CCHT Exam ACCURATE TESTED VERSIONS OF THE EXAM FROM 2023TO 2024 | ACCURATE AND VERIFIED, Exams of Nursing

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CCHT Exam ACCURATE TESTED

VERSIONS OF THE EXAM FROM 2023TO

2024 | ACCURATE AND VERIFIED | NEXT

GEN FORMAT | GUARANTEED PASS

At the completion of a dialysis treatment, it's important to rinse back as much blood as possible in order to

• Ans - reduce the severity of anemia. If a power outage occurs and backup power fails, before using the hand crank to return the patient's blood, the technician must
• Ans - remove the venous line for the air detector. If a patient's blood pressure is 142/88 before dialysis and 108/72 at the completion of dialysis, the most likely intervention is
• Ans - infusion of normal saline to increase blood pressure. Prior to opening a sterile package, the technician spills sterile normal saline on the package. The technician should
• Ans - discard the package. When washing the hands, the hands should be wet and soap applied and then the hands rubbed together for at least
• Ans - 15 seconds. How long can hepatitis B virus live on surfaces if they are not properly disinfected? - Ans - 7 days In the event that a fire occurs in a dialysis center, the RACE method of response includes
• Ans - rescue, activate alarm, contain/confine fire, and extinguish/evacuate. If the technician needs to move boxes of supplies from the floor to elevated shelves, the technician should
• Ans - bend down at the knees and keep the back straight while lifting. For documentation in the medical record, which of the following includes a correct abbreviation, symbol, or acronym?
• Ans - 0.5 kg For a hemodialysis cannulation with a blood flow rate of fewer than 300 mL/min, which of the following needle gauge sizes is usually recommended?

• Ans - 17 If the nephrologist has ordered a pre-dialytic and post-dialytic BUN (blood urea nitrogen) for a patient with an AV fistula, the pre-dialytic blood sample should be obtained from the
• Ans - arterial needle. The primary focus of the Life Safety Code® is on
• Ans - protection of people. The dialysis prescription is for a 3-hour treatment with 1.5 kg to be removed. During treatment, 250 mL is used as saline prime and 200 mL as saline rinseback. The patient ingests 150 mL of fluid that contains oral protein supplement. The ultrafiltration rate to be removed per hour is
• Ans - 700 mL. If the ultrafiltration rate to be removed per hour is 600 mL and the dialyzer KUF is 40, what is the transmembrane pressure (TMP)?
• Ans - 15 mm Hg If using a combination chlorhexidine gluconate and alcohol skin prep (such as ChloraPrep®) before cannulation, how much skin contact time is required?
• Ans - 30 seconds Which of the following preventive measures is usually the best approach for patients who routinely experience hypotension during dialysis because of volume-related problems associated with large weight gain between treatments?
• Ans - Increasing restriction of sodium intake If a patient undergoing hemodialysis and in the care of the technician has a persistent cough, standard precautions require that the
• Ans - patient wear a mask. What color is arterial blood tubing for hemodialysis most often color-coded?
• Ans - Red During hemodialysis, how much blood is usually outside of a patient's body at one time?
• Ans - 100 to 250 mL During the first week of treatment with a new AV fistula, the initial needle size and blood flow rate are usually
• Ans - 17 - gauge needle and blood flow of 200 to 250 mL/min. With an AV fistula, cannulation should usually be done at an angle of
• Ans - 25° to 35°.

A hemodialysis system includes blood volume monitoring to assess changes in the patient's hematocrit. If the hematocrit increases rapidly, this means

• Ans - blood volume is decreasing. A patient has a newly created AV fistula. When assessing the fistula, the technician raises the patient's involved arm above the head. In this position, the fistula should - Ans - collapse. during cannulation, a tourniquet should be used
• Ans - while placing needles in all AV fistula The difference between a buttonhole needle and a standard needle for hemodialysis is that the buttonhole needle has a
• Ans - blunt tip. If a hemodialysis patient has an extreme fear of needles and the physician prescribes EMLA cream to prevent pain, the cream must be applied
• Ans - 60 minutes prior to treatment. Following formation of an AV fistula and beginning of hemodialysis, the technician notes that the patient's nailbed and skin on the hand below the fistula are cyanotic during hemodialysis, and the patient complains of pain in the hand. This is likely an indication of
• Ans - steal syndrome. After a hemodialysis needle is removed at the end of treatment, the correct procedure is to apply pressure to
• Ans - each access site with two fingers for up to 20 minutes. A patient who wants to learn self-cannulation may do so if
• Ans - the patient receives appropriate training. Thrombosis in a newly-created access may be caused by
• Ans - low blood pressure. If a new patient has a HeRO® (Hemodialysis Reliable Outflow) graft, the cannulation site is generally in the
• Ans - proximal upper arm (below the axilla). If effluent (used dialysate) spills onto the floor, the technician should
• Ans - notify staff trained in hazardous waste removal. A patient is receiving hemodialysis with 17-gauge needles, but his blood flow rate has been increased to 450 mL/min. The patient complains of symptoms consistent with hemolysis (breakdown of red blood cells): sudden onset of chest tightness, back pain,

dyspnea, reddening of skin color, and blood in the venous line appearing port-wine in color. What is the likely cause of this complication?

