A client on hemodialysis presents with a severe headache, confusion, and seizures. What action should the nurse take first?

Administer an antiepileptic medication.

Assess the client's blood glucose levels.

Document the findings and monitor the client.

Check the client's pre-dialysis weight.

Answer and Explanation

The Correct Answer is B

A. Incorrect. While administering an antiepileptic medication may be necessary if the client is experiencing seizures, it is essential to identify the underlying cause first.

B. Correct. The client's severe headache, confusion, and seizures may be indicative of dialysis disequilibrium syndrome, which is a complication of rapid solute removal during hemodialysis. Hypoglycemia can also present with similar symptoms, so assessing blood glucose levels is crucial to differentiate between the two conditions.

C. Incorrect. Documenting the findings and monitoring the client's condition are important, but addressing the acute symptoms and potential cause should be the priority.

D. Incorrect. Checking the client's pre-dialysis weight is not the priority when the client is experiencing severe neurological symptoms. Immediate assessment and intervention are needed.

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Correct Answer is B

Explanation

A. Incorrect. Administering a prescribed analgesic may be necessary, but it is not the priority when the client is experiencing sudden chest pain and dyspnea.

B. Correct. The sudden onset of chest pain and dyspnea can be indicative of potential complications, such as dialysis-related hypotension, cardiac issues, or fluid overload. Assessing the client's blood pressure and heart rate is the priority to identify any acute changes or abnormalities.

C. Incorrect. Monitoring the client's weight is important to assess fluid status, but it is not the immediate priority when the client presents with acute chest pain and dyspnea.

D. Incorrect. Placing the client in a semi-Fowler's position may be appropriate for respiratory distress, but the nurse should first assess the client's vital signs and overall condition before implementing positioning changes.

A. Hypertension B. Hypercalcemia C. Hyperkalemia D. Hypokalemia

Correct Answer is C

Explanation

A) This statement is incorrect. Hypertension (high blood pressure) is a common complication of kidney disease, but it is not the primary indication for initiating dialysis. Dialysis is primarily indicated to address the impaired filtration and waste removal functions of the kidneys, which can lead to electrolyte imbalances like hyperkalemia.

B) This statement is incorrect. Hypercalcemia (elevated calcium levels) is not a primary indication for initiating dialysis. While calcium imbalances can be associated with kidney disease, hyperkalemia takes precedence as a more critical indication for dialysis initiation.

C) This statement is accurate. Hyperkalemia (elevated potassium levels) is a critical indication for initiating dialysis. Dialysis helps remove excess potassium from the bloodstream when the kidneys are unable to do so, preventing potentially life-threatening complications.

D) This statement is incorrect. Hypokalemia (low potassium levels) is not an indication for initiating dialysis. In fact, dialysis may lead to a reduction in potassium levels, and clients on dialysis are more likely to experience hyperkalemia.

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A client on hemodialysis presents with a severe headache, confusion, and seizures. What action should the nurse take first?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A client on hemodialysis develops a sudden onset of chest pain and dyspnea. What is the nurse's priority action?

Correct Answer is B

Explanation

A nurse is caring for a client with end-stage renal disease (ESRD). The client's blood work shows elevated levels of creatinine, blood urea nitrogen (BUN), and potassium. Which of the following conditions is the primary indication for initiating dialysis?

Correct Answer is C

Explanation

A nurse is caring for a client with chronic kidney disease (CKD) who is scheduled to start hemodialysis. The client asks, "How does hemodialysis work?" Which of the following responses by the nurse is accurate?

A client on peritoneal dialysis is prescribed erythropoietin-stimulating agents (ESAs) to manage anemia. Which of the following laboratory values should the nurse monitor closely during ESA therapy?

A nurse is teaching a client undergoing hemodialysis about the importance of maintaining vascular access. Which statement by the client indicates a correct understanding of the teaching?

A client on peritoneal dialysis is concerned about the risk of infection at the catheter insertion site. Which of the following instructions should the nurse provide to the client?

A nurse is educating a client about the different types of dialysis. The client asks which type of dialysis uses the peritoneal membrane as a filter. Which of the following responses by the nurse is accurate?

A nurse is providing education to a client with chronic kidney disease (CKD). The client asks about the purpose of dialysis. Which of the following responses by the nurse is accurate?

A client with acute kidney injury (AKI) has a significantly decreased glomerular filtration rate (GFR). Which of the following is the primary indication for initiating dialysis in this client?

A client on hemodialysis has a history of arteriovenous (AV) fistula creation. Which of the following assessments should the nurse perform to ensure proper functioning of the AV fistula?