CCHT EXAM | ACCURATE QUESTIONS AND DETAILED ANSWERS | GUARANTEED PASS | GRADED A, Exams of Nursing

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CCHT EXAM | ACCURATE QUESTIONS AND DETAILED ANSWERS | GUARANTEED PASS | GRADED A | LATEST UPDATE What is the primary role of the hemodialysis technician in preparing the patient for dialysis? - Ans - To ensure patient comfort and safety during treatment What conditions can result from excessive fluid removal during hemodialysis? - Ans - Hypotension In hemodialysis, what is the primary function of the dialyzer membrane? - Ans - To separate blood from the dialysate What is a common electrolyte imbalance in hemodialysis patients characterized by elevated potassium levels? - Ans - Hyperkalemia _____________________ refers to elevated potassium levels in the blood and is a common concern in hemodialysis patients - Ans - Hyperkalemia In hemodialysis, what is the primary function of the arteriovenous (AV) fistula or graft? - Ans - To provide access for vascular catheters What is a common complication associated with hemodialysis access and can lead to reduced blood flow? - Ans - Stenosis _______________, or narrowing of the vascular access, is a common complication that can reduce blood flow during hemodialysis. - Ans - Stenosis What is the purpose of heparin during hemodialysis treatment? - Ans - To prevent clotting in the dialysis machine. What laboratory tests is used to assess a hemodialysis patient's anemia status? - Ans - Hemoglobin (Hb) ________________ are monitored in hemodialysis patients to access their anemia status. - Ans - Hemoglobin levels What is the primary role of the dialysis nurse in hemodialysis care? - Ans - To assess vascular access function and suitability. Which of the following medications are commonly prescribed to stimulate red blood cell production in hemodialysis patients? - Ans - Erythropoietin (EPO) _______________ is prescribed to stimulate the production of red blood cells in hemodialysis patients with anemia. - Ans - Erythropoietin (EPO) What is a common electrolyte imbalance in hemodialysis patients characterized by low calcium levels? - Ans - Hypocalcemia ___________________ refers to low calcium levels in the blood and can occur in hemodialysis patients. - Ans - Hypocalcemia What laboratory tests is used to assess a hemodialysis patient's kidney function? - Ans - Serum creatinine ________________ levels are commonly used to assess kidney function in hemodialysis patients. - Ans - Serum creatinine What is the function of the carbon tanks? - Ans - Removes chlorine and chloramines What is empty bed contact time? - Ans - The time that the water is actually in contact with the carbon filter. What is the minimum empty bed contact time (EBCT) allowed? - Ans - minimum of 12 minutes How often is the empty bed contact time (EBCT) calculated? - Ans - Monthly by technical team Where is empty bed contact time (EBCT) documented? - Ans - ER-1 log or TMS What is the maximum allowable limit fir total chlorine? - Ans - 0.09ppm What is the action level for total chlorine? - Ans - It is known as TB What is an element's tiniest particle that keeps the element's property? - Ans - It is known as Atom What feed would be used in a hemodialysis distribution system when the water is sent to a storage tank? - Ans - It should be indirect A patient is undergoing kidney transplant. You will educate the family about the major risk involved in the process, what is a significant risk? - Ans - Risk of rejection For each hemodialysis treatment, how many needles are used? - Ans - Two needles are used The preceptor utilize which of the following communication methods to get more information from the trainee? - Ans - Direct questions is the best method What renal structure is responsible for filtering blood and forming urnine? - Ans - Nephron The __________ is the functional unit of the kidney responsible for filtering blood, reabsorbing essential substances, and forming urine. - Ans - Nephron What is the primary function of the renal pelvis? - Ans - Transport of the urine to the bladder The ___________________ collects urine from the nephron and transports it to the bladder for storage and eventual elimination. - Ans - Renal pelvis What is a primary electrolyte that is carefully controlled during hemodialysis? - Ans - Potassium __________________ levels are closely monitored during hemodialysis because imbalances can lead to cardiac arrhythmias and other serious