DIALYSIS STUDY QUESTIONS 2026
COMPLETE ANSWERS OFFERED
⫸ 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.. Answer: 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.
⫸ 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.. Answer: 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.
⫸ 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.. Answer: 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.
⫸ 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.. Answer: 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.
⫸ 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.. Answer: 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.
⫸ The client newly diagnosed with chronic renal failure recently has
begun hemodialysis. Knowing that the client is at risk for
disequilibrium syndrome, the 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..
Answer: 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.
⫸ 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.. Answer: 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.
COMPLETE ANSWERS OFFERED
⫸ 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.. Answer: 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.
⫸ 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.. Answer: 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.
⫸ 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.. Answer: 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.
⫸ 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.. Answer: 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.
⫸ 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.. Answer: 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.
⫸ The client newly diagnosed with chronic renal failure recently has
begun hemodialysis. Knowing that the client is at risk for
disequilibrium syndrome, the 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..
Answer: 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.
⫸ 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.. Answer: 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.
