Renal Disorders, Dialysis
& Peritoneal Dialysis
NCLEX 2026 | Q&A &
Detailed Rationales
|Graded A+ | Guaranteed
success|
Updated 2026 Questions and Answers
100% Verified Exam Prep and Comprehensive
Rationales
Included
,The client being hemodialyzed suddenly becomes short A
of breath and complains of chest pain. The client is If the client experiences air embolus during hemodialysis, the nurse should
tachycardic, pale, and anxious. The nurse suspects air terminate dialysis immediately, notify the physician, and administer oxygen as
embolism. The priority action for the nurse is to: needed. Options 2, 3, and 4 are incorrect.
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.
The nurse has completed client teaching with the C
hemodialysis client about self-monitoring between The client on hemodialysis should monitor fluid status between hemodialysis
hemodialysis treatments. The nurse determines that the treatments by recording intake and output and measuring weight daily. Ideally, the
client best understands the information if the client states hemodialysis client should not gain more than 0.5 kg of weight/day.
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.
The client with an external arteriovenous shunt in place D
for hemodialysis is at risk for bleeding. The priority nurse An arteriovenous shunt is a less common form of access site but carries a risk for
action would be to: bleeding when it is used because two ends of an external cannula are tunneled
a. Check the shunt for the presence of bruit and thrill. subcutaneously into an artery and a vein, and the ends of the cannula are joined.
b. Observe the site once as time permits during the shift. If accidental disconnection occurs, the client could lose blood rapidly. For this
c. Check the results of the prothrombin times as they are reason, small clamps are attached to the dressing that covers the insertion site for
determined. use if needed. The shunt site also should be assessed at least every 4 hours.
d. Ensure that small clamps are attached to the
arteriovenous shunt dressing.
A nurse is assessing the patency of a client's left arm A
arteriovenous fistula prior to initiating hemodialysis. The nurse assesses the patency of the fistula by palpating for the presence of a
Which finding indicates that the fistula is patent? thrill or auscultating for a bruit. The presence of a thrill and bruit indicate patency
a. Palpation of a thrill over the fistula. of the fistula. Although the presence of a radial pulse in the left wrist and capillary
b. Presence of a radial pulse in the left wrist. refill shorter than 3 seconds in the nail beds of the fingers on the left hand are
c. Absence of a bruit on auscultation of the fistula. normal findings, they do not assess fistula patency.
d. Capillary refill less than 3 seconds in the nail beds of
the fingers of the left hand.
The client newly diagnosed with chronic renal failure D
recently has begun hemodialysis. Knowing that the client Disequilibrium syndrome is characterized by headache, mental confusion,
is at risk for disequilibrium syndrome, the nurse assesses decreasing level of consciousness, nausea, vomiting, twitching, and possible
the client during dialysis for: seizure activity. Disequilibrium syndrome is caused by rapid removal of solutes
a. Hypertension, tachycardia, and fever. from the body during hemodialysis. At the same time, the blood-brain barrier
b. Hypotension, bradycardia, and hypothermia. interferes with the efficient removal of wastes from brain tissue. As a result, water
c. Restlessness, irritability, and generalized weakness. goes into cerebral cells because of the osmotic gradient, causing brain swelling
d. Headache, deteriorating level of consciousness, and and onset of symptoms. The syndrome most often occurs in clients who are new
twitching. to dialysis and is prevented by dialyzing for shorter times or at reduced blood
flow rates.
, A client with chronic renal failure has completed a A
hemodialysis treatment. The nurse would use which of the Following dialysis, the client's vital signs are monitored to determine whether the
following standard indicators to evaluate the client's client is remaining hemodynamically stable. Weight is measured and compared
status after dialysis? with the client's predialysis weight to determine effectiveness of fluid extraction.
a. Vital signs and weight. Laboratory studies are done as per protocol but are not necessarily done after
b. Potassium level and weight. the hemodialysis treatment has ended.
c. Vital signs and BUN.
d. BUN and creatinine levels.
The hemodialysis client with a left arm fistula is at risk for B
arterial steal syndrome. The nurse assesses this client for Steal syndrome results from vascular insufficiency after creation of a fistula. The
which of the following manifestations? client exhibits pallor and a diminished pulse distal to the fistula. The client also
a. Warmth, redness, and pain in the left hand. complains of pain distal to the fistula, caused by tissue ischemia. Warmth, redness,
b. Pallor, diminished pulse, and pain in the left hand. and pain probably would characterize a problem with infection. The
c. Edema and reddish discoloration of the left arm. manifestations described in options 3 and 4 are incorrect.
d. Aching pain, pallor, and edema of the left arm.
