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CCHT Practice Exam New Updated Test Bank with Questions and 100% Correct Answers (Best St, Exams of Nursing

CCHT Practice Exam New Updated Test Bank with Questions and 100% Correct Answers (Best Studying Material for Coming Exam)

Typology: Exams

2023/2024

Available from 04/12/2024

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Download CCHT Practice Exam New Updated Test Bank with Questions and 100% Correct Answers (Best St and more Exams Nursing in PDF only on Docsity!

CCHT Practice Exam New Updated Test Bank with

Questions and 100% Correct Answers (Best Studying

Material for Coming Exam)

A hemodialysis patient suddenly develops trouble breathing, hives, itching, and hypotension. The most likely cause is: (A) an air embolism. (B) an anaphylactic reaction. (C) angina. (D) disequilibrium syndrome -------- Correct Answer -------- B The main difference between an arteriovenous shunt (AVS) and an arteriovenous fistula (AVF) is an: (A) AVS is entirely within the arm (B) AVF is entirely within the arm (C) AVF is more likely to become clotted or infected (D) AVF requires an external tube -------- Correct Answer -------- B Which of the following dialyzers is used currently? (A) Kiil (B) Flat plate (C) Coil (D) Hollow tube -------- Correct Answer -------- D One difference between peritoneal dialysis (PD) and hemodialysis (HD) is: (A) there is a greater incidence of disequilibrium syndrome in PD. (B) there are more dietary restrictions in PD. (C) fluid buildup is less of a problem in HD. (D) the patient is subjected to constant dialysis in PD rather than intermittent dialysis in HD. -------- Correct Answer -------- D 1.Which of the following best describes the reason for wearing gloves when handling machine prior to blood? a) patient comfort b) asepsis c) universal precautions d) HIV --------- Correct Answer --------- c) universal precautions 2 You test for sterilant levels in a hemodialysis machine prior to patient use. The test is positive for sterilant. This means the machine: a) is sterile & bacteria free b) needs further rinsing c) needs more sterilant

d) is in conductivity --------- Correct Answer --------- b) needs further rinsing 3.Choose the correct statement regarding serum abnormalities in renal failure: a) creatinine, BUN, & phosphorus are elevated b) creatinine BUN creatinine, BUN, & phosphorus are depressed c) calcium & bicarbonate are elevated d) calcium & bicarbonate are depressed --------- Correct Answer --------- a) creatinine, BUN, & phosphorus are elevated 4.Hemodialysis requires a means to channel the patient's blood to the hemodialyzer & then back to the body. It's called: a) vascular access b) hemodialyzer c) dialyzing fluid delivery system d) infusion pump --------- Correct Answer --------- a) vascular access 5.Which of the following is correct regarding a fistula? a) usually created in the leg, near the ankle b) usually created in the forearm, near the wrist c) are made of salastic tubing d) none of the above --------- Correct Answer --------- b) usually created in the forearm, near the wrist 6.Blood leak detectors are extremely sensitive & can determine: a) blood type b) amount of blood loss c) blood leakage immediately d) volume changes e) serum potassium levels --------- Correct Answer --------- c) blood leakage immediately 7.Which of the following foods are high in potassium? a) milk, ice cream, yogurt b) legumes, cheese, pizza

c) chips, colas, canned meat d) bananas, tomatoes, oranges --------- Correct Answer --------- d) bananas, tomatoes, oranges 8.What lab values are monitored for assessing bone disease? a) calcium, phosphorus & PTH b) calcium, phosphorus & albumin c) calcium, phosphorus & potassium d) calcium, phosphorus & magnesium --------- Correct Answer --------- a) calcium, phosphorus & PTH 9.Which is the most common cause of chronic kidney failure in the US? a) diabetes b) hypertension c) polycystic kidney smaller molecular disease d) glomerulonephritis --------- Correct Answer --------- a) diabetes 10.The reason potassium dialyzes and RBC's do not is: a) potassium has a larger molecular weight b) potassium has a smaller molecular weight c) RBC's are not water soluble d) RBC's have a negative charge --------- Correct Answer --------- b) potassium has a smaller molecular weight 11.Acceptable limits for total chlorines in water for hemodialysis are? a) less than 0 .1mg/L (ppm) b) 0.5 mg/L to 1 mg/L(ppm) c) 3.5 mg/L to 5.5 mg/L to 5.5 mg/L(ppm) d) greater than 6.0 mg/L(ppm) --------- Correct Answer --------- a) less than 0 .1mg/L (ppm) 12.If a new patient starts with a very high BUN, dialysis is purposely made less efficient to prevent: a) rapid decrease in hct b) dialysis disequilibrium syndrome c) cardiac arrhythmia's d) excessive coagulation --------- Correct Answer --------- b) dialysis disequilibrium syndrome

