Nursing A Hemodialysis Patient Quiz
What do you know about hemodialysis? Do you know about nursing a hemodialysis patient? Try this quiz if you want to learn about dealing with a hemodialysis patient. Hemodialysis, which is also spelled hemodialysis, or simply you can say dialysis, is known as a process of purifying the person's blood whose kidneys are unable to work normally. These hemodialysis NCLEX questions will test you and teach you more about nursing hemodialysis patients. All the best!
- 1.
A hemodialysis client has a newly created left arm fistula. The nurse monitors the affected extremity for which signs and symptoms that indicate a complication related to stealing syndrome?
- A.
Edema and purplish discoloration
- B.
Aching pain, pallor, and edema
- C.
Warmth, redness, and pain
- D.
Pallor, diminished pulse. and pain
Correct Answer
D. Pallor, diminished pulse. and painExplanation
Pallor, diminished pulse, and pain are signs and symptoms that indicate a complication related to stealing syndrome in a hemodialysis client with a newly created left arm fistula. Stealing syndrome occurs when blood flow is diverted from the extremities to the fistula, resulting in decreased blood supply to the affected limb. Pallor, or paleness, is a result of reduced blood flow, while diminished pulse indicates decreased circulation. Pain may be present due to inadequate oxygen and nutrient supply to the tissues. These symptoms suggest that the fistula is causing insufficient blood flow to the extremity and should be addressed promptly.Rate this question:
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- 2.
A patient with CKD has a low erythropoietin (EPO) level. The patient is at risk for
- A.
Hypercalcemia
- B.
Anemia
- C.
Blood clots
- D.
Hyperkalemia
Correct Answer
B. AnemiaExplanation
A patient with chronic kidney disease (CKD) has a low erythropoietin (EPO) level, which is a hormone responsible for stimulating the production of red blood cells. This low EPO level can lead to a decreased production of red blood cells, resulting in anemia. Anemia is a condition characterized by a low level of red blood cells, leading to symptoms such as fatigue, weakness, and shortness of breath. Therefore, the patient with CKD and low EPO level is at risk for anemia.Rate this question:
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- 3.
A patient with Stage 5 CKD is experiencing extreme pruritus and has several areas of crystallized white deposits on the skin. As the nurse, you know this is due to excessive amounts of what substance found in the blood?
- A.
Calcium
- B.
Urea
- C.
Phosphate
- D.
Erythropoietin
Correct Answer
A. CalciumExplanation
Excessive amounts of calcium in the blood can lead to the formation of crystallized white deposits on the skin, a condition known as calcinosis cutis. In patients with Stage 5 CKD (Chronic Kidney Disease), the kidneys are unable to properly filter and excrete calcium, leading to its accumulation in the blood. This can result in symptoms such as extreme pruritus (itchiness) and the formation of calcium deposits on the skin. Therefore, the correct answer is calcium.Rate this question:
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- 4.
Your patient with chronic kidney disease is scheduled for dialysis in the morning. While examining the patient's telemetry strip, you note tall peaked T-waves. You notify the physician who orders a STAT basic metabolic panel (BMP). What result from the BMP confirms the EKG abnormality?
- A.
Phosphate 3.2 mg/dL
- B.
Calcium 9.3 mg/dL
- C.
Magnesium 2.2 mg/dL
- D.
Potassium 7.1 mEq/L
Correct Answer
D. Potassium 7.1 mEq/LExplanation
The correct answer is Potassium 7.1 mEq/L. In patients with chronic kidney disease, high levels of potassium can lead to hyperkalemia, which can cause EKG abnormalities such as tall peaked T-waves. Therefore, the elevated potassium level confirms the abnormality seen on the telemetry strip.Rate this question:
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- 5.
A patient with stage 4 chronic kidney disease asks what type of diet they should follow. You explain the patient should follow a:
- A.
Low protein, low sodium, low potassium, low phosphate diet
- B.
High protein, low sodium, low potassium, high phosphate diet
- C.
Low protein, high sodium, high potassium, high phosphate diet
- D.
Low protein, low sodium, low potassium, high phosphate diet
Correct Answer
A. Low protein, low sodium, low potassium, low phosphate dietExplanation
Patients with stage 4 chronic kidney disease often have impaired kidney function, which can lead to the accumulation of waste products in the blood. A low protein diet is recommended to reduce the production of waste products from protein metabolism. Additionally, a low sodium diet helps to control fluid balance and blood pressure, while a low potassium diet helps to prevent hyperkalemia. Finally, a low phosphate diet is important to manage mineral and bone disorders associated with kidney disease. Therefore, a low protein, low sodium, low potassium, low phosphate diet is the most appropriate recommendation for this patient.Rate this question:
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- 6.
