Dialysis Practice Questions and Answers
Updated 2026
The patient with CKD is receiving dialysis, and the nurse observes excoriations on the patient's skin.
What
pathophysiologic changes in CKD can contribute to this finding (select all that apply)?
a. Dry skin
b. Sensory neuropathy
c. Vascular calcifications
d. Calcium-phosphate skin deposits
e. Uremic crystallization from high BUN - Answera, b, d. Pruritus is common in patients receiving
dialysis.
It causes scratching from dry skin, sensory neuropathy,
and calcium-phosphate deposition in the skin. Vascular
calcifications contribute to cardiovascular disease, not to
itching skin. Uremic frost rarely occurs without BUN levels
greater than 200 mg/dL, which should not occur in a patient
on dialysis; urea crystallizes on the skin and also causes
pruritis.
What accurately describes the care of the patient with CKD?
a. A nutrient that is commonly supplemented for the patient on dialysis because it is dialyzable is
iron.
b. The syndrome that includes all of the signs and symptoms seen in the various body systems in CKD
is azotemia.
c. The use of morphine is contraindicated in the patient with CKD because accumulation of its
metabolites may
cause seizures.
d. The use of calcium-based phosphate binders in the patient with CKD is contraindicated when
serum calcium
levels are increased. - Answerd. In the patient with CKD, when serum calcium levels
are increased, calcium-based phosphate binders are not
used. The nutrient supplemented for patients on dialysis is
folic acid. The various body system manifestations occur
,with uremia, which includes azotemia. Meperidine is
contraindicated in patients with CKD related to possible
seizures.
The patient with chronic kidney disease is considering whether to use peritoneal dialysis (PD) or
hemodialysis (HD).
What are advantages of PD when compared to HD (select all that apply)?
a. Less protein loss
b. Rapid fluid removal
c. Less cardiovascular stress
d. Decreased hyperlipidemia
e. Requires fewer dietary restrictions - Answerc, e. Peritoneal dialysis is less stressful for the
cardiovascular system and requires fewer dietary
restrictions. Peritoneal dialysis actually contributes to more
protein loss and increased hyperlipidemia. The fluid and
creatinine removal are slower with peritoneal dialysis than
hemodialysis.
In which type of dialysis does the patient dialyze during sleep and leave the fluid in the abdomen
during the day?
a. Long nocturnal hemodialysis
b. Automated peritoneal dialysis (APD)
c. Continuous venovenous hemofiltration (CVVH)
d. Continuous ambulatory peritoneal dialysis (CAPD) - Answerb. Automated peritoneal dialysis (APD)
is the type of
dialysis in which the patient dialyzes during sleep and
leaves the fluid in the abdomen during the day. Long
nocturnal hemodialysis occurs while the patient is
sleeping and is done up to six times per week. Continuous
venovenous hemofiltration (CVVH) is a type of continuous
renal replacement therapy used to treat AKI. Continuous
ambulatory peritoneal dialysis (CAPD) is dialysis that is
,done with exchanges of 1.5 to 3 L of dialysate at least four
times daily.
To prevent the most common serious complication of PD, what is important for the nurse to do?
a. Infuse the dialysate slowly.
b. Use strict aseptic technique in the dialysis procedures.
c. Have the patient empty the bowel before the inflow phase.
d. Reposition the patient frequently and promote deep breathing. - Answerb. Peritonitis is a common
complication of peritoneal
dialysis (PD) and may require catheter removal
and termination of dialysis. Infection occurs from
contamination of the dialysate or tubing or from
progression of exit-site or tunnel infections and strict
sterile technique must be used by health professionals as
well as the patient to prevent contamination. Too-rapid
infusion may cause shoulder pain and pain may be caused
if the catheter tip touches the bowel. Difficulty breathing,
atelectasis, and pneumonia may occur from pressure of
the fluid on the diaphragm, which may be prevented by
elevating the head of the bed and promoting repositioning
and deep breathing.
A patient on hemodialysis develops a thrombus of a subcutaneous arteriovenous (AV) graft, requiring
its removal.