• Ans - Needle too small for blood flow rate When handing off a patient to another staff person, the technician should always - Ans - follow the hand-off protocol established by the institution. The technician should ensure when exposing the opening of a central catheter to air (such as when removing the cap or a syringe) that the
  • Ans - clamp is closed. The hemodialysis center has instituted a "zero lift" policy. The primary purpose of such a policy is to
  • Ans - prevent injuries. If the dialysis center has an extra hemodialysis machine that has not been used in the previous 2 weeks, how frequently does this machine need to be disinfected?
  • Ans - Every 48 hours Five minutes after a patient begins a hemodialysis treatment, the patient has difficulty breathing and rapidly develops generalized hives, itching, and swelling about the eyes. After asking the nurse for help, the next action should be to
• Ans - stop dialysis and clamp all lines. A patient routinely experiences hypotensive episodes near the end of a session and experiences malaise (tiredness), muscle cramps, and dizziness after dialysis. What is the most likely cause?
  • Ans - The dry weight is set too low. An adolescent patient has required frequent hospitalizations because of nonadherence to the treatment plan. The best approach to take with the patient is to
  • Ans - ask the patient how the staff can help the patient manage better. When the first carbon tank (the worker) in the water system is exhausted, the next step is to
  • Ans - remove the first tank, move the second tank to first position, and add a new tank in second position. Following dialysis, the patient's blood pressure in semi-reclining position is 128/86. The technician takes a series of 4 blood pressures over 3 minutes after the patient stands. At which blood pressure should the technician alert the nurse that the patient is exhibiting orthostatic hypotension?
  • Ans - 108/ The technician is able to feel no pulse or thrill along the patient's outflow vein and can detect no bruit. The technician should suspect

• Ans - thrombosis. If a dialysis patient is very large in both stature and weight, which of the following is most likely to improve the effectiveness of hemodialysis?
• Ans - Increase dialyzer size. The duties that the technician is allowed to carry out depend primarily on the ____________.
• Ans - state regulations/standards of practice. If a dialysis center carries out dialyzer reprocessing and uses peracetic acid as the germicide, the contact time needed is ____________.
• Ans - 11 hours. If a dialysis center uses electronic charting, the technician may share his/her password with ____________.
• Ans - no one. When creating a buttonhole tract, how many consecutive cannulations are usually required before the tract is adequately formed?
• Ans - 8 to 10. If a patient complains of persistent itching, which of the following nonprescription methods may help relieve symptoms?
• Ans - Take oatmeal baths. When testing water for the level of chloramine, the technician finds that the total chlorine level is 1.1 parts per million (ppm) and the free chlorine is 0.9 ppm. Therefore, the chloramine level is ____________.
• Ans - 0.2 ppm. Patients receiving hemodialysis should be advised to avoid salt substitutes because the substitutes often ____________.
• Ans - contain potassium. Patients with uremia develop foamy or bubbly urine because ____________.
• Ans - protein leaks into the urine. Which of the following is a function of the End-Stage Renal Disease Networks?
• Ans - Help resolve patient-staff conflicts. When using a slide board to transfer a patient from the dialysis chair to a wheelchair, at what angle should the slide board be placed between the two sitting surfaces?
• Ans - 45 degrees.

When the technician is teaching a patient to self-cannulate using the tandem-hand technique, the ____________.

• Ans - patient places the thumb and finger behind the technician's thumb and finger. A patient has a right internal jugular central venous catheter for hemodialysis, but a pressure alarm sounds during treatment indicating that the blood flow rate is lower than prescribed. On checking, the technician finds that the lines appear clear and there are no signs of kinking, bleeding, or air entering the system. The next intervention should be to ____________.
• Ans - lower the patient's head and ask the patient to cough. The PDCA cycle used for continuous quality improvement refers to ____________. - Ans - plan-do-check-act. Substances that form ions (charged particles) are ____________.
• Ans - electrolytes. Which members of the dialysis center team are responsible for carrying out the quality assessment and performance improvement program at a dialysis center?
• Ans - All staff. A new female patient is admitted to the dialysis center in the company of a male who appears to be her spouse. If the patient's chart lists her name as Mary Jo Johnson, how should the patient be addressed?
• Ans - Ask the patient. Infections in buttonhole tracts are almost always caused by ____________.
• Ans - improper scab removal. What percentage of the water that is filtered out of the blood by the glomeruli is excreted as urine?
• Ans - 1%. Which of the following hormones directs the bone marrow to produce more red blood cells?
• Ans - Erythropoietin. To reinforce teaching, the technician should remind patients with kidney failure that they should avoid ____________.
• Ans - fsmoking. Which of the following is a genetic (inherited) disease that can lead to kidney failure? - Ans - Polycystic kidney disease. With uremia, as waste products build up in the blood, this can result in ____________. - Ans - ammonia breath.