A client has an arteriovenous (AV) fistula in place in the right upper extremity for hemodialysis treatments. When planning care for this client, which of the following measures should the nurse implement to promote the client's safely?
- A.
Take blood pressure only on the right arm to ensure accuracy
- B.
Use the fistula for all venipunctures and intravenous infusions
- C.
Ensure that small clamps are attached to the AV fistula dressing
- D.
Assess the fistula for the presence of a bruit and thrill every 4 hours
Correct Answer
D. Assess the fistula for the presence of a bruit and thrill every 4 hoursExplanation
Assessing the fistula for the presence of a bruit and thrill every 4 hours is important to promote the client's safety because it allows the nurse to monitor the patency and function of the AV fistula. A bruit is a humming sound caused by turbulent blood flow through the fistula, indicating adequate blood flow. A thrill is a vibration felt over the fistula, indicating proper arterial-venous connection. Regular assessment of these signs can help detect any complications or changes in the fistula's function, allowing for prompt intervention and prevention of complications such as clotting or infection.Rate this question:
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- 7.
The home care nurse is making follow-up visits to a client following a renal transplant. The nurse assesses the client for which signs of acute graft rejection?
- A.
Hypotension, graft tenderness, and anemia
- B.
Hypertension, oliguria, thirst, and hypothermia
- C.
Fever, hypertension, graft tenderness, and malaise
- D.
Fever, vomiting, hypotension, and copious amounts of dilute urine
Correct Answer
C. Fever, hypertension, graft tenderness, and malaiseExplanation
Following a renal transplant, the nurse should assess the client for signs of acute graft rejection. Fever, hypertension, graft tenderness, and malaise are all indicative of acute graft rejection. Fever and malaise are common signs of inflammation and immune response, while hypertension and graft tenderness suggest that the transplanted kidney is being rejected by the recipient's immune system. This combination of symptoms should prompt further evaluation and intervention to prevent further complications.Rate this question:
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- 8.
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 time as they are determined
- D.
Ensure that small clamps are attached to the arteriovenous shunt dressing
Correct Answer
D. Ensure that small clamps are attached to the arteriovenous shunt dressingExplanation
The correct answer is to ensure that small clamps are attached to the arteriovenous shunt dressing. This is because the client with an external arteriovenous shunt is at risk for bleeding, and attaching small clamps to the dressing can help prevent any accidental dislodgement or bleeding from the shunt. Checking the shunt for the presence of bruit and thrill is important, but it is not the priority action in this situation. Observing the site once during the shift may not provide adequate monitoring for bleeding. Checking the results of the prothrombin time is important, but it is not the priority action in preventing bleeding.Rate this question:
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- 9.
The client, hemodialyzed, suddenly becomes short of breath and complains of chest pain. The client is tachycardic, pale, and anxious. The nurse suspects an 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 air embolus
Correct Answer
A. Discontinue dialysis and notify the physicianExplanation
The client's symptoms of sudden shortness of breath, chest pain, tachycardia, pallor, and anxiety are consistent with an air embolism. An air embolism occurs when air enters the bloodstream and can be life-threatening. The priority action for the nurse is to discontinue dialysis immediately to prevent further air from entering the bloodstream. Notifying the physician is also important to ensure prompt medical intervention. Monitoring vital signs every 15 minutes and continuing dialysis at a slower rate are not appropriate actions in this situation. Bolusing the client with normal saline may not effectively break up the air embolism and could potentially worsen the condition.Rate this question:
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- 10.
The client has end-stage renal disease. He had undergone a kidney transplant five days ago. Which of the following is the most important intervention for the client to prevent infection?
- A.
Observe asepsis
- B.
Increase fluid intake
- C.
Avoid clients with flu
- D.
Avoid crowded places
Correct Answer
A. Observe asepsisExplanation
The most important intervention for the client to prevent infection after a kidney transplant is to observe asepsis. Asepsis refers to the practice of maintaining a sterile environment and following strict infection control measures. This is crucial for preventing the introduction of pathogens that could potentially cause infections in the client, especially since they have end-stage renal disease and have undergone a recent transplant. Increasing fluid intake, avoiding clients with the flu, and avoiding crowded places can also be beneficial in reducing the risk of infection, but observing asepsis is the most important intervention in this case.Rate this question:
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