The client with chronic renal failure returns to the nursing C
unit following a hemodialysis treatment. On assessment, The client may have an elevated temperature following dialysis because the
the nurse notes that the client's temperature is 100.2F. dialysis machine warms the blood slightly. If the temperature is elevated
Which of the following is the appropriate nursing action? excessively and remains elevated, sepsis would be suspected and a blood sample
a. Encourage fluids. would be obtained as prescribed for culture and sensitivity determinations.
b. Notify the physician.
c. Continue to monitor vital signs.
d. Monitor the site of the shunt for infection.
The nurse is performing an assessment on a client who B
has returned from the dialysis unit following hemodialysis. Disequilibrium syndrome may be caused by the rapid decreases in the blood urea
The client is complaining of headache and nausea and is nitrogen level during hemodialysis. These changes can cause cerebral edema that
extremely restless. Which of the following is the most leads to increased intracranial pressure. The client is exhibiting early signs of
appropriate nursing action? disequilibrium syndrome and appropriate treatments with anticonvulsive
a. Monitor the client. medications and barbiturates may be necessary to prevent a life-threatening
b. Notify the physician. situation. The physician must be notified.
c. Elevate the head of the bed.
d. Medicate the client for nausea.
A nurse is analyzing the posthemodialysis lab test results D
for a client with chronic renal failure (CRF). The nurse Hemodialysis typically lowers the amounts of fluid, sodium, potassium, urea
interprets that the dialysis is having an expected but nitrogen, creatinine, uric acid, magnesium, and phosphate levels in the blood.
nontherapeutic effect if the results indicate a decreased: Hemodialysis also worsens anemia, because RBCs are lost in dialysis from blood
a. Phosphorus. sampling and anticoagulation during the procedure, and from residual blood that
b. Creatinine. is left in the dialyzer. Although all of these results are expected, only the lowered
c. Potassium. RBC count is nontherapeutic and worsens the anemia already caused by the
d. Red blood cell count disease process.
& Peritoneal Dialysis
NCLEX 2026 | Q&A &
Detailed Rationales
|Graded A+ | Guaranteed
success|
Updated 2026 Questions and Answers
100% Verified Exam Prep and Comprehensive
Rationales
Included
,The client being hemodialyzed suddenly becomes short A
of breath and complains of chest pain. The client is If the client experiences air embolus during hemodialysis, the nurse should
tachycardic, pale, and anxious. The nurse suspects air terminate dialysis immediately, notify the physician, and administer oxygen as
embolism. The priority action for the nurse is to: needed. Options 2, 3, and 4 are incorrect.
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.
The nurse has completed client teaching with the C
hemodialysis client about self-monitoring between The client on hemodialysis should monitor fluid status between hemodialysis
hemodialysis treatments. The nurse determines that the treatments by recording intake and output and measuring weight daily. Ideally, the
client best understands the information if the client states hemodialysis client should not gain more than 0.5 kg of weight/day.
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.
The client with an external arteriovenous shunt in place D
for hemodialysis is at risk for bleeding. The priority nurse An arteriovenous shunt is a less common form of access site but carries a risk for
action would be to: bleeding when it is used because two ends of an external cannula are tunneled
a. Check the shunt for the presence of bruit and thrill. subcutaneously into an artery and a vein, and the ends of the cannula are joined.
b. Observe the site once as time permits during the shift. If accidental disconnection occurs, the client could lose blood rapidly. For this
c. Check the results of the prothrombin times as they are reason, small clamps are attached to the dressing that covers the insertion site for
determined. use if needed. The shunt site also should be assessed at least every 4 hours.
d. Ensure that small clamps are attached to the
arteriovenous shunt dressing.
A nurse is assessing the patency of a client's left arm A
arteriovenous fistula prior to initiating hemodialysis. The nurse assesses the patency of the fistula by palpating for the presence of a
Which finding indicates that the fistula is patent? thrill or auscultating for a bruit. The presence of a thrill and bruit indicate patency
a. Palpation of a thrill over the fistula. of the fistula. Although the presence of a radial pulse in the left wrist and capillary
b. Presence of a radial pulse in the left wrist. refill shorter than 3 seconds in the nail beds of the fingers on the left hand are
c. Absence of a bruit on auscultation of the fistula. normal findings, they do not assess fistula patency.
d. Capillary refill less than 3 seconds in the nail beds of
the fingers of the left hand.