complications - Ans - Potassium What is the purpose of the dialysate in hemodialysis? - Ans - To remove waste products from the blood The _____________ is a specialized used in hemodialysis to help remove waste products and excess fluids from the patient's blood. - Ans - Dialysate What is the primary function of the arteriovenous fistula (AVF) or graft in hemodialysis? - Ans - To provide access for blood withdrawal and return. The AVF or graft serves as a ____________ for the hemodialysis procedure, allowing blood to be withdrawn, filtered, and returned to the patient. - Ans - vascular access point What factor can contribute to hypotension during hemodialysis? - Ans - Excessive ultrafiltration Excessive removal of fluid also known as ultrafiltration during hemodialysis can lead to a drop in blood pressure, causing what? - Ans - Hypotension What is the recommended temperature range for the dialysate in a hemodialysis machine? - Ans - 35-40 C The dialysate temperature is typically maintained in the range of __________ to ensure patient comfort and efficient dialysis. - Ans - 35-40 C What is the primary purpose of heparin in hemodialysis? - Ans - To prevent clotting in the dialyzer. ____________________ is used in hemodialysis to prevent blood clotting within the dialyzer . - Ans - Heparin What condition is characterized by the buildup of waste products and toxins in the blood due to kidney dysfunction? - Ans - Chronic Kidney Disease (CKD) ________________ is a condition in which the kidneys gradually lose their ability to filter waste and toxins from the blood. - Ans - Chronic Kidney Disease (CKD) What is the role of the glomerulus in the nephron? - Ans - Filtration of blood The _______________ is responsible for filtering blood, allowing small molecules and waste products to enter the renal tubules. - Ans - Glomerulus What represents the patient's weight without excess fluid? - Ans - The "dry weight" of a hemodialysis patient. _______________________________ of a hemodialysis patient is the weight at which they are free of excess fluid, which is important for accurate ultrafiltration during dialysis. - Ans - The "dry weight" What complications can occur due to vascular access problems in hemodialysis? - Ans - Infection What is the primary function of the peritoneal membrane in peritoneal dialysis? - Ans - To exchange fluids and waste products The peritoneal membrane in peritoneal dialysis serves as a ________________ for the exchange of fluids and waste products between the patient's peritoneal cavity and the dialysate. - Ans - Semipermeable barrier What laboratory value is typically monitored to assess anemia in hemodialysis patients? - Ans - Hemoglobin (Hb) ____________________ levels are routinely monitored in hemodialysis patients to assess and manage anemia. - Ans - Hemoglobin (Hb) What is the primary purpose of the Kt/V measurement in hemodialysis? - Ans - To quantify dialysis adequacy ______ is a measurement used to assess the adequacy of dialysis treatment in removing waste products from the blood. - Ans - Kt/V What factor can lead to dialysis-related amyloidosis in long-term hemodialysis patients? - Ans - Accumulation of beta-2 microglobulin Dialysis-related __________ can occur due to the accumulation of beta-2 microglobulin in long-term hemodialysis patients. - Ans - amyliodosis What is the primary role of the dialysate solution in hemodialysis? - Ans - To remove waste products from the patient's blood. The ___________________ is essential in hemodialysis for its role in removing waste products and excess fluids from the patient's blood. - Ans - Dialysate solution What is a common complication of vascular access in hemodialysis and often requires surgical intervention? - Ans - Aneurysm formation _____________________ is a common vascular access complication in hemodialysis and may require surgical intervention? - Ans - Aneurysm formation In hemodialysis, what complication can result from inadequate ultrafiltration? - Ans - Hypotentsion _______________ during hemodialysis can lead to hypotension (low blood pressure) in patients. - Ans - Inadequate ultraflitration What term refers to the process of removing waste products and excess fluid from the blood during hemodialysis? - Ans - Ultrafiltration ___________________ is the process if removing waste products and excess fluid from the blood during hemodialysis. - Ans - Ultrafiltration What is the primary function of the peritoneal catheter in peritoneal