The aluminum level in dialysis water should be ____________. - Ans - ≤ 0.01 mg/L. Normal saline has a sodium chloride concentration of ____________. - Ans - 0.9%. As part of anemia management for patients receiving hemodialysis, the technician should ____________. - Ans - rinse back as much blood as possible. Patients receiving hemodialysis are at risk for amyloidosis. Which of the following symptoms may indicate amyloidosis? - Ans - Joint pain. A patient who experiences numbness, tremors, muscle spasms, and muscle pain may have low levels of ____________. - Ans - calcium. Which of the following laboratory tests is often done before and after hemodialysis to measure the effectiveness of dialysis in removing waste products from the body? - Ans - Blood urea nitrogen. A patient beginning hemodialysis usually has a hemoglobin test every ____________. - Ans - one to two weeks. The most common treatment for patients with end-stage kidney disease in the United States is ____________. - Ans - daytime in-center hemodialysis. Which of the following is an indication that a patient may be losing fat and/or muscle mass even though he or she reaches the target dry weight after treatment? - Ans - Patient becomes short of breath if lying flat after treatment. Which member of the hemodialysis care team is responsible for setting up the plan of care for a patient? - Ans - Nephrologist. If a patient comes for hemodialysis treatment but weighs less than the target dry weight before treatment, the technician should ____________. - Ans - notify the nurse and dietician. The first step in treating malnutrition in a dialysis patient is usually to ____________. - Ans - encourage the patient to eat more. One-half teaspoon of salt is equal to about how many milligrams of sodium? - Ans - 1000 mg. Because of increasing phosphorus levels, a patient has been prescribed a phosphate binder, but the patient is unsure when to take the medication. The best advice is to take the medication____________. - Ans - with meals.

If a patient is concerned about loss of income because of the need for hemodialysis, the best person to speak to the patient about this concern is the ____________. - Ans - social worker. When using active listening, which of the following is a good example of a short, open- ended question to use to encourage patient communication? - Ans - "What does the pain in your abdomen feel like?" If a patient has refused to participate in education, asks no questions, and shows no interest in learning about hemodialysis, the best approach for the technician is to ____________. - Ans - talk through all steps in the procedures. Diffusion is a process that involves ____________. - Ans - movement of solutes though a semipermeable membrane from an area of higher A dialysis machine is set up to use 36.1X parts dialysate. If the concentrate proportioning ratio calls for 1.00 part acid and 1.10 parts bicarbonate, how many parts of water are needed? - Ans - 34.0. About what percentage of body water is in the intravascular space (inside blood vessels)? - Ans - 10%. The mass transfer coefficient of a dialyzer refers to ____________. - Ans - When using an alcohol-based hand rub, the hand rub should be applied to one palm and the hands rubbed together ____________. When using an alcohol-based hand rub, the hand rub should be applied to one palm and the hands rubbed together ____________. - Ans - until dry. The three processes that affect dialyzer clearance are (1) diffusion, (2) convection, and (3) ____________. - Ans - adsorption. If a dialyzer has a sieving coefficient of 0.6 for a solute, what percentage of the solute should pass through the membrane? - Ans - 60%.. Most dialyzer membranes used today are made of____________. - Ans - synthetic If a dialyzer has a urea clearance rate of 200 mL/min and a blood flow rate of 400 mL/min, what percentage of the 400 mL of blood is cleared of urea in one minute? - Ans

• 50%. The storage time for a reprocessed dialyzer is ____________. - Ans - set by the manufacturer. If a low-conductivity alarm sounds, the technician should suspect ____________. - Ans
• lack of concentrate in the proportioning system.

If the blood leak alarm sounds during a hemodialysis treatment and the blood pump stops and lines clamp but the dialysate appears clear, the technician should ____________. - Ans - use Hemastix® to check the extent of the leak. When using a portable pH monitor to verify that an in-line pH monitor reading is correct, the technician should first ____________. - Ans - test a solution with a known pH. If a solution has an equal number of acid and base ions and is neutral, the pH is ____________. - Ans - 7. A volumetric ultrafiltration control system has ____________. - Ans - two identical dialysate chambers. The extracorporeal circuit carries blood ____________. - Ans - from arterial access to the dialyzer and back to venous access. A drip chamber that contains a fine mesh screen should be placed ____________. - Ans - between the dialyzer and the venous access. If a low-pressure alarm for arterial pressure (prepump) sounds during dialysis, this could indicate ____________. - Ans - infiltration of the arterial needle. If a high-pressure alarm for the predialyzer (postpump) pressure sounds during dialysis, this could indicate ____________. - Ans - clotted dialyzer. The lifespan of an arteriovenous graft is usually ____________. - Ans - 3 to 5 years. The heart must work harder when patients have an arteriovenous fistula because the ____________. - Ans - blood flow is faster. The technician should alert the nurse that the patient is experiencing tachycardia (rapid pulse) when the pulse exceeds ____________. - Ans - 100. A patient has opted to have a buttonhole tract for hemodialysis. Which of the following is the most important factor for creation of a buttonhole tract? - Ans - The same cannulator should do treatments until the tunnel is established. When a patient is utilizing home hemodialysis, the purpose of teaching the patient to "snap and tap" the tubing and filter is to ____________. - Ans - remove air bubbles. An 85-year-old patient with end-stage kidney disease and multiple health problems has started hemodialysis, but the patient is now refusing treatment, stating that death is preferable to the loss of independence and continued illness. The technician should ____________. - Ans - respect the patient's decision.

