Dialysis NCLEX Questions and Answers

Renal Disorders/Dialysis & Peritoneal Dialysis NCLEX Questions and Answers 100% Pass

The nurse is performing an assessment on a client who has returned from the dialysis unit following hemodialysis. The client is complaining of headache and nausea and is extremely restless. Which of the following is the most appropriate nursing action?

• Monitor the client.
• Notify the physician.
• Elevate the head of the bed.
• Medicate the client for nausea. ✔✔B

Disequilibrium syndrome may be caused by the rapid decreases in the blood urea nitrogen level during hemodialysis. These changes can cause cerebral edema that leads to increased intracranial pressure. The client is exhibiting early signs of disequilibrium syndrome and appropriate treatments with anticonvulsive medications and barbiturates may be necessary to prevent a life- threatening situation. The physician must be notified.

A nurse is analyzing the posthemodialysis lab test results for a client with chronic renal failure (CRF). The nurse interprets that the dialysis is having an expected but nontherapeutic effect if

the results indicate a decreased:

• Phosphorus. 1 / 4

• Creatinine.
• Potassium.
• Red blood cell count ✔✔D

Hemodialysis typically lowers the amounts of fluid, sodium, potassium, urea nitrogen, creatinine, uric acid, magnesium, and phosphate levels in the blood. Hemodialysis also worsens anemia, because RBCs are lost in dialysis from blood sampling and anticoagulation during the procedure, and from residual blood that is left in the dialyzer. Although all of these results are expected, only the lowered RBC count is nontherapeutic and worsens the anemia already caused by the disease process.

A client diagnosed with chronic renal failure (CRF) is scheduled to begin hemodialysis. The nurse assesses that which of the following neurological and psychosocial manifestations if exhibited by this client would be unrelated to the CRF?

• Labile emotions.
• Withdrawal.
• Euphoria.
• Depression. ✔✔C

The client with CRF often experiences a variety of psychosocial changes. These are related to uremia, as well as the stress associated with living with a chronic disease that is life-threatening.Clients with CRF may have labile emotions or personality changes and may exhibit withdrawal, 2 / 4

depression, or agitation. Delusions and psychosis also can occur. Euphoria is not part of the clinical picture for the client in renal failure.

A nurse is working with the client newly diagnosed with chronic renal failure (CRF) to set up a schedule for hemodialysis. The client states, "This is impossible! How can I even think about leading a normal life again if this is what I'm going to have to do?" The nurse assesses that the

client is exhibiting:

• Withdrawal
• Depression
• Anger
• Projection ✔✔C

Psychosocial reactions to CRF and hemodialysis are varied and may include anger. Other reactions include personality changes, emotional lability, withdrawal, and depression. The individual client's response may vary depending on the client's personality and support systems.The client in this question is exhibiting anger. The client has not projected blame on the nurse, nor does the client statement reflect withdrawal or depression.

A client undergoing hemodialysis has an arteriovenous (AV) fistula in the left arm. A related nursing diagnosis for the client is risk for infection. The nurse should formulate which of the following outcome goals as most appropriate for this nursing diagnosis? 3 / 4

• The client's temperature remains less than 101F
• The client's WBC count remains within normal limits.
• The client washes hands at least once per day.
• The client states to avoid blood pressure measurement in the left arm. ✔✔B

General indicators that the client is not experiencing infection include a temperature and WBC count within normal limits. The client also should use proper hand-washing technique as a general preventive measure. Hand washing once per day is insufficient. It is true that the client should avoid BP measurement in the affected arm; however, this would relate more closely to the nursing diagnosis risk for injury.

A nurse is giving general instructions to a client receiving hemodialysis. Which of the following statements would be appropriate for the nurse to include?

• Several types of medications should be withheld on the day of dialysis until after the

procedure.

• Medications should be double-dosed on the morning of hemodialysis to prevent loss.
• It's acceptable to exceed the fluid restriction on the day before hemodialysis.
• It's acceptable to eat whatever you want on the day before hemodialysis. ✔✔A

Many medications are dialyzable, which means they are extracted from the bloodstream during dialysis. Therefore, many medications may be withheld on the day of dialysis until after the procedure. It is not typical for medications to be "double-dosed," because there is no way to be

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