dialysis? - Ans - To provide access for vascular catheters The ________________ in peritoneal dialysis provides access for the introduction of dialysis into the peritoneal cavity. - Ans - Peritoneal catheter In hemodialysis, what complication can occur if the dialyzer is not properly rinsed with saline before use? - Ans - Hemolysis Failure to properly _________________________ with saline before use can lead to hemolysis (rupture of red blood cells) during hemodialysis. - Ans - Rinse the dialyzer What is the primary role of the dialysate solution in peritoneal dialysis? - Ans - To facilitate the exchange of fluids and waste products. Hemolysis - Ans - rupture of red blood cells What is the primary function of the parathyroid glands in calcium regulation? - Ans - To stimulate calcium release from bones The parathyroid glands secrete _____________________, which stimulates the release of calcium from the bones into the bloodstream. - Ans - parathyroid hormone (PTH) What is the role of the interdialytic period in hemodialysis? - Ans - It represents the time between hemodialysis sessions. What is the common complication of long-term hemodialysis that results from aluminum accumulation in the body? - Ans - Osteoporosis Accumulation of aluminum in the body due to long-term hemodialysis can lead to ____________. - Ans - Osteoporosis What is the primary role of the vascular access coordinator in hemodialysis care? - Ans - To assess vascular access function and suitablility The ______________________ in hemodialysis is responsible for assessing the function and suitability of vascular access for patients. - Ans - vascular access coordinator What is the following laboratory values is typically monitored to assess fluid balance in hemodialysis patients? - Ans - Serum sodium _________________________ are monitored in hemodialysis patients to assess fluid balance and sodium regulation. - Ans - Serum sodium levels In hemodialysis, what is the primary role of the dialyzer membrane? - Ans - To separate blood from the dialysate. The __________________ in hemodialysis serves to separate the patient's blood from the dialysate, allowing for the exchange of waste products and excess fluids. - Ans - Dialyzer membrane What is the role of the dialysate in hemodialysis? - Ans - It removes waste products from the patient's blood What is the primary function of the peritoneal dialysis catheter in peritoneal dialysis? - Ans - To facilitate the exchange of fluids and waste products. The ____________________ facilitates the exchange of fluids and waste products between the peritoneal cavity and the dialysate solution. - Ans - Peritoneal dialysis catheter In hemodialysis, what complication can occur due to inadequate anticoagulation during treatment? - Ans - Clotting in the dialyzer or vascular access. ______________________ during hemodialysis can lead to clotting in the dialyzer or vascular access, affecting treatment efficiency. - Ans - Inadequate anticoagulation What hormone is produced by the kidneys and helps regulate blood pressure by promoting the release of aldosterone. - Ans - Renin The kidneys produce renin, which plays a role in regulating blood pressure by promoting the release of ________________________. - Ans - Aldosterone What is the primary role of the hemodialysis technician in preparing the patient for dialysis? - Ans - To ensure patient comfort and safety during treatment. What is the primary purpose of phosphate binders in hemodialysis? - Ans - To reduce phosphate absorption from the diet. What is the role of the dialysate temperature in hemodialysis? - Ans - It controls the rate of waste removal. What is the primary function of the dialyzer membrane in hemodialysis? - Ans - To separate blood from the dialyzer What medication is commonly used to lower high blood pressure in hemodailysis patients? - Ans - Antihypertensive drugs What is the role of the dialysate flow rate in hemodialysis? - Ans - It controls the rate of waste removal The ____________________ in hemodialysis controls the rate at which waste products and excess fluids are removed from the patient's blood - Ans - Dialysate flow rate (DFR) What is the primary purpose of the venous needle during hemodialysis? - Ans - To return filtered blood to the patient The _______________ in hemodialysis is responsible for returning filtered blood to the patient's circulation after it has passed through the dialyzer. - Ans - Venous needle What condition can result