STUVIA 2024/2025
Renal nclex review 11 and 12
77. 2,3,4. The nurse instructs the client to protect the site of the fistula. The client should avoid
pressure on the involved arm such as sleeping on it, wearing tight jewelry, or obtaining BP. The client
is also advised to assess the area distal to the fistula for adequate circulation, such as warmth and
color. When the client is hospitalized, the nurse posts a sign on the client's bed not to draw blood or
obtain BP on the left side; the client is also instructed to be sure that none of the healthcare team
members do so. - ✔✔77. A client with end-stage renal failure has an internal arteriovenous fistula in
the left arm for vascular access during hemodialysis. What should the nurse instruct the client to do?
Select all that apply.
1. Remind healthcare providers (HCPs) to draw blood from veins on the left side.
2. Avoid sleeping on the left arm.
3. Wear wristwatch on the right arm.
4. Assess fingers on the left arm for warmth.
5. Obtain BP from the left arm.
78. 2,4,1,3. The nurse first assures an IV access site in case the client has respiratory or cardiac
arrest. Next, the nurse monitors the client's heart rate and rhythm: Cardiovascular signs of elevated
serum potassium levels are irregular, slow heart rate; decreased BP; narrow, peaked T waves;
%
widened QRS complexes, prolonged PR intervals, and flattened D waves; frequent ectopy; ventricular
fibrillation; and ventricular standstill. The nurse then administers calcium gluconate, which has an
immediate action to antagonize the effect of hyperkalemia on cardiac muscle. Last, the nurse
administers polystyrene sulfonate, which is a cation-exchange resin that removes potassium from the
body by exchanging sodium ion for potassium; potassium-containing resin is then excreted; onset is
in several hours to days. - ✔✔78. A client with end-stage chronic renal failure is admitted to the
hospital with a serum potassium level of 7 mEq/L. In what order of priority from first to last does the
nurse perform the prescriptions? All options must be used.
1. Administer calcium gluconate.
2. Start an IV access site.
3. Administer sodium polystyrene sulfonate.
4. Attach the client to a cardiac monitor.
79. 2. The nurse must always auscultate for a bruit and palpate for a thrill in the arm with the fistula
and promptly report the absence of either a thrill or bruit to the healthcare provider (HCP) as it
indicates an occlusion. The client should not have a pressure dressing on the shunt and should avoid
wearing tight clothing or carrying heavy items such as purse over the area of the shunt to avoid
restricting blood flow in the shunt. No procedures such as IV access, blood pressure measurements,
or blood draws are done on an arm with a fistula as they could damage the fistula. - ✔✔79. A client
stuvia
, STUVIA 2024/2025
with chronic renal failure is receiving hemodialysis three times a week. In order to protect the fistula,
the nurse should:
1. take the blood pressure in the arm with the fistula.
2. report the loss of a thrill or bruit on the arm with the fistula.
3. maintain a pressure dressing on the shunt.
4. start a second IV in the arm with the fistula.
79. 3. The nurse must always palpate for a thrill and auscultate for a bruit in the arm with the fistula
and promptly report the absence of either/or a thrill or bruit to the health care provider as it indicates
an occlusion. No procedures such as IV access, blood pressure measurements, or blood draws are
done on an arm with a fistula as they could damage the fistula. - ✔✔79.A client with chronic renal
failure is receiving hemodialysis three times a week. In order to protect the fistula the nurse should:
1.Take the blood pressure in the arm with the fistula.
2.Report the loss of a thrill or bruit on the arm with the fistula.
3.Auscultate for a thrill and palpate for a bruit on the arm with the fistula.
4.Start a second IV in the arm with the fistula.
80. 2, 4, 5. To manage nausea, the nurse can advise the client to drink limited amounts of fluid only
when thirsty, eat food before drinking fluids to alleviate dry mouth, encourage strict follow-up for blood
work, dialysis, and health care provider visits. Smaller, more frequent meals may help to reduce
%
nausea and facilitate medication taking. The client should be as active as possible to avoid
immobilization because it increases bone demineralization. The client should also maintain the
dialysis schedule because the dialysis will remove wastes that can contribute to nausea. - ✔✔80.A
client with chronic renal failure who receives hemodialysis three times a week is experiencing severe
nausea. What should the nurse advise the client to do to manage the nausea? Select all that apply.
1.Drink fluids before eating solid foods.
2.Have limited amounts of fluids only when thirsty.
3.Limit activity.
4.Keep all dialysis appointments.
5.Eat smaller, more frequent meals.
80. 2,4,5. To manage nausea, the nurse can advise the client to drink limited amounts of fluid only
when thirsty and eat food before drinking fluids to alleviate dry mouth, and encourage strict follow-up
for blood work, dialysis, and healthcare provider (HCP) visits. Smaller, more frequent meals may help
to reduce nausea and facilitate medication taking. The client should be as active as possible to avoid
immobilization because it increases bone demineralization. The client should also maintain the
dialysis schedule because the dialysis will remove wastes that can contribute to nausea. - ✔✔80. A
client with chronic renal failure who receives hemodialysis three times a week is experiencing severe
nausea. What should the nurse advise the client to do to manage the nausea? Select all that apply.
