CCHT Practice Exam Questions with Answers Correctly Solved, Exams of Nursing

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CCHT Practice Exam Questions with Answers Correctly Solved

1. In hemodialysis, the term "anastomosis" refers to the connection of: Two blood vessels

2. A patient requests information about home hemodialysis. However, his wife stops the technician in

the waiting room and says, "Please do not encourage home training for my husband." Which of these actions should the technician take initially?: Report the wife's concern to the RN

3. The dialysis personnel's first response in the event of a fire is to: Rescue PTs in immediate

danger

4. 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

5. Venous pressure is a result of resistance created by the: Blood returning to the patient

6. 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

7. A patient who is receiving an initial hemodialysis treatment on a

non-reusable dialyzer should be observed for signs of: First-use syndrome

8. A patient is experiencing large weight gains between hemodialysis treat- ments. The technician

should remind the patient that the best dietary measure to control weight gain is to decrease the intake of: Salt

9. Mrs. Miller's calculated Kt/Vurea is 0.9. One of the factors that affects her Kt/Vurea is her: TX

time

10.In order to minimize access recirculation, the technician should place Mrs. Miller's fistula

needles: As far apart as possible

11.Heparin is given during Mrs. Miller's dialysis treatment to lower the risk for: clot formation

12.Mrs. Miller asks the technician, "Why can't I completely cover up with a blanket during my

hemodialysis treatment? I'm cold." Which of these respons- es by the technician would be best?: "we need to ensure early detection of needle dislodgment"

13.During a treatment, Mrs. Miller's venous needle infiltrates. Which of these actions should the

technician take first?: make sure the blood pump stopped

14.The technician observes that a patient's dialysate lines were incorrect- ly 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

15.A substance that is cleared from the body by healthy kidneys is: Creatinine

16.One purpose of priming the bloodlines and extracorporeal circuit pre-dial- ysis is to: remove

disinfectant

17. 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

18.A fire has broken out on the treatment floor. The technician must begin disconnecting

patients, starting with patients who are: ambulatory

19.Holding needle puncture sites instead of using spring-loaded fistula clamps is

recommended to avoid access: thrombosis

20.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

21.A hemodialysis extracorporeal circuit is routinely primed with saline in which of these

concentrations?: 0.9%

22.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.

23.A patient with a right arteriovenous (AV) fistula arrives at the dialysis facility complaining of pain,

tingling, and cold fingers in his right hand. The technician would expect the nurse will notify which of the following physicians for possible corrective action?: vascular surgeon

24.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

25.What is a DISADVANTAGE of an arteriovenous fistula as a hemodialysis access compared to

other types of access?: time required to mature

26.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

27.The role of the renal dietitian includes: teaching patients how to meet nutrition needs

28.Which of the following components of the dialysis machine is designed to protect the patient

from bubbles/foam?: air detector

29.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

30.Chloramine levels in treated water that are in excess of the standards of the Association for the

Advancement of Medical Instrumentation (AAMI) could result in: a life-threatening condition

31.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

32.The greatest reduction in microorganisms in the dialysis machine is ac- complished by:

disinfecting

33.A patient is diagnosed with hepatitis C. Beyond standard precautions, what additional measures,

if any, should be taken for the patient?: no additional precautions are necessary for the patient

34.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

35.Which of the following types of vascular access has the lowest incidence of infection?:

arteriovenous (AV) fistula

36.Which of the following actions can the dialysis technician take to help min- imize anemia?:

adequately rinse back as much of the patient's blood as possible at each TX

37.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

38.Mrs. King is scheduled for a revision of her arteriovenous (A-V) fistula im- mediately after today's

hemodialysis treatment. Which of these interventions should occur today?: Hold heparin sodium during the hemodialysis TX

39.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

40.During Mrs. King's hemodialysis treatment, she starts actively yawning. The technician

suspects she may be experiencing: hypotension

41.Hypotension. symptoms: dizziness, tachycardia (rapid pulse), restlessness, and excessive

yawning

42.Mrs. King tells the technician, "I'm considering stopping dialysis treat- ments." Which of these

responses by the technician would be most appro- priate?: "Tell me why you want to stop dialysis"

43.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

44.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

45.Which of the following actions by a technician would be a HIPAA viola- tion?: sharing a

recently transplanted patient's good news

46.Changing the composition of the dialysis solution can influence the pa- tient's: blood

electrolyte levels

47.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

48.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

49.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."

