Answer: Hyperkalemia
,Rationale: Impaired renal potassium excretion can cause hyperkalemia, which
may produce life-threatening cardiac dysrhythmias.
6. A patient with chronic kidney disease is scheduled for hemodialysis. Which
medication class may require special consideration because dialysis can
remove some medications from the bloodstream?
A. Topical moisturizers
B. Certain antimicrobial medications
C. Eye lubricants
D. Skin emollients
Answer: Certain antimicrobial medications
Rationale: Some medications are dialyzable and may require dose or timing
adjustments. Medication reconciliation is important before and after dialysis.
7. Which symptom is commonly associated with intradialytic hypotension?
A. Hypertension
B. Dizziness
C. Bradycardia with hypertension
D. Increased urine output
Answer: Dizziness
Rationale: Excessive fluid removal during hemodialysis can cause hypotension,
resulting in dizziness, weakness, nausea, cramping, or altered mental status.
8. What is the primary purpose of ultrafiltration during hemodialysis?
A. Increase red blood cell production
B. Remove bacteria from the bloodstream
C. Remove excess fluid from the blood
D. Increase serum albumin
Answer: Remove excess fluid from the blood
Rationale: Ultrafiltration removes plasma water across the dialysis membrane
and is used to reduce fluid overload.
, 9. Which laboratory value is especially important when monitoring a patient
receiving hemodialysis?
A. Hemoglobin A1c only
B. Serum potassium
C. Amylase only
D. Bilirubin only
Answer: Serum potassium
Rationale: Kidney failure commonly impairs potassium excretion. Both pre- and
post-dialysis potassium levels may be important in evaluating treatment and
safety.
10.A patient develops painful muscle cramps during hemodialysis. What is a
common contributing factor?
A. Excessive dietary protein
B. Hyperglycemia
C. Rapid fluid removal
D. Increased hemoglobin
Answer: Rapid fluid removal
Rationale: Rapid ultrafiltration can decrease intravascular volume and
contribute to muscle cramping, hypotension, and discomfort.
11.Which finding should the nurse report immediately when assessing an
arteriovenous fistula?
A. Audible bruit
B. Palpable thrill
C. Warm skin
D. Absent thrill
Answer: Absent thrill
Rationale: An absent thrill may indicate thrombosis or loss of blood flow
through the fistula and requires prompt evaluation.
