RENAL NCLEX 2026 ACTUAL
COMPLETE EXAM
QUESTIONS WITH DETAILED
VERIFIED ANSWERS (100%
CORRECT ANSWERS)A+
STUDY MATERIAL
A nurse is explaining the concept of fluid restriction to a client with chronic renal failure who has
started hemodialysis. The nurse tells the client that the fluid restriction is planned by adding the
amount of the daily urine output (if any) and:
a) 1800 to 2000 ml
b) 1200 to 1500 ml
c) 500 to 700 ml
d) 200 to 300 ml
C
- The usual allowable daily fluid intake of the hemodialysis client is the total of the daily urine output
plus 500 to 700 mL. Options 1 and 2 identify high volumes of fluid intake, and option 4 identifies an
insufficient volume.
A nurse is caring for a client newly diagnosed with chronic renal failure who has recently begun
hemodialysis. The nurse determines that the client has not tolerated the procedure optimally if the
client experiences which symptoms that represent disequilibrium syndrome?
a) restlessness, irritability, and generalized weakness
b) headache, deteriorating level of consciousness, and seizures
c) hypertension, tachycardia, and fever
d) hypotension, bradycardia, and hypothermia
B
- Disequilibrium syndrome is characterized by headache, mental confusion, decreasing level of
consciousness, nausea, vomiting, twitching, and possible seizure activity. It results from the rapid
removal of solutes from the body during hemodialysis. The blood-brain barrier interferes with equally
, 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. It 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 been on dialysis for 4 years and has been taking aluminum
hydroxide (Amphojel tablets) as prescribed as part of the medication regimen. The client develops
confusion and dementia, and complains of bone pain. The nurse interprets that this client is at risk for
developing:
a) advancing uremia
b) folic acid defieciency
c) phosphate overdose
d) aluminum intoxication
D
- Aluminum intoxication can occur when there is accumulation of aluminum, an ingredient in many
phosphate-binding antacids. Symptoms include mental cloudiness, dementia, and bone pain from
infiltration of the bone with aluminum. This complication is treated with aluminum chelating agents,
which make aluminum available to be dialyzed from the body. It is prevented by avoiding or limiting the
use of phosphate-binding agents that contain aluminum.
A client is undergoing hemodialysis and receives heparin during the dialysis procedure. The nurse
monitors the results of which of the following laboratory tests during the dialysis procedure?
a) thrombin time
b) bleeding time
c) partial thromboplastin time (PTT)
d) prothrombin time (PT)
C
- Heparin is used as an anticoagulant during hemodialysis. The hemodialysis nurse monitors the extent
of anticoagulation by measuring the PTT, which measures heparin effect. The PT is measured to monitor
the effect of warfarin (Coumadin) therapy. Thrombin and bleeding times are not used to measure the
effect of heparin therapy, although they are useful in the diagnosis of other clotting abnormalities.
A client undergoing hemodialysis becomes hypotensive. The nurse immediately prepares to take
which action?
a) administer 1000 ml 5% dextrose in water
b) administer a 250 ml normal saline bolus
c) increase the blood flow into the dialyzer
d) lower the client's legs and feet
B
- To treat hypotension during hemodialysis, a normal saline bolus of up to 500 mL may be given. The
client's feet and legs are raised to enhance cardiac return. Albumin may be given as per protocol to
increase colloid oncotic pressure. The blood flow rate into the dialyzer may be decreased. All of these
COMPLETE EXAM
QUESTIONS WITH DETAILED
VERIFIED ANSWERS (100%
CORRECT ANSWERS)A+
STUDY MATERIAL
A nurse is explaining the concept of fluid restriction to a client with chronic renal failure who has
started hemodialysis. The nurse tells the client that the fluid restriction is planned by adding the
amount of the daily urine output (if any) and:
a) 1800 to 2000 ml
b) 1200 to 1500 ml
c) 500 to 700 ml
d) 200 to 300 ml
C
- The usual allowable daily fluid intake of the hemodialysis client is the total of the daily urine output
plus 500 to 700 mL. Options 1 and 2 identify high volumes of fluid intake, and option 4 identifies an
insufficient volume.
A nurse is caring for a client newly diagnosed with chronic renal failure who has recently begun
hemodialysis. The nurse determines that the client has not tolerated the procedure optimally if the
client experiences which symptoms that represent disequilibrium syndrome?
a) restlessness, irritability, and generalized weakness
b) headache, deteriorating level of consciousness, and seizures
c) hypertension, tachycardia, and fever
d) hypotension, bradycardia, and hypothermia
B
- Disequilibrium syndrome is characterized by headache, mental confusion, decreasing level of
consciousness, nausea, vomiting, twitching, and possible seizure activity. It results from the rapid
removal of solutes from the body during hemodialysis. The blood-brain barrier interferes with equally
, 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. It 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 been on dialysis for 4 years and has been taking aluminum
hydroxide (Amphojel tablets) as prescribed as part of the medication regimen. The client develops
confusion and dementia, and complains of bone pain. The nurse interprets that this client is at risk for
developing:
a) advancing uremia
b) folic acid defieciency
c) phosphate overdose
d) aluminum intoxication
D
- Aluminum intoxication can occur when there is accumulation of aluminum, an ingredient in many
phosphate-binding antacids. Symptoms include mental cloudiness, dementia, and bone pain from
infiltration of the bone with aluminum. This complication is treated with aluminum chelating agents,
which make aluminum available to be dialyzed from the body. It is prevented by avoiding or limiting the
use of phosphate-binding agents that contain aluminum.
A client is undergoing hemodialysis and receives heparin during the dialysis procedure. The nurse
monitors the results of which of the following laboratory tests during the dialysis procedure?
a) thrombin time
b) bleeding time
c) partial thromboplastin time (PTT)
d) prothrombin time (PT)
C
- Heparin is used as an anticoagulant during hemodialysis. The hemodialysis nurse monitors the extent
of anticoagulation by measuring the PTT, which measures heparin effect. The PT is measured to monitor
the effect of warfarin (Coumadin) therapy. Thrombin and bleeding times are not used to measure the
effect of heparin therapy, although they are useful in the diagnosis of other clotting abnormalities.
A client undergoing hemodialysis becomes hypotensive. The nurse immediately prepares to take
which action?
a) administer 1000 ml 5% dextrose in water
b) administer a 250 ml normal saline bolus
c) increase the blood flow into the dialyzer
d) lower the client's legs and feet
B
- To treat hypotension during hemodialysis, a normal saline bolus of up to 500 mL may be given. The
client's feet and legs are raised to enhance cardiac return. Albumin may be given as per protocol to
increase colloid oncotic pressure. The blood flow rate into the dialyzer may be decreased. All of these