50.A patient on hemodialysis goes to the emergency department for persis- tent 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 PT must receive dialysis in a hospital in a special isolation room

51.The hepatitis B virus is able to survive on environmental surfaces for as long as: 7 days

52.Bicard last?: 24 hours

53.when you see cherry blood what does it mean?: Hemolysis

54.supplement of salt issues is?: phosphorus

55.What is used to control phosphorus?: Binder

56.Acronym for fire is?: P.A.S.S

57.from low to high concentration: Osmosis

58.from high to low concentration: diffusion

59.When venous infiltrates where is the new needle located?: Above the infil- tration

60.When an arterial infiltrates where is the new needle located?: above or below the

infiltration

61.What is the reason for a proper prime?: Remove air

62.When Pt uses the restroom the lines are recirculated (BFR) at ?: 100-

63.What color is chemical in the card?: Blue

64.Where do you clamp so all the saline doesn't go to the patient?: Double clamp saline line

65.Water check?: Is in the primary and secondary tank

66.Water softener checks for?: Salt

67.If your a preceptor and your student doesn't feel safe poking the PT with Hepatitis you....: You

do it and explain the safety

68.What PT's can you attend when doing PT with Hepatitis B ?: Only immune Pt's

69.Carbon tanks: 4

70.After Heprin is ignited how long before you start TX?: 3-5 minutes

71.If the blood of a positive & there is a blood leak what do you do?: Throw away the lines, No

rinse back.

72.Blood leaks alarms?: Check from the outlet dialyzer

73.To avoid anemia you must?: Rinse back as much blood back to the PT

74.If a new lady is nervous?: Explain all the steps

75.Check adequacy: POST BUN

76.What can effect a BUN result?: Eating during TX

77.If PT w/infection and using the gallon bath ex: 2201, what do you do if not all was used?: Dispose

of it

78.A man who curious about peritoneal dialysis ?: Encourage to tell the staff during his next

meeting

79.PT going to hospice?: Support service for the family

80.If a PT is falling?: Guide them to the floor

81.Pt eating peanut snacks?: Phosphorus not a diet

82.A women ask about her mom who is a PT...: We can't share that information you have to go

talk to her.

83.PT BP drops what do you do?: Lay them down, and put legs up

84.Air in the lines what is the next step you must do?: Clamp lines

85.If there is a possible clot you must?: Give Bolus to clean the clot

86. To properly collect the post BUN sample it is necessary to turn off the?: -

Ultrafiltration Rate (UF)

87.To determine the adequacy of dialysis treatment, evaluate the

laboratory: Blood Urea Nitrogen (BUN)

88.When removing needle from us, internal access, the needle safety device should be while

removing needle from patient's access: engaged

89.When it connectivity alarm occurs, the machine enters: Bypass mode

90.When teaching a patient about the prevention of hypotension during treat- ment, the nurse should

instruct the patient to measure their daily including food that at room temperature: Food intake, melt

91.The first thing you should do if a fistula needle has infiltrated is to turn off the: Blood pump

92.A rise in transmembrane pressure (TMP) during hemodialysis is likely to indicate: Clotted

fibers

93.Sharps containers MUST be replaced when they are full: 2/3 to 3/

94.Draw PRE-treatment lab samples after and before is adminis-

tered.: cannulating, heparin

95. Draw POST-treatment labs after and before the

patient's blood is : Treatment, rinsed back

96.You should draw samples for BUN immediately after treatment ends be- cause BUN levels:

Change rapidly

97.Always draw lab samples from the line: arterial

98.Draw pre and post BUN samples on the same...: day

99.The wall clock indicates the patient has had 3 hours of treatment and the machine indicates only