While waiting for a replacement graft or fistula, the patient is most likely to have what done for
treatment?
a. Peritoneal dialysis
b. Peripheral vascular access using radial artery
c. Silastic catheter tunneled subcutaneously to the jugular vein
d. Peripherally inserted central catheter (PICC) line inserted into subclavian vein - Answerc. A more
permanent, soft, flexible Silastic double-lumen
catheter is used for long-term access when other forms of
, vascular access have failed. These catheters are tunneled
subcutaneously and have Dacron cuffs that prevent infection
from tracking along the catheter.
A man with end-stage kidney disease is scheduled for hemodialysis following healing of an
arteriovenous fistula
(AVF). What should the nurse explain to him that will occur during dialysis?
a. He will be able to visit, read, sleep, or watch TV while reclining in a chair.
b. He will be placed on a cardiac monitor to detect any adverse effects that might occur.
c. The dialyzer will remove and hold part of his blood for 20 to 30 minutes to remove the waste
products.
d. A large catheter with two lumens will be inserted into the fistula to send blood to and return it
from the dialyzer. - Answera. While patients are undergoing hemodialysis, they can
perform quiet activities that do not require the limb that has
the vascular access. Blood pressure is monitored frequently
and the dialyzer monitors dialysis function but cardiac
monitoring is not usually indicated. The hemodialysis
machine continuously circulates both the blood and the
dialysate past the semipermeable membrane in the machine.
Graft and fistula access involve the insertion of two needles
into the site: one to remove blood from and the other to
return blood to the dialyzer.
What is the primary way that a nurse will evaluate the patency of an AVF?
a. Palpate for pulses distal to the graft site.
b. Auscultate for the presence of a bruit at the site.
c. Evaluate the color and temperature of the extremity.
d. Assess for the presence of numbness and tingling distal to the site. - Answerb. A patent
arteriovenous fistula (AVF) creates turbulent
blood flow that can be assessed by listening for a bruit
or palpated for a thrill as the blood passes through the
graft. Assessment of neurovascular status in the extremity
Updated 2026
The patient with CKD is receiving dialysis, and the nurse observes excoriations on the patient's skin.
What
pathophysiologic changes in CKD can contribute to this finding (select all that apply)?
a. Dry skin
b. Sensory neuropathy
c. Vascular calcifications
d. Calcium-phosphate skin deposits
e. Uremic crystallization from high BUN - Answera, b, d. Pruritus is common in patients receiving
dialysis.
It causes scratching from dry skin, sensory neuropathy,
and calcium-phosphate deposition in the skin. Vascular
calcifications contribute to cardiovascular disease, not to
itching skin. Uremic frost rarely occurs without BUN levels
greater than 200 mg/dL, which should not occur in a patient
on dialysis; urea crystallizes on the skin and also causes
pruritis.
What accurately describes the care of the patient with CKD?
a. A nutrient that is commonly supplemented for the patient on dialysis because it is dialyzable is
iron.
b. The syndrome that includes all of the signs and symptoms seen in the various body systems in CKD
is azotemia.
c. The use of morphine is contraindicated in the patient with CKD because accumulation of its
metabolites may
cause seizures.
d. The use of calcium-based phosphate binders in the patient with CKD is contraindicated when
serum calcium
levels are increased. - Answerd. In the patient with CKD, when serum calcium levels
are increased, calcium-based phosphate binders are not
used. The nutrient supplemented for patients on dialysis is
folic acid. The various body system manifestations occur
,with uremia, which includes azotemia. Meperidine is
contraindicated in patients with CKD related to possible
seizures.
The patient with chronic kidney disease is considering whether to use peritoneal dialysis (PD) or
hemodialysis (HD).
What are advantages of PD when compared to HD (select all that apply)?
a. Less protein loss
b. Rapid fluid removal
c. Less cardiovascular stress
d. Decreased hyperlipidemia
e. Requires fewer dietary restrictions - Answerc, e. Peritoneal dialysis is less stressful for the
cardiovascular system and requires fewer dietary
restrictions. Peritoneal dialysis actually contributes to more
protein loss and increased hyperlipidemia. The fluid and
creatinine removal are slower with peritoneal dialysis than
hemodialysis.
