Renal Disorders/Dialysis & Peritoneal Dialysis NCLEX
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Renal Disorders/Dialysis & Peritoneal Dialysis NCLEX
Questions With very accurate answers,
2024/2025(brand new)!!!!
1. The nurse instructs a client with renal failure who is receiving hemodialysis
about dietary modifications. The nurse determines that the client understands these
dietary modifications if the client selects which items from the menu? a. Cream of
wheat, blueberries, coffee
b. Sausage and eggs, banana, orange juice.
c. Bacon, cantaloupe melon, tomato juice.
d. Cured pork, grits, strawberries, orange juice.: A
The diet for a client with renal failure who is receiving hemodialysis should include
controlled amounts of sodium, phosphorus, calcium, potassium, and fluids. Options 2, 3,
and 4 are high in sodium, phosphorus and potassium.
2. The client with chronic renal failure is scheduled for hemodialysis this morning is
due to receive a daily dose of enalapril (Vasotec). The nurse should plan to
administer this medication: a. During dialysis.
b. Just before dialysis.
c. The day after dialysis.
d. On return from dialysis.: D
Antihypertensive medications such as enalapril are given to the client following
hemodialysis. This prevents the client from becoming hypotensive during dialysis and
also from having the medication removed from the bloodstream by dialysis. No rationale
exists for waiting an entire day to resume the medication. This would lead to ineffective
control of the blood pressure.
3. The client being hemodialyzed suddenly becomes short of breath and complains
of chest pain. The client is tachycardic, pale, and anxious. The nurse suspects air
embolism. The priority action for the nurse is to: a. Discontinue dialysis and notify
the physician.
b. Monitor vital signs every 15 minutes for the next hour.
c. Continue dialysis at a slower rate after checking the lines for air.
d. Bolus the client with 500 mL of normal saline to break up the embolus.: A If the
client experiences air embolus during hemodialysis, the nurse should terminate
dialysis immediately, notify the physician, and administer oxygen as needed.
Options 2, 3, and 4 are incorrect.
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4. The nurse has completed client teaching with the hemodialysis client about self-
monitoring between hemodialysis treatments. The nurse determines that the client
best understands the information if the client states to record daily the:
a. Amount of activity.
b. Pulse and respiratory rate.
c. Intake and output and weight.
d. Blood urea nitrogen and creatinine levels.: C
The client on hemodialysis should monitor fluid status between hemodialysis treatments
by recording intake and output and measuring weight daily. Ideally, the hemodialysis
client should not gain more than 0.5 kg of weight/day.
5. The client with an external arteriovenous shunt in place for hemodialysis is at
risk for bleeding. The priority nurse action would be to:
a. Check the shunt for the presence of bruit and thrill.
b. Observe the site once as time permits during the shift.
c. Check the results of the prothrombin times as they are determined.
d. Ensure that small clamps are attached to the arteriovenous shunt dressing.-: D
An arteriovenous shunt is a less common form of access site but carries a risk for
bleeding when it is used because two ends of an external cannula are tunneled
subcutaneously into an artery and a vein, and the ends of the cannula are joined. If
accidental disconnection occurs, the client could lose blood rapidly. For this reason, small
clamps are attached to the dressing that covers the insertion site for use if needed. The
shunt site also should be assessed at least every 4 hours.
6. A nurse is assessing the patency of a client's left arm arteriovenous fistula prior to
initiating hemodialysis. Which finding indicates that the fistula is patent?
a. Palpation of a thrill over the fistula.
b. Presence of a radial pulse in the left wrist.
c. Absence of a bruit on auscultation of the fistula.
d. Capillary refill less than 3 seconds in the nail beds of the fingers of the left
hand.: A
The nurse assesses the patency of the fistula by palpating for the presence of a thrill or
auscultating for a bruit. The presence of a thrill and bruit indicate patency of the fistula.
Although the presence of a radial pulse in the left wrist and capillary refill shorter than 3
seconds in the nail beds of the fingers on the left hand are normal findings, they do not
assess fistula patency.