After a patient receives the initial heparin bolus for hemodialysis, when should dialysis be initiated? - Ans - Within three to five minutes. Which of the following signs and symptoms are indications of infection of an arteriovenous fistula or graft? - Ans - Redness, tenderness, and swelling. If the technician feels unsure about cannulating a patient's fistula because of irregular vessel shapes, the best solution is to ____________. - Ans - ask a more experienced staff member to cannulate. Which of the flowing needle sizes has the largest lumen (diameter)? - Ans - 14 gauge. Retrograde (against the blood flow) insertion of arterial dialysis needles can result in ____________. - Ans - increased scarring. The best method to secure a dialysis needle is probably ____________. - Ans - the butterfly technique. When removing an access needle at the completion of hemodialysis, the technician completely removes the needle before applying pressure. This technique ____________. - Ans - is the correct procedure. If a patient is terrified of needles and often feels faint and nauseated during cannulation, the best position to place the patient in during cannulation is ____________. - Ans - flat. If the blood in the arterial line looks very dark ("black blood syndrome"), the likely cause is ____________. - Ans - recirculation. The best method to prevent aneurysms in a fistula is to ____________. - Ans - use proper technique when inserting needles. If the air detector alarm sounds, the blood pump stops, and the venous line clamps, but the technician notes air in the venous line and is concerned that some air may have entered the patient's vein, the technician should immediately ____________. - Ans - Place the patient in the Trendelenburg position (head below heart) on the left side. The heparin infusion line should generally be placed ____________. - Ans - in the arterial line between the blood pump and the dialyzer. If the power goes out during a treatment, the blood in the bloodlines is ____________. - Ans - returned by hand cranking the blood pump. If a technician notes a high-pitched bruit, a "water-hammer" (pounding) pulse, and evidence of clotting in the extracorporeal circuit during hemodialysis, the technician should suspect ____________. - Ans - stenosis.

If the skin above an arteriovenous graft appears taut and shiny, and previous needle sites are unhealed, the technician should alert the nurse to possible ____________. - Ans - pseudoaneurysm. If the rate of blood flow is too low, this increases the risk of ____________. - Ans - thrombosis (clots) Dialysate is made by mixing water with acid and bicarbonate concentrates. Acid concentrate contains ____________. - Ans - electrolytes, such as calcium and magnesium. When a patient's arteriovenous graft has healed and is ready for the first cannulation, what needle size is usually indicated? - Ans - standard gauge for the blood flow rate. When placing needles in an arteriovenous graft, how far away from the previous needle sites should cannulation be done? - Ans - 0.5 inch. The most common site for development of stenosis in an arteriovenous graft is at ____________. - Ans - the venous end of the anastomosis. Which of the following sites for a central venous catheter may prevent future venous access in the limb on the same side? - Ans - Subclavian vein. The preferred solution to clean exit sites for central venous catheters is ____________.

• Ans - chlorhexidine gluconate 2% with 70% isopropyl alcohol. What length of needle is usually needed for a forearm arteriovenous (AV) fistula? - Ans
• 0.6 inch (3/5 inch). When drawing a blood sample from the injection port of the arterial bloodline, the personal protective equipment that the technician should wear is ____________. - Ans - gloves, facemask, eye protection, and gown. The first step in teaching a patient to self-cannulate is to tell the patient about ____________. - Ans - how the patient's graft/fistula works. When using "touch cannulation" to cannulate a buttonhole tract, the cannulator ____________. - Ans - holds the tubing 1 to 2 cm behind the needle. When taking a manual blood pressure reading on a patient's non-access arm, the blood pressure should be checked ____________. - Ans - at heart level. If an item, such as a piece of equipment, is considered "clean," this means it is ____________. - Ans - disinfected but not free from all germs.

When hanging a new bag of normal saline, the technician touches the spike to the outside of the bag. The technician must ____________. - Ans - discard the spike and attached tubing. How frequently should patients and staff members of a dialysis center have tuberculosis skin tests? - Ans - Once a year. If a patient has completed a dialysis session and is walking toward the door with the technician but becomes unsteady and begins to fall, the first thing the technician should do is to ____________. - Ans - ease the patient to the floor. The first thing to do when using a portable lift device, such as a Hoyer® lift, to transfer an obese patient is to ____________. - Ans - check the lift's weight limit and sling size. A small fire begins in a waste receptacle, and the technician uses a fire extinguisher to put out the flames. If using the P.A.S.S. protocol, the technician should ____________.