13.The following are factors in poor clearance during dialysis except: a) poor dialyzer reuse b) access recirculation c) low hematocrit d) low blood flow rate --------- Correct Answer --------- c) low hematocrit 14.The movement of water from an area of low solute concentration to an area of high solute concentration is called: a) diffusion b) osmosis c) ultrafiltration d) dialysis --------- Correct Answer --------- b) osmosis 15.Potting compound, casing, fibers and headers are part of a: a) dialysis machine b) water treatment system c) R. O. system d) dialyzer --------- Correct Answer --------- d) dialyzer 16.Mr. Jones has a dry weight of 72 kg. He weighed 73 kg after last treatment. Today he weighs 75.5 kg. Assume prime and rinse back =500 ml total. What is Mr.Jones' fluid removal goal for today? a) 2.5 liters or 2500 ml b) 3.0 liters or 3000 ml c) 4.0 liters or 4000 ml d) 4.5 liters or 4500 --------- Correct Answer --------- c) 4.0 liters or 4000 ml 17.A hematocrit test indicates which of the following? a) concentration of platelets b) concentration of creatinine in the blood c) concentration of red blood cells in the blood d) concentration of white blood cells in the blood --------- Correct Answer --------- c) concentration of red blood cells in the blood 18.What factors should be considered when establishing a patient's dry weight? a) blood pressure b) patient well being c) evidence of dehydration or fluid overload d) all of the above --------- Correct Answer --------- d) all of the above 19.In a dialysis machine, the proportioning system does what?

a) prepare the dialysate to the proper pH b) warm the dialysate to the proper temperature c) appropriately mix the dialysate concentrates with water d) to monitor the dialysate flow rate --------- Correct Answer --------- c) appropriately mix the dialysate concentrates with water 20.The complication in which blood has a "cherry pop"appearance is: a) blood leak b) air embolism c) hemolysis d) none of the above --------- Correct Answer --------- c) hemolysis 21.The use of high a sodium dialysate may predispose a patient to: a) fluid overload b) hypertension c) thirst d) all of the above --------- Correct Answer --------- d) all of the above 22.The capability of a dialyzer to remove fluid, expressed as ml/mmHg/hr is: a) UF Coefficient b) clearance c) surface area d) priming volume --------- Correct Answer --------- a) UF Coefficient 23.A pre-pump arterial pressure reading is measuring: a) the pressure required to pump the blood through the dialyzer b) resistance to blood flow out of the access c) pressure within the dialyzer d) none of the above --------- Correct Answer --------- b) resistance to blood flow out of the access through the dialyzer 24.What determines the surface area of a hollow fiber dialyzer? a) number of fibers b) internal diameter of fibers c) length of fibers d) all of the above --------- Correct Answer --------- d) all of the above 25.The purpose of using counter-current flow is to:

a) increase the rate of fluid removal b) increase the rate of waste removal c) decrease the amount of dialysate used d) decrease the surface area of the membrane --------- Correct Answer --------- b) increase the rate of waste removal 26.Chloramine exposure in dialysis can result in: a) hypernatremia b) hemolysis c) pericarditis d) bleeding --------- Correct Answer --------- b) hemolysis 27.Part of the reuse process involves the reuse machine testing the dialyzer to verify: a) the dialyzer is free of sterilant b) the dialyzer is free of bacteria c) the dialyzer is free of endotoxins d) the dialyzer fibers are free of leaks --------- Correct Answer --------- d) the dialyzer fibers are free of leaks 28.According to AAMI RD52, what is the maximum allowable level of bacteria in dialysate? a) 1,000 CFU's b) 50 CFU's c) 200 CFU's d) 500 CFU's --------- Correct Answer --------- c) 200 CFU's 29.According to AAMI RD52, how often should bacterial cultures be sampled? a) weekly b) monthly c) quarterly d) annually --------- Correct Answer --------- b) monthly 30.According to AAMI RD52, what is the action level for bacteria in dialysate? a) 50 CFU's b) 75 CFU's c) 100 CFU's d) 200 CFU's --------- Correct Answer --------- a) 50 CFU's 31.Bacterial exposure from water may cause which of the following symptoms? a) hemolysis b) fever/chills c) bone disease d) hypotension --------- Correct Answer --------- b) fever/chills 32.Who developed the first permanent blood access, the "Shunt"?

a) Scribner and Quinton b) Kolff c) Brescia and Cimino d) Turner --------- Correct Answer --------- a) Scribner and Quinton 33.Venous pressure meters are calibrated in: a) PSI b) mm/Hg c) mL/hour d) mg% --------- Correct Answer --------- b) mm/Hg 34.TPM is measured as: a) mL/hr b) mm/Hg c) mL/min d) none of the above --------- Correct Answer --------- b) mm/Hg 35.The hemodialysis machine continuously monitors many parameters. Which of these parameters must be verified by an external measuring device? a) blood flow b) dialysate flow c) pH and conductivity d) temperature and transmembrane pressure --------- Correct Answer --------- c) pH and conductivity 36.Prior to each patient shift, it would be essential to perform a water quality check for which of these substances? a) calcium and magnesium b) chlorine and chloramine c) organic contaminants d) inorganic contaminants --------- Correct Answer --------- b) chlorine and chloramine 37.The term pH is a measurement of the concentration of: a) all ions in solution b) hydrogen ions c) bicarbonate ions d) acetate ions --------- Correct Answer --------- b) hydrogen ions 38.The technician's role in patient teaching should be to: a) assess the patient"s barriers to learning b) check the patient's readiness to learn new information c) determine the patient's learning needs

