While a patient is receiving hemodialysis, which of the following finding are most concerning?

Blood pressure 89/60

urine output>300ml/24 hr

HR 100

productive cough

Answer and Explanation

The Correct Answer is A

A. Blood pressure 89/60 is correct because hypotension is a common and serious complication during hemodialysis. Rapid removal of fluid from the vascular system can lead to decreased perfusion to vital organs, including the heart and brain, and may result in dizziness, syncope, or shock. This requires immediate nursing intervention, such as slowing or pausing ultrafiltration, administering IV fluids, and monitoring hemodynamic status.

B. Urine output >300 mL/24 hr is incorrect because this indicates some residual kidney function, which is expected in many dialysis patients, especially those with acute kidney injury or partial chronic kidney disease. It is not acutely concerning.

C. HR 100 is incorrect because mild tachycardia can be a compensatory response to fluid shifts or stress during dialysis, but it is less immediately dangerous than hypotension. Continuous monitoring is appropriate.

D. Productive cough is incorrect because while respiratory assessment is important, a cough does not represent an immediate hemodynamic threat during dialysis unless associated with pulmonary edema or hypoxia.

Nursing Test Bank

Test Bank #1: RN Pharmacology Exams Test Bank #2: RN Medical-Surgical Exams Test Bank #3: RN Fundamentals Exams Test Bank #4: RN Maternal-Newborn Exams Test Bank #5: RN Anatomy and Physiology Exams Test Bank #6: RN Obstetrics and Pediatrics Exams Test Bank #7: RN Fluid and Electrolytes Exams Test Bank #9: RN Adult Health Test Bank #10: RN Dosage Calculation Test Bank #11: RN Community Health Exams Test Bank #12: RN Psychology Exams Test Bank #13: RN Nursing Care Of Children Test Bank #14: RN Foundations of Nursing Exams

Get 100+ Naxlex Exit Exams for $79 Try Naxlex NCLEX-RN (14 Day Free-Trial)

Naxlex Comprehensive Predictor Exams

Exam #1: RN Comprehensive predictor 2023 proctored exam Exam #2: Ati rn vati comprehensive predictor proctored exam Exam #3: Ati Rn Comprehensive Predictor Proctored Exam 2023 Exam #4: Rn Comprehensive Predictor 2023 Proctored Exam - St. Joseph Exam #5: RN Comprehensive Predictor Proctored Exam (National U CA San Diego) Exam #6: Ati rn comprehensive predictor 2023 retake proctored exam Exam #7: RN Hesi Exit Proctored Exam Exam #8: Hesi RN Exit proctored exam Exam #9: Hesi rn exit proctored exam Exam #10: Hesi Rn compass exit B proctored exam

Free Nursing Study Resources

Correct Answer is B

Explanation

A. The patient has a cough for the last 5 days is incorrect because while a prolonged cough may require assessment and management, it is not immediately life-threatening in the context of ICP monitoring. It is a secondary concern compared to potential complications of the monitoring system itself.

B. Cloudy cerebrospinal fluid drainage is correct because cloudy CSF is a sign of possible infection, such as ventriculitis or meningitis. Patients with ventriculostomy drains or ICP monitors are at high risk for infections due to the direct access of the central nervous system. Infection in this context is a serious and urgent concern that can increase ICP, worsen neurological status, and rapidly become life-threatening. Immediate notification of the healthcare provider and implementation of infection-control measures are required.

C. You notice a rash developing on his coccyx is incorrect because while a pressure injury is concerning and requires intervention, it is not as immediately critical as signs of CNS infection in a patient with ICP monitoring.

D. Cerebrospinal fluid production at 20 mL/hr is incorrect because normal CSF production ranges from approximately 20–30 mL/hr (about 500 mL/day). This rate is within expected limits and not concerning in itself.

A. This is used more commonly than an AV fistula B. This is more likely to become infected when compared to an AV fistula C. This is a temporary access site D. Patient cannot be discharged home with an AV graft

Correct Answer is B

Explanation

A. This is used more commonly than an AV fistula is incorrect because AV fistulas are preferred over AV grafts for long-term hemodialysis due to lower infection rates and longer patency. AV grafts are generally used when a patient’s vasculature is not suitable for a fistula.

B. This is more likely to become infected when compared to an AV fistula is correct because AV grafts involve synthetic material that connects an artery and vein. The presence of synthetic material increases the risk of infection compared to a native AV fistula. Additionally, grafts are more prone to thrombosis and stenosis.

C. This is a temporary access site is incorrect because AV grafts are considered semi-permanentaccess sites. Temporary access is typically established with a central venous catheter. Grafts are intended for repeated use over months to years, although they have a shorter lifespan than fistulas.

D. Patient cannot be discharged home with an AV graft is incorrect because patients with AV grafts can safely go home and perform regular daily activities. Proper education on infection prevention, graft care, and monitoring for complications is essential, but hospitalization is not required solely because of the graft.

View Question and Answer

Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.

Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today

While a patient is receiving hemodialysis, which of the following finding are most concerning?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Which of the following findings would be most concerning to you in a patient with continuous ICP monitoring?

Correct Answer is B

Explanation

Your patient has an AV graft in their left arm for dialysis. Which of the following is true regarding the AV graft?

Correct Answer is B

Explanation

Your patient with acute kidney injury seems to be urinating more frequently after having a period of reduced urine output. You begin to think they are in the diuretic phase of AKI at this time. What do you want to monitor in this patient during this stage?

You are taking care of a patient who has acute tubular necrosis (ATN), which of the following questions would you want to ask the patient when taking their history?

Your patient in ED with a head injury develops rhinorrhea. You quickly grab a 4x4 gauze to test the drainage. When you observe the drainage on the gauze, which of the following would indicate a positive Halo sign?

While caring for a patient with diabetic ketoacidosis (DKA), which of the following lab values would you want to communicate with the HCP before starting an insulin drip?

A nurse is caring for a patient with severe TBI receiving mechanical ventilation. ICP is 28 mmHg.CPP (cerebral perfusion pressure) is 55 mmHg. The patient's PaCO2, is 60 mmHg.

Which of the following conditions would put a patient at risk for prerenal acute kidney injury?

You are caring for an elderly patient who sustained a head injury earlier today. She seems be acting confused. The patient's family members say that she is usually confused at baseline at home as well. However, you as the RN are still concerned about which of the following with this patient?

Which of the following findings in a patient with increased ICP signals brainstem compression and impending death?