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Hand washing with soap and water utilizing vigorous rubbing should last a minimum of a. 5 seconds b. 15 seconds c. 30 seconds d. 60 seconds If a Hep B positive patient is on census in the facility, the dialysis machine can be used a. By any patient after disinfection b. by any patient before the Hep B positive patient c. by any Hep B immune patient d. Only Hep B positive patients Blood spills must be cleaned by a tuberculocidal disinfectant or a bleach solution of at least a. 1:1 dilution b. 1:10 dilution c. 1:100 dilution d. no dilution is needed After the treatment , what measures are taken to prevent blood loss? a. completely rinse back as much blood as possible b. ensure that the patients puncture sites are clotted c. none of the above d. both a and b The following statements all pertain to active listening except one a. it is a skill used to give patients undivided attention b. allows patients to be heard c. just tell the patient yes or no d. involve focusing on the conversation and uses questions to clarify important issues John Smith is a 30 year old blind diabetic who has been admitted recently to an assisted living facility to manage his diabetes after several prolonged hospitalizations. He states that he is depressed and you

a. tell hi what you did to get better when you were depressed b. tell him it will get better and try change the subject c. listen to him and acknowledge that he has been through a lot in the last several months d. focus on starting dialysis and explain that you will be back later to give him advice Mary Jones began dialysis one month ago, She confide in you that she has concerns about her finances now that she can no longer work. You explain to her that a. she needs to talk to the charge nurse regarding her finances b. her information is kept c. our main concern is for patient/ caregiver confidentially d. both b and c Mary Smith has been a dialysis patient for 20 years at your center. She is recent new grandmother and states that you feel like family here at the center as she invites you to the first birthday part. You know. a. The a small gift is acceptable to give if you cant attend b. that becoming attached is important to the patience caregiver relationship c. it is not appropriate to socialize with patients outside of the center d. a professional relationship can be extended outside the center

• Mrs. Jones is 81 years old and new to dialysis. You will need to consider all except one of the following with respect to teaching a. adults only learn what they feel they need to know b. adults learn when they are ready c. pain will not influence the learning process d. all learning must be tailored to the learner Mrs. Smith is 59 years old and has stayed at home to raise children for years and is concerned about staying active in life now that she is new to dialysis and is asking for some guidance. An approach might be a. recommend that getting a job will her busy b. talk to her about what she enjoys doing c. b and d d. allow the patient to do as much as she can, physically The #1 rule of patient/ caregiver interaction is a. not listening to the patient b. confidentiality c. discussing personal matters

d. the focus is on the emotional relationship Thirty minutes after initiation if dialysis you notice Mr. Adams has been dialysating on a 2 K+ bath and his order is for a 3 K+. You should : a. leave him on the 2k+ for the remainder of the treatment b. notify the RN of the error and complete an incident report c. switch to 3k+ and draw a potassium d. instruct the patients to be more liberal with potassium in his diet today Setting machine parameters include a. ensure proper TMP/Ultra filtration rate and alarm limits are set b. ensure proper blood flow rate and dialysate flow rates, as ordered c. ensure a proper anticoagulant rate is set, if applicable d. all of the above Mr. Rice, has arrived late for dialysis again. His order is to dialyze for 4 hours. He has a catheter and the prescribed blood flow is 350 ml/min. His time to go on dialysis is 13: but he arrived late and did not go on until 13:30. The blood rate (BFR) is maximum 300 ml/min. What is the most appropriate a. Take him off at 1700 and tell him you are cutting him time b. report to the nurse in charge the time Mr. Rice went on dialysis and the obtainable c. Explain to the patient that even a treatment for the prescribed times and blood is only about 15% of normal kidney so every minute is important for adequate dialysis d. both b and c A patient would be considered at dry weight post dialysis if a. shortness of breath assessed by the nurse pre dialysis has diminished b. the patient has low blood pressure c. there is no edema or swelling d. the patient feels fine while sitting, but comes lightheaded when standing Mr. Barton is a very pleasant elderly man, To assist the other technician, you volunteer to document his post dialysis weight. When he returns to you to repost his weight it is 2kg above his pre dialysis weight. You ask him to pre-weight to verify. What information will you gather prior to reporting to the nurse your findings a. comparison of pre-dialysis assessment to post dialysis assessment and the flow sheet b. how much Mr. Barton ate and drank the night before c. who is his primary caretaker at home d. none of the above