• Ans - pull the pin, aim the nozzle, squeeze the handle, and spray from side to side. When setting up hemodialysis equipment with a reprocessed dialyzer before a treatment, the primary purpose of priming the bloodlines and the dialyzer with normal saline is to ____________. - Ans - remove air and germicide. When using a reprocessed dialyzer for a treatment, the first thing that the technician should check the dialyzer for is the ____________. - Ans - patient's name. Which of the following signs or symptoms may indicate that a patient is below dry weight following a hemodialysis treatment? - Ans - Low blood pressure. A radial pulse is accessed at the ____________. - Ans - wrist (thumb side). In modern dialysis machines, in order to start a treatment, the technician must enter into the machine the ____________. - Ans - total number of milliliters to be withdrawn and the duration of treatment. If a patient develops hypotension (low blood pressure) during a hemodialysis treatment, and the technician finds that the patient has developed a rapid and irregular heartbeat, then the technician should notify the nurse and ____________. - Ans - decrease the ultrafiltration rate. A patient is nearing the end of a treatment and complains of headache and nausea and appears very restless and anxious. The technician checks the vital signs and finds that the blood pressure is 180/100, and the pulse is 72 and is slightly irregular. The technician should suspect ____________. - Ans - disequilibrium syndrome. The permeability of a dialyzer membrane to water is indicated by its ____________. - Ans - ultrafiltration coefficient.

If a patient requires a blood draw for laboratory tests before a hemodialysis treatment, and the laboratory has provided four vacuum tubes for the blood samples, then the technician should ____________. - Ans - check the order of the draw. If a patient is not to receive a saline prime at the beginning of a hemodialysis treatment, and the saline prime is drained into a waste container on the side of the dialysis machine, then the technician must connect the venous line to the access when blood reaches the ____________. - Ans - venous chamber. If a patient develops a nosebleed during a hemodialysis treatment, this could indicate that the ____________. - Ans - heparin dosage is too high. A patient undergoing hemodialysis for the first time does well initially, but at 15 minutes into the treatment, she begins to complain of back pain, itching, slight shortness of breath, and nausea. The most likely cause of these signs and symptoms is ____________. - Ans - first-use syndrome. The best method to prevent leg cramps during hemodialysis is to ____________. - Ans

• correctly calculate the target ultrafiltration goal. After a blood sample is collected into a blood tube, the technician should ____________. - Ans - gently invert the tube back and forth about eight times If the dialysate is too warm, it can result in ____________. - Ans - hemolysis. After rinsing and cleaning a dialyzer that is to be reprocessed, the performance test or tests that must be performed are ____________. - Ans - total cell volume test and leak test. If the water pressure downstream of a multimedia filter in the water system is decreased, this indicates a need to ____________. - Ans - backwash the filter. If a dialyzer is to be reprocessed at the completion of a dialysis treatment, the dialyzer should be ____________. - Ans - flushed with normal saline. If the water distribution system uses an indirect feed system, the speed of water flow through the distribution system should be ____________. - Ans - 3 feet per second. How often should colony counts and limulus amebocyte lysate tests be conducted on the water feeding the bicarbonate mixer? - Ans - Monthly. Hepatitis B is spread through ____________. - Ans - contact with blood or body fluids. If testing a water sample for bacteria, the sample should be processed at room temperature within ____________. - Ans - 1 to 2 hours.

If three patients having dialysis at the same time in a center that uses a central dialysate delivery system complain of sudden onset of nausea, the technician should suspect a problem with the ____________. - Ans - water system. One fluid ounce is equal to ____ mL. - Ans - 30ml A patient and his spouse are undergoing training for in-home hemodialysis, but the patient tells the technician, "I'm so nervous. What happens if I can't learn to do this?" The best response is ____________. - Ans - "You will only do in-home dialysis when you feel ready." In the extracorporeal circuit, the highest positive pressure is found at the ____________. - Ans - arterial header of the dialyzer. If testing before a hemodialysis treatment shows that the patient's blood level of potassium is too low, the level of potassium in the dialysate is usually ____________. - Ans - increased. The factor that has the most influence on a dialysis patient's level of thirst between treatments is ____________. - Ans - salt intake. The purpose of using a water softener in the water distribution system is to ____________. - Ans - reduce levels of calcium and magnesium. Patients receiving high-flux dialysis may have ____________. - Ans - shorter treatment times. If a patient becomes nauseated and vomits during hemodialysis, the initial intervention should be to ____________. - Ans - assess for hypotension. A HeRO® Graft is indicated for ____________. - Ans - patients with stenosis/blockage of central veins leading to the heart. Water is removed from a patient's blood during hemodialysis by ____________. - Ans - osmosis. The fluid velocity (speed) of blood through tubing is based on flow rate and ____________. - Ans - tube diameter. When a dialysis treatment starts, the first point of restriction is the ____________. - Ans

• needle. If there is a kink in the venous bloodline between the venous pressure gauge and the venous access, what type of alarm should sound? - Ans - High venous pressure alarm.

In an arteriovenous fistula, the venous portion enlarges because of the ____________.