from excessive fluid removal during hemodialysis? - Ans - Hypotension _________________________ during hemodialysis can lead to hypotension (low blood pressure) in patients. - Ans - Excessive fluid removal What is the primary role of the vascular access nurse in hemodialysis care? - Ans - To assess vascular access function and suitablility The _______________ in hemodialysis is responsible for assessing the function and suitability of vascular access for patients. - Ans - Vascular access nurse What is a common complication of vascular access in hemodialysis and often requires surgical intervention? - Ans - Aneurysm formation ________________ is a common vascular access complication in hemodialysis and may require surgical correction. - Ans - Aneurysm formation What is the primary role of the arterial needle during hemodialysis? - Ans - To withdraw blood from the patient What term refers to the process of removing waste products and excess fluid from the blood during hemodialysis? - Ans - Ultrafiltration 2. Externally, using teflon tubes 3.Internally in the carotid vessels 4. Intravascularly, using 4 inch catheters - Ans - 2.Externally, using teflon tubes Which U.S. President signed the bill that allowed Medicare coverage to pay for treatment for all patients with chronic kidney disease? 1.Roosevelt 2.Nixon 3.Ford 4.Carter - Ans - 2.Nixon In 1989, FDA approval of this medication diminished the need for blood transfusions in the chronic renal disease patients: 1.Lovenox 2.Epoetin alfa (epogen) 3. Factor VIII 4. Ruxolitinib - Ans - 2. Epoetin alfa (epogen) An electrolyte is a substance that dissolves in water to form: 1. charged atoms 2. solute 3. ionized particles 4. electrical current - Ans - 3.Ionized particles What may result if a dialysate solution contains too much sodium? 1. Water may shift into pt's blood cells, causing hypotension and cramping 2. Fluid may leave the cells, causing blood cells to shrivel 3. Pt may experience heart failure & ventricular dysrhythmias 4. Pt may experience hypertension, profound thirst, and headache - Ans - 2 & 4 With osmosis, water moves from areas of: 1.Lower water concentration to areas of higher water concentration 2. Low concentration of solutes to areas of high concentration of solutes 3. Acidity to areas of alkalinity 4. Higher temps to lower temps - Ans - 2. Low concentration of solutes to areas of high concentration of solutes Buffers minimize pH changes when an acid or a base is added to a solution. What is the major plasma buffer in the body? 1. Sodium 2. Bicarbonate 3. Potassium 4.Lactate - Ans - 2.Bicarbonate Kidney failure causes retention of hydrogen ions. What is the result? 1. Metabolic alkalosis 2. Metabolic acidosis 3. Respiratory alkalosis 4. Respiratory acidosis - Ans - 2. Metabolic acidosis Which of these patient populations has the lowest proportion of body water? 1.Geriatric patients 2. Adult females 3.Adult males 4.Infants - Ans - 2. Adult females The vasa recta capillaries surround the loop of Henle nephrons and play a major role in: 1. Electrolyte balance 2. Concentration of urine as it moves through the tubules 3. Fluid secretion and reabsorption 4. Excretion of waste products - Ans - 2.Concentration of urine as it moves through the tubules In the formation of urine, what action is occurring in Step 2? 1. Water moves from the glomerulus into the Bowman's capsule? 2. Water & other dissolved substances move from the tubules into the blood in the peritubular capillaries 3. There is movement of selected substances from the blood in the peritubular capillaries back into the tubules 4. There is secretion of hormones into the blood capillaries which will cause the kidneys to hold onto water - Ans - 2. Water & other dissolved substances move from the tubules into the blood in the peritubular capillaries The glomerular filtration rate is the amount of filtrate produced by the kidneys per minute. What is glomerular filtration dependent on? 1. Sufficient blood circulation to the glomerulus 2. Proper reabsorption of ions & molecules 3. Adequate glucose to supply energy for renal functions 4. Maintenance of normal filtration pressures - Ans - 1 & 4 Blood urea levels are influenced by many factors. Decreased levels may result from: 1.Gastrointestinal tract bleeding 2. Low dietary protein intake 3.Overhydration 4.Steroid use - Ans - 2 & 3 At the conference for Kidney Disease: Improving Global Outcomes (KDIGO) on Chronic Kidney Disease it was recommended that stage 3 be subdivided into 3a and 3b. What is the recommended glomerular filtration rate for 3b? 1. 