2 1/2 hours treatment. What happened?: The machine was on bypass for 30 mins

100. When washing hands with soap and water, how log must you was your hands?: 40-

secs

101. When cleaning hands with sanitizer, how long must you rub your hands?-

: 20-30 secs

102. The number one cause of chronic renal failure is: diabetes

103. When going from a dirty area to retrieve supplies in a clean area staff are required to

complete hand hygiene? TRUE or FALSE?: True

104. Hazardous Material Identification System HMIS labels are required on all hazardous

materials, including individual bicarbonate containers? TRUE or FALSE?: True

105. The FIRST bleach solution used to clean a large blood spill area greater than 10ml is?: 1

parts of bleach 9 parts of water solution

106. The bleach solution used to clean surfaces/machines for 100ml are?: 1 parts of bleach

99 parts of water solution

107. The main brought a transmission of hepatitis B in

hemodialysis facilities is by exposure to infected and : blood, bodily fluids

108. When carrying for a Patient who is Hepatitis B positive, after disconnect- ing the

bloodlines, the technician MUST perform which three actions before documenting?: Remove gloves, sanitize hands, put on a fresh pair of gloves

109. According to the CDC, patients who are Hepatitis B surface Antigen (HBsAg) positive

should be dialyzed in a area of the dialysis center, on machine: Separate, dedicated

110. What MUST the dialysis

technician do prior to leaving the patient at the dialysis station to get clean supplies? Remove , hands and retrieve .: gloves, wash/sanitize, items

111. dialysis technician has performed a rinse back on a patient and failed to gather all the

supplies needed to disconnect the patient. What two things MUST the dialysis technician do prior to getting clean supplies?: remove gloves, wash/sanitize hands

112. You must wear a full face shield, or mask with goggles, when in an area with a risk of::

blood splatter

113. Normal saline is used to remove and

from the extracorporeal circuit: sterilant, air

114. Improperly primed dialyzer and bloodlines can increase the risk of

& in the dialyzer: air embolism, clotting

115. A low arterial alarm sound. The staff member

should look for a possible cause in the circuit from the through to the : arterial needles , blood pump

116. When a high venous alarm sounds, the staff member should look from the

top of the through the the end of the to determine the cause.: venous chamber, venous needle

117. The adequacy of a dialysis treatment may be compromised by: hepariza- tion

118. The patient presents to the dialysis center with a pulse rate of 44/min, but does not appear

to be in any distress. What should be the dialysis technicians immediate action?: Notify the RN

119. During dialysis, the patient's and must be uncovered: access, face

120. What can result from a low level arterial pressure drip chamber? entering the system?:

air

121. Is the needle infiltrates, the first thing you should do is turn off the?: pump

122. During dialysis and large clot his notice in the Venus chamber. The clini- cian should

replace the.: Venous line

123. The venous pressure on a dialysis machine begins to rise, but the Venous needle is not

infiltrated. The most likely cause is a clotted.: Venous lines

124. The condition most likely to raise the venous pressure is: venous needle occlusion

125. When it is expected that a patient has an air embolism, the

FISRT inter- vention, should be to the PT'S : clamp, bloodline

126. The major complication that kind of curve when the patient is dialyze on hypotonic

dialysate is: Hemolysis

127. hypoklemia (high potassium)

can result in and : weak muscle, death

128. During the dialysis treatment a large clot is noted

in the venous chamber. The clinician should replace the : venous line

129. The new needle placement, following an ARTERIAL needle

infiltration should be located the infiltration: above or below

130. What is the minimum amount of saline that must be in the badgering TX?: 300ml

131. What is an acceptable range for a KECN value?: 200-

132. You notice a large amount of blood pooling under the patient's chair. What should you

do?: Turn off the pump, clamp the lines and call for help

133. Use of a diasafe filter allows the production of: Ultrapure dialystate

134. Normal is used to rinse and prime the tubing of the extracorpo- real

circuit to remove sterilant and air.: saline

135. Air is removed from the extracorporeal circuit before initiating

treatment because it may cause when trapped in the dialyzer.: clotting

136. the most likely cause of contamination of the extracorporeal circuit are

in the prime bucket with end caps: bloodlines, open

137. A low-level arterial drip

chamber can result in entering the system causing an air embolism or clotting.: air

138. is the ability of a substance to contact an electrical charge: conduc- tivity

139. When blood escapes from the dialyzer blood compartment into the dialysate fluid

compartment this is known as: blood leak

140. The final dialysate must have a

pH between: and .: 6.9, 7.

141. how often should staff clean the dialysis machine with acid?: daily

142. When should alarm and Pressure Holding Tests (PHT) should be per- formed on

dialysis machines?: before each treatment

143. what is removed by normal saline during the priming process?: Air in the dialyzer

144. Before the start of treatment,

check that the machine's conductivity alarm parameters are set at of the machine's theoret- ical conductivity.: + or - 0.