• Ans - high-pressure flow of blood from an artery. If an arteriovenous fistula is referred to as autogenous, this means that the fistula ____________. - Ans - is made from the person's own blood vessels. A brachiocephalic arteriovenous fistula is located in the ____________. - Ans - upper arm. If using ethyl chloride spray on an access site to reduce discomfort, ____________. - Ans - the skin must be cleansed before and after spraying. Signs and symptoms of steal syndrome include ____________. - Ans - the hand on side of access feels cold and painful. If the technician is unable to feel a pulse or thrill or to hear a bruit in the outflow vein of an arteriovenous fistula, this may indicate ____________. - Ans - thrombosis. When preparing to administer hemodialysis through a central venous catheter, the technician is unable to flush the catheter with normal saline because of resistance. The technician should ____________. - Ans - hold treatment and notify the nurse. Which of the following kinds of dialysis needles can be used without a safety device to prevent needle-stick injuries? - Ans - buttonhole needles. Which of the following is an extracorporeal alarm rather than a dialysate alarm? - Ans - Air detector. A normal respiration rate for most adults is ____________. - Ans - 12 to 16 per minute. When a patient is undergoing hemodialysis, all technical systems should be monitored at least ____________. - Ans - every 30 minutes. After the onset of hemodialysis, an anaphylactic reaction usually occurs within ____________. - Ans - 5 to 10 minutes. If a reprocessed dialyzer has been accidentally exposed to two germicides, the dialyzer ____________. - Ans - must be discarded. The most common site for placement of a straight graft is the ____________. - Ans - forearm. Which of the following is an indication of a pyrogenic reaction to hemodialysis? - Ans - Development of chills and fever 45 minutes into treatment.

If a high-pressure alarm for venous pressure sounds during hemodialysis, this could indicate ____________. - Ans - infiltration of the venous needle. All of the following might be considered categories of acute renal failure except? - Ans - Chronic Chronic is not considered one of the three categories of acute renal failure.The three categories includes: - Ans - Pre-renal intrinsic (internal) Post-renal Medicare pays for dialysis treatments for patients using which of the following methods?

• Ans - PPS stands for Prospective Program Payment System. In 1991, the Patient Self-Determination Act passed requiring which of the following? - Ans - That every patient be given information regarding their legal rights to make decisions about their medical care and treatment that they are to receive. Typically, how often are calcium levels drawn on a dialysis patient? - Ans - Monthly Substances that form charged particles could be considered which of the following? - Ans - Electrolytes The kidneys control the electrolytes in a person's blood. Which of the following does the kidneys use to make calcitriol? - Ans - Vitamin D Which of the body's organs works the most to metabolize fat-soluble medications so theycan be excreted? - Ans - Liver Of the following, which would not be considered as part of the treatment for pericarditis?
• Ans - Transplantation The blocking, suppression or delaying of clotting of the blood would be considered whichof the following? - Ans - Anticoagulation Which of the following carries the person's oxygen-rich blood from the heart and lungs to the rest of the body? - Ans - Arteries GAC stands for which of the following? - Ans - Granular Activated Charcoal-This charcoal is very porous and because of its largesurface area, helps to remove contaminants from the water. Mirtazapine (antidepressant) would be eliminated by which of the following? - Ans - Kidneys Sertraline, paroxitine, and fluoxetine antidepressants - Ans - would be eliminated by the liver.

The two types of deionization systems includes the dual and mixed bed systems. Of these two,which would make the highest quality water? - Ans - Mixed bed-The mixed bed tanks contain both anion resin beads and cation resin beads. The mixed bedsystems make the highest quality water Which of the following has the potential to irritate the lining around the heart causing inflammation? - Ans - Fluid overload Uremic toxins Viral infections The rib cage and which of the following helps to protect the kidneys? - Ans - pads of fat help to protect the kidneys-Each kidney weighs approximately 5 ounces and is located at the back of the body. Which of the following would be used to classify an obstruction of the urinary tract that would be considered either partial or complete? - Ans - Degree Which of the following is typically considered an in-facility renal replacement therapy that is now being performed by some patient's at home? - Ans - Hemodialysis With the end-stage renal disease patient, anemia could potential cause all of the following except? - Ans - A pro-longed life span of their red blood cells Patient rights would not include which of the following? - Ans - To have 24 hour around the clock medical service at home. If an end-stage renal disease patient receives transfusions, which of the followingcomplications might occur? - Ans - Contract infections Develop iron overload Experience transfusion reactions Which of the following medications would not be eliminated through hemodialysis? - Ans - Ceftazidime The medications that would be eliminated through peritoneal dialysis instead of hemodialysis - Ans - Ceftazidime Aminoglycoside antibiotics Cefipime Enalapril Medications which would be eliminated through both hemodialysis and peritoneal dialysis - Ans - Fluconazole Imipenem Lithium Mannitol

Phenobarbital Salicylate Sulfisoxazole Which of the following should be monitored for bacterial growth and endotoxins? - Ans - Dialysate Water storage tanks Water distribution piping system Which of the following conditions can cause sharp calcium phosphate crystals to form in a patient's joints, heart, eyes or skin? - Ans - Extraskeletal calcification-s a rare condition that occurs when the phosphorus and calcium levels become too high at the same time and bonds together. GN stands for which of the following? - Ans - Glomerulonephritis-GN is considered the third most common cause of end-stage renal disease. All but which of the following medications would not interfer with the results of a serum creatinine level test? - Ans - Salicylates _________ _________ is a rare condition in which the calcium and the phosphorus levels aretoo high at the same time and they bond together? - Ans - Extraskeletal calcification All but which of the following would be considered a goal for the patient that is on dialysis? - Ans - To cure the patient The educational process that is used to prepare the hemodialysis patient to self- cannulate typically last for how long? - Ans - Four weeks The technician/LPN should know the average length of a needle that might be required to cannulatean upper arm access. Which of the following would be considered correct?