Ms. Miller is 35 years old and frequently requests the technician to only remove 2kg despite her weight gain. You complete her treatment and while performing your post dialysis assessment you note the following: edema to ankles, blood pressure unchanged from pre assessment, and she is above her dry weight by 3kg. What actions would you take? a. report to the nurse at the end of the day b. address with the patient your concerns and refer the situation to the nurse immediately, prior to the patient being discharged c. nothing. she knows what she is doing d. scold the patient for being non compliant

• Mr. Chavez informs you that after dialysis today she is going to New Mexico to visit her family for the weekend and will not be coming on Saturday. What actions should you take? a. educate the patient on the possible complications of skipping dialysis b. inform the nurse c. inform the social worker as you are afraid the family may not be aware of the consequences d. all of the above Mr. Smith requested to come off 20 minutes early to meet a friend in town. Your best response would be a. "Thats okay, you can make up on your next treatment" b. "you need to sign a release" c. "i understand your excitement to see you friend but it is important for you to complete your treatment to avoid complications like inadequate dialysis" d. "i cant help you right now, i have a take off" Mrs, Chavez is cared for by her place. upon assessment today you notice a bruise on her upper arms and a bruise on her forehead. You asked if she fell and she did not answer immediately. When you asked the niece she became very defensive and said she fell. What would you do? a. notify the nurse and the social worker immediately. as healthcare providers we are obligated to report any suspicion of abuse b. not put her on until the nurse is notified, if she fell there may need to be further intervention c. nothing, continue to put her on and deal with it later d. both a and b Wright's hemogloblin level is 8.0 g/dL. He does not feel well and you overheard the doctor tell him that he needs a blood transfusion. You know that he is Jehovahs witness

and will not receive a blood transfusion. How does knowing this effect the patients treatment plan a. healthcare team will need to discuss with the patients how best to address the situation and allow his religious beliefs to be respected b. force the patient to have a blood transfusion c. call his religious advisor and discuss the situation with them d. none of the above Ms. Davis is 32 years old. She has been on dialysis for 3 months. Her fistula is ready to be used. The first cannulation went well. As you pull her needles she does not want to look. What things can you do to help her get involved and take more responsibility with her care? a. tell her what you are doing as you are doing it b, have her hold pressure on her sites after you pull so she can touch and acknowledge her own body c. refer to the social worker, it is not your place to encourage patient involvement d. both a and b a. 5625 units 75 units x 75 kg - Ans - Today is Mr. Hong's first day on dialysis. His heparin order reads: 75 units per kilogram. his weight is 75 kg. how much heparin will you give? a. 5625 units b. 5650 units c. 6600 units d. 6650 units you are using a 5cc syringe of administer the heparin, how many would you draw up? a. 1cc b. 5cc c. 10cc d. none of the above Normal saline is used for all of the following in dialysis except a. hypertension b. hypotension c. cramps d. rinseback the blood after treatment complete

• What is the concentration of saline in Normal Saline?

a. 0.45% b. 9% c. 0.9% d. 0.1% Kip Marks is 23 years old. He has had diarrhea for 2 days. He presented 1 kg below dry weight. His ultrafiltration goal was set for rinse back only. Thirty minutes into the run he begins to cramp and feels faint with change in level of consciousness. What following intervention would be implemented? a. Stop ultrafiltration and put patient in trendelenburg position b. normal saline bolus 200cc c. neither d. both a and b An AV/V fistula is preferred access for hemodialysis because: a. There is a lower incidence of complications b. Surgeons are more experience and prefer creating AV fistulas c. There is a lower incidence of thrombosis d. Both A and C

