CCHT EXAM 2024/25 QUESTIONS AND ANSWERS ALREADY PASSED, Exams of Medicine

Download CCHT EXAM 2024/25 QUESTIONS AND ANSWERS ALREADY PASSED and more Exams Medicine in PDF only on Docsity!

CCHT EXAM QUESTIONS AND

ANSWERS ALREADY PASSED

While technical staff are preforming duties in the dialysis unit which team member must always be present A. Registered nurse B. Medical director for unit

C. Lab technician ✔✔A. Registered nurse

Two techs are heatedly discussing pt care situation. Which team member is responsible for disciplinary action A. Registered practical nurse B. Human resource manager

C. Dialysis nurse manager ✔✔C. Dialysis nurse manager

Which credentialing agency for dialysis includes items such as water treatment and dialysate preparation and complication of dialysis as part of their practice domains A. Board of nephrology examiners nursing in technology B. Nephrology nursing certification commission

C. National nephrology certification organization ✔✔C. NNCO

Prior to starting dialysis what must the technician and or nurse verify A. That patient has provided informed written consent for dialysis B. That the patient has not eaten any food or beverages for the last six hours C. That the patient has a driver to pick him up after dialysis ✔✔A. Consent

Which external agencies provide additional guidelines and standards in the areas of infectious disease testing immunizations dialysis treatment safety and infection control? A. Centers for disease control and prevention B. Centers for Medicare and Medicaid service C. Association for the advancement of medical instrumentation

D. Council of nephrology ✔✔A B and C

Prior to passing the Social Security amendments treatment for chronic kidney disease was available only to few who met certain criteria. The amendments extended Medicare coverage for almost all patients who signed the amendment and then what year A. Jimmy Carter in 1979 B. Richard Nixon 1972

C. John f Kennedy 1961 ✔✔B. Richard Nixon 1972

Which organization recently approved by CMS to be an independent organization allowed to conduct surveys for Medicare certification fostering faster approval for dialysis clinics A. National kidney foundation B. Medicare bundle dialysis prospective payment system

C. National dialysis accreditation commission ✔✔C. NDAC

What is the composition of saline A. 10% salt added to water B. Albumin C. 0.9g of sodium chloride and 100ml of water ✔✔C. 0.9g of sodium and 100ml of h2o

When caring for a patient if the dialysate solution contains two little sodium the water may shift into the patient's blood cells which signs or symptoms would you see A. Hypotension B. Cramping C. Thirst

D. Headache ✔✔A and B

Which buffer is the major plasma buffer therefor important during dialysis A. Bicarbonate B. Amino acid C. Protein ✔✔A. Bicarbonate

While reviewing the body weight for a dialysis patient the tech knows that ——— of the total amount of water is contained in the intracellular fluid compartment A. 20% B. 30% C. 40% ✔✔C. 40%

How much water is lost through evaporation form lungs every day A. 250-499 ml of water B. 700-1,000 ml of water C. 1500-2000 ml of water ✔✔B.

A patient asks to explain what the normal kidney does in addition to making urine what's the response A. Regulate fluid volume in body B. Regulate pH in blood C. produce erythropoietin that controls red blood cell production

D. I receptor sites for several hormones ✔✔All of the above

A patient with a renal failure asks if his candies will regenerate how does the technician answer A. With a diet low in sodium and exercise there's a good chance you'll get some function back B. If nephrons are damaged they do no regenerate C. If the heart can pump in a blood to the kidney there is a possibility that some of the nephrons can regenerate ✔✔B. If nephrons are damaged they won't regenerate

This patient's kidneys have permanently lost most of their ability to remove waste and maintain fluid in chemical balance what's the patient's likely estimated glomerular filtration rate A. Less than 15 ml/min/ B. 60-89 ml/min/1.