60-88 mL/min/1.73 m2 2. 30-44 mL/min/ 1.73 m2 3. 45-59 mL/min/1.73 m2 4. 15-29 mL/min/1.73 m2 - Ans - 30-44 mL/min/1.73 m2 The National Kidney Foundation (NKF) recommends that all individuals be assessed for increased risk for developing chronic kidney disease (CKD). Which of these laboratory values should be included in this evaluation? 1. Blood Urea Nitrogen (BUN) 2. Creatinine level 3. Aldosterone level 4. Erythropoietin level - Ans - Creatinine level When is a patient considered to be in Stage 5 CKD? 1. When the patient has been diagnosed with stage 1 CKD with GFR of 90 mL/min/1.73 m2 2. When the patient requires maintenance dialysis for survival 3. When he has a GFR between 60-89 mL/min/1.73 m2 4. When she has moderately decreased GFR - Ans - When the patient requires maintenance dialysis for survival A patient with a diagnosis of nephroschlerosis may exhibit which of these manifestations? 1. Blood in urine 2. Proteinuria 3. Uncontrolled hypertension 4. Foamy urine - Ans - 1,2, & 3 What is a common clinical manifestation of renal cell carcinoma? 1.Excess ankle swelling 2.Blood in urine 3.Periorbital edema 4. Weight gain - Ans - Blood in urine Which of the following maybe a cause of postrenal acute renal failure? 1. Severe dehydration 2. Obstruction in the ureter or urethera 3. Heart failure 4. Toxicity related to antibiotic administration - Ans - Obstruction in the ureter or urethera What is the target blood pressure in patients with CKD recommended by the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High BP? 1. less than 130/80 2. less than 150/90 3. less than 140/85 4. less than 125/75 - Ans - Less than 130/80 1.The bicarbonate concentrate is very susceptible to bacterial contamination 2.Calcium & magnesium are very stable in solution with bicarbonate 3. The 'A' (acidified) concentrate is made up primarily of potassium 4. The 'B' (bicarbonate) concentrate is very stable & has a long shelf life - Ans - The bicarbonate concentrate is very susceptible to bacterial contamination Which laboratory test is used to detect & quantify bacterial endotoxins? 1.Limulus amebocyte lysate (LAL) 2. Culture and sensitivity (C & S) 3. Colony-forming units (CFU) 4. Enzyme-linked immunosorbent assay (ELISA) - Ans - Limulus amebocyte lysate (LAL) What may occur if the bicarbonate concentrate is overmixed? 1.A decrease in serum calcium levels 2.An increase in sodium levels 3.A drop in phosphate levels 4.An increase in magnesium levels - Ans - A decrease in serum calcium levels During a dialysis session, it is important for the dialysis technician to monitor dialysate temp since fluid temps ____ cause hemolysis of RBC's 1.>41C 2.<36C 3.<40C 4.>30C - Ans - >41C What action should be taken if a blood leak detector alarm is activated and no blood can be confirmed on visual inspection of the site? 1.Test the dialysate with an approved blood leak test strip 2.Stop the dialysis machine & re-prime the blood lines 3.Check the dialysate with a rapid-acting protein strip 4.Turn off the alarm & proceed with the session - Ans - Test the dialysate with an approved blood leak test strip How can air enter the bloodlines? 1.At connections that are not absolutely tight 2.By osmosis thru contact with blood tubing 3.From empty fluid containers attached at the infusion sidearm 4.Thru mixing of hydrogen peroxide with blood from insufficient rinsing of equipment - Ans - 1 & 3 What does high efficiency dialysis require? 1.Highly permeable cellulosic membrane with surface area of 1.5 m2 or more 2.Reliable blood flow of at least 200 mL/min 3.Dialysate flow rate of 300 mL/min or more 4.Ultrafiltration coefficients of 10-15mL/hr/mmHg - Ans - Highly permeable cellulosic membrane with surface area of 1.5 m2 or more Dialysis technicians working with patients undergoing high-flux dialysis should be alert to the development of bacterial infection. Why is blood contamination a problem with high-flux dialysis? 1.The lack of filters placed in the dialysate path so that high volumes can be maintained 2.High-flux membranes readily pass particles of 2000-10000 daltons in size 3.The inability of cleaning solutions to reach the inner portion of the membrane during reuse 4.Breaks in the blood tubing due to high volume pressure - Ans - High-flux membranes readily pass particles of 2000-10000 daltons in size Several factors affect the removal of toxins in dialysis. Which one of these principles is accurately stated? 