CCHT PRACTICE EXAM NNCC VERSION 1., Exams of Nursing

Download CCHT PRACTICE EXAM NNCC VERSION 1. and more Exams Nursing in PDF only on Docsity! CCHT PRACTICE EXAM NNCC VERSION 1. A substance that is cleared from the body by healthy kidneys is - Answers -creatinine. The patient tells the technician, "The doctor told me I'm anemic. What does that mean?" Which of these responses by the technician would be correct? - Answers -"You don't have enough red blood cells to carry oxygen." According to the standards of the Association for the Advancement of Medical Instrumentation (AAMI), pre-treatment water should be checked for chloramine at which of these times? - Answers -Before each patient shift. Which of the following types of vascular access has the lowest incidence of infection? - Answers -Arteriovenous (AV) fistula. During a patient's dialysis treatment, the dialysis machine's blood leak detector alarm sounds. The technician should take which of these actions first? - Answers -Confirm the blood leak. While performing the end-of-day water hardness check, the technician notes that the hardness exceeds the allowable limit. In addition to notifying the equipment technician, the technician should check which component of the water system? - Answers -Salt level in the brine tank. The technician observes that a patient's dialysate lines were incorrectly placed on the dialyzer. The technician corrects the line placement. The principle underlying the technician's action is that clearance is maximized by - Answers -countercurrent flow. Venous pressure is a result of resistance created by the - Answers -blood returning to the patient. A patient who is receiving an initial hemodialysis treatment on a non-reusable dialyzer should be observed for signs of - Answers -first-use syndrome. Holding needle puncture sites instead of using spring-loaded fistula clamps is recommended to avoid access - Answers -thrombosis. A patient who has an arteriovenous (AV) fistula receives a bolus dose of heparin at the beginning of a hemodialysis treatment and a continuous heparin infusion during the treatment. The patient's heparin administration should be terminated 30-60 minutes before the end of the treatment in order to - Answers -prevent prolonged bleeding. During a dialysis treatment, a patient suddenly develops fever and chills. The initial action that should be taken is to determine - Answers -whether other patients are having similar symptoms. A patient who recently had an arteriovenous (AV) fistula placed in the left forearm is experiencing numbness and tingling of the left hand. The patient's left hand is cold and the fingernail beds are blue. The patient most likely has which of these syndromes? - Answers -Steal. One purpose of priming the bloodlines and extracorporeal circuit pre-dialysis is to - Answers -remove disinfectant. A new technician is being oriented to the water treatment system. The equipment technician explains that the purpose of the ultraviolet (UV) light is to - Answers -change the DNA of microbes so they die or cannot multiply. Which of the following actions can the dialysis technician take to help minimize anemia? - Answers -Adequately rinse back as much of the patient's blood as possible at each treatment. CASE: Manuel Rivera, 75 years old, has a hemodialysis catheter and a newly placed right forearm artriovenous (AV) fistula. He arrives at the dialysis facility complaining of pain and swelling of his right arm. For pain management, Mr. Rivera is taking narcotic pain pills as prescribed by his doctor. The dialysis technician knows that taking this medication puts Mr. Rivera at increased risk for - Answers -falls. CASE:Manuel Rivera, 75 years old, has a hemodialysis catheter and a newly placed right forearm artriovenous (AV) fistula. He arrives at the dialysis facility complaining of pain and swelling of his right arm. What is a DISADVANTAGE of an arteriovenous fistula as a hemodialysis access compared to other types of access? - Answers -Time required to mature. CASE: Manuel Rivera, 75 years old, has a hemodialysis catheter and a newly placed right forearm artriovenous (AV) fistula. He arrives at the dialysis facility complaining of pain and swelling of his right arm. Mr. Rivera's pre-dialysis weight is 157.6 lb (71.5 kg) and the prescribed target weight is 150.3 lb (68.3 kg). The treatment time is four hours. Excluding prime and rinseback, Mr. Rivera's hourly ultrafiltration rate should be how many mL per hour? - Answers -800 The following method should be used to calculate the ultrafiltration rate per hour of treatment: 71.5 kg