Renal/Dialysis ATI questions

A nurse is assessing a client who is receiving peritoneal dialysis. Which of the following findings should the nurse report to the provider immediately?

A. Difficulty draining the effluent

B. Redness at the access site

C. Fluid flowing from the catheter site

D. Cloudy effluent

A nurse is assessing a client who is receiving continuous ambulatory peritoneal dialysis. Which of the following findings should the nurse report to the provider?

A. WBC 6,000/mm^3

B. Potassium 3.0 mEq/L

C. Clear, pale yellow drainage

D. Report of abdominal fullness

A nurse is caring for a client who is receiving intermittent peritoneal dialysis. The nurse observes that the peritoneal fluid is not adequately draining. Which of the following actions should the nurse take?

A. Turn the client from side to side

B. Elevate the height of the dialysate bag

C. Lower the head of the client’s bed

D. Advance the catheter approximately 2.5 cm (1 in) further

A nurse is caring for a client who is scheduled to receive peritoneal dialysis. Which of the following actions should the nurse take?

A. Warm the dialysate solution prior to administration

B. Cleanse the catheter site using a back and forth motion, beginning at the end of the catheter and moving inward

C. Place the drainage bag at the level of the client's chest

D. Apply clean gloves and cleanse the client's catheter site with cold water

A. Warm the dialysate solution prior to administration

A nurse is caring for a client who is receiving peritoneal dialysis. The nurse should monitor the client for which of the following adverse effects?

A. Diarrhea

B. Increased serum albumin

C. Hypoglycemia

D. Peritonitis

A nurse is assessing a client who is receiving hemodialysis for the first time. Which of the following findings indicates that the client is developing dialysis disequilibrium syndrome (DDS)?

A. Elevated BUN

B. Bradycardia

C. Headache

D. Temperature 39.2°C (102.5°F)

A nurse is teaching a client with chronic kidney disease about predialysis dietary recommendations. The nurse should recommending restricting the intake of which of the following nutrients?

A. Protein

B. Carbohydrates

C. Calcium

D. Monounsaturated fats

A nurse is caring for a client who has chronic kidney disease. The kidneys regulate body fluids as well as assisting with which of the following functions?

A. Regulation of acid-base balance

B. Reabsorption of nutrients for cellular growth

C. Regulation of body temperature

D. Secretion of hormones needed for growth

A nurse is checking the laboratory values of a client who has chronic kidney disease. The nurse should expect elevations in which of the following values?

A. Potassium and magnesium

B. Calcium and bicarbonate

C. Hemoglobin and hematocrit

D. Arterial pH and PaCO2

A nurse is providing dietary teaching a client who has late-stage chronic kidney disease (CKD). Which of the following nutrients should the nurse instruct the client to increase in her diet?

A. Calcium

B. Phosphorous

C. Potassium

D. Sodium

A nurse is teaching a client who has chronic kidney disease (CKD). Which of the following instructions should the nurse include?

A. Limit fluid intake

B. Limit caloric intake

C. Eat a diet high in phosphorus

D. Eat a diet high in protein

A nurse is reviewing the arterial blood gas values of a client who has chronic kidney disease. Which of the following sets of values should the nurse expect?

pH 7.25, HCO3- 19 mEq/L, PaCO2 30 mm Hg

A nurse is reviewing the arterial blood gas levels of a client who has chronic kidney disease. Which set of ABG values should the nurse expect as a possible clinical finding?

pH 7.32, HCO3 20, PACO2 35 (causes metabolic acidosis)

A nurse is planning an in-service for nursing staff about managing care for clients who develop disequilibrium syndrome. Which of the following interventions should the nurse include in the teaching?

A. Administer an opioid medication.

B. Monitor for the development of chest pain.

C. Assess level of consciousness.

D. Start an intravenous infusion of dextrose 50%.

A nurse is preparing to initiate hemodialysis through an Arteriovenous (AV) fistula for a client who has end stage kidney disease. Which of the following actions should the nurse take? (Select all that apply.)

A. Review the client's current medications.

B. Assess the AV fistula for a bruit.

D. Measure the client's weight.

A client who is to begin continuous ambulatory peritoneal dialysis asks the nurse what this entails. What information should the nurse include when answering the client’s question?

A. Hemodialysis and peritoneal dialysis will be done together

B. Peritoneal dialysis is performed in an ambulatory care clinic

C. About a quarter of a liter of dialysate is maintained in the peritoneal cavity

D. Constant contact is maintained between the dialysate and the peritoneal membrane

A nurse is providing a meal tray to a client who has just returned from hemodialysis treatment. Which best describes the dietary choices most likely to be included in the client's meal?

A. High-calorie, high-protein foods

B. Low-calorie, high-sodium foods

C. High-calorie saturated fats

D. Low-calorie, low-protein foods

A nurse is teaching a newly licensed nurse about hemodialysis for clients who have chronic kidney disease. Which of the following statements by the newly licensed nurse indicates an understanding of the teaching?

A. "Hemodialysis restores kidney function."

B. "Hemodialysis requires the placement of a catheter into the peritoneal space."

C. "Hemodialysis allows an unrestricted diet.

D. "Hemodialysis returns a balance to serum electrolytes."

A 10-year-old client with ESRD (end-stage renal disease) is receiving hemodialysis, and experiences chills. Which of the following is the most appropriate nursing intervention?

A. Provide blankets or extra clothing

B. Increase the temperature of the room

C. Notify the physician immediately

D. Stop dialysis

D. Stop dialysis

A nurse is caring for a client with diabetic nephropathy who is receiving peritoneal dialysis and experiences abdominal pain and chills. The client has a temperature of 100.3°F (37.9°C) and a glucose level of 180 mg/dL. Which of the following is the priority nursing intervention?

A. Assist the client to the high-Fowler’s position

B. Administer intravenous insulin

C. Obtain peritoneal fluid for culture and sensitivity

D. Warm the dialysate

C. Obtain peritoneal fluid for culture and sensitivity