7. The client newly diagnosed with chronic renal failure recently has begun
hemodialysis. Knowing that the client is at risk for disequilibrium syndrome, the
, Renal Disorders/Dialysis & Peritoneal Dialysis NCLEX
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nurse assesses the client during dialysis for: a. Hypertension, tachycardia, and
fever.
b. Hypotension, bradycardia, and hypothermia.
c. Restlessness, irritability, and generalized weakness.
d. Headache, deteriorating level of consciousness, and twitching.: D
Disequilibrium syndrome is characterized by headache, mental confusion, decreasing
level of consciousness, nausea, vomiting, twitching, and possible seizure activity.
Disequilibrium syndrome is caused by rapid removal of solutes from the body during
hemodialysis. At the same time, the blood-brain barrier interferes with the efficient
removal of wastes from brain tissue. As a result, water goes into cerebral cells because of
the osmotic gradient, causing brain swelling and onset of symptoms. The syndrome most
often occurs in clients who are new to dialysis and is prevented by dialyzing for shorter
times or at reduced blood flow rates.
8. A client with chronic renal failure has completed a hemodialysis treatment. The
nurse would use which of the following standard indicators to evaluate the client's
status after dialysis? a. Vital signs and weight.
b. Potassium level and weight.
c. Vital signs and BUN.
d. BUN and creatinine levels.: A
Following dialysis, the client's vital signs are monitored to determine whether the client
is remaining hemodynamically stable. Weight is measured and compared with the client's
predialysis weight to determine effectiveness of fluid extraction. Laboratory studies are
done as per protocol but are not necessarily done after the hemodialysis treatment has
ended.
9. The hemodialysis client with a left arm fistula is at risk for arterial steal
syndrome. The nurse assesses this client for which of the following manifestations?
a. Warmth, redness, and pain in the left hand.
b. Pallor, diminished pulse, and pain in the left hand.
c. Edema and reddish discoloration of the left arm.
d. Aching pain, pallor, and edema of the left arm.: B
Steal syndrome results from vascular insufficiency after creation of a fistula. The client
exhibits pallor and a diminished pulse distal to the fistula. The client also complains of
pain distal to the fistula, caused by tissue ischemia. Warmth, redness, and pain probably
would characterize a problem with infection. The manifestations described in options 3
and 4 are incorrect.
10. The client with chronic renal failure returns to the nursing unit following a
hemodialysis treatment. On assessment, the nurse notes that the client's
, Renal Disorders/Dialysis & Peritoneal Dialysis NCLEX
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temperature is 100.2F. Which of the following is the appropriate nursing action? a.
Encourage fluids.
b. Notify the physician.
c. Continue to monitor vital signs.
d. Monitor the site of the shunt for infection.: C
The client may have an elevated temperature following dialysis because the dialysis
machine warms the blood slightly. If the temperature is elevated excessively and remains
elevated, sepsis would be suspected and a blood sample would be obtained as prescribed
for culture and sensitivity determinations.
11. The nurse is performing an assessment on a client who has returned from the
dialysis unit following hemodialysis. The client is complaining of headache and
nausea and is extremely restless. Which of the following is the most appropriate
nursing action? a. Monitor the client.
b. Notify the physician.
c. Elevate the head of the bed.
d. Medicate the client for nausea.: B
Disequilibrium syndrome may be caused by the rapid decreases in the blood urea
nitrogen level during hemodialysis. These changes can cause cerebral edema that leads to
increased intracranial pressure. The client is exhibiting early signs of disequilibrium
syndrome and appropriate treatments with anticonvulsive medications and barbiturates
may be necessary to prevent a life-threatening situation. The physician must be notified.
12. A nurse is analyzing the posthemodialysis lab test results for a client with
chronic renal failure (CRF). The nurse interprets that the dialysis is having an
expected but nontherapeutic effect if the results indicate a decreased: a.
Phosphorus.
b. Creatinine.
c. Potassium.
d. Red blood cell count: D
Hemodialysis typically lowers the amounts of fluid, sodium, potassium, urea nitrogen,
creatinine, uric acid, magnesium, and phosphate levels in the blood. Hemodialysis also
worsens anemia, because RBCs are lost in dialysis from blood sampling and
anticoagulation during the procedure, and from residual blood that is left in the dialyzer.
Although all of these results are expected, only the lowered RBC count is nontherapeutic
and worsens the anemia already caused by the disease process.
13. A client diagnosed with chronic renal failure (CRF) is scheduled to begin
hemodialysis. The nurse assesses that which of the following neurological and
Study online at https://quizlet.com/_auubod
Renal Disorders/Dialysis & Peritoneal Dialysis NCLEX
Questions With very accurate answers,
2024/2025(brand new)!!!!
