CCHT Exam Practice | ACCURATE AND VERIFIED FOR GUARANTEED PASS | GUARANTEED, Exams of Nursing

Download CCHT Exam Practice | ACCURATE AND VERIFIED FOR GUARANTEED PASS | GUARANTEED and more Exams Nursing in PDF only on Docsity! CCHT Exam Practice | ACCURATE AND VERIFIED FOR GUARANTEED PASS | GUARANTEED | LATEST UPDATE 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 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 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 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 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