C. 30-44 ml/min ✔✔A. Less than 15

The patient asks the dialysis technician if there's anything she can do to slow the progression of her kidney disease. Which risk factor could the technician mention during the conversation A. Control your blood glucose levels if you're a diabetic B. Maintain healthy weight C. Control cholesterol levels

D. Stop use of alcohol ✔✔A B and C

Which recommendation would've nephrologist likely make for a patient who has read stages three or four chronic kidney disease A. We'll tele health visits discussing daily urine output B. Dietary restriction on sodium phosphorus and protein C. Monitoring for mineral bone disease D. Education on cardiovascular disease ✔✔B,C and D

Which patient would be considered at higher risk for developing chronic kidney disease A. Hispanic female who is unaware that she is hypertensive B. White female with family history of diabetes who watches her exercise and diet C. Asian male who schedules regular visits with healthcare provider

D. African-American female whose parents both died following stroke ✔✔A and D

Patient with chronic kidney disease asks what her goal hemoglobin level should be what level as recommended by the national kidney foundation kidney disease guidelines A. 9% B. 7%

C. 11% ✔✔B.7%

Patient with chronic kidney disease arrives at the center after his nephrology visit he relays to the staff that the doctor said he was hardening of the kidneys what is the cause of this condition A. Prolonged severe hypertension B. Daily ingestion of sugar sweetened drinks C. High fat diet D. Too much calcium in the diet along with hypertension ✔✔A.

What is one cause of postrenal failure A. Renal trauma B. Prostrate disease

C. Fluid volume shifts D. Kidney infections ✔✔B. Prostate disease

The family member of a dialysis technician has noted blood in his urine the tech also noted the weight loss and rubbing of the flank to ease the cramping pain which disease comes to mind A. Nephrotic syndrome B. Bladder infection C. Kidney stones

D. Renal carcinoma ✔✔D. Renal carcinoma

Which integumentary changes are commonly seen in patients with chronic kidney disease A. Brittle nails B. Excessive sweating C. Bruising

D. Increase number of moles ✔✔A and C

Monday also patients infection account for about one and 10 fatalities which condition increases a patient's susceptibility to infection

A. Diabetes B. Malnutrition C. Bone abnormalities

D. Frequent invasive procedures ✔✔A B and D

Management of renal bone disease requires that ministration of which type of medication with every meal and snack A. Potassium and substitutes B. Antacids C. Phosphate binders ✔✔C. Phosphate binders

Patients with chronic kidney disease are at risk for developing peripheral neuropathy. How may neuropathy present in the patient A. Intolerance to touch B. Burning feet C. Restless legs ✔✔B and C

What are some disadvantages of using hollow-fibers dialyzers

A. They're not compliant B. They require meticulous care to remove air or gas from the fiber bundle C. Blood distribution may be uneven at inflow header space

D. Higher heparin doses may be needed to prevent clotting in hollow fibers ✔✔B C and D

If a patient is experiencing adverse reactions from the residual toxic products of ethylene oxide sterilization of the hollow fibers what other ways can you sterilize it. A. Gamma radiation B. Pure alcohol flushing C. Electron beam ✔✔A and C

Which manifestation would lead to the tech to suspect the patient is experiencing intradialytic complement A. Anemia B. Intradialytic hypoxemia C. Chest pain

D. Back pain ✔✔B C and D

If the bicarbonate concentrate is over mixed what lab values will result A. Increase pH B. Decrease in serum calcium level C. Increase in magnesium level D. Decrease in RBC level ✔✔A and B

Which method/test is most commonly used to check the dialysate composition A. Bicarbonate concentration test B. Total conductivity C. Microbial count ✔✔B. Microbial count

How is the temp of the dialysate controlled A. By using one or more sensors and a micro controller circuit on the heater B. By checking accuracy regularly with a certified glass thermometer

C. By using a separate center with visual and audible alarms for any out of limit state ✔✔All of the above

What can cause a "false" blood leak alarm

A. Particulate matter and air bubbles in the dialyzer B. Reduction in the light received by a photo cell

C. Change in translucency ✔✔A. Particular matter

What are the system requirements for high flux dialysis A. Reliable blood flow rate at at least 200 B. Hi dialysate flow rate C. Precise control of ultrafiltration volume

D. Use of synthetic membrane filters ✔✔B C and D

Which factors affect removal of toxins in dialysis A. The higher the temperature of dialysate the greater the removal of solute B. The slower the dialysate flow the greater removal of solute's C. The slower the blood flow rate the greater removal of solute

D. The more permeable the membrane the greater removal of solutes ✔✔A and D

To accomplish saw you removal and dialysis what is needed A. Mass transfer

B. Countercurrent flow C. A difference in concentration ✔✔C. Difference

Why is reversed filtration important A. The bicarbonate concentrate encourages and supports bacterial proliferation B. Endotoxins may be carried across the high flux membrane into the bloodstream