d) Reinforce teaching that the patient has received from other team members --------- Correct Answer --------- c) determine the patient's learning needs 39.What can dialysis staff do to reduce the risk of being infected with a blood borne pathogen? a) proper hand washing b) universal precautions c) proper sharps disposal d) all of the above --------- Correct Answer --------- d) all of the above 40.Which of the following are ways to handle chemicals safely? a) wash hands before eating or drinking b) wear protective clothing c) don't eat or drink in the work area d) all of the above --------- Correct Answer --------- d) all of the above 41.What is the correct angle in which to cannulate a fistula? a) 10-15 degrees b) 25-35 degrees c) 35-45 degrees d) it dosen't matter --------- Correct Answer --------- b) 25-35 degrees 42.Which of the following affects access recirculation? a) distance between the tips of the needles b) presence of stenosis c) direction of needles d) all of the above --------- Correct Answer --------- d) all of the above 43.The technician observes that the hardness reading after the water softener isabove the acceptable limit. The technician should check the softener tank's level of: a) salt b) chlorine c) carbon d) sand --------- Correct Answer --------- a) salt

  1. A technician observes all of the following in the hemodialysis unit. Which one poses an environmental risk? a) the wheels of the hemodialysis machines are locked b) charts are lying on bedside tables c) about one ounce (30 ml) of fluid is on the floor d) a patient's family member is present during treatment --------- Correct Answer --------- c) about one ounce (30 ml) of fluid is on the floor
  1. When preparing a bleach solution for cleaning equipment, the technician accidentally spills undiluted bleach on the floor. Which of these resources will provide the technician with information about how to properly handle spill of the chemical? a) Material Safety Data Sheet (MSDS) b) Centers for Disease Control & Prevention (CDC) c) Association for the Advancement of Medical Instrumentation (AAMI) d) State Department of Health (DOH) --------- Correct Answer --------- a) Material Safety Data Sheet (MSDS)
  2. A conductivity alarm sounds during a hemodialysis treatment. The technician should expect which of these events to have occurred? a) the blood pump has stopped b) the dialysate flow rate has increased c) the electrical power source was interrupted d) the dialyzer was bypassed --------- Correct Answer --------- d) the dialyzer was bypassed
  3. During routine water testing, the technician notes that the chloramine level after the first carbon tank is 0.2mg/L. Which of these actions should the technician take next? a) bypass the carbon tanks b) descale the reverse osmosis membranes c) obtain a sample after the second d) immediately terminate hemodialysis treatments --------- Correct Answer --------- c) obtain a sample after the second
  4. A female technician has been caring for a male patient for several months. The patient tells the technician that he is lonely and depressed. He asks the technician to go out to dinner with him. In addition to politely declining the patient's invitation, which of these actions, if any, should be taken: a) refer the patient to the social worker b) recommend an over-the-counter mood stimulant, such as St. John's wort c) share the patient's need for socialization with other patients d) no further action is needed --------- Correct Answer --------- a) refer the patient to the social worker
  5. A hemodialysis technician suspects that a patient who is receiving a hemodialysistreatment has an air embolus. After stopping the blood pump, the patient should be placed in which of these positions? a) low-fowlers b) high-fowlers c) right-sided trendelenberg

d) left-sided trendelenberg --------- Correct Answer --------- d) left-sided trendelenberg

  1. During hemodialysis a patient goes into cardiac arrest. Which of these actions shouldbe taken first? a) apply a precordial thump to the patient b) call for help c) return the patient's blood d) stop ultrafiltration --------- Correct Answer --------- b) call for help In a patient with gross Adema which symptoms of hypotension shared the dialysis tech be watching for A. Shortness of breath B. Flushed face and nose bleed C. Paleness D. Excessive yawning -------- Correct Answer --------- A C and D A tech reports to the RN that the blood is transparent in the circuit with a cherry soda pop color what complication should the tech suspect the patient is experiencing A. Hemolysis B. Thrombosis C. Septicemia -------- Correct Answer --------- A. Hemolysis What can cause a "false" blood leak alarm A. Particulate matter and air bubbles in the dialyzer B. Reduction in the light received by a photo cell C. Change in translucency -------- Correct Answer --------- A. Particular matter What are the system requirements for high flux dialysis A. Reliable blood flow rate at at least 200 B. Hi dialysate flow rate C. Precise control of ultrafiltration volume D. Use of synthetic membrane filters -------- Correct Answer --------- B C and D Which factors affect removal of toxins in dialysis A. The higher the temperature of dialysate the greater the removal of solute B. The slower the dialysate flow the greater removal of solute's C. The slower the blood flow rate the greater removal of solute D. The more permeable the membrane the greater removal of solutes -------- Correct Answer --------- A and D To accomplish saw you removal and dialysis what is needed A. Mass transfer B. Countercurrent flow C. A difference in concentration -------- Correct Answer --------- C. Difference Why is reversed filtration important

