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61. A client with chronic renal failure is scheduled to begin hemodialysis therapy. As part of general teaching about hemodialysis, the nurse tells the client to expect the typical dialysis schedule to be:
a) 2 to 3 hours treatment 5 days per week
b) 2 hours of treatment 6 days per week
c) 5 hours of treatment 2 days per week
d) 3 to 4 hours of treatment 3 days per week
62. A nurse is hemodialyzing a client. The client suddenly becomes short of breath and complains of chest pain. The nurse notes that the client is tachycardic, pale, and anxious. The nurse should take which action?
a) monitor vital signs every half hours for the next 2 hours
b) bolus the client with 500 ml normal saline
c) check the tubing for air and continue dialysis at a slower rate
d) discontinue dialysis and notify the physician
63. A nurse is teaching a hemodialysis client about self-monitoring between hemodialysis treatments. The nurse tells the client to record which of the following on a daily basis?
a) calorie count
b) activity log
c) pulse, respiratory rate
d) intake and output, weight
64. A nurse is providing home care instructions to a client who has a cystoscopy in the physician's office. The nurse gives the client which instruction?
a) take cold tub baths two or three times a day
b) expect small episodes of bright red bleeding
c) drink increased amounts of fluids
d) try to avoid taking analgesic medications
65. A nurse has taught a client with chronic renal failure about medication therapy used in its treatment. The nurse determines that the client needs additional teaching if the client states which medication is needed to enhance red blood cell (RBC) production?
a) calcium carbonate (Tums)
b) multivitamins (MVI)
c) ferrous sulfate (Feosol)
d) folic acid (Folvite)
Test for Kidneys
Answers and Rationale
- The typical schedule for hemodialysis is 3 to 4 hours of treatment 3 days per week. Individual adjustments may be made according to variables such as the size of the client, type of dialyzer, the rate of blood flow, personal client preferences, and others. Options A, B, and C do not represent the typical hemodialysis schedule.
- The signs and symptoms exhibited by the client are compatible with air embolism. If the client experiences air embolus during hemodialysis, the nurse should stop the dialysis immediately, notify the physician, and administer oxygen as needed. All of the other actions are incorrect.
- The client monitors his or her own status between dialysis procedures by measuring intake and output and daily weight. These measures will assist the client in preventing fluid volume excess. The other options do not need to be recorded by the client daily.
- Because clients may be discharged immediately after cystoscopy, clients must understand home care measures. Pink-tinged urine is common, but not bright red bleeding. Increased intake of fluids helps prevent this from occurring. Clients often experience bladder spasm and bladder pain, feelings of bladder fullness and burning, and burning on urination after this procedure. Mild analgesics and warm tub baths are recommended to relieve these discomforts.
- Calcium carbonate is a calcium salt that is used as a phosphate binder in the client with chronic renal failure. It has nothing to do with the treatment of anemia. Folic acid is a vitamin that is needed for RBC production, and it is usually deficient in the client with chronic renal failure. Iron supplements (ferrous sulfate) are needed to produce adequate hemoglobin. Multivitamins supplement dietary vitamins and minerals but do not specifically enhance RBC production.
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Test for Kidneys (NCLEX 1-7)
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Test for Kidneys (NCLEX 66-70)