1. The nurse instructs a client with renal failure who is receiving hemodialysis
about dietary modifications. The nurse determines that the client understands these
dietary modifications if the client selects which items from the menu? a. Cream of
wheat, blueberries, coffee
b. Sausage and eggs, banana, orange juice.
c. Bacon, cantaloupe melon, tomato juice.
d. Cured pork, grits, strawberries, orange juice.: A
The diet for a client with renal failure who is receiving hemodialysis should include
controlled amounts of sodium, phosphorus, calcium, potassium, and fluids. Options 2, 3,
and 4 are high in sodium, phosphorus and potassium.
2. The client with chronic renal failure is scheduled for hemodialysis this morning is
due to receive a daily dose of enalapril (Vasotec). The nurse should plan to
administer this medication: a. During dialysis.
b. Just before dialysis.
c. The day after dialysis.
d. On return from dialysis.: D
Antihypertensive medications such as enalapril are given to the client following
hemodialysis. This prevents the client from becoming hypotensive during dialysis and
also from having the medication removed from the bloodstream by dialysis. No rationale
exists for waiting an entire day to resume the medication. This would lead to ineffective
control of the blood pressure.
3. The client being hemodialyzed suddenly becomes short of breath and complains
of chest pain. The client is tachycardic, pale, and anxious. The nurse suspects air
embolism. The priority action for the nurse is to: a. Discontinue dialysis and notify
the physician.
b. Monitor vital signs every 15 minutes for the next hour.
c. Continue dialysis at a slower rate after checking the lines for air.
d. Bolus the client with 500 mL of normal saline to break up the embolus.: A If the
client experiences air embolus during hemodialysis, the nurse should terminate
dialysis immediately, notify the physician, and administer oxygen as needed.
Options 2, 3, and 4 are incorrect.
, Renal Disorders/Dialysis & Peritoneal Dialysis NCLEX
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4. The nurse has completed client teaching with the hemodialysis client about self-
monitoring between hemodialysis treatments. The nurse determines that the client
best understands the information if the client states to record daily the:
a. Amount of activity.
b. Pulse and respiratory rate.
c. Intake and output and weight.
d. Blood urea nitrogen and creatinine levels.: C
The client on hemodialysis should monitor fluid status between hemodialysis treatments
by recording intake and output and measuring weight daily. Ideally, the hemodialysis
client should not gain more than 0.5 kg of weight/day.
5. The client with an external arteriovenous shunt in place for hemodialysis is at
risk for bleeding. The priority nurse action would be to:
a. Check the shunt for the presence of bruit and thrill.
b. Observe the site once as time permits during the shift.
c. Check the results of the prothrombin times as they are determined.
d. Ensure that small clamps are attached to the arteriovenous shunt dressing.-: D
An arteriovenous shunt is a less common form of access site but carries a risk for
bleeding when it is used because two ends of an external cannula are tunneled
subcutaneously into an artery and a vein, and the ends of the cannula are joined. If
accidental disconnection occurs, the client could lose blood rapidly. For this reason, small
clamps are attached to the dressing that covers the insertion site for use if needed. The
shunt site also should be assessed at least every 4 hours.
6. A nurse is assessing the patency of a client's left arm arteriovenous fistula prior to
initiating hemodialysis. Which finding indicates that the fistula is patent?
a. Palpation of a thrill over the fistula.
b. Presence of a radial pulse in the left wrist.
c. Absence of a bruit on auscultation of the fistula.
d. Capillary refill less than 3 seconds in the nail beds of the fingers of the left
hand.: A
The nurse assesses the patency of the fistula by palpating for the presence of a thrill or
auscultating for a bruit. The presence of a thrill and bruit indicate patency of the fistula.
Although the presence of a radial pulse in the left wrist and capillary refill shorter than 3
seconds in the nail beds of the fingers on the left hand are normal findings, they do not
assess fistula patency.
