Practice Questions
Week 7
Case Study
The client’s daughter asks why her mother must be weighted
before and after the dialysis treatment. What is the appropriate
nursing response?
A. “It is part of the protocol for dialysis.”
B. “It ensures that she is getting adequate nutrition.”
C. “It estimates the amount of fluid and sodium your mother is
retaining and how much is taken off during dialysis.”
D. “It is essential for calculating the fluid restriction your mother
will receive on non-dialysis days.”
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Answer to Case Study
ANS: C
• The best way to estimate fluid and sodium retention
and removal is by weighing the client.
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Case Study
Following dialysis, what assessment finding does the
nurse anticipate?
A. Weight increased after dialysis.
B. Temperature higher following dialysis.
C. Clotting studies reduced post-dialysis.
D. Blood pressure higher than pre-dialysis.
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Answer to Case Study
Question
ANS: B
• The client’s temperature is elevated after dialysis
because the dialysis machine warms the blood slightly.
Weight and blood pressure should be decreased
because excess fluid is removed during dialysis. Heparin
is required during hemodialysis and increases clotting
time.
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Case Study
As the client is preparing to discharge, the nurse will
teach restrictions of which dietary elements? (Select all
that apply.)
A. Potassium
B. Phosphorus
C. Calcium
D. Protein
E. Vitamins
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Answer to Case Study
Question 4
ANS: A, B, D
• Sodium is restricted because it causes retention of
fluids. Potassium is restricted to prevent dangerous
cardiac dysrhythmias. Vitamins must be supplemented,
not restricted. There is an inverse relationship between
phosphorus and calcium; when phosphorus is high,
calcium is low and should not be restricted.
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Question
Which assessment finding in a client with
AKI requires immediate nursing
intervention?
A. Heart rate of 105 beats/min
B. Blood pressure of 156/88
C. Urine specific gravity of 1.001 mm
Hg
D. Intake of 2000 mL and output of
1500 mL in the past 24 hours
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Answer to Question
ANS: C
• Decreased urine specific gravity indicates a loss of
urine-concentrating ability and is the earliest sign of
renal tubular damage and early kidney failure. Normal
urine specific gravity ranges from 1.002 to 1.028.
Assessing the client’s perfusion status is also very
important in the prevention and/or treatment of kidney
disease.
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Question
A client with end-stage kidney disease
(ESKD) has this serum laboratory analysis:
K+ 5.9 mEq/L
Na+ 152 mEq/L
Creatinine 6.2 mg/dL
BUN 60 mg/dL
What is the priority nursing intervention?
A. Assess heart rate and rhythm.
B. Implement seizure precautions.
C. Assess the client’s respiratory status.
D. Evaluate the client’s acid–base
balance.
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Answer to Question
ANS: A
• Clients with ESKD experience significant fluid and electrolyte
imbalances that are managed with medications and dialysis.
Hyperkalemia can be a life-threatening event. In clients with
kidney disease, the myocardial response (heart rate and
rhythm) to hyperkalemia should be assessed to effectively
determine appropriate treatment. High sodium can increase the
client’s risk for seizures, excessive fluid balance will negatively
effect breathing, and clients with ESKD experience acid–base
imbalances from an inability to synthesize bicarbonate.
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Question
The nurse is caring for a client who will soon
receive a kidney transplant. When the client
says, “what will I do if this transplant doesn’t
work?”, what is the appropriate nursing
response?
A. “Try to focus on getting through the surgery
first.”
B. “Kidney transplants are almost always
successful.”
C. “It sounds like you are concerned about the
outcome of the procedure.”
D. “If this transplant doesn’t work, I’m sure
there will be another donor soon.”
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Answer to Question
ANS: C
• The nurse should allow the client to express his or her
feelings; the client’s question demonstrates concern—
possibly anxiety or fear—and the nurse allows further
exploration of those feelings by verbalizing the implied.
Response B gives false reassurance; response D
dismisses the client’s feelings; response A does not
address the client’s feelings.
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