C. Pyrogens reaction may occur ✔✔All of the above

What modifications to the dialysis procedure can be made to prevent intradialytic complications associated with fluid removal A. Lower the temp of the machine B. Extend treatment times

C. Check serum sodium levels every 15 min ✔✔A and B

Which water contaminants may cause methemoglobinemia in which red cell hemoglobin cannot transport oxygen A. Fluoride and Tin B. Nitrates and chloramines

C. Zinc and aluminum ✔✔B. Nitrates and chloramine

What is the process utilized when two carbon tanks are used to remove chlorine and chloramine from tank water A. Adsorption B. Absorption

C. Diffusion ✔✔A. Adsorption

What type of contaminants are removed from water used in dialysis A. Endotoxins B. Aqueous salts C. Water softeners ✔✔A and B

When preparing for reverse osmosis what type of membranes should the tech be prepared to utilize A. Peritoneum B. Cellulose acetate C. Thin film composites

D. Chlorine resistant polysulfone ✔✔B C and D

Which problems may occur when using a deionizer A. It can be hard initially to obtain the maximum flow rate needed B. The service life of a deionizer may be short and essential that the filters be placed downstream C. Resin beds tend to exhaust suddenly in the tanks may need to be exchanged

D. If the resin tanks are used to exhaustion previously removed ions may be released ✔✔All of the above

When preparing the water used for the dialysate and reprocessing of dialyzers the CMS require "conventional dialysate" to have a max level of bacteria less than ——— CFU A. 300 B. 100 C. 200 ✔✔C. 200

How often at a minimum is it recommended to cleanse all components of the water treatment system with an approved disinfectant A. Quarterly B. Monthly

C. Biweekly ✔✔B. Monthly

What are the most common methods for reducing microbiological contaminants and water use during dialysis A. Infusion of antibiotics in water tank B. Applying a sub micron filter

C. Use of a filtration device ✔✔B and C

Which person on the team is responsible for ensuring the quality of water used for dialysis has met the standards A. Registered nurse B. Nurse manager

C. Medical director ✔✔C. Medical director

When a dialyzer is prepared to use what actions are required prior to beginning the session A. Prime the dialyzer B. Remove all air in the dialyzer C. Flush the dialyzer with Celine prime to remove all particulate matter

D. Remove any disinfectant left behind by rinsing under cold water ✔✔B and C

place the steps for a re-processing/re-using a dialyzer in the correct order A. Disinfect with chemical or heat B. Flush dialyzer to remove most of blood C. Test dialyzer

D. Cleanse dialyzer with chemicals and reverse ultrafiltration ✔✔B then D then C then A

According to standard precautions when should gloves be changed and hands washed A. When gloves are contaminated B. When going from clean body side to contaminated body site on the same person C. After handling infectious waste containers

D. After touching patient as in preforming physical assessment ✔✔A C and D

How should hand hygiene be performed A. With bar of soap and scrub brush B. With antiseptic soap and water C. With hand sanitizer

D. With waterless alcohol base hand rub with 60-90% alcohol content ✔✔B and D

What type of garment should be worn during processes likely to generate droplets of bodily fluids A. Patient gown tied in back B. Weighted lead aprons

C. Impervious isolation gowns ✔✔C. Isolation gowns

When washing hands with soap and water what's the minimum number of seconds hands should be rubbed together A. 10 B. 15

C. 30 ✔✔B. 15

What are the most common ways Hep B virus is transmitted in a unit A. Skin penetration by contaminated sharps B. Contact of contaminated blood with broken skin

C. Pts with Hep B breathing or coughing on others ✔✔A and B

Filling the accidental exposure to blood from a pt HIV positive what tx is recommended A. 3 month prescription of med to prevent HIV B. Follow up blood test three months after exposure C. 4 week 2 drug regimen is recommended within 72 hours of exposure ✔✔C.

