NURS3725 FINAL EXAM | 105 QUESTIONS | WITH
COMPLETE SOLUTIONS.
Which of the following are *goals* of dialysis? Select all that apply.
A. remove creatinine and urea
B. maintain a safe concentration of electrolytes, especially potassium
C. correct alkalosis and replenish the blood bicarbonate buffer system
D. increase fluid in the blood Answer - A and B
dialysis corrects *acidosis* and removes *excess* fluid from the blood (kidneys
are not able to excrete optimal amounts of urine, so patients on dialysis will
likely have very little/no urine output)
Which of the following is *not true* about dialysis?
A. without dialysis, patients require an in and out catheter every 24 hours
B. hemodialysis cannot be done at home; peritoneal dialysis can
C. if a patient is receiving dialysis 3 times a week, they likely only need an in
and out catheter every few days
D. may be used to treat drug overdoses Answer - A
without dialysis, patients require an in and out catheter every ~8 hours
,You are a community nurse working with a patient who does peritoneal dialysis
at home. Today, you have a student shadowing you. Which of the following
statements by the student requires further teaching?
A. "glucose is added to the dialysate to create an osmotic gradient so excess
fluid is pulled from the blood"
B. "sterile dialysate is instilled into the peritoneal cavity to allow for substance
exchange"
C. "dwell time for substance exchange is 4 hours"
D. "the three processes that occur during dwell time are diffusion, osmosis, and
ultrafiltration" Answer - C
dwell time is prescribed based on the patients goals
You are working in the community with a student. Which of the following
statements by the student about peritoneal dialysis requires further teaching?
A. "the catheter won't be sealed for one to two weeks after insertion"
B. "exit site care should be done using antibacterial soap, or mild disinfectant,
and patients should always assess for signs of infection"
C. "two to four weeks after the catheter is implanted, the exit site should be
clean, dry and have no redness or tenderness"
D. "patients should perform exit site care once a week" Answer - D
exit site care should be done daily or every second day
Which of the following is *false* about dialysis solutions and cycles?
,A. ultrafiltration often involves dextrose and increases the risk of
hypertriglyceridemia and hyperglycemia
B. the drain phase takes 1-2 hours
C. dwell times can range from minutes to hours depending on the patients
goals
D. during the inflow phase, a prescribed amount of solution is infused through
a catheter by gravity over ~10 minutes Answer - B
the drain phase takes 15-30 minutes
You are a clinical instructor and a student is asking about *continuous
ambulatory peritoneal dialysis*. Which of the following statements requires
further teaching?
A. "patients should have at least 4 exchanges a day"
B. "after draining dialysate, patients should wait at least 30 minutes before
infusing a new bag"
C. "dwell times average about 4 hours"
D. "maintaining aseptic technique will help to prevent peritonitis" Answer - B
after dwell time (reaching equilibrium), the dialysate is drained from the
peritoneal cavity and a new bag is infused. dialysis fluid is always in the
peritoneal cavity, so dialysis is continually ongoing
You are a nurse working in the community. Which of the following statements
by a patient about their *automated peritoneal dialysis* requires further
teaching?
A. "i should make sure to maintain aseptic technique to prevent peritonitis"
, B. "i will be connected to the cycler during the night while I sleep"
C. "the fluid should be drained from my peritoneal cavity in the morning before
i disconnect from the machine"
D. "my cycler completes the fill, dwell, and drain phases" Answer - C
the patient disconnects from the machine in the morning and carries dialysate
in the abdomen during the day
Which of the following would *not* be a potential contraindication for
peritoneal dialysis?
A. history of diverticulitis
B. severe COPD
C. low BMI
D. chronic back pain Answer - C
severe obesity with abdominal wall and fat deposits would be a potential
complication. anything that wouldn't tolerate extra pressure in the abdomen
(i.e., 2L of fluid) would be a potential contraindication
Which of the following are complications of peritoneal dialysis? Select all that
apply.
