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CCHT Practice exam NNCC Version 1.
Typology: Exams
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A substance that is cleared from the body by healthy kidneys is creatinine. The patient tells the technician, "The doctor told me I'm anemic. What does that mean?" Which of these responses by the technician would be correct? "You don't have enough red blood cells to carry oxygen." According to the standards of the Association for the Advancement of Medical Instrumentation (AAMI), pre-treatment water should be checked for chloramine at which of these times? Before each patient shift. Which of the following types of vascular access has the lowest incidence of infection? Arteriovenous (AV) fistula. During a patient's dialysis treatment, the dialysis machine's blood leak detector alarm sounds. The technician should take which of these actions first? Confirm the blood leak. While performing the end-of-day water hardness check, the technician notes that the hardness exceeds the allowable limit. In addition to notifying the equipment technician, the technician should check which component of the water system? Salt level in the brine tank. The technician observes that a patient's dialysate lines were incorrectly placed on the dialyzer. The technician corrects the line placement. The principle underlying the technician's action is that clearance is maximized by countercurrent flow. Venous pressure is a result of resistance created by the blood returning to the patient. A patient who is receiving an initial hemodialysis treatment on a non-reusable dialyzer should be observed for signs of first-use syndrome. Holding needle puncture sites instead of using spring-loaded fistula clamps is recommended to avoid access thrombosis. A patient who has an arteriovenous (AV) fistula receives a bolus dose of heparin at the beginning of a hemodialysis treatment and a continuous heparin infusion during the treatment. The patient's heparin administration should be terminated 30-60 minutes before the end of the treatment in order to prevent prolonged bleeding. During a dialysis treatment, a patient suddenly develops fever and chills. The initial action that should be taken is to determine whether other patients are having similar symptoms.
A patient who recently had an arteriovenous (AV) fistula placed in the left forearm is experiencing numbness and tingling of the left hand. The patient's left hand is cold and the fingernail beds are blue. The patient most likely has which of these syndromes? Steal. One purpose of priming the bloodlines and extracorporeal circuit pre-dialysis is to remove disinfectant. A new technician is being oriented to the water treatment system. The equipment technician explains that the purpose of the ultraviolet (UV) light is to change the DNA of microbes so they die or cannot multiply. Which of the following actions can the dialysis technician take to help minimize anemia? Adequately rinse back as much of the patient's blood as possible at each treatment. CASE: Manuel Rivera, 75 years old, has a hemodialysis catheter and a newly placed right forearm artriovenous (AV) fistula. He arrives at the dialysis facility complaining of pain and swelling of his right arm. For pain management, Mr. Rivera is taking narcotic pain pills as prescribed by his doctor. The dialysis technician knows that taking this medication puts Mr. Rivera at increased risk for falls. CASE:Manuel Rivera, 75 years old, has a hemodialysis catheter and a newly placed right forearm artriovenous (AV) fistula. He arrives at the dialysis facility complaining of pain and swelling of his right arm. What is a DISADVANTAGE of an arteriovenous fistula as a hemodialysis access compared to other types of access? Time required to mature. CASE: Manuel Rivera, 75 years old, has a hemodialysis catheter and a newly placed right forearm artriovenous (AV) fistula. He arrives at the dialysis facility complaining of pain and swelling of his right arm. Mr. Rivera's pre-dialysis weight is 157.6 lb (71.5 kg) and the prescribed target weight is 150.3 lb (68.3 kg). The treatment time is four hours. Excluding prime and rinseback, Mr. Rivera's hourly ultrafiltration rate should be how many mL per hour? 800 The following method should be used to calculate the ultrafiltration rate per hour of treatment: 71.5 kg predialysis weight
CASE: Christine Miller, 54 years old, has been receiving hemodialysis treatments for one year. Her vascular access is a left forearm graft. During a treatment, Mrs. Miller's venous needle infiltrates. Which of these actions should the technician take first? Make sure the blood pump stopped. A female patient complains of loneliness and financial difficulty after her husband's death last month. The technician should report this information to the social worker. The hepatitis B virus is able to survive on environmental surfaces for as long as 7 days. A patient on hemodialysis goes to the emergency department for persistent coughing and fever. He is diagnosed with active tuberculosis (TB). Which of the following actions would the technician expect to be taken in regard to the patient's dialysis treatment? The patient must receive dialysis in a hospital in a special isolation room. Which of the following actions by a technician would be a HIPAA violation? Sharing a recently transplanted patient's good news. A patient has an arteriovenous (AV) fistula in his lower left arm. When choosing a cannulation site, the technician observes where previous needles were placed and chooses to use alternate sites for arterial and venous needle insertion. This practice is an example of rope and ladder technique. When doing a routine patient check, the technician notices a puddle of clear liquid underneath a dialysis machine. After wiping it up, which of these actions, if any, should the technician take? Notify the equipment technician. A hemodialysis extracorporeal circuit is routinely primed with saline in which of these concentrations? 0.9% (sodium chloride (salt) Some technicians use one disinfectant wipe, while others use two wipes for surface cleaning. When determining whether to use one or two wipes, the technician should be most concerned about which of the following? Sufficient wet contact time. Which of the following components of the dialysis machine is designed to protect the patient from bubbles/foam? Air detector. The technician is busy with a patient when a machine across the room alarms. The dietitian standing nearby mutes the alarm. The technician should have which of these understandings concerning this action? It is not permitted by the current ESRD regulations. The role of the renal dietitian includes teaching patients how to meet nutrition needs. A fire has broken out on the treatment floor. The technician must begin disconnecting patients, starting with patients who are ambulatory.
No additional precautions are necessary for the patient. Blood flow is manually maintained during a power outage. The technician must take which of these actions? Remove the line from the venous line clamp. In hemodialysis, the term "anastomosis" refers to the connection of two blood vessels. CASE: Helen King, 79 years old, has been on maintenance hemodialysis for six years. Mrs. King is scheduled for a revision of her arteriovenous (A-V) fistula immediately after today's hemodialysis treatment. Which of these interventions should occur today? Hold heparin sodium during the hemodialysis treatment. CASE: Helen King, 79 years old, has been on maintenance hemodialysis for six years. Mrs. King arrives for her next dialysis treatment after a holiday weekend complaining of extreme muscle weakness and abdominal cramps. She has an irregular heartbeat and is having difficulty walking. The technician should suspect Mrs. King has a high potassium level. CASE: Helen King, 79 years old, has been on maintenance hemodialysis for six years. During Mrs. King's hemodialysis treatment, she starts actively yawning. The technician suspects she may be experiencing hypotension. CASE: Helen King, 79 years old, has been on maintenance hemodialysis for six years. Mrs. King tells the technician, "I'm considering stopping dialysis treatments." Which of these responses by the technician would be most appropriate? Tell me why you want to stop dialysis."