A. The bicarbonate concentrate encourages and supports bacterial proliferation B. Endotoxins may be carried across the high flux membrane into the bloodstream C. Pyrogens reaction may occur -------- Correct Answer --------- All of the above What modifications to the dialysis procedure can be made to prevent intradialytic complications associated with fluid removal A. Lower the temp of the machine B. Extend treatment times C. Check serum sodium levels every 15 min -------- Correct Answer --------- A and B Which water contaminants may cause methemoglobinemia in which red cell hemoglobin cannot transport oxygen A. Fluoride and Tin B. Nitrates and chloramines C. Zinc and aluminum -------- Correct Answer --------- B. Nitrates and chloramine What is the process utilized when two carbon tanks are used to remove chlorine and chloramine from tank water A. Adsorption B. Absorption C. Diffusion -------- Correct Answer --------- A. Adsorption What type of contaminants are removed from water used in dialysis A. Endotoxins B. Aqueous salts C. Water softeners -------- Correct Answer --------- A and B When preparing for reverse osmosis what type of membranes should the tech be prepared to utilize A. Peritoneum B. Cellulose acetate C. Thin film composites D. Chlorine resistant polysulfone -------- Correct Answer --------- B C and D Which problems may occur when using a deionizer A. It can be hard initially to obtain the maximum flow rate needed B. The service life of a deionizer may be short and essential that the filters be placed downstream C. Resin beds tend to exhaust suddenly in the tanks may need to be exchanged D. If the resin tanks are used to exhaustion previously removed ions may be released -- ------ Correct Answer --------- All of the above When preparing the water used for the dialysate and reprocessing of dialyzers the CMS require "conventional dialysate" to have a max level of bacteria less than ——— CFU A. 300 B. 100

C. 200 -------- Correct Answer --------- C. 200 How often at a minimum is it recommended to cleanse all components of the water treatment system with an approved disinfectant A. Quarterly B. Monthly C. Biweekly -------- Correct Answer --------- B. Monthly What are the most common methods for reducing microbiological contaminants and water use during dialysis A. Infusion of antibiotics in water tank B. Applying a sub micron filter C. Use of a filtration device -------- Correct Answer --------- B and C Which person on the team is responsible for ensuring the quality of water used for dialysis has met the standards A. Registered nurse B. Nurse manager C. Medical director -------- Correct Answer --------- C. Medical director When a dialyzer is prepared to use what actions are required prior to beginning the session A. Prime the dialyzer B. Remove all air in the dialyzer C. Flush the dialyzer with Celine prime to remove all particulate matter D. Remove any disinfectant left behind by rinsing under cold water -------- Correct Answer --------- B and C place the steps for a re-processing/re-using a dialyzer in the correct order A. Disinfect with chemical or heat B. Flush dialyzer to remove most of blood C. Test dialyzer D. Cleanse dialyzer with chemicals and reverse ultrafiltration -------- Correct Answer ----- ---- B then D then C then A According to standard precautions when should gloves be changed and hands washed A. When gloves are contaminated B. When going from clean body side to contaminated body site on the same person C. After handling infectious waste containers D. After touching patient as in preforming physical assessment -------- Correct Answer -- ------- A C and D How should hand hygiene be performed A. With bar of soap and scrub brush B. With antiseptic soap and water C. With hand sanitizer

D. With waterless alcohol base hand rub with 60-90% alcohol content -------- Correct Answer --------- B and D What type of garment should be worn during processes likely to generate droplets of bodily fluids A. Patient gown tied in back B. Weighted lead aprons C. Impervious isolation gowns -------- Correct Answer --------- C. Isolation gowns When washing hands with soap and water what's the minimum number of seconds hands should be rubbed together A. 10 B. 15 C. 30 -------- Correct Answer --------- B. 15 While technical staff are preforming duties in the dialysis unit which team member must always be present A. Registered nurse B. Medical director for unit C. Lab technician -------- Correct Answer --------- A. Registered nurse Two techs are heatedly discussing pt care situation. Which team member is responsible for disciplinary action A. Registered practical nurse B. Human resource manager C. Dialysis nurse manager -------- Correct Answer --------- C. Dialysis nurse manager Which credentialing agency for dialysis includes items such as water treatment and dialysate preparation and complication of dialysis as part of their practice domains A. Board of nephrology examiners nursing in technology B. Nephrology nursing certification commission C. National nephrology certification organization -------- Correct Answer --------- C. NNCO Prior to starting dialysis what must the technician and or nurse verify A. That patient has provided informed written consent for dialysis B. That the patient has not eaten any food or beverages for the last six hours C. That the patient has a driver to pick him up after dialysis -------- Correct Answer ------- -- A. Consent Which external agencies provide additional guidelines and standards in the areas of infectious disease testing immunizations dialysis treatment safety and infection control? A. Centers for disease control and prevention B. Centers for Medicare and Medicaid service C. Association for the advancement of medical instrumentation D. Council of nephrology -------- Correct Answer --------- A B and C