predialysis weight - 68.3 kg target weight 3.2 kg to be removed over four hours 1 kg = 1,000 mL Which of the following components of the dialysis machine is designed to protect the patient from bubbles/foam? - Answers -Air detector. The technician is busy with a patient when a machine across the room alarms. The dietitian standing nearby mutes the alarm. The technician should have which of these understandings concerning this action? - Answers -It is not permitted by the current ESRD regulations. The role of the renal dietitian includes - Answers -teaching patients how to meet nutrition needs. A fire has broken out on the treatment floor. The technician must begin disconnecting patients, starting with patients who are - Answers -ambulatory. - Answers -No additional precautions are necessary for the patient. Blood flow is manually maintained during a power outage. The technician must take which of these actions? - Answers -Remove the line from the venous line clamp. In hemodialysis, the term "anastomosis" refers to the connection of - Answers -two blood vessels. CASE: Helen King, 79 years old, has been on maintenance hemodialysis for six years. Mrs. King is scheduled for a revision of her arteriovenous (A-V) fistula immediately after today's hemodialysis treatment. Which of these interventions should occur today? - Answers -Hold heparin sodium during the hemodialysis treatment. CASE: Helen King, 79 years old, has been on maintenance hemodialysis for six years. Mrs. King arrives for her next dialysis treatment after a holiday weekend complaining of extreme muscle weakness and abdominal cramps. She has an irregular heartbeat and is having difficulty walking. The technician should suspect Mrs. King has - Answers -a high potassium level. CASE: Helen King, 79 years old, has been on maintenance hemodialysis for six years. During Mrs. King's hemodialysis treatment, she starts actively yawning. The technician suspects she may be experiencing - Answers -hypotension. CASE: Helen King, 79 years old, has been on maintenance hemodialysis for six years. Mrs. King tells the technician, "I'm considering stopping dialysis treatments." Which of these responses by the technician would be most appropriate? - Answers -Tell me why you want to stop dialysis." A central venous catheter may be used as a vascular access when patient has inadequate blood vessels in the limbs Before a dialysis treatment, the patient tells the technician "yesterday, I felt terrible and vomited up some blood. I feel much better today" the technician can expect the patients treatment will be modified by decreasing the heparin dose At the end of a patient's treatment which of the following vitals should a tech report to the nurse? A pulse rate of 55 The patient asks the tech "my doctor says I have mineral bone disorder what does that mean?" The tech is unsure about the answer which of the following would be the most appropriate? It's pretty complicated I'll ask the nurse to explain it to you During the last hour of dialysis the patient's blood pressure drops to 82/44. After changing the fluid removal rate what action would the tech take? Place him in Trendelenburg Legally, if a treatment was performed but not charted in the patient's record, it was not done The most common reason for a low conductivity alarm during dialysis is an exhausted concentrate supply A patient who has diabetes mellitus should be observed for signs of low blood pressure, which include anxiety and confusion Mr. Chase's dry weight is 70 kg and he receives dialysis three times a week for four hours. Mr. Chase's pre-treatment weight is 72 kg. The tech determines the fluid to be removed today is how many mL? 2,000 At his target weight 70kg he his likely to be? Normotensive The water supply to the water treatment system is called feed water The primary goal of Quality Assessment and Performance Improvement (QAPI) is? achieve better patient outcomes After Mr.Chase's treatment his standing blood pressure is 90/55. He insists he can walk to the scale. The tech's initial reaction would be? instruct him to sit down Mr. Chases claims his access is clotted. His statement would be true given a bruit was absent The patient asks what a high venous pressure alarm is. The tech should explain that it could be due to clotting of blood in the access Which part of the water system removes endotoxins? ultrafilter Which of the following occurs when the machine enters bypass? Dialysate stops flowing through the dialyzer Care providers must wash their hands instead of using germx in which situation? When their hands are visibly soiled