ATI MED SURG RN FLUID AND ELECTROLYTE BALANCE: CHRONIC KIDNEY
FAILURE AND HEMODIALYSIS 3.0 CASE STUDY TEST
Question 1 of 5
A nurse is providing teaching to a client who has chronic kidney failure (CKF) and is scheduled to begin
hemodialysis. Which of the following statements should the nurse make about the hemodialysis procedure?
A. “Toxins. waste, and excess fluids are removed from arterial blood using a machine two to three times per
week."
Correct
The nurse should instruct the client that hemodialysis is a process that removes toxins and waste from the
blood and eliminates excess fluids. Hemodialysis involves the use of vascular access, a dialyzer, dialysate, and
a hemodialysis machine that regulates and monitors the process.
B. "Waste, fluid, and electrolytes are exchanged within the peritoneal cavity by gravity 7 days per week."
Incorrect
The nurse should use this description to describe continuous ambulatory peritoneal dialysis.
C. "A tissue compatible kidney is received from a living or cadaver donor."
Incorrect
The nurse should use this description to describe a kidney transplant.
D. “Waste, fluid, and electrolytes are exchanged within the peritoneal cavity using a cycling machine during
sleeping hours."
Incorrect
The nurse should use this description to describe automated peritoneal dialysis,
Question 2 of 5
A nurse is reviewing the medical record of a client who has chronic kidney failure (CKF). Which of the
following diseases in the client's history is a main cause of CKF?
A. Diabetes mellitus
Correct
Diabetes mellitus and hypertension are the most common causes of CKF.
B. Rheumatoid arthritis
Incorrect
Rheumatoid arthritis is not a known cause of CKF.
C. Asthma
Incorrect
Asthma is not a known cause of CKF.
D. Gout
Incorrect
Although gout can lead to CKF, it is not a main cause. Diabetes and hypertension are the most common causes
of CKF.
Question 3 of 5
A nurse is reviewing laboratory values for a client who has chronic kidney failure (CKF). Which of the
following values should the nurse expect?
A. BUN 1 8 mg/dL
Incorrect
Clients who have CKF will have an increased BLIN level caused by the inability of the kidneys to excrete
waste and the buildup of nitrogenous products. This BUN level is within the expected reference range of 10 to
20 mg/dL.
B. Potassium 5.6 mEq/L
Correct
The most common cause of hyperkalemia is acute or Chronic kidney failure because the damaged kidneys are
unable to excrete potassium. This potassium level is above the expected reference range of 3.5 to 5 mEq/L.
C. Hematocrit 40%
Incorrect
Clients who have CKF will have a decreased hematocrit level due to anemia caused by a reduced production of
erythropoietin by the kidneys. This hematocrit level is within the expected reference range of 37% to 52%.
D. Creatinine 0.9 mg/dL
Incorrect
Clients who have CKF will have an increased creatinine level caused by the inability of the kidneys to excrete
waste and the buildup of nitrogenous products. This creatinine level is within the expected reference range of
0.5 to 1.3 mg/dL.
Question 4 of 5
A nurse is providing teaching to a client who has chronic kidney failure and is scheduled to begin
hemodialysis. Which of the following access sites should the nurse describe to the client?
A. Peripherally inserted central catheter (PICC)
Incorrect
PICCs are not used for the purpose of hemodialysis.
B. Central venous catheter
Incorrect
Central venous catheters are not used for the purpose of hemodialysis.
C. Arteriovenous fistula (AVE)
Correct
AVFs are one of the internal accesses used for hemodialysis therapy. An AVF is created by surgically joining
an artery and a vein.
D. Peripheral IV catheter
Incorrect
Peripheral IV catheters are not used for the purpose of hemodialysis.
Question 5 of 5
A nurse is providing teaching to a client who has chronic kidney failure (CKF) and is scheduled to begin
hemodialysis treatments. Which of the following client statements indicates an understanding of the teaching?
A. "l will be sure to weigh myself every week when I start dialysis treatments."
Incorrect
Clients who are undergoing hemodialysis treatment should be taught to weigh themselves every day.
B. "l will be on dialysis treatments until I can start urinating an my own again.
Incorrect
Clients who have CKF that requires dialysis have reached a stage of their disease in which renal replacement
or transplantation is required. Their kidneys will not recover to provide for adequate urination.
C. "l will only need dialysis treatments when my lab values are abnormal."
Incorrect
Once renal replacement therapy starts, it will have to be continued on a routine basis of two to three treatments
per week, unless a kidney transplant is performed.
D. " 1 will have to have dialysis treatments two or three times a week."
Correct
Hemodialysis treatments vary with each client, but are usually performed two to three times per week.