Prior to passing the Social Security amendments treatment for chronic kidney disease was available only to few who met certain criteria. The amendments extended Medicare coverage for almost all patients who signed the amendment and then what year A. Jimmy Carter in 1979 B. Richard Nixon 1972 C. John f Kennedy 1961 -------- Correct Answer --------- B. Richard Nixon 1972 Which organization recently approved by CMS to be an independent organization allowed to conduct surveys for Medicare certification fostering faster approval for dialysis clinics A. National kidney foundation B. Medicare bundle dialysis prospective payment system C. National dialysis accreditation commission -------- Correct Answer --------- C. NDAC What is the composition of saline A. 10% salt added to water B. Albumin C. 0.9g of sodium chloride and 100ml of water -------- Correct Answer --------- C. 0.9g of sodium and 100ml of h2o When caring for a patient if the dialysate solution contains two little sodium the water may shift into the patient's blood cells which signs or symptoms would you see A. Hypotension B. Cramping C. Thirst D. Headache -------- Correct Answer --------- A and B Which buffer is the major plasma buffer therefor important during dialysis A. Bicarbonate B. Amino acid C. Protein -------- Correct Answer --------- A. Bicarbonate While reviewing the body weight for a dialysis patient the tech knows that ——— of the total amount of water is contained in the intracellular fluid compartment A. 20% B. 30% C. 40% -------- Correct Answer --------- C. 40% How much water is lost through evaporation form lungs every day A. 250-499 ml of water B. 700-1,000 ml of water C. 1500-2000 ml of water -------- Correct Answer --------- B. A patient asks to explain what the normal kidney does in addition to making urine what's the response

A. Regulate fluid volume in body B. Regulate pH in blood C. produce erythropoietin that controls red blood cell production D. I receptor sites for several hormones -------- Correct Answer --------- All of the above A patient with a renal failure asks if his candies will regenerate how does the technician answer A. With a diet low in sodium and exercise there's a good chance you'll get some function back B. If nephrons are damaged they do no regenerate C. If the heart can pump in a blood to the kidney there is a possibility that some of the nephrons can regenerate -------- Correct Answer --------- B. If nephrons are damaged they won't regenerate This patient's kidneys have permanently lost most of their ability to remove waste and maintain fluid in chemical balance what's the patient's likely estimated glomerular filtration rate A. Less than 15 ml/min/ B. 60-89 ml/min/1. C. 30-44 ml/min -------- Correct Answer --------- A. Less than 15 The patient asks the dialysis technician if there's anything she can do to slow the progression of her kidney disease. Which risk factor could the technician mention during the conversation A. Control your blood glucose levels if you're a diabetic B. Maintain healthy weight C. Control cholesterol levels D. Stop use of alcohol -------- Correct Answer --------- A B and C Which recommendation would've nephrologist likely make for a patient who has read stages three or four chronic kidney disease A. We'll tele health visits discussing daily urine output B. Dietary restriction on sodium phosphorus and protein C. Monitoring for mineral bone disease D. Education on cardiovascular disease -------- Correct Answer --------- B,C and D Which patient would be considered at higher risk for developing chronic kidney disease A. Hispanic female who is unaware that she is hypertensive B. White female with family history of diabetes who watches her exercise and diet C. Asian male who schedules regular visits with healthcare provider D. African-American female whose parents both died following stroke -------- Correct Answer --------- A and D Patient with chronic kidney disease asks what her goal hemoglobin level should be what level as recommended by the national kidney foundation kidney disease guidelines A. 9%

B. 7%

C. 11% -------- Correct Answer --------- B.7% Patient with chronic kidney disease arrives at the center after his nephrology visit he relays to the staff that the doctor said he was hardening of the kidneys what is the cause of this condition A. Prolonged severe hypertension B. Daily ingestion of sugar sweetened drinks C. High fat diet D. Too much calcium in the diet along with hypertension -------- Correct Answer --------- A. What is one cause of postrenal failure A. Renal trauma B. Prostrate disease C. Fluid volume shifts D. Kidney infections -------- Correct Answer --------- B. Prostate disease The family member of a dialysis technician has noted blood in his urine the tech also noted the weight loss and rubbing of the flank to ease the cramping pain which disease comes to mind A. Nephrotic syndrome B. Bladder infection C. Kidney stones D. Renal carcinoma -------- Correct Answer --------- D. Renal carcinoma Which integumentary changes are commonly seen in patients with chronic kidney disease A. Brittle nails B. Excessive sweating C. Bruising D. Increase number of moles -------- Correct Answer --------- A and C Monday also patients infection account for about one and 10 fatalities which condition increases a patient's susceptibility to infection A. Diabetes B. Malnutrition C. Bone abnormalities D. Frequent invasive procedures -------- Correct Answer --------- A B and D Management of renal bone disease requires that ministration of which type of medication with every meal and snack A. Potassium and substitutes B. Antacids C. Phosphate binders -------- Correct Answer --------- C. Phosphate binders