145. You should disinfect the dialysis machine with heat after doing what?: -

after cleaning it with ACID

146. In addition to safety checks, what tests must you perform to ensure a safe patient

treatment?: meter conductivity and PH

147. Why do you compare the machine conductivity setting to the meter conductivity

results?: to make sure the machine display is accurate

148. what is the allowable variance between a meter reading and actual con- ductivity on the

machine?: +-0.3 ms/cm

149. pr

ior to applying the blood pressure cuff on a new PT, the patient care technician should both the PT's arms for the presence of an : - exam, access

150. Available weight gain is described as the pre-treatment weight minus: dry weight

151. A red and warm vascular access may be a sign of an: infection

152. Pre treatment evaluation of an internal vascular access includes palpat- ing for a :

thrill

153. what three of PPE are required when performing venipuncture?: Gloves, full face shield

or mask protecting eye wear w/side shield& full resistant gown

154. Damage to the intimal lining of the vessel is likely to occur when

the needle is after insertion.: flipped

155. where cannulating a new A-V fistula always apply a and stay at

least inches from the anastomosis: tourniquet, 1.5-2.

156. Pre-pump arterial pressure should not exceed: -250mm/Hg

157. Make sure access is stabilized and remains: uncovered

158. The patients venous needle

has infiltrated and another needle needs to be inserted. You should insert the new needle the infiltrated and apply to the area.: above, ice

159. When removing needles from an internal access the needle should be

: engaged while removing the needle from the PT's access

160. Access can jeopardize the adequacy of the dialysis treatment.: -

recirculation

161. You should apply the access needle safety devices as the needle is being::

removed from the access

162. An arterial pressure reading

of negative can cause blood to he- molyze.: 270

163. in which direction of the blood flow, should you place a patient's arterial needle?: either

with or against the flow.

164. In which direction of blood flow should you place a Venous needle?: with the flow of the

blood

165. Report a blood pressure reading over

to the nurse.: 180/

166. Report a pulse less than or greater than beats per

minute to the nurse.: 60, 100

167. Before cannulating a patient's access, you should clean the site for at least how

long?: 30 seconds

168. After cannulating an access , you should place the tape directly over the

: butterfly wings

169. how long should you wait to initiate TX after administrating heparin bolus?: 3-

minutes

170. The three types of errors associated with a "Just Culture" are: Simple human, at risk

and reckless

171. Near misses, are sometimes referred to as because

they help diagnose a and reduce : Good catches, system problem, Patient injury

172. failure to report errors or near misses can result in: an adverse event

173. The three keys to a

culture of safety are , , and .: Commu- nication, Error learning, the right way

174. Reporting an adverse

event is a requirement that provides opportunity to identify, report and evaluated: regulatory

175. Near misses are also referred to as "good

catch" because, reporting a Near Miss can diagnoses and reduce patient : a system problem, injury

176. Failure to report or can result in an adverse event, and

an increase of patient injury: errors, near misses

177. An is defined as any time there is failure to follow established pro- cedures, TX

prescriptions, or an event tat causes PT injury or death: adverse event

178. during dialysis a patient has cardiac arrest. What action should be com- pleted on the

dialysis machine before the machine is used by another patient? Technical must perform. on the machine: functional test

179. To prepare for

disasters, such as a hurricane, or possible, flooding, staff to lock down seal and secure all in the locked : lids on sharps containers, boxes/bags, biohazard storage room

180. The purpose of maintaining a log of water quality checks is to prove has been

documented: safe water

181. Which of the following complications is most likely caused by kink in the bloodline?:

Hemolysis

182. Excessive fluid removal during dialysis, combine with a patient taking an antihypertensive

medication may result in the patient having?: Hypotension

183. A patient has been observed for symptoms of uremia, which include?: -

Loss of appetite

184. Hemolyzed blood could be caused by: An arterial pressure of negative 270

185. During the final 30 minutes of dialysis the patient complains of blurred vi- sion and

dizziness. The technician should evaluate for signs of?: Hypotension

186. The group of symptoms that include feelings of faintness, double vision, respiration,

irritability, and hunger may be associated with what patient com- plication:: Hypoglycemia