• Ans - 1 inch When the technician/LPN is cleaning the patient's central venous catheter site, which of thefollowing interventions could be considered the most correct? - Ans - Recline the patient prior to using the catheter. When taking a dialysis patient's respirations, the technician/LPN should know that thenormal respiratory rate for an adult would be which of the following? - Ans - 12 - 16 breaths per minute The complication of uremic syndrome could potentially cause all of the following pulmonary complications with the chronic kidney failure patient except? - Ans - COPD

All but which of the following would help prevent the patient from developing a clot in their venous access? - Ans - Allow the use of the access arm for IV infusion in the site NANT stands for which of the following? - Ans - National Association of Nephrology Technicians/Technologists-This is an association that offers educational programs to help the technicians keep up to date on their skills and knowledge. One of the ingredients of typical dialysate fluid would be considered glucose. Which of the following would this ingredient help the dialysis patient with? - Ans - Helps to decrease the amount of potassium in the blood/ Helps prevent low blood sugar __________ molecules move faster than ________ ones? - Ans - Warm/cold When the kidneys excrete waste and excess water as urine, all but which of the following would be considered correct for where these would come from? - Ans - Respirations Which of the following would be the correct professional association for LPN/technicians? - Ans - NANT-NANT stands for National Association of Nephrology Technicians/Technologists. They offereducational programs that helps the technicians keep up to date on both their knowledge and skills. Of the following, which would be considered a main role of the LPN/technician? - Ans - Patient care Assembling and maintenance of equipment Which of the following would be eliminated from the body only by peritoneal dialysis? - Ans - Ceftazidime The technician/LPN is attempting to determine if a patient's catheter is an internal jugularor a subclavian, which of the following would be considered correct? - Ans - If the technician can't feel the catheter over the clavicle, it would be considered a subclavian. Of the following, which would be considered one of the factors that is convenient about using an automated system for reprocessing dialyzers? - Ans - The automated system can self-test. Which of the following foods would be considered high in potassium? - Ans - Cantaloupe Chocolate Tips which could be used by the technician/nurse when lifting/moving a patient would not include? - Ans - Always lift the patient by yourself

The KDOQI guidelines regarding a pseudoaneurysm could include which of the following? - Ans - These guidelines state to never place dialysis needles into a pseudoaneurysm. When the germicide peracetic acid is diluted, it breaks down to biodegradable acetic acid, oxygem, and water. Which of the following would be considered a reason for this germicide not be used? - Ans - High cost If a group of patients develop a reaction while using a dialyzer from a reprocess program, which of the following interventions should be done? - Ans - Stop the program and do not restart until the whole reprocessing system has been checked. If a patient develops analgesic nephropathy related to taking NSAIDS, which of the following would be considered the main treatment that would be considered correct? - Ans - Cessation of the NSAIDs Which of the following statements would be the most correct regarding the nephrology nurse? - Ans - The nephrology nurse has the potential to both support the patient and be instrumental inpreventing some of the complications of kidney failure. Which of the following will tell the technician/LPN the level of the total dissolved solids(TDS) in the water, in parts per million? - Ans - Conductivity The amount of time that it takes a medication to decrease by 50% in it's serum concentration would be considered? - Ans - Half-life All of the following would be considered types of diabetes mellitus except? - Ans - Neuropathy The types of diabetes consists of: - Ans - Type 2 Gestational Secondary Type 1 Pre-diabetes The organ in the body that does the largest percentage of metabolism of the fat-soluble medications so that they can be excreted would be considered? - Ans - Liver __________ would be considered a thin layer of tissue? - Ans - Membrane Which of the following statements would be considered the most correct in regards to convection? - Ans - During hemodialysis, when the solvent moves from the blood side to the dialysate side ofthe membrane dragging molecules of dissolved solute. Arterialization would be best described as which of the following? - Ans - When the strong fast arterial blood flow begins to enlarge the fistula making it tougher.

The temperature that the water is heated to when performing a 3-cycle heat disinfection process (for hemodialysis machine) is considered 85-95 C. How long is this hot water passed through the hydraulic circuit in a recirculation cycle? - Ans - 20 - 60 minutes Which of the following complications might be considered responsible for the dialysis patient to experience tetany? - Ans - Hypocalcemia-Symptoms of the complication can include:Tetany (muscle spasms, facial twitches, and muscle pain)SeizuresNumbness If bright cherry red blood is seen in the patient's lines during hemodialysis, which of the following should be the first thing the technician should do? - Ans - Stop treatment immediately During hemodialysis, it is possible for too much fluid to be taken off. Which of the following would not be considered a complication of too much fluid being taken off? - Ans - Shortness of breath Of the following interventions which would not be considered an intervention for helpingprevent seizures during dialysis? - Ans - Encourage the patient to follow their fluid restrictions. Which of the following would be considered the normal range amount of chloride in the human body? - Ans - 95 - 110 mEq/L would be the normal amount of calcium in the body. - Ans - 8.6-10.3 mg/dL would be the normal amount of urea in the body. - Ans - 5 - 25 mg/dL Of the following, which would not be considered correct regarding peritoneal dialysis? - Ans - Is not more work-friendly The following would be considered correct regarding peritoneal dialysis: - Ans - Is performed at home Is considered a self-care therapy treatment Is more flexible than hemodialysis Infections and which of the following would be considered common graft complications which can occur? - Ans - Pseudoaneurysm Dialysis dementia (caused by a build up of aluminum) in the dialysis patient, can lead toall of the following except? - Ans - Severe headaches Which of the following interventions would be considered correct for the technician to do if the sterile package that is obtained for a hemodialysis treatment is wet? - Ans - Do not use the pack

