Patient Monitoring During Dialysis and Laboratory Test

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✅ MCQs – Patient Monitoring During Dialysis & Lab Tests (Set 1)

1. Which of the following should be monitored and recorded at least every 30 minutes during a hemodialysis session?
A. Hemoglobin level
B. Blood pressure and pulse
C. Serum potassium
D. Blood glucose
➡️ Answer: B. Blood pressure and pulse

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2. Which lab test is most commonly used to assess dialysis adequacy?
A. Serum albumin
B. KT/V
C. Hemoglobin
D. C-reactive protein
➡️ Answer: B. KT/V

3. Which lab parameter indicates anemia of chronic kidney disease (CKD) in dialysis patients?
A. Low WBC count
B. Low Hemoglobin (Hb)
C. Low Platelet count
D. High Calcium
➡️ Answer: B. Low Hemoglobin (Hb)

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4. When should the dialysis nurse document pre-dialysis weight?
A. After connecting the patient to the machine
B. Before starting dialysis
C. During dialysis
D. Only if hypotension occurs
➡️ Answer: B. Before starting dialysis

5. A sudden rise in venous pressure during dialysis may indicate:
A. Venous needle dislodgement
B. Dialyzer clotting or access stenosis
C. Hypotension
D. Low TMP
➡️ Answer: B. Dialyzer clotting or access stenosis

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6. Which of the following laboratory results would require immediate action before starting dialysis?
A. Potassium 5.2 mmol/L
B. Hemoglobin 10.5 g/dL
C. Potassium 7.2 mmol/L
D. Albumin 3.5 g/dL
➡️ Answer: C. Potassium 7.2 mmol/L

7. Which clinical sign should be checked before needling an AV fistula?
A. Hematoma
B. Presence of thrill and bruit
C. Blood pressure
D. Dialysate conductivity
➡️ Answer: B. Presence of thrill and bruit

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8. The most important pre-dialysis lab value to assess for cardiac arrhythmia risk is:
A. Hemoglobin
B. Serum albumin
C. Serum potassium
D. Serum creatinine
➡️ Answer: C. Serum potassium

9. A decreasing trend in serum albumin in a dialysis patient suggests:
A. Improved nutrition
B. Hemodialysis adequacy
C. Poor nutritional status or chronic inflammation
D. Low phosphate intake
➡️ Answer: C. Poor nutritional status or chronic inflammation

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10. Which monthly lab test is essential to guide erythropoiesis-stimulating agent (ESA) therapy?
A. Phosphorus
B. Creatinine
C. Hemoglobin
D. Uric acid
➡️ Answer: C. Hemoglobin

11. Post-dialysis weight is important to determine:
A. Serum calcium level
B. Interdialytic weight gain
C. Residual renal function
D. Anemia management
➡️ Answer: B. Interdialytic weight gain

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12. What does a high arterial pressure alarm during dialysis usually indicate?
A. Venous needle dislodgement
B. Bloodline kink or clot before the pump
C. Low blood flow rate
D. Machine malfunction
➡️ Answer: B. Bloodline kink or clot before the pump

13. What is the normal target range for hemoglobin in a stable hemodialysis patient?
A. 8–9 g/dL
B. 9–10 g/dL
C. 10–11.5 g/dL
D. >13 g/dL
➡️ Answer: C. 10–11.5 g/dL

(Per KDIGO guidelines, aim is typically 10–11.5 to avoid both anemia and cardiovascular risk.)

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14. Why is serum calcium and phosphorus monitoring important in ESRD patients?
A. To prevent anemia
B. To reduce infection risk
C. To monitor mineral bone disorder and vascular calcification
D. To adjust sodium bath
➡️ Answer: C. To monitor mineral bone disorder and vascular calcification

15. What does a consistently low KT/V (<1.2) suggest?
A. Excellent dialysis clearance
B. Overhydration
C. Inadequate dialysis dose
D. Low phosphorus levels
➡️ Answer: C. Inadequate dialysis dose

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16. Which of the following must be assessed before giving IV iron or ESA during dialysis?
A. Creatinine and BUN
B. Ferritin and transferrin saturation (TSAT)
C. Calcium and phosphate
D. Potassium
➡️ Answer: B. Ferritin and transferrin saturation (TSAT)

17. An increase in pre-dialysis blood pressure may suggest:
A. Improved fluid control
B. Excessive ultrafiltration
C. Volume overload or non-compliance with fluid restrictions
D. Normal variation
➡️ Answer: C. Volume overload or non-compliance with fluid restrictions

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18. Which lab test is most useful to assess long-term dialysis adequacy and uremic control?
A. Serum urea
B. Creatinine
C. Bicarbonate
D. KT/V or URR
➡️ Answer: D. KT/V or URR (Urea Reduction Ratio)

19. What is the purpose of checking conductivity and dialysate temperature during dialysis?
A. To ensure sodium and bicarbonate levels are balanced
B. To prevent air embolism
C. To check blood pressure
D. To measure hemoglobin
➡️ Answer: A. To ensure sodium and bicarbonate levels are balanced

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20. Which symptom requires immediate monitoring during dialysis?
A. Mild headache
B. Yawning
C. Chest pain
D. Mild thirst
➡️ Answer: C. Chest pain