7. The client newly diagnosed with chronic renal failure recently has begun
hemodialysis. Knowing that the client is at risk for disequilibrium syndrome, the
, Renal Disorders/Dialysis & Peritoneal Dialysis NCLEX
Study online at https://quizlet.com/_auubod
nurse assesses the client during dialysis for: a. Hypertension, tachycardia, and
fever.
b. Hypotension, bradycardia, and hypothermia.
c. Restlessness, irritability, and generalized weakness.
d. Headache, deteriorating level of consciousness, and twitching.: D
Disequilibrium syndrome is characterized by headache, mental confusion, decreasing
level of consciousness, nausea, vomiting, twitching, and possible seizure activity.
Disequilibrium syndrome is caused by rapid removal of solutes from the body during
hemodialysis. At the same time, the blood-brain barrier interferes with the efficient
removal of wastes from brain tissue. As a result, water goes into cerebral cells because of
the osmotic gradient, causing brain swelling and onset of symptoms. The syndrome most
often occurs in clients who are new to dialysis and is prevented by dialyzing for shorter
times or at reduced blood flow rates.
8. A client with chronic renal failure has completed a hemodialysis treatment. The
nurse would use which of the following standard indicators to evaluate the client's
status after dialysis? a. Vital signs and weight.
b. Potassium level and weight.
c. Vital signs and BUN.
d. BUN and creatinine levels.: A
Following dialysis, the client's vital signs are monitored to determine whether the client
is remaining hemodynamically stable. Weight is measured and compared with the client's
predialysis weight to determine effectiveness of fluid extraction. Laboratory studies are
done as per protocol but are not necessarily done after the hemodialysis treatment has
ended.
9. The hemodialysis client with a left arm fistula is at risk for arterial steal
syndrome. The nurse assesses this client for which of the following manifestations?
a. Warmth, redness, and pain in the left hand.
b. Pallor, diminished pulse, and pain in the left hand.
c. Edema and reddish discoloration of the left arm.
d. Aching pain, pallor, and edema of the left arm.: B
Steal syndrome results from vascular insufficiency after creation of a fistula. The client
exhibits pallor and a diminished pulse distal to the fistula. The client also complains of
pain distal to the fistula, caused by tissue ischemia. Warmth, redness, and pain probably
would characterize a problem with infection. The manifestations described in options 3
and 4 are incorrect.
10. The client with chronic renal failure returns to the nursing unit following a
hemodialysis treatment. On assessment, the nurse notes that the client's
, Renal Disorders/Dialysis & Peritoneal Dialysis NCLEX
Study online at https://quizlet.com/_auubod
temperature is 100.2F. Which of the following is the appropriate nursing action? a.
Encourage fluids.
b. Notify the physician.
c. Continue to monitor vital signs.
d. Monitor the site of the shunt for infection.: C
The client may have an elevated temperature following dialysis because the dialysis
machine warms the blood slightly. If the temperature is elevated excessively and remains
elevated, sepsis would be suspected and a blood sample would be obtained as prescribed
for culture and sensitivity determinations.
11. The nurse is performing an assessment on a client who has returned from the
dialysis unit following hemodialysis. The client is complaining of headache and
nausea and is extremely restless. Which of the following is the most appropriate
nursing action? a. Monitor the client.
b. Notify the physician.
c. Elevate the head of the bed.
d. Medicate the client for nausea.: B
Disequilibrium syndrome may be caused by the rapid decreases in the blood urea
nitrogen level during hemodialysis. These changes can cause cerebral edema that leads to
increased intracranial pressure. The client is exhibiting early signs of disequilibrium
syndrome and appropriate treatments with anticonvulsive medications and barbiturates
may be necessary to prevent a life-threatening situation. The physician must be notified.
12. A nurse is analyzing the posthemodialysis lab test results for a client with
chronic renal failure (CRF). The nurse interprets that the dialysis is having an
expected but nontherapeutic effect if the results indicate a decreased: a.
Phosphorus.
b. Creatinine.
c. Potassium.
d. Red blood cell count: D
Hemodialysis typically lowers the amounts of fluid, sodium, potassium, urea nitrogen,
creatinine, uric acid, magnesium, and phosphate levels in the blood. Hemodialysis also
worsens anemia, because RBCs are lost in dialysis from blood sampling and
anticoagulation during the procedure, and from residual blood that is left in the dialyzer.
Although all of these results are expected, only the lowered RBC count is nontherapeutic
and worsens the anemia already caused by the disease process.
13. A client diagnosed with chronic renal failure (CRF) is scheduled to begin
hemodialysis. The nurse assesses that which of the following neurological and
