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1. A patient receiving hemodialysis develops hypotension. What is the nurse’s first action?
A. Increase ultrafiltration
B. Stop dialysis permanently
C. Reduce fluid removal and assess patient
D. Administer potassium
Correct Answer: C. Reduce fluid removal and assess patient
Rationale: Hypotension during dialysis is commonly related to excessive fluid removal;
immediate assessment and reduction of ultrafiltration are indicated.
2. Which electrolyte imbalance is most common in end-stage renal disease?
A. Hypokalemia
B. Hyperkalemia
C. Hypercalcemia
D. Hypernatremia
Correct Answer: B. Hyperkalemia
Rationale: Impaired renal excretion often causes potassium retention.
3. Which finding requires immediate intervention in a dialysis patient?
A. BP 130/80 mmHg
B. Potassium 6.5 mEq/L
C. Weight gain 0.5 kg
D. Hemoglobin 11 g/dL
Correct Answer: B. Potassium 6.5 mEq/L
Rationale: Severe hyperkalemia can cause life-threatening dysrhythmias.
4. The nurse assesses a newly created AV fistula. Which finding is expected?
A. Absent thrill
B. Bruit and thrill present
C. Cool extremity only
D. Severe pain
Correct Answer: B. Bruit and thrill present
Rationale: A functioning AV fistula should have a palpable thrill and audible bruit.
5. Which laboratory value best reflects kidney function?
A. Hemoglobin
B. Platelets
C. Creatinine
D. Albumin
Correct Answer: C. Creatinine
Rationale: Serum creatinine is a key indicator of renal function.
6. Which action is appropriate when caring for an arm with an AV fistula?
A. Obtain blood pressure on that arm
B. Start IV therapy in that arm
C. Avoid venipuncture in that arm
, D. Apply restraints
Correct Answer: C. Avoid venipuncture in that arm
Rationale: Protecting the fistula preserves vascular access.
7. Which symptom is commonly associated with fluid overload?
A. Dry mucous membranes
B. Crackles in lungs
C. Hypotension
D. Weight loss
Correct Answer: B. Crackles in lungs
Rationale: Fluid accumulation often produces pulmonary congestion and crackles.
8. A patient reports chest pain during dialysis. What should the nurse do first?
A. Assess patient and notify provider
B. Ignore complaint
C. Increase blood flow rate
D. Continue treatment unchanged
Correct Answer: A. Assess patient and notify provider
Rationale: Chest pain may indicate a serious cardiovascular complication.
9. Which food should a renal patient limit?
A. Apples
B. White rice
C. Bananas
D. Bread
Correct Answer: C. Bananas
Rationale: Bananas are high in potassium.
10. What is the priority assessment after dialysis?
A. Hair condition
B. Vital signs
C. Nail color
D. Hearing ability
Correct Answer: B. Vital signs
Rationale: Post-dialysis complications often affect hemodynamic stability.
11. Which medication is commonly used to treat anemia in chronic kidney disease?
A. Insulin
B. Epoetin alfa
C. Digoxin
D. Warfarin
Correct Answer: B. Epoetin alfa
Rationale: Erythropoiesis-stimulating agents treat renal anemia.
12. A patient with ESRD has edema and shortness of breath. The likely cause is:
A. Fluid overload
B. Dehydration
C. Infection
D. Hypoglycemia