Of the following, which would be considered step 1 in filling a UF (ultrafiltration) burette during dialysis? - Ans - The high and low level sensors in the UF burette signal a valve to both open and close. During dialysis, water soluble vitamins may be removed. Which of the following would notbe considered one of these vitamins? - Ans - Vitamin E Temperature and which of the following would be considered profiling programs which the hemodialysis machine can run? - Ans - Dialysate flow rate The hemodialysis machines have the ability to run profiling programs. Which of the followingwould be considered one of these programs? - Ans - Ultrafiltration Sodium All of the following are considered alternative dialysis therapies except? - Ans - Triple needle hemodialysis When the technician/LPN checks the patient and sees bright cherry red blood in the patient'slines, which of the following interventions should be done first? - Ans - Stop the treatment Any venous access for dialysis requires an increase in the patient's cardiac output. What would be thetypical percentage of increase would an access require? - Ans - 10%- increase in the volume of blood passing through the heart will be required for the patient to have a fistula. When attempting to decrease the serum calcium level of the hemodialysis patient during their treatment, which of the following would not be considered correct? - Ans - Use a dialysate that is high in glucose The cephalic vein and which of the following would be used to form the brachiocephalic fistula? - Ans - Brachial artery The access site scarring that is similar to ear piercing that can occur because of placing the sharp dialysis needles into the same place for 3-4 weeks would be considered? - Ans - Buttonhole technique Which of the following is used as the filter for peritoneal dialysis and is full of capillaryblood vessels that act as tiny filters? - Ans - Peritoneum If a medication is ordered BID, which of the following would be considered correct as to how often it should be adminsitered? - Ans - Two times a day The technician has completed a treatment of a hemodialysis patient and is now cleaning up in preparation for the next patient. An item that has not been used is found on top of

the dialysis machine. Which of the following would be considered correct for what should be done with the item that was found? - Ans - Throw it out The new graft option that can be used on patient's whose only option would be a centralvenous catheter would be? - Ans - Hemodialysis Reliable Outflow Of the following, which term would be correct for when the strong fast arterial blood flowbegins to enlarge the fistula making it tougher? - Ans - Arterialization During the reprocessing treatment, the length of time that a disinfectant is required tostay in the dialyzer to make certain there is proper disinfection is referred to as whichof the following? - Ans - Dwell time The device on the dialysis machine that is used to detect air in the venous chamber, issometimes referred to as which of the following? - Ans - Air-embolism detector Foam detector The process of passing fluid through a filter would be considered which of the following?

• Ans - Filtration Clinical judgment and which of the following would be considered things that the hemodialysis technician/nurse needs to have a full understanding of? - Ans - Math Which of the following would be considered a professional organization that is for the dialysis patient not the staff? - Ans - American Association of Kidney Patients Of the following core curriculum modules, which one should the trainee practice drawing up medications from a vial? - Ans - Module 6 All of the following could be considered ways that the preceptor could use to help teachthe dialysis technician/LPN except? - Ans - Be talkative when the trainee is attempting to focus. Of the following, which could potentially help the trainee to learn? - Ans - Encouragement Positive feedback For which of the following reasons would having a dialysis technician/LPN training programbe good for a dialysis center? - Ans - No volunteer trainees should be allowed. It can work to boost the competence of any new staff. A plastic cap that covers the ends of the hollow fibers that are enclosed in the dialyzerwould be which of the following? - Ans - Headers

The hemodialysis patient typically weighs daily at home for which of the following reasons? - Ans - Can help determine how well they are controlling their fluid balance between treatments. The core curriculum modules for dialysis technician/LPN training contains all of thefollowing except? - Ans - Acknowledgment Which of the following could be considered different dialysis technician/LPN trainingprograms that could be utilized? - Ans - Independent study On-the-job training Vocational programs Which of the following would be considered the most correct statement about how themachine used in the dialysis process works to control the ultrafiltration and howmuch water is removed during a dialysis treatment? - Ans - The pressure is varied in order to control the ultrafiltration. High pressure in the blood compartments forces water out of the blood. If an infiltration occurs during the cannulation process, which of the following would not be considered a sign or symptom? - Ans - Diaphoresis Which of the following might be considered an appropriate intervention if the hemodialysis patient experiences an infiltrate from needle cannulation? - Ans - Place an ice pack on the site of the infiltrate Patient care and which of the following would be covered in the Certified Hemodialysis Technician (CHT) exam? - Ans - Dialyzer reprocessing Of the following, which would not be considered correct for a boundary that the technician/nurse in the dialysis center should observe? - Ans - Never wash hands prior to touching a patient