• The pressure difference between the blood side and the dialysate side of the dialyzer is called a. Ultrafiltration Factor b. Dialysate Flow Rate c. Transmembrane Pressure d. Urea Reduction Ration What is the best way to prepare an access for cannulation a. Scrub with a gauze or pad soaked with a germicidal agent in a circular motion from the outside inward b. Scrub in a circular motion from the inside to the outside and allow the recommended time for skin contact before cannulation c. rub vigorously up and down the area to be cannulated then insert the needle d. No further preparation is required if the patient has just washed their access Which of the following statements is not true about the Nephron? a. the nephron is the functional unit of the kidney b. nephrons process about 7500 mL of filtrates per hour c. a nephron is composed of renal tubules and collecting ducts d. nephrons are located in the bladder

c. ask a few open ended questions that would indicate whether there is a personal issue

• Ans - Mr. Pitt is always joking. He usually requests to be called "Bob". He presents today very quiet and when you called him "bob" he did not respond. How would you further investigate this change in behavior? a. go get the nurse without further investigation b. put him on and worry about it later c. ask a few open ended questions that would indicate whether there is a personal issue d. nothing he simply may not to talk today d. both a and c - Ans - Which of the following statements is not true about renal tubules? a. approximatel 66% of water from the filtrate is reabsorbed in proximal convoluted tubule b. loop of Henle reabsorbs sodium chloride which promotes water conservation in times of dehydration c. distal convoluted tubule maintains balance in the liver d. both a and c b. <15 mL - Ans - Stage 5 CKD is defined by a GFR of a. >90 mL b. <15 mL c. 30-59 mL d. 15-29 mL a. intense thirst, flushed skin, dry mucus membrane - Ans - Hypernatremia is defined as a plasma sodium concentration of a above 146mEQ/L. It is manifested by: a. intense thirst, flushed skin, dry mucus membrane b. headaches, seizures, muscle cramps c. fever d. agitation, low body temperature d. all of the above - Ans - Which of the following are symptoms of uremia: a. fatigue, weakness, mental confusion b. flu like symptoms c. metallic taste in the mouth d. all of the above d. all of the above - Ans - Factors to be considered in managing nutrition of ESRD patients are: a. comorbid conditions

b. laboratory date c. medications d. all of the above d. all of the above - Ans - Mr. Peterson experience an episode of hypotension. He is symptomatic. He only has 10 minutes left of his run and the nurse indicates to take him off. The UF goal was 1.4kg and the machine indicates that 1.3kg was removed his weight 0.8 below his dry weight. What is the possible cause(s) for the variance? a. the pre weight was inaccurate b. the math calculated for fluid removal was wrong c. the patient was not wearing the same clothing while weighing both ties d. all of the above d. renal osteodystrophy def: Depletion of bone minerals - Ans - Elevated Parathyroid Hormone (PTH) can cause which of the following conditions: a. uremia b. pericarditis c. nephritis d. renal osteodystrophy d. both a and b - Ans - Hypokalemia is manifested by a. muscle weakness and paralysis b. cardiac arrhythmia c. tingling of lips and fingers d. both a and b d. both a and c - Ans - Which of the follow statements is/are true about transplants? a. transplant patients have fewer dietary limits than in center hemodialysis patients b. kidney transplant is a cure for kidney disease c. anti-rejection drugs may cause high blood pressure, increase of infection and weight gain d. both a and c a. low blood pressure, cramps nausea, and vomiting - Ans - Which of the following complications can happen when removing too much fluid during dialysis? a. low blood pressure, cramps nausea, and vomiting b. pruritis, dry and scaly itch c. bleeding, hematoma, anemia d. chest pain and shortness of breath