According to the CDC health care workers exposed to needle stick involving HIV infected blood have a 0.23% chance of becoming infected if untreated. After a needle stick or sharps exposure to hep C virus what is the risk of developing infection A. 0.01% B. 0.5%

C. 1.8% ✔✔C. 1.8%

What are the recommendations for dialysis personnel caring for patients with clostridium difficile colitis A. Wear gloves when treating patient B. Impervious gowns upon entering room

C. Wash hands with soap and water ✔✔All of the above

Why is anticoagulation therapy used in dialysis A. To foster good venous blood flow in fingers and toes B. To reduce clotting within the extracorporeal circuit

C. To optimize dialyzer efficiency ✔✔B and C

How is heparin commonly administered A. Initial loading dose of heparin is given before tx begins B. Directly into arterial needle

C. Administered throughout tx by direct injection ✔✔A. Initial dose

When blood is transfused into at risk patients during heparin free dialysis what complication should the technician be monitoring for A. Fluid removal overload B. Anaphylaxis reaction

C. Increased velocity of the blood in the dialyzer ✔✔C. Increased velocity

If a dialysis patient does not have adequate vessels to create an internal fistula what is the remedy

A. Veins surgically transferred from other areas of the body B. Wrapping mesh around scarred veins

C. Using synthetic grafts ✔✔C. Using synthetic grafts

A patient tells the text that she woke up in the morning with her fistula arm underneath her head and that it has been asleep and feeling funny all day knowing this which complication should the tech assess the patient for prior to assessing her site A. Cervical disc pain resulting in nerve damage B. Thrombosis caused by compression of blood flow

C. Aneurysm of the official site due to kinking of the artery ✔✔B.

After the initial skin prep for cannulation the tech is interrupted by a coworker asking a question when she proceeds to cannulation she noticed the skin prep has dried what action should the tech take A. Proceed with cannulation B. Perform new assessment by palpating the site and then cannulate

C. Re-prep the access to ensure the patient has not accidentally touch the site ✔✔C.

How should the needles be positioned

A. Please the needles in the same general area during each treatment B. To achieve best blood flow placed the arterial needle near the anastomosis keeping the tip no closer than 1 1/2 to 2 inches from the anastomosis C. placed the arterial needle point in the direction of the flow D. Space the needles at least 1 inch apart ✔✔B C and D

What care should be provided for official arm between dialysis treatments A. Maintain adequate pressure over the puncture site for 10 to 20 minutes after the needles been removed B. Allow the skin over the access site to breathe by removing dressings after the bleeding has stopped

C. Clean the fistula arm daily with soap ✔✔A and C

In patients with stage four or five chronic kidney disease which access site should be avoided to prevent risk of stenosis and thrombosis A. Fistula B. Subclavian vein catheter

C. Peripherally Inserted central catheter ✔✔B and C

Immediately after insertion of a jugular catheter which complication should be assessed in the newly diagnosed stage five chronic kidney disease patient A. Slurred speech B. Collapsed lung C. Chest pain ✔✔B. Collapsed lung

According to KDOQI guidelines on goals of therapy for CKD patient on dialysis which post dialysis blood pressure goal is recommended A. Less than 140/90 B. Less than 130/80 C. Less than 150/95 ✔✔B

According to the centers for Medicare and Medicaid what is the maximum amount of fluid that can be safely removed during a standard treatment A. 30% of fluid way as long as the pressure is normal B. No more than 20% of total body weight C. Ultrafiltration rate of 13/ML/KG/HR or less ✔✔C.

Related to rapid decrease in the circulation blood volume caused by ultrafiltration what is the most common complication during treatment A. Hypotension B. Bleeding C. Dehydration ✔✔A. Hypotension

In a patient with gross Adema which symptoms of hypotension shared the dialysis tech be watching for A. Shortness of breath B. Flushed face and nose bleed C. Paleness

D. Excessive yawning ✔✔A C and D

A tech reports to the RN that the blood is transparent in the circuit with a cherry soda pop color what complication should the tech suspect the patient is experiencing A. Hemolysis B. Thrombosis

C. Septicemia ✔✔A. Hemolysis

Which symptoms will alert the tech a patient is experiencing type a dialyzer reaction A. Dyspnea B. Chest and back pain C. Sense of impending doom D. Numbness around the mouth ✔✔A B and C

The dialysis tech knows that reducing intake of this nutrient may be beneficial in delaying the progression of kidney disease A. Water B. Carbohydrates C. Proteins ✔✔C.

Albumin is a bio-marker monitored to assess the nutritional status of patients with CKD which patients are likely to have a lower serum albumin A. Patient who is dehydrated B. Patient with fatigue and low energy

C. Patient with hair loss and muscle wasting ✔✔B and C