Patients with chronic kidney disease are at risk for developing peripheral neuropathy. How may neuropathy present in the patient A. Intolerance to touch B. Burning feet C. Restless legs -------- Correct Answer --------- B and C What are some disadvantages of using hollow-fibers dialyzers A. They're not compliant B. They require meticulous care to remove air or gas from the fiber bundle C. Blood distribution may be uneven at inflow header space D. Higher heparin doses may be needed to prevent clotting in hollow fibers -------- Correct Answer --------- B C and D If a patient is experiencing adverse reactions from the residual toxic products of ethylene oxide sterilization of the hollow fibers what other ways can you sterilize it. A. Gamma radiation B. Pure alcohol flushing C. Electron beam -------- Correct Answer --------- A and C Which manifestation would lead to the tech to suspect the patient is experiencing intradialytic complement A. Anemia B. Intradialytic hypoxemia C. Chest pain D. Back pain -------- Correct Answer --------- B C and D If the bicarbonate concentrate is over mixed what lab values will result A. Increase pH B. Decrease in serum calcium level C. Increase in magnesium level D. Decrease in RBC level -------- Correct Answer --------- A and B Which method/test is most commonly used to check the dialysate composition A. Bicarbonate concentration test B. Total conductivity C. Microbial count -------- Correct Answer --------- B. Microbial count How is the temp of the dialysate controlled A. By using one or more sensors and a micro controller circuit on the heater B. By checking accuracy regularly with a certified glass thermometer C. By using a separate center with visual and audible alarms for any out of limit state --- ----- Correct Answer --------- All of the above What are the most common ways Hep B virus is transmitted in a unit A. Skin penetration by contaminated sharps B. Contact of contaminated blood with broken skin

C. Pts with Hep B breathing or coughing on others -------- Correct Answer --------- A and B Filling the accidental exposure to blood from a pt HIV positive what tx is recommended A. 3 month prescription of med to prevent HIV B. Follow up blood test three months after exposure C. 4 week 2 drug regimen is recommended within 72 hours of exposure -------- Correct Answer --------- C. According to the CDC health care workers exposed to needle stick involving HIV infected blood have a 0.23% chance of becoming infected if untreated. After a needle stick or sharps exposure to hep C virus what is the risk of developing infection A. 0.01% B. 0.5% C. 1.8% -------- Correct Answer --------- C. 1.8% What are the recommendations for dialysis personnel caring for patients with clostridium difficile colitis A. Wear gloves when treating patient B. Impervious gowns upon entering room C. Wash hands with soap and water -------- Correct Answer --------- All of the above Why is anticoagulation therapy used in dialysis A. To foster good venous blood flow in fingers and toes B. To reduce clotting within the extracorporeal circuit C. To optimize dialyzer efficiency -------- Correct Answer --------- B and C How is heparin commonly administered A. Initial loading dose of heparin is given before tx begins B. Directly into arterial needle C. Administered throughout tx by direct injection -------- Correct Answer --------- A. Initial dose When blood is transfused into at risk patients during heparin free dialysis what complication should the technician be monitoring for A. Fluid removal overload B. Anaphylaxis reaction C. Increased velocity of the blood in the dialyzer -------- Correct Answer --------- C. Increased velocity If a dialysis patient does not have adequate vessels to create an internal fistula what is the remedy A. Veins surgically transferred from other areas of the body B. Wrapping mesh around scarred veins C. Using synthetic grafts -------- Correct Answer --------- C. Using synthetic grafts

A patient tells the text that she woke up in the morning with her fistula arm underneath her head and that it has been asleep and feeling funny all day knowing this which complication should the tech assess the patient for prior to assessing her site A. Cervical disc pain resulting in nerve damage B. Thrombosis caused by compression of blood flow C. Aneurysm of the official site due to kinking of the artery -------- Correct Answer --------- B. After the initial skin prep for cannulation the tech is interrupted by a coworker asking a question when she proceeds to cannulation she noticed the skin prep has dried what action should the tech take A. Proceed with cannulation B. Perform new assessment by palpating the site and then cannulate C. Re-prep the access to ensure the patient has not accidentally touch the site -------- Correct Answer --------- C. How should the needles be positioned A. Please the needles in the same general area during each treatment B. To achieve best blood flow placed the arterial needle near the anastomosis keeping the tip no closer than 1 1/2 to 2 inches from the anastomosis C. placed the arterial needle point in the direction of the flow D. Space the needles at least 1 inch apart -------- Correct Answer --------- B C and D What care should be provided for official arm between dialysis treatments A. Maintain adequate pressure over the puncture site for 10 to 20 minutes after the needles been removed B. Allow the skin over the access site to breathe by removing dressings after the bleeding has stopped C. Clean the fistula arm daily with soap -------- Correct Answer --------- A and C In patients with stage four or five chronic kidney disease which access site should be avoided to prevent risk of stenosis and thrombosis A. Fistula B. Subclavian vein catheter C. Peripherally Inserted central catheter -------- Correct Answer --------- B and C Immediately after insertion of a jugular catheter which complication should be assessed in the newly diagnosed stage five chronic kidney disease patient A. Slurred speech B. Collapsed lung C. Chest pain -------- Correct Answer --------- B. Collapsed lung According to KDOQI guidelines on goals of therapy for CKD patient on dialysis which post dialysis blood pressure goal is recommended A. Less than 140/ B. Less than 130/