1. Drink fluids before eating solid foods.
stuvia
Renal nclex review 11 and 12
77. 2,3,4. The nurse instructs the client to protect the site of the fistula. The client should avoid
pressure on the involved arm such as sleeping on it, wearing tight jewelry, or obtaining BP. The client
is also advised to assess the area distal to the fistula for adequate circulation, such as warmth and
color. When the client is hospitalized, the nurse posts a sign on the client's bed not to draw blood or
obtain BP on the left side; the client is also instructed to be sure that none of the healthcare team
members do so. - ✔✔77. A client with end-stage renal failure has an internal arteriovenous fistula in
the left arm for vascular access during hemodialysis. What should the nurse instruct the client to do?
Select all that apply.
1. Remind healthcare providers (HCPs) to draw blood from veins on the left side.
2. Avoid sleeping on the left arm.
3. Wear wristwatch on the right arm.
4. Assess fingers on the left arm for warmth.
5. Obtain BP from the left arm.
78. 2,4,1,3. The nurse first assures an IV access site in case the client has respiratory or cardiac
arrest. Next, the nurse monitors the client's heart rate and rhythm: Cardiovascular signs of elevated
serum potassium levels are irregular, slow heart rate; decreased BP; narrow, peaked T waves;
%
widened QRS complexes, prolonged PR intervals, and flattened D waves; frequent ectopy; ventricular
fibrillation; and ventricular standstill. The nurse then administers calcium gluconate, which has an
immediate action to antagonize the effect of hyperkalemia on cardiac muscle. Last, the nurse
administers polystyrene sulfonate, which is a cation-exchange resin that removes potassium from the
body by exchanging sodium ion for potassium; potassium-containing resin is then excreted; onset is
in several hours to days. - ✔✔78. A client with end-stage chronic renal failure is admitted to the
hospital with a serum potassium level of 7 mEq/L. In what order of priority from first to last does the
nurse perform the prescriptions? All options must be used.
1. Administer calcium gluconate.
2. Start an IV access site.
3. Administer sodium polystyrene sulfonate.
4. Attach the client to a cardiac monitor.
79. 2. The nurse must always auscultate for a bruit and palpate for a thrill in the arm with the fistula
and promptly report the absence of either a thrill or bruit to the healthcare provider (HCP) as it
indicates an occlusion. The client should not have a pressure dressing on the shunt and should avoid
wearing tight clothing or carrying heavy items such as purse over the area of the shunt to avoid
restricting blood flow in the shunt. No procedures such as IV access, blood pressure measurements,
or blood draws are done on an arm with a fistula as they could damage the fistula. - ✔✔79. A client
stuvia
, STUVIA 2024/2025
with chronic renal failure is receiving hemodialysis three times a week. In order to protect the fistula,
the nurse should:
1. take the blood pressure in the arm with the fistula.
2. report the loss of a thrill or bruit on the arm with the fistula.
3. maintain a pressure dressing on the shunt.
4. start a second IV in the arm with the fistula.
79. 3. The nurse must always palpate for a thrill and auscultate for a bruit in the arm with the fistula
and promptly report the absence of either/or a thrill or bruit to the health care provider as it indicates
an occlusion. No procedures such as IV access, blood pressure measurements, or blood draws are
done on an arm with a fistula as they could damage the fistula. - ✔✔79.A client with chronic renal
failure is receiving hemodialysis three times a week. In order to protect the fistula the nurse should:
1.Take the blood pressure in the arm with the fistula.
2.Report the loss of a thrill or bruit on the arm with the fistula.
3.Auscultate for a thrill and palpate for a bruit on the arm with the fistula.
4.Start a second IV in the arm with the fistula.
80. 2, 4, 5. To manage nausea, the nurse can advise the client to drink limited amounts of fluid only
when thirsty, eat food before drinking fluids to alleviate dry mouth, encourage strict follow-up for blood
work, dialysis, and health care provider visits. Smaller, more frequent meals may help to reduce
%
nausea and facilitate medication taking. The client should be as active as possible to avoid
immobilization because it increases bone demineralization. The client should also maintain the
dialysis schedule because the dialysis will remove wastes that can contribute to nausea. - ✔✔80.A
client with chronic renal failure who receives hemodialysis three times a week is experiencing severe
nausea. What should the nurse advise the client to do to manage the nausea? Select all that apply.
1.Drink fluids before eating solid foods.
2.Have limited amounts of fluids only when thirsty.
3.Limit activity.
4.Keep all dialysis appointments.
5.Eat smaller, more frequent meals.
80. 2,4,5. To manage nausea, the nurse can advise the client to drink limited amounts of fluid only
when thirsty and eat food before drinking fluids to alleviate dry mouth, and encourage strict follow-up
for blood work, dialysis, and healthcare provider (HCP) visits. Smaller, more frequent meals may help
to reduce nausea and facilitate medication taking. The client should be as active as possible to avoid
immobilization because it increases bone demineralization. The client should also maintain the
dialysis schedule because the dialysis will remove wastes that can contribute to nausea. - ✔✔80. A
client with chronic renal failure who receives hemodialysis three times a week is experiencing severe
nausea. What should the nurse advise the client to do to manage the nausea? Select all that apply.
1. Drink fluids before eating solid foods.
stuvia