187. Hypoglycemia: low blood sugar

188. The primary cause of anemia in the dialysis patient is: A decrease in the production of

erythropoietin

189. Erythropoietin (EPO): hormone secreted by the kidney to stimulate the pro- duction

of red blood cells by bone marrow

190. Drain safety checks to technician notes the following: which one requires intervention::

Access inpatient face are covered

191. What happens when the dialysate flow stops during dialysis?: The pa- tient's blood is

no longer getting cleaned

192. Which alarm will NOT stop the blood pump?: Blood pressure alarm

193. A patient begins to experience shortness of breath, chest pain, and sudden hypotension,

the blood is bright red and translucent. The complication and MOST LIKELY occurring is?: Hemolysis

194. Chloramines or bleach in the dialysate during dialysis can cause a patient death due to:

Hemolysis

195. Improperly primed dialyzers and bloodlines can increase the risk of:: Air embolism and

clotting in the dialyzer

196. P.A.S.S: Pull, Aim, Squeeze, Sweep

197. AAMI (Association for the Advancement of Medical Instrumentation): Or- ganization that

sets standards for dialysis equipment, fluids, and water

198. HBcAb: Hepatitis B core antibody. (exposure)

199. HBsAb: Hepatitis B surface antibody (Immunity)

200. HBsAg: hepatitis B surface antigen (infection)

201. HBV: Hepatitis B (virus)

202. Bicarbonate: HCO-3 A buffer

203. mmHg: millimeters of mercury (pressure)

204. UF (Ultrafiltration): Removal of water in dialysis

205. UFR (Ultrafiltration rate): rate of water removal

206. UV (ultraviolet): invisible spectrum of light

207. Alum: Compound made of aluminum often added to the city water supplies to

remove sediment and make the water clearer.

208. Aluminum: A blood protein.

209. Backwashing: means forcing water backwards thru a filter, removes particles

clogging filter

210. Anemia: a deficiency of red blood cells

211. aneurysm: ballooning or bulging of a weak spot in a blood vessel.

212. carbon tank: Carbon tanks are water treament devices. They contain granular,

activated carbon that adsorbs low molecular weight particles from water. Carbon tanks are mainly used to remove chlorine, chloramines, pesticides, solvents, and some trace organic substances from water used for dialysis.

213. Capillaries: Tiny blood vessels, where oxygenated blood crosses from arteries into

veins. any of the fine branching blood vessels that form a network between the arterioles and venules.

214. Chloramine: mixture of chlorine and ammonia

215. Chloride: an electrolyte in dialysate and in the human body.

216. Chlorine: element is a greenish yellow gas that can harm the lungs if it is

inhaled.

217. concentrate: one or two sal solutions (acid and bicarbonate) that are mixed

together to form dialysate

218. concentration: solute dissolved in a measure of fluid.

219. extracorporeal: outside the body

220. extracorporeal circuit: is the arterial bloodline, dialyzer, venous bloodline, and

extracorporeal circuit monitors. it is an extension of patients blood vessels outside of the body bringing blood back from the access to the dialyzer and then back to patient.

221. Feed water: RAW tap water before it passes through a dialysis water treatment system

222. Hemeostasis: a constant internal balance of the body. a state of equilibrium or

constant state of natural balance in the internal environment of the body.

223. Hypercalcemia: too much calcium in the blood

224. Hypercalcemia symptoms: weak muscles, fatigue, constipation, loss of ap- petite,

abdominal cramps, nausea, vomiting and coma

225. hyperglycemia: high blood sugar

226. Hyperglycemia symptoms: thirst in a PT who has diabetes.

227. Hyperkalemia: excessive potassium in the blood

228. Hyperkalemia symptoms: muscle cramps, cardiac or may die.

229. Hypermagnesemia: too much magnesium (electrolyte) in the blood

230. Hypermagnesemia needed for: muscle and nerve function

231. Hypermagnesemia causes: feeling sleepy, or have nerve problems, low blood pressure,

and slower breathing. cardiac arrest may occur.

232. Hypokalemia: deficient level of potassium in the blood

233. Hypotonic: Having a lower concentration of solute than another solution

234. nephron: functional unit of the kidney

235. Definition nephron: A tiny blood purification filter in