The client newly diagnosed with chronic renal failure D
recently has begun hemodialysis. Knowing that the client Disequilibrium syndrome is characterized by headache, mental confusion,
is at risk for disequilibrium syndrome, the nurse assesses decreasing level of consciousness, nausea, vomiting, twitching, and possible
the client during dialysis for: seizure activity. Disequilibrium syndrome is caused by rapid removal of solutes
a. Hypertension, tachycardia, and fever. from the body during hemodialysis. At the same time, the blood-brain barrier
b. Hypotension, bradycardia, and hypothermia. interferes with the efficient removal of wastes from brain tissue. As a result, water
c. Restlessness, irritability, and generalized weakness. goes into cerebral cells because of the osmotic gradient, causing brain swelling
d. Headache, deteriorating level of consciousness, and and onset of symptoms. The syndrome most often occurs in clients who are new
twitching. to dialysis and is prevented by dialyzing for shorter times or at reduced blood
flow rates.
, A client with chronic renal failure has completed a A
hemodialysis treatment. The nurse would use which of the Following dialysis, the client's vital signs are monitored to determine whether the
following standard indicators to evaluate the client's client is remaining hemodynamically stable. Weight is measured and compared
status after dialysis? with the client's predialysis weight to determine effectiveness of fluid extraction.
a. Vital signs and weight. Laboratory studies are done as per protocol but are not necessarily done after
b. Potassium level and weight. the hemodialysis treatment has ended.
c. Vital signs and BUN.
d. BUN and creatinine levels.
The hemodialysis client with a left arm fistula is at risk for B
arterial steal syndrome. The nurse assesses this client for Steal syndrome results from vascular insufficiency after creation of a fistula. The
which of the following manifestations? client exhibits pallor and a diminished pulse distal to the fistula. The client also
a. Warmth, redness, and pain in the left hand. complains of pain distal to the fistula, caused by tissue ischemia. Warmth, redness,
b. Pallor, diminished pulse, and pain in the left hand. and pain probably would characterize a problem with infection. The
c. Edema and reddish discoloration of the left arm. manifestations described in options 3 and 4 are incorrect.
d. Aching pain, pallor, and edema of the left arm.
The client with chronic renal failure returns to the nursing C
unit following a hemodialysis treatment. On assessment, The client may have an elevated temperature following dialysis because the
the nurse notes that the client's temperature is 100.2F. dialysis machine warms the blood slightly. If the temperature is elevated
Which of the following is the appropriate nursing action? excessively and remains elevated, sepsis would be suspected and a blood sample
a. Encourage fluids. would be obtained as prescribed for culture and sensitivity determinations.
b. Notify the physician.
c. Continue to monitor vital signs.
d. Monitor the site of the shunt for infection.
The nurse is performing an assessment on a client who B
has returned from the dialysis unit following hemodialysis. Disequilibrium syndrome may be caused by the rapid decreases in the blood urea
The client is complaining of headache and nausea and is nitrogen level during hemodialysis. These changes can cause cerebral edema that
extremely restless. Which of the following is the most leads to increased intracranial pressure. The client is exhibiting early signs of
appropriate nursing action? disequilibrium syndrome and appropriate treatments with anticonvulsive
a. Monitor the client. medications and barbiturates may be necessary to prevent a life-threatening
b. Notify the physician. situation. The physician must be notified.
c. Elevate the head of the bed.
d. Medicate the client for nausea.
A nurse is analyzing the posthemodialysis lab test results D
for a client with chronic renal failure (CRF). The nurse Hemodialysis typically lowers the amounts of fluid, sodium, potassium, urea
interprets that the dialysis is having an expected but nitrogen, creatinine, uric acid, magnesium, and phosphate levels in the blood.
nontherapeutic effect if the results indicate a decreased: Hemodialysis also worsens anemia, because RBCs are lost in dialysis from blood
a. Phosphorus. sampling and anticoagulation during the procedure, and from residual blood that
b. Creatinine. is left in the dialyzer. Although all of these results are expected, only the lowered
c. Potassium. RBC count is nontherapeutic and worsens the anemia already caused by the
d. Red blood cell count disease process.