C. Less than 150/95 -------- Correct Answer --------- B According to the centers for Medicare and Medicaid what is the maximum amount of fluid that can be safely removed during a standard treatment A. 30% of fluid way as long as the pressure is normal B. No more than 20% of total body weight C. Ultrafiltration rate of 13/ML/KG/HR or less -------- Correct Answer --------- C. Related to rapid decrease in the circulation blood volume caused by ultrafiltration what is the most common complication during treatment A. Hypotension B. Bleeding C. Dehydration -------- Correct Answer --------- A. Hypotension Which symptoms will alert the tech a patient is experiencing type a dialyzer reaction A. Dyspnea B. Chest and back pain C. Sense of impending doom D. Numbness around the mouth -------- Correct Answer --------- A B and C The dialysis tech knows that reducing intake of this nutrient may be beneficial in delaying the progression of kidney disease A. Water B. Carbohydrates C. Proteins -------- Correct Answer --------- C. Albumin is a bio-marker monitored to assess the nutritional status of patients with CKD which patients are likely to have a lower serum albumin A. Patient who is dehydrated B. Patient with fatigue and low energy C. Patient with hair loss and muscle wasting -------- Correct Answer --------- B and C According to KDOQI which pre-dialysis albumin level should be the outcome goal for dialysis patient A. Equal to or greater than the normal range of four B. Equal to or greater than the normal range of three C. Equal to or greater than the normal range of one -------- Correct Answer --------- A. A 73-year-old dialysis patient is discussing with the tech her desire to convert to a total plant-based diet which statement is important for the tech to share A. There is no way to satisfy a patient's protein needs with a total plant-based diet B. Plant proteins are low biological value proteins and need to be combined to get all building blocks her body needs C. No plant protein foods are considered high proteins so it will be hard for her to satisfy her protein needs -------- Correct Answer --------- B.

For a patient with stage 5 CKD phosphorus intake should be limited to what level A. 400 to 800 B. 1200 to 1600 C. 800 to 1200 -------- Correct Answer --------- C. A patient with CKD is having difficulty controlling her phosphorus intake why is control of phosphorus challenging A. Phosphorus is abundant in fresh food such as vegetables and fruit B. Phosphorus is found in high amounts of coffee and tea C. Phosphorus additives are commonly found in best-selling processed foods -------- Correct Answer --------- C. A patient with stage 5CKD has C Dash reactive protein level of 25 what does this level suggest A. Early onset diabetes B. Inflammation in the body C. Heart attack -------- Correct Answer --------- B. Parathyroid hormone helps to regulate calcium and phosphorus levels low serum calcium levels stimulate secretion of parathyroid hormone this results in which change of the body A. Increase calcium absorption from small intestine B. Calcium loss in the urine is minimize C. Movement of calcium out of the bones D. Creation of a urinary buffer for acid base balance -------- Correct Answer --------- A B and C How can a dialysis procedure be modified for a CKD patient with severe elevated blood urea nitrogen level A. Shorten dialysis time B. Increase blood flow rate C. Increased time rinsing the equipment D. Use a larger dialyzer -------- Correct Answer --------- B and D Which asymptomatic patient meet the criteria for testing for diabetes or prediabetes A. African-American and Latino or Native American B. Triglyceride level of 150 MG/DL C. Patient is on antihypertensive medication -------- Correct Answer --------- A and C A pts lab results revealed a significant drop in hemoglobin. Which med would the tech expect the nurse to administer to the pt A. Calcitrol B. Erythropoietin C. Vancomycin -------- Correct Answer --------- B. Which of the following practices helps to build a pts immunity to hep B

A. Isolation B. Vaccination C. Sequestration -------- Correct Answer --------- B The tech is unsure which one of a patient's arteriovenous graft is arterial and which one is Venus in order to differentiate what do you do A. Cannulate both sides and observe the color B. Apply a tourniquet to the arm and feel for venous resistance C. Compressed a graft in the middle and palpate each side -------- Correct Answer ------- -- C. At the end of a patient's treatment which of these findings is observed by the tech should be reported A. Pulse rate of 55 B. Temp of 98 C. Weight loss of 6.6 -------- Correct Answer --------- A. Why are pts more likely to become infected with germs like MRSA A. Their diet is restricted B. Have weak immune systems C. Often have allergies to most antibiotics -------- Correct Answer --------- B. A pt who has diabetes should be observed for signs of low blood sugar which include A. Fever and chills B. Thirst and weight gain C. Anxiety and confusion -------- Correct Answer --------- C. The water supply to the water treatment system is called A. Ground water B. Carbonated water C. Feed water -------- Correct Answer --------- C Which part of the water treatment system removes endotoxin A. Ultra filter B. Resin bed C. Softener -------- Correct Answer --------- A. A pt asks why they need a profile on their machine the techs response should be that the understanding of the profile is to A. Minimize clotting B. Minimize hypotension C. Maximize flow rate -------- Correct Answer --------- B. Which occurs when the machine alarms and goes into bypass A. Arterial pressure increases B. Heparin isn't administered

