Calamba Doctors College Test Questions in Hemodialysis Name: _________________________________ Date: _____________ Score: _____________ Direction: encircle the

letter of the correct answer. 1. Most aluminum is protein bound so the kidneys may not be able to filter it out of the blood. It is then stored in various tissues in the body, including the brain and bone. What are the symptoms of aluminum toxicity? a. Nausea, vomiting, diarrhea, fever, chills, upper respiratory tract infection, elevated white blood count, headache b. Behavioral changes, memory loss, slurred speech, lack of energy, loss of appetite bone disease, dementia, anemia, constipation c. Joint pain and redness, gangrene of fingers and toes, back pain, fractures, itching d. Nausea, vomiting, poor appetite, metallic taste, fetid breath, GI bleeding, diarrhea, functional constipation 2. Many factors affect the successful removal of toxins during dialysis. Which of the following is correct? a. Lower temperature of dialysate = higher amount of solutes removed b. Slower flow of dialysate = greater removal of solutes c. Lower molecular weight of solutes = more solutes removed d. Greater blood flow rate = lesser removal of solutes 3. A male patient who has diabetes and receives hemodialysis treatments sometimes drinks juice when his blood sugar is low. Which of the following types of juice would be best for this patient, since it is lowest in potassium? a. Prune juice. c. Vegetable juice cocktail (V-8) b. Grapefruit juice. d. Cranberry juice cocktail. 4. Which clinical finding would the nurse look for in a client with chronic renal failure? a. Hypotension c. metabolic alkalosis b. Uremia d. polycythemia 5. After a retropubic prostatectomy, a client needs continous bladder irrigation. The client has an I.V. of D5W infusing at 40ml/hr and a triple lumen urinary catheter with normal saline solution infusing at 200ml/hr. the nurse empties the urinary catheter drainage bag three times during an 8 hour period for a total of 2,780 ml. how many milliliters does the nurse calculate as urine? a. 1,180 ml c. 1,500 ml b. 1,200 ml d. 800 ml 6. A client with acute renal failure is undergoing dialysis for the first time. The nurse monitors the client closely for dialysis equilibrium syndrome, a complication that is most common during the first few dialysis sessions. Typically, dialysis equilibrium syndrome causes: a. Confusion, headache, and seizures c. Weakness, tingling, and cardiac arrhythmias b. Acute bone pain and confusion d. Hypotension, tachycardia and tachypnea 7. A client requires hemodialysis. Which type of drug should be withheld before this procedure? a. Phosphate binders c. Antibiotics b. Insulin d. Cardiac glycosides 8. A client with chronic renal failure who receives hemodialysis three times weekly has a hemoglobin (Hb) level of 7 g/dl. The most therapeutic pharmacologic intervention would be to administer: a. Ferrous sulfate ( Feratab) c. Filgrastim (Neupogen) b. Epoetin alfa (Epogen) d. Enoxaparin (Lovenox) 9. A client with CRF is receiving a hemodialysis treatment. After hemodialysis, the nurse knows that the client is most likely to experience: a. Hematuria c. Increase urine output b. Weight loss d. Increased blood pressure 10. After undergoing small bowel resection, a client is prescribed metronidazole (Flagyl) 500 mg I.V. The mixed IV solution contains 100 ml. The nurse is to run the drug over 30 minutes. The drip factor of the available IV tubing is 15 gtt/ml. What is the drip rate? a. 45 b. 50 c. 55 d. 60 11. The client is to receive an IV infusion of 3,000 ml of dextrose and normal saline solution over 24 hours. The nurse observes that the rate is 150 ml/hr. If the solution runs continuously at this rate, the infusion will be completed in: a. 12 hr b. 20 hr

12.

13.

14.

15.

16.

17.

18.

19.

20.

21.

22.

23.

24.

25.

c. 24 hr d. 50 hr A 75 yr old client is admitted to the hospital with lower GI bleeding. His hemoglobin on admission to the emergency departments is 7.3 g/dl. The physician prescribes 2 U of packed RBC to infuse over 1 hr each. The blood administration set has a drip factor of 10 gtt/ml. What is the flow rate in drops per minute? a. 32 b. 21 c. 42 d. 12 The physician orders heparin, 7,500 units, to be administered subcutaneously every 12 hours. The vial reads 10,000 units per milliliter. The nurse should anticipate giving how much heparin for each dose? a. ml b. ml c. ml d. 1 ml What principle involves the movement of water from an area of low concentration potential to an area of high concentration potential? a. Diffusion c. Ultrafiltration b. Osmosis d. Active transport It is created surgically by joining an artery to a vein. a. Graft c. Fistula b. Anastomosis d. Central Venous catheter Acute dialysis is indicated to the following except: a. high and rising level of serum potassium c. end-stage renal disease (ESRD) b. fluid overload d. pericarditis During hemodialysis, the toxins and wastes in the blood are removed as they move from an area of higher concentration in the blood to an area of lower concentration in the dialysate which is also known as: a. Diffusion c. Ultrafiltration b. Osmosis d. Active transport This refers to the ability of the dialyzer to accomplish its objectives without causing hypersensitive, allergic or adverse reactions. a. Dialysis c. Dialyzer b. Biocompatibility d. Dialyzate Fistula takes how many weeks to mature before it is ready to use? a. 2-3 wks c. 4-6 wks b. 3-5wks d. 1-3 wks In order to increased the size of the vessels and thereby to accommodate the large-bore needles used in hemodialysis, the patient needs to: a. Elevate his arm c. Undergo a surgery b. Squeeze a rubber ball d. none of the above This is the principle of hemodialysis wherein water moves under high pressure to an area of lower pressure. a. Diffusion c. Ultrafiltration b. Osmosis d. Active transport What drug is being administered during dialysis to keep blood from clotting in the dialysis circuit? a. Heparin c. Acetaminophen b. Vitamin C d. Potassium chloride A needle is inserted into the venous segment of the fistula to: a. To dilate the vessels c. Reinfuse the dialyzed blood b. For arterial flow d. To collect blood These are the Goals of nutritional therapy except: a. To minimize uremic symptoms and fluid and electrolyte imbalances; b. To maintain good nutritional status through adequate protein, calorie, vitamin, and mineral intake; c. To enable the patient to eat a palatable and enjoyable diet. d. To eliminate uremic symptoms The following are nursing responsibilities to patients undergoing hemodialysis except one. a. Access the thrill and bruit of the access site each shift b. Give water soluble medications after dialysis c. Use patients dialysis access arm for administering IV meds, taking bp and withdrawing blood d. Address the psychosocial aspects of ESRD patients ===== GOD BLESS and GOOD LUCK =====