d. all of the above - Ans - As a member of the health care team, a dialysis technician can help improve anemia outcomes by: a. rinsing patient's blood back until the bloodlines are clear b. reporting to the nurse if a patient complains of bloody stools c. monitoring access sites for bloodlines separations of exsanguination d. all of the above b. steal syndrome - Ans - Your patient is complaining of pain and numbness on the access limb more so during dialysis treatment. The patient may be experiencing a. infiltration b. steal syndrome c. infection d. recirculation b. patients with hep c must be dialyzed in isolation room - Ans - The following statements are true about Hepatitis C (HCV) except: a. hep c is spread by contact with infected food b. patients with hep c must be dialyzed in isolation room c. outbreaks of JCV in dialysis centers have been linked to cross contamination among patients d. universal precautions must be observed in all patients, whether or not they have HCV a. needles stick from a contaminated needle - Ans - What is the most common cause of transmission of Hep B (HBV) in dialysis centers? a. needles stick from a contaminated needle b. sharing of contaminated supplies c. reentry of single dose vitals d. non separation of laboratory from medication preparation areas a. Hospital acquired infection - Ans - Methicillin Resistant Staphylococcus Aureus (MRSA) an Vancomycin Resistant Enterococcus (VRE) can be nosocomial acquired infections. Nosocomial is defined as: a. Hospital acquired infection b. community acquire infection c. dialysis acquired infection d. none of the above a. tell the nurse about his symptoms - Ans - You are taking care of Mr. Brown today. His pre treatment temperature is 100.8 *F. He complains of weakness and diaphoresis at night. He reports of coughing productively for 2 weeks. Your initial reaction is to:

a. tell the nurse about his symptoms b. put on your mask and continue his treatment c. give him acetaminophen to reduce his fever d. tell him to see his primary physician d. pyrogen reaction - Ans - About one hour into the treatment, the patients complain of fever, chill, nausea and vomiting. What condition do you think the patient are experiencing? a. bone disease b. hemolysis c. anemia d. pyrogen reaction d. hypertension - Ans - Pre-Blood pump arterial pressure alarms are caused by suction on the vascular side by the blood pump. Increasing negative pressure may indicate all of the following except: a. flow problem with the access related to the blood pump b. kinking of the arterial blood tubing between the access and the arterial monitor c. increased blood velocity due to ultra filtration d. hypertension c. choose the angle of insertion based on the depth of the vein, in general about 45* - Ans - When inserting a hemodialysis fistula needle, insert a what angle until a flashback of blood is observed? a. 15* b. 90* c. choose the angle of insertion based on the depth of the vein, in general about 45* d. 60* b. zinc - Ans - The following lab values are monitored at least monthly except: a. blood urea nitrogen b. zinc c. calcium d. potassium c. Mr Adam is not adequately dialyzed and should be evaluated by the care team to determine what can be adjusted in his treatment regime - Ans - John Adam dialyzes 3 hours on a F180 dialyzer using an AV fistula in his left forearm. His Urea Reduction ration (URR) this month is 62% and Kt/V is 1.0. These lab values indicate: a. Mr. Adams is being adequately dialyzed

b. the AV fistula probably has a stenosis and Mr. Adams should be referred back to the vascular surgeon c. Mr Adam is not adequately dialyzed and should be evaluated by the care team to determine what can be adjusted in his treatment regime d. Mr. Adam needs a bigger dialyzer b. transplant status - Ans - Documentation that needs to be noted at each dialysis include all except a. patient weight gain/loss b. transplant status c. medications given during dialysis d. overall patient status d. all of the above - Ans - You are helping another technician on the floor. To assist that other technician, you volunteer to document the patient's post dialysis weight. When the patient returns to the station to report his post dialysis scale weight, it is 2kg above his pre dialysis weight. What action(s) should take? a. Go over to the scale with the patient to verify the weight b. Ask the patient if he is wearing the same clothing during pre dialysis weight c. Recalculate the fluid removal calculation on the treatment record for accuracy. d. all of the above d. place a pressure dressing over the site to control the bleeding - Ans - During the treatment the patient's needle starts to bleed slowly around the insertion site. You should: a. change the blue pad beneath the patients arm b. flip the needle to stop the bleeding c. reposition the arm d. place a pressure dressing over the site to control the bleeding b. kinked venous bloodline - Ans - All of the following are causes of air in the blood except a. pre-blood pump tubing collapsing related to the inadequate blood flow from the arterial needle b. kinked venous bloodline c. low levels in the drip chambers d. not removing all air during dialyzer primer a. pain in the access extremity - Ans - which would not be a sign or system of exsanguination a. pain in the access extremity