A. bleeding
B. leakage at catheter site
C. peritonitis
D. portal hypertension Answer - A, B and C
COMPLETE SOLUTIONS.
Which of the following are *goals* of dialysis? Select all that apply.
A. remove creatinine and urea
B. maintain a safe concentration of electrolytes, especially potassium
C. correct alkalosis and replenish the blood bicarbonate buffer system
D. increase fluid in the blood Answer - A and B
dialysis corrects *acidosis* and removes *excess* fluid from the blood (kidneys
are not able to excrete optimal amounts of urine, so patients on dialysis will
likely have very little/no urine output)
Which of the following is *not true* about dialysis?
A. without dialysis, patients require an in and out catheter every 24 hours
B. hemodialysis cannot be done at home; peritoneal dialysis can
C. if a patient is receiving dialysis 3 times a week, they likely only need an in
and out catheter every few days
D. may be used to treat drug overdoses Answer - A
without dialysis, patients require an in and out catheter every ~8 hours
,You are a community nurse working with a patient who does peritoneal dialysis
at home. Today, you have a student shadowing you. Which of the following
statements by the student requires further teaching?
A. "glucose is added to the dialysate to create an osmotic gradient so excess
fluid is pulled from the blood"
B. "sterile dialysate is instilled into the peritoneal cavity to allow for substance
exchange"
C. "dwell time for substance exchange is 4 hours"
D. "the three processes that occur during dwell time are diffusion, osmosis, and
ultrafiltration" Answer - C
dwell time is prescribed based on the patients goals
You are working in the community with a student. Which of the following
statements by the student about peritoneal dialysis requires further teaching?
A. "the catheter won't be sealed for one to two weeks after insertion"
B. "exit site care should be done using antibacterial soap, or mild disinfectant,
and patients should always assess for signs of infection"
C. "two to four weeks after the catheter is implanted, the exit site should be
clean, dry and have no redness or tenderness"
D. "patients should perform exit site care once a week" Answer - D
exit site care should be done daily or every second day
Which of the following is *false* about dialysis solutions and cycles?
,A. ultrafiltration often involves dextrose and increases the risk of
hypertriglyceridemia and hyperglycemia
B. the drain phase takes 1-2 hours
C. dwell times can range from minutes to hours depending on the patients
goals
D. during the inflow phase, a prescribed amount of solution is infused through
a catheter by gravity over ~10 minutes Answer - B
the drain phase takes 15-30 minutes
You are a clinical instructor and a student is asking about *continuous
ambulatory peritoneal dialysis*. Which of the following statements requires
further teaching?
A. "patients should have at least 4 exchanges a day"
B. "after draining dialysate, patients should wait at least 30 minutes before
infusing a new bag"
C. "dwell times average about 4 hours"
D. "maintaining aseptic technique will help to prevent peritonitis" Answer - B
after dwell time (reaching equilibrium), the dialysate is drained from the
peritoneal cavity and a new bag is infused. dialysis fluid is always in the
peritoneal cavity, so dialysis is continually ongoing
You are a nurse working in the community. Which of the following statements
by a patient about their *automated peritoneal dialysis* requires further
teaching?
A. "i should make sure to maintain aseptic technique to prevent peritonitis"
, B. "i will be connected to the cycler during the night while I sleep"
C. "the fluid should be drained from my peritoneal cavity in the morning before
i disconnect from the machine"
D. "my cycler completes the fill, dwell, and drain phases" Answer - C
the patient disconnects from the machine in the morning and carries dialysate
in the abdomen during the day
Which of the following would *not* be a potential contraindication for
peritoneal dialysis?
A. history of diverticulitis
B. severe COPD
C. low BMI
D. chronic back pain Answer - C
severe obesity with abdominal wall and fat deposits would be a potential
complication. anything that wouldn't tolerate extra pressure in the abdomen
(i.e., 2L of fluid) would be a potential contraindication
Which of the following are complications of peritoneal dialysis? Select all that
apply.
A. bleeding
B. leakage at catheter site
C. peritonitis
D. portal hypertension Answer - A, B and C