1.The greater the flow rate, the greater the removal of solutes 2.The higher the temp, the lower the solute removal 3.The larger the molecular weight, the greater the removal of solutes 4.The lower the concentration gradient, the greater the amount of diffusion - Ans - The greater the flow rate, the greater the removal of solutes To achieve an optimal concentration gradient, which direction should blood and dialysate flow? 1.In the same direction 2.In opposite directions 3.In a cyclic fashion 4.As determined by flux - Ans - In opposite directions During ultrafiltration, what happens when positive pressure is applied to the blood side of the dialyzer? 1.Red blood cells will be pushed out 2.Plasma fluid will be pushed out 3.An increased amount of electrolytes will be pushed out 4.All endotoxins will be pushed out - Ans - Plasma fluid will be pushed out If reverse filtration occurs and dialysis water is moved into the blood, what potential patient complication should be monitored by dialysis personnel? 1.Rupture of blood vessels 2.A pyrogen reaction(fever) 3.Water on the basin 4.Hypertensive crisis - Ans - A pyrogen reaction (fever) Which of these principles is used to increase treatment tolerance and decrease complications related to fluid removal? 1.Ultrafiltration profiling 2.Diffusion 3.Reverse filtration 4.Osmosis - Ans - Ultrafiltration profiling A patient is being dialyzed on a machine with Crit-Line Monitor. If fluid removal is greater than the volume the patient can shift into the intravascular space, the renal term should intervene before the patient becomes: 1.Hypovolemic 2.Fluid overload 3.Anemic 4.Hypotensive - Ans - Hypovolemic What is the most common impurity in tap water? 1.Calcium carbonate 2.Zinc 3.Lead 4.Mercury - Ans - Calcium carbonate Which of the following chemicals may cause methemoglobinemia, in which red cell hemoglobin cannot transport oxygen? 1.Nitrates 2.Chloramines 3.Fluoride 4.Aluminum - Ans - 1 & 2 In order to remove smaller solutes, such as endotoxins, which filter should be used? 1.Ultrafilters 2.Wound filaments 3.Membrane cartridges 4.Carbon filters - Ans - Ultrafilters Which statements regarding the removal of chlorine & chloramines from water using two carbon tanks is accurate? 1.If sampling reveals there is chloramine in excess of 0.1 ppm leaving the first tank, then water must be sampled after leaving the second tank 2.Sampling must be done to ensure that the carbon tank does not remove too many electrolytes, such as calcium and sodium 3.If a sample from the second tank contains any amount of chloramine, the dialysis session should be cancelled 4.Chlorine and chloramine testing must be done at the beginning of each treatment week - Ans - If sampling reveals there is chloramine in excess of 0.1 ppm leaving the first tank, then water must be sampled after leaving the second tank Polyamide membranes, used for reverse osmosis: 1.Have a very long service life 2.Have a wide pH tolerance 3.Degrade at temps greater than 35C What is the significance of a new dialysis patient beginning to ask questions about his treatment regimen or procedures specific to his care? 1.The patient's anti-anxiety drugs have reached a therapeutic level 2.The patient is in the bargaining phase of grief 3.The patient is exhibiting a readiness to learn 4.The patient has finally completed the stages of grief - Ans - The patient is exhibiting a readiness to learn What are some of the barriers to effective patient education? 1.Lack of time to spend one-on-one with the patient 2.Lack of patient-appropriate education materials 3.Cultural variables such as language differences 4.Anxiety, depression, or fear on the part of the patient - Ans - All of these factors are barriers to effective patient education What can patients expect when they decide not to initiate dialysis and elect palliative care instead? 1.To die pain-free with dignity 2.That all further treatment options will be discontinued 3.That death will occur in a matter of days 4.That treatment for fluid overload symptoms will be withheld - Ans - To die pain-free with dignity With the dialysis patients which of the following medications may result in sexual dysfunction? 1.Antihypertensives 2.Long-term antibiotics 3.Phosphate-binding agents 4.Calcium supplements - Ans - Antihypertensives What key points should be discussed when orienting new staff to professional boundaries? 