b. hypotension c. arterial and or venous pressure alarms d. visual observation of blood d. all of the above - Ans - which vital signs must be assessed before and after every dialysis treatment a. blood pressure b. temperature c. pain level d. all of the above c. the permacath may have an underlying infection - Ans - Mrs. Mantel arrives to dialysis with a complaint of feeling cold, her temperature pre dialysis is 97.8% and her blood pressure is 160/80. She dialyzes with a tunneled permacath which has been in place for there months. Shorty after initiation of dialysis she stated having chills and her temperature is no 99 F*, B/P is 100/60. You would suspect: a. Mrs. Mantel is experiencing a reaction to the dialyzer b. This is probably dialysis disequilibrium syndrome c. the permacath may have an underlying infection d. the temperature on the machine is out of range b. acid and bicarb concentrate - Ans - All of the following make up the extracorporeal circuit except: a. transducer protectors b. acid and bicarb concentrate c. dialyzer d. bloodlines d. all of the above - Ans - When factors need to be considered when setting or adjusting the ultrafiltration (UF) goals: a. the desired weight loss b. fluids given during treatments orally or with IV mediations c. fluid output during dialysis (urine, emesis) d. all of the above d. both a and c - Ans - Mr. rice's dialyzer has cleared poorly. What may be a factor affecting his dialyzer rinse back: a. the blood flow rate is reduced b. he has not dialyzed the prescribed length of treatment on several occasions

c. with a catheter he should receive hourly infusions of heparin via a heparin pump or pushed every hour. The amount of heparin he is getting hourly may need to be increased d. both a and c d. all of the above - Ans - Prior to returning the patient's blood , what following things should be done? a. check pulse b. check blood pressure c. check temperature d. all of the above c. " Mr. Tate, taking a standing blood pressure is very important and it's for your safety. I want to ensure that your blood pressure remains stable when you begin to ambulate" - Ans - Mr. Tate is planning on going to the casino after dialysis today. He is anxious for you to terminate treatment so he can go, after you return the blood you request for him to stand for a blood pressure prior to pulling his needles. He gets very upset and says "no one makes me do that". How would you best respond to this? a. "Well, i do not care what other technicians do" b. "okay whatever you want " c. " Mr. Tate, taking a standing blood pressure is very important and it's for your safety. I want to ensure that your blood pressure remains stable when you begin to ambulate" d. Call the nurse over and let her or him deal with it a. be sure to completely remove the needle prior to holding pressure to the skin - Ans - When removing fistula needles, what is the most important things to keep in mind? a. be sure to completely remove the needle prior to holding pressure to the skin b. be sure to hold pressure as you are pulling the needle out of the skin c. just ask the patient to remove his/her own needles d. none above a. Use arm clamps and firmly tape around the clamps - Ans - The best method holding sites it a. Use arm clamps and firmly tape around the clamps b. Leave the pressure bandages on until the next treatment c. ask patients to hold their own sites d. none of the above b. "Part of your dialysis prescriptions includes an order for heparin, a medication that thins your blood so that the can circulate freely outside your body" - Ans - Mr. Simmons is a new dialysis patient. This is the second time you have cannulated him. Your plans of care today include teach him him to hold his own sites. While you are returning his

blood he asks you the following questions, " Why does it take so long for the bleeding o stop after i am done?" How would you best respond to this situation? a. "Let me get your nurse and she or he can tell you" b. "Part of your dialysis prescriptions includes an order for heparin, a medication that thins your blood so that the can circulate freely outside your body" c. "That is for the doctor to explain' d. All of the above d. both b and c - Ans - After treatment, patient that is at their ordered dry weight should have the following. a. high blood pressure b. no edema c. no shortness of breath d. both b and c b. Patient below their dry weight - Ans - Mrs. Hit has just completed her treatment. You note the following on her post assessment, Hypotension, light headaches, cramping even after rinseback and nausea. What are these signs and symptoms? a. Patient at the their prescribed weight b. Patient below their dry weight c. Patient above their dry weight d. Hypoglycemia c. prolonged bleeding from the puncture sites - Ans - You're training a new technician. You ask him or her to recite a sign of too much heparin. What is the correct answer? a. blood clots noted in the venous chamber b. shortness of breath c. prolonged bleeding from the puncture sites d. both a and b b. Nothing, if symptoms were not admissible in court - Ans - You are aware the Mr. Brown had a severe episode with cramping and hypotension the previous treatment. Today he is assigned to you. He states that he feels tired with some cramping yesterday and reports to you that he felt poorly after his last dialysis treatment. As a patient care technician, you report this to the nurse. She reviews the treatment records, but finds n documentation to support the previous treatment's episode. Knowing that all medical records can be called into court, what would the previous treatment record, with no documentation, show to the lawyer? a. The run sheet would not be admissible to court b. Nothing, if symptoms were not admissible in court c. Mr. Brown lied about the previous treatment