In which type of dialysis does the patient dialyze during sleep and leave the fluid in the abdomen
during the day?
a. Long nocturnal hemodialysis
b. Automated peritoneal dialysis (APD)
c. Continuous venovenous hemofiltration (CVVH)
d. Continuous ambulatory peritoneal dialysis (CAPD) - Answerb. Automated peritoneal dialysis (APD)
is the type of
dialysis in which the patient dialyzes during sleep and
leaves the fluid in the abdomen during the day. Long
nocturnal hemodialysis occurs while the patient is
sleeping and is done up to six times per week. Continuous
venovenous hemofiltration (CVVH) is a type of continuous
renal replacement therapy used to treat AKI. Continuous
ambulatory peritoneal dialysis (CAPD) is dialysis that is
,done with exchanges of 1.5 to 3 L of dialysate at least four
times daily.
To prevent the most common serious complication of PD, what is important for the nurse to do?
a. Infuse the dialysate slowly.
b. Use strict aseptic technique in the dialysis procedures.
c. Have the patient empty the bowel before the inflow phase.
d. Reposition the patient frequently and promote deep breathing. - Answerb. Peritonitis is a common
complication of peritoneal
dialysis (PD) and may require catheter removal
and termination of dialysis. Infection occurs from
contamination of the dialysate or tubing or from
progression of exit-site or tunnel infections and strict
sterile technique must be used by health professionals as
well as the patient to prevent contamination. Too-rapid
infusion may cause shoulder pain and pain may be caused
if the catheter tip touches the bowel. Difficulty breathing,
atelectasis, and pneumonia may occur from pressure of
the fluid on the diaphragm, which may be prevented by
elevating the head of the bed and promoting repositioning
and deep breathing.
A patient on hemodialysis develops a thrombus of a subcutaneous arteriovenous (AV) graft, requiring
its removal.
While waiting for a replacement graft or fistula, the patient is most likely to have what done for
treatment?
a. Peritoneal dialysis
b. Peripheral vascular access using radial artery
c. Silastic catheter tunneled subcutaneously to the jugular vein
d. Peripherally inserted central catheter (PICC) line inserted into subclavian vein - Answerc. A more
permanent, soft, flexible Silastic double-lumen
catheter is used for long-term access when other forms of
, vascular access have failed. These catheters are tunneled
subcutaneously and have Dacron cuffs that prevent infection
from tracking along the catheter.
A man with end-stage kidney disease is scheduled for hemodialysis following healing of an
arteriovenous fistula
(AVF). What should the nurse explain to him that will occur during dialysis?
a. He will be able to visit, read, sleep, or watch TV while reclining in a chair.
b. He will be placed on a cardiac monitor to detect any adverse effects that might occur.
c. The dialyzer will remove and hold part of his blood for 20 to 30 minutes to remove the waste
products.
d. A large catheter with two lumens will be inserted into the fistula to send blood to and return it
from the dialyzer. - Answera. While patients are undergoing hemodialysis, they can
perform quiet activities that do not require the limb that has
the vascular access. Blood pressure is monitored frequently
and the dialyzer monitors dialysis function but cardiac
monitoring is not usually indicated. The hemodialysis
machine continuously circulates both the blood and the
dialysate past the semipermeable membrane in the machine.
Graft and fistula access involve the insertion of two needles
into the site: one to remove blood from and the other to
return blood to the dialyzer.
What is the primary way that a nurse will evaluate the patency of an AVF?
a. Palpate for pulses distal to the graft site.
b. Auscultate for the presence of a bruit at the site.
c. Evaluate the color and temperature of the extremity.
d. Assess for the presence of numbness and tingling distal to the site. - Answerb. A patent
arteriovenous fistula (AVF) creates turbulent
blood flow that can be assessed by listening for a bruit
or palpated for a thrill as the blood passes through the
graft. Assessment of neurovascular status in the extremity