C. Dialysate stops flowing through the dialyzer -------- Correct Answer --------- C. Which therapy is recommended for pt with a hemoglobin level of 7.5% who watches her diet and exercises during the week A. Quadratic therapy with metformin and three meds B. Monotherapy and metformin C. Dual therapy with metformin plus one med -------- Correct Answer --------- B. KDOQI guidelines recommend screening patients with diabetes for diabetic nephropathy which test will be ordered A. Urine for microalbuminuria B. eGGR for Values below 90 mL/min C. Fasting glucose <100 -------- Correct Answer --------- A and B A child who has in just a large amount of poison is brought to the emergency room the tech is preparing the child for dialysis for it to remove the poison the poison must have which characteristic A. High degree of Protein binding B. Water solubility C. Low molecular weight -------- Correct Answer --------- B and C While reviewing the latest information on hypertension the dialysis tech notes that a blood pressure of 130/80 mmHg or higher is considered hypertension in which people A. Those with diabetes B. Those with CKD C. Those this cardiovascular disease -------- Correct Answer --------- A and B A dialysis patient regularly experiences intradialytic hypotension which medication may be given 15 to 30 minutes before dialysis for blood pressure support A. Amlodipine calcium channel blocker B. Losartan angiontensin receptor blocker C. Midodrine a vasopressor -------- Correct Answer --------- C. A dialysis patient asked the technician why am I taking Velphoro what medication does this fall under A. Phosphate binders B. Calcium channel blocker C. Cation exchange resin -------- Correct Answer --------- A. A patient has been diagnosed with acute kidney injury what symptoms might the family notice A. Listlessness B. Dark circles under eyes C. Confusion D. Fatigue -------- Correct Answer --------- A c and D

What are some of the most common indications for acute dialysis A. Elevated BUN level B. Symptomatic Hypokalemia C. Weakness in one side of body D. Acute pulmonary edema -------- Correct Answer --------- A and D A patient with first used syndrome is experiencing severe symptoms including breathing difficulty and cardiac rhythm abnormalities as the tech working which action should be implemented A. Return the blood to patient as quickly as possible B. Ask the RN to dispense Benadryl C. Discard the dialyzer -------- Correct Answer --------- C. If a patient is receiving acute dialysis what adjustment to the dialysis machine will help the patient with hypertension lower it to relatively normal reading A. Infusion of normal saline B. Ultrafiltration C. Transfuse one unit of packed cells -------- Correct Answer --------- B. Which action by the dialysis staff will help prevent or minimize disequilibrium A. Decrease flow rate B. Implement isolated ultrafiltration to remove fluid C. Utilize a small dialyzer with lower clearance properties D. Lower heparin dose to 250 units/hour -------- Correct Answer --------- A and C The emergency department is sending a patient to the dialysis unit due to a drug overdose which condition should the dialysis tech be aware of prior to patient arrival A. Hypertension B. Respiratory apnea C. Severe acid base in balance -------- Correct Answer --------- B and C A new client with CKD asks the tech what does nocturnal intermittent peritoneal dialysis mean how do you answer A. The initial volume will be small but will increase to a total volume infused every morning B. The machine will provide 3 to 5 exchanges every night but only minimal or no dwelling during the day C. You will receive dialysis 3 to 4 times a week with dry periods In between treatments - ------- Correct Answer --------- B. The patient has had an expected progression of CKDN needs urgent start peritoneal dialysis what problems may be present in the patient who has been prescribed urgent start A. Fluid volume overload B. New onset jaundice C. High BUN and creatinine levels -------- Correct Answer --------- A and C

What is considered the advantage of coiled catheters for peritoneal dialysis A. Improve patient comfort B. Better flow fluid C. Les linking -------- Correct Answer --------- A. Which complication of peritoneal dialysis should the tech report when he observes Cloudy effluent A. Tunnel infection B. Fibrin formation C. Peritonitis -------- Correct Answer --------- C. Which patient complaint leads to tech to suspect air has entered the peritoneal cavity A. Shoulder pain B. Swelling in the neck C. Scrotal Adema -------- Correct Answer --------- A. A family member asks what is the most frequent complication of peritoneal dialysis how would you answer A. Formation of Fibrin stands B. Peritonitis C. Leakage of dialysate -------- Correct Answer --------- B. What are some disadvantages of a kidney transplant that should be shared with patient and family A. Abdominal pain due to incising muscles B. Need for lifelong immunosuppression C. That's potential complications of immunosuppression -------- Correct Answer --------- B and c A patient ask the tech how long does a patient have to stay in the hospital after undergoing a kidney transplant what is the response A. 2 to 3 months until kidneys functioning B. One month C. Three to five days -------- Correct Answer --------- C. Following transplantation which electrolyte abnormalities are treated with dialysis A. High potassium level B. Acidosis C. Low magnesium levels -------- Correct Answer --------- A and B Transplant patient who is undergoing dialysis for hyperkalemia asks which vaccination should I avoid after I have this new kidney which one should be avoided A. Flu shot B. Small pox vaccine C. Bacillus calmette-guerin -------- Correct Answer --------- B and C