d. both A and C c. to get other technicians in trouble - Ans - All of the following are reasons that the patients records are kept except: a. legal document admissible in court b. data for research and quality assurance c. to get other technicians in trouble d. a way for the staff to communicate and share patient information; create continuity d. size of dialyzer - Ans - Factors that affect patient's treatment time include all of the following except a. frequent alarms that divert dialysate to the drain b. frequent alarms that stop the blood pump c. cutting patients treatment time d. size of dialyzer d. both a and b - Ans - Herbert Pinkham usually runs 3.5 hours. His usual access is an arteriovenous fistula (AVF) however, it is clotted and he using a central venous catheter (CVC) while awaiting surgery. Surgery is not yet scheduled. His bod flow is only 300 mL/min. What may he need to ensure he is getting adequate clearance? A. draw a pre and post Blood Urea Nitrogen (BUN) to assess adequacy b. based on adequacy result of Kt/V of 1.0, increase dialysis time is needed c. Nothing, it is only for a few weeks d. both a and b b. 3562 ml - Ans - Upon completion of Herbert's treatment the following information is obtained: Ultrafiltration removed 3562 mL, Ultrafiltration goal is 4000 ml. There is 400cc left in the bag (assume the bag is full prior to infiltration of treatment) What the total amount of fluid removal? a. 4000 ml b. 3562 ml c. 2962 ml d. 438 ml d. all of the above - Ans - Herbet Pinkham usually runs 210 minutes. His usual access is arteriovenous fistula, however, it is clotted and he is using a central venous catheter while awaiting surgery. Surgery is not scheduled. His blood flow obtained is only 300 ml/min. You drew a pre and post BUN the previous treatment. The results indicated that the current blood flow and time is insufficient. How are can the dialysis prescription be adjusted to achieve the desired results? a, increase dialysis time

b. increase size of the dialyzer c. increase blood flow or dialysis, if applicable d. all of the above d. all of the above - Ans - For clinics that participate in reuse, it is important that the dialyzer is fully rinsed post treatment. what factors affect how well the dialyzer is rinsed? a. amount of saline circulated through it b. adequate heparinization c. adequate blood flow during the treatment d. all of the above b. test rinse water for absence of chemical - Ans - After chemical disinfection of a machine, what one thing must be done prior to starting the next treatment? a. document the machine disinfection log that it was done b. test rinse water for absence of chemical c. heat disinfect d. both a and b a. <10 mlU/ml - Ans - Patients are considered susceptible Hep B if their Hep B result is: a. <10 mlU/ml b. >10 mlU/ml c. tested at 1-2 months after vaccination d. retested immediately after re-vaccination technical b. heat and chemical disinfection - Ans - Prior to the machine being closed for the day, what two things must be done? a. cultures of dialysate and central water delivery b. heat and chemical disinfection c. water lines disconnected from drains and machines unplugged from the wall d. both a and c d. cultures - Ans - Which of the following is not documented in the daily water checks? a. total dissolved solids (TDS) b. water hardness c. temperature d. cultures d. all of the above - Ans - Post dialysis treatment in getting ready for the next treatment, what things are requires by Centers for Medicare & Medicaid Services (CMS) to be done?