1.Spending time with patients outside of the workplace is not recommended 2.Gifts, monetary, or otherwise, should never be accepted from a patient or family member 3.Socializing with patients is acceptable as long as family members are present 4.It is acceptable to establish a business relationship with patients who have experience in the field about which you are seeking information - Ans - 1 & 2 A dialysis patient is participating in an in-center self-care program in which he shares responsibility with the clinic staff for performing the dialysis treatment. What activities may this patient perform? 1.Pre- and post treatment weight measurements 2.Preparation and cannulation of his vascular access device 3.Setting up and programming the dialysis machine 4.Cleaning and sanitizing the machine and dialyzer - Ans - 1,2, & 3 What is the amount of saline required to prime the dialyzer? 1.500-1000 mL 2.200-300 mL 3.350-450 mL 4.1200-1500 mL - Ans - 500-1000mL When would a reused dialyzer be rejected? 1. Renalin exposure time was 4 hrs total 2.TCV is 90% of initial volume 3.Applied pressure causes the dialyzer to maintain pressure 4.Visual inspection reveals a few clotted fibers - Ans - Renalin exposure time was 4 hrs total Many dialysis units require two people to verify and document that ___ & that _____ before using a reprocessed dialyzer 1.The dialyzer is correct for the specific patient 2.The disinfectant test is negative 3.A blood sample was obtained from the correct patient 4.Heparin is available in the med cart prior to beginning dialysis - Ans - 1 & 2 Hepatitis B: 1. Is highly transmissible 2.Is treatable utilizing ultra-filtrate dialysis 3.Is not transmitted by percutaneous exposure 4.Can survive for several days on environmental surfaces at room temp - Ans - 1 & 4 A staff member is immune to hepatitis B due to vaccination series. What will laboratory results show? 1.HBsAg positive 2.Anti-HBc negative 3.Anti-HBs positive 4.IgM anti-HBc negative - Ans - 2 & 3 A staff member tests positive for IgM antibody to hepatitis B core antigen (IgM anti- HBc). What does this mean? 1.He is a chronic carrier of hepatitis B 2.He has had a recent infection with hepatitis B virus 3.He is immune to hepatitis B 4.He has been exposed to hepatitis B but is immune - Ans - He has had a recent infection with hepatitis B virus What is the CDC recommendation for hepatitis C serological screening? 1.Routine screening of staff for the HCV antibody 2.Routine screening of patients for the hepatitis C virus (HCV) antibody 3.Monitoring all patients monthly for liver enzyme elevations 4.Bi-monthly testing for anti-HCV - Ans - Monitoring all patients monthly for liver enzyme elevations How can patients who are infected with methicillin-resistant Staphylococcus aureus (MRSA) or vancomycin-resistant enterococci (VRE) be safely cared for in the dialysis unit? 1.By following standard precautions, making sure to wear gloves if touching soiled skin or clothing 2.By hanging IV antibiotics and infusing throughout the entire dialysis treatment 3.By isolating patients with draining wounds in a room dedicated to all infectious patients 4.By making sure that reusable equipment is not used for the care of other patients until it has been sanitized - Ans - 1 & 4 When a patient is infected with carbapenem-resistant enterbacteriaceae (CRE), what type of precautions should be implemented? 1.airborne 2.standard precautions alone 3.Contact 4.Droplet - Ans - Contact What is the half-life of heparin? 1.60 minutes 2.30 minutes 3. 1.5 hours 4. 4 hours - Ans - 1.5 hours When Citrasate dialysate is used: 1.Additional blood testing is required 2.Hypocalcemia is not a concern 3.Anticoagulation is improved, preventing clotting of fibers in the dialyzer 4.The risk of bleeding is increased - Ans - 2 & 3 What is the preferred vascular access in patients undergoing chronic hemodialysis? 1. Brachiocephalic AV fistula 2.Radial-cephalic AV fistula 3.Transposed brachiobasilic fistula 4.Polytetrafluoroethylene graft - Ans - Radial-cephalic AV fistula What precautions should patients with stage 4-5 CKD follow? 1.Have an AV graft implanted at least 6 mnths in advance to needing dialysis 2.Wear a Medic Alert bracelet signaling healthcare providers to avoid vessels for venipuncture that may be needed for dialysis access 3.Drink fluids frequently to maintain residual urine output 4.Consent to have a venous catheter placed several months in advance before beginning dialysis - Ans - Wear medic alert bracelet