Peritoneal and Hemodialysis Review Questions

Ernie Lindain, BSN, RN, MEDSURG-BC

William Paterson University

Graduate Student

Question 1 – Peritoneal Dialysis Complication

• A nurse is caring for a client receiving peritoneal dialysis. Which assessment finding should the nurse report to the provider immediately?

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• A. Clear, straw-colored effluent
• B. Mild abdominal fullness during dwell time
• C. Cloudy peritoneal effluent and abdominal tenderness
• D. A small amount of fibrin strands in the drainage

Question 1 – Peritoneal Dialysis Complication – Answer & Rationale

• ✅ Correct Answer: C. Cloudy peritoneal effluent and abdominal tenderness

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• Rationale: These findings indicate peritonitis, the most serious complication of PD. Immediate reporting is required.

Question 2 – Hemodialysis Access Care

• Which nursing action is most appropriate when caring for a client with an arteriovenous (AV) graft?

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• A. Use the arm for IV infusions to maintain patency
• B. Palpate for a thrill and auscultate for a bruit each shift
• C. Measure blood pressure on the access arm for accuracy
• D. Apply cold compresses to the access site after dialysis

Question 2 – Hemodialysis Access Care – Answer & Rationale

• ✅ Correct Answer: B. Palpate for a thrill and auscultate for a bruit each shift

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• Rationale: A thrill and bruit confirm graft patency. The access arm should never be used for BP or IVs.

Question 3 – Hemodialysis Complication

• During hemodialysis, a patient becomes dizzy and hypotensive. What is the nurse’s priority action?

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• A. Stop dialysis and remove needles immediately
• B. Increase ultrafiltration rate
• C. Place patient flat and raised feet up, administer fluid bolus
• D. Notify the provider after dialysis is completed

Question 3 – Hemodialysis Complication – Answer & Rationale

• ✅ Correct Answer: C. Place patient flat and feet raised up, administer fluid bolus
• Rationale: This action restores perfusion during hypotension. Increasing UF worsens hypotension; dialysis is not stopped unless the patient is unstable.

Question 4 – Comparing Dialysis Modalities

• Which client would be the best candidate for peritoneal dialysis rather than hemodialysis?

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• A. A client with severe abdominal adhesions
• B. A client who prefers home-based therapy and self-management
• C. A client with severe respiratory compromise
• D. A client unable to perform self-care activities

Question 4 – Comparing Dialysis Modalities – Answer & Rationale

• ✅ Correct Answer: B. A client who prefers home-based therapy and self-management

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• Rationale: PD is suitable for motivated patients who can manage self-care. Adhesions and limited self-care ability are contraindications.

Question 5 – Nursing Education

• A nurse is teaching a client about hemodialysis access care. Which statement indicates a need for further teaching?

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• A. I should keep the access arm clean and dry.
• B. I will check for a thrill or bruit each day.
• C. I can allow my family member to take my blood pressure in that arm.
• D. I will report any redness or drainage from the site.

Question 5 – Nursing Education – Answer & Rationale

• ✅ Correct Answer: C. I can allow my family member to take my blood pressure in that arm.

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• Rationale: No BP, IVs, or restrictive items on the access arm. This prevents damage and loss of access patency.