a. machine put through pressure and alarm test b. station (machine, equipment, and chairs) completely cleaned with disinfectant c. make sure the dialysis machine is plugged into the ground fault interrupter (GFI) plug d. all of the above b. Association for the Advancement of Medical Instrumentations - Ans - The letters of AAMI stand for: a. American Association of Medical Instrumentals b. Association for the Advancement of Medical Instrumentations c. Auxillary Alarms for Medical Instruments d. Alerts Alarms for Medical Instruments b. urea - Ans - A waste product found in high concentration in the blood pre dialysis is a. bicarbonate b. urea c. water d. uremia c. obtain a Sodium Modeling order for next dialysis - Ans - Mrs. Smith is hypotensive pre dialysis and it has been a struggle to get her ordered dry weight. You suggest to the charge nurse the following a. use a larger surface area dialyzer b. to shorten her dialysis c. obtain a Sodium Modeling order for next dialysis d. ask the dietician to increase dietary sodium d. all o the above - Ans - Clearance depends on : a. a blood flow rate b. membrane surface area c. dialysate flow rate d. all o the above c. increase blood flow rate and increase dialysate flow rate - Ans - The dialyzer surface area is fixed, so in order to improve clearance we can a. give more heparin b. increase blood flow rate and decrease flow rate c. increase blood flow rate and increase dialysate flow rate d. use sodium modeling d. treated water and acid concentrate and bicarbonate concentrate - Ans - Dialysate is a combination of

a. untreated water and acid concentrate and bicarbonate concentrate b. acid concentrate and treated water c. bicarbonate concentrate and treated water d. treated water and acid concentrate and bicarbonate concentrate c. carbon tanks - Ans - The water treatment component to protect patients from chlorine/ chloramines is a. softners tanks b. sediment filter c. carbon tanks d. ultrafilter b. no real movement happens, it just decreases blood pressure - Ans - All of the following are true about ultrafiltration except a. it is the mechanism responsible for moving plasma water from the blood into the dialysate b. no real movement happens, it just decreases blood pressure c. it is the movement of solvent from an area of higher hydrostatic pressure to an area of lower hydrostatic pressure d. it is the movement of solvent across a semipermeable membrane d. 200 cfu/ml - Ans - The maximum allowable bacteriological level in dialysate is a. 1 cfu/ml b. 2 cfu/ml c. 50 cfu/ml d. 200 cfu/ml a. maintain a high flow velocity - Ans - A strategy for bacterial control of Reverse Osmosis (RO) distribution system is to a. maintain a high flow velocity b. install dead legs in the distribution pipe c. maintain a high chemical quality d. slow down the flow velocity c. once a month - Ans - The minimum frequency for RO distribution system disinfection is a. once a day b. once a week c. once a month d. once a year

a. 2 eu/ml - Ans - The maximum allowable endotoxin level for water for dialysate is a. 2 eu/ml b. 5 eu/ml c. 10 eu/ml d. 50 ey/ml a. aspirin - Ans - Mrs. Hernandez was just released from the hospital. She presents today with the list of discharge instructions and new medications. Which of these medications listed may effect bleeding times and effect heparin dosing? a. aspirin b. vicodin c. tums d. multi-vitamins carbon tanks - Ans - The anemia management nurse is calling the Medical Director to report that all patients have a significant drop in their monthly hemogloblin. She suspects a problem in the water treatment system may have occurred which would result in widespread drops in the hemogloblin. Which part of the water treatment may have failed? a. carbon tanks b. water softner c. ultrafilter d. blending valve b. monthly - Ans - The minimum frequency for bacterial and endotoxin assay is a. weekly b. monthly c. annually d. PRN d. annually - Ans - The minimum frequency for product water chemical analysis is a. weekly b. monthly c. bi annual d. annually b. calcium and magnesium - Ans - The primary ions of concern in softner ion exchange application are a. calcium and aluminum

b. calcium and magnesium c. potassium and calcium d. potassium and aluminum b. <0.1 mg/l - Ans - the allowable concentrations of chloramine is a. <1.0 mg/l b. <0.1 mg/l c. <5.0 mg/l d. <0.5 mg/l d. 10 minute - Ans - The effective removal of chorine/ chloramine requires the use of series carbon tanks with a total empty bed contact tie of: a. 1 minute b. 2 minute c. 5 minute d. 10 minute d. all of the above - Ans - Who can define the acceptable ranges the units water treatment system? a. medical director b. manufactures c. AAMI d. all of the above b. Quality Assessment and Performance Improvement (QAI) meeting - Ans - Any water results including cultures and Limulus Amoebocyte Lysate (LAL)'s that exceed AAMI standards must be addressed in the following a. staff meeting b. Quality Assessment and Performance Improvement (QAI) meeting c. Employee review d. Department of Public Health (DPH) Survey a. physician order - Ans - What first step needs to happen before a patient can begin reuse? a. physician order b. getting the right dialyzer in stock c. patient signs a reuse consent d. informing the patients family d. total time taken to reprocess the dialyzer - Ans - Which of the following is not required for the reprocessing records?

a. date of each reprocessing step b. person performing each step c. results of the testing of the dialyzer d. total time taken to reprocess the dialyzer b. the ability of the dialyzer to transport solutes and ultrafilter at its next use - Ans - The total cell volume (TCV) measures? a. total number of cells attached to the fibers in the dialyzer b. the ability of the dialyzer to transport solutes and ultrafilter at its next use c. measures how many cells in the blood d. how much water the dialyzer can hold a. Material Safety Data Safety Sheet (MSDS) - Ans - All chemicals used in the facility must have the following a. Material Safety Data Safety Sheet (MSDS) b. packing list c. PAR levels d. item number d. all of the above - Ans - which one of the following steps must be completed prior to using a reprocessed dialysis for a patient? a. correct dialyzer for patient b. adequate level of disinfectant before it is used c. all of the disinfectant was rinsed out of prior to use d. all of the above a. as per dialysis unit's policies and procedures - Ans - Dialysis machine must be disinfected at least a. as per dialysis unit's policies and procedures b. once a week c. between each patient treatment d. once a month b. just before the treatment is initiated - Ans - When should the absence of the chemical on reuse dialyzer be checked? a. once priming of the dialyzer is completed b. just before the treatment is initiated c. after the recirculation is completed d. when getting the dialyzer from the reuse personnel

d. 200 cfu/ml - Ans - The maximum allowable bacterial level for water of dialysate is a. 50 cfu/ml b. 100 cfu/ml c. 150 cfu/ml d. 200 cfu/ml a. chloramine level of 1.0 ppm - Ans - Hemolysis is the destruction of red blood cells. Which of the following can cause hemolysis in dialysis? a. chloramine level of 1.0 ppm b. chlorine level of 0.5 ppm c. machine temperature of 36 d. none of the above c. put all blood tubing in the common trash - Ans - After the patient treatment is done. All of the following are done in the preparation for the next except a. clean surface at the station including chair, side table and outside machine b. replace blood pressure cuff with a new, cleaned one c. put all blood tubing in the common trash d. none of the above c. 1:100 - Ans - An intermediate level disinfection is a ration of bleach to water at a. 1:1 b. 1:10 c. 1:100 d. 1:4 c. universal precautions - Ans - The principle that all blood, body fluids, secretions, and excretions, (except sweat), non-intact skin, and mucous membrane, may contain transmissible infections agents is called a. there are no set standards b. dialysis precautions c. universal precautions d. hepatitis precautions b. monthly water/ dialysate cultures - Ans - Centers for Disease Control and Prevention (CDC) components of a comprehensive infection control program to prevent transmission of infections among chronic hemodialysis patients does not include a. routine serologic testing for Hep B virus infection b. monthly water/ dialysate cultures c. infection control training and education

d. vaccination of susceptible patients for Hep B a. annually - Ans - Training and education in infection control rationales and practices must be provided initially on employment and at least a. annually b. prior to department of Public of Health (DPH) inspection c. Semi- Annual d. quarterly d. sleeveless aprons - Ans - The following are examples of personal protective equipment (PPE) except: a. mask b. gown c. face shield d. sleeveless aprons e. none of the above b. priming - Ans - Staff should wear personal protective equipment (PPE)'s during all of the following activities: a. the initiation of dialysis b. priming c. termination of dialysis d. monthly blood draws b. hand washing - Ans - According to the Centers for Disease Control and Preventions (CDC), what is the most important measure to prevent, contaminant transmission? a. changing gloves when soiled b. hand washing c. dedicated supplies d. wearing protective gowns d. all of the above - Ans - Hand hygiene should be performed a. immediately after gloves are removed b. before and after direct contact with patients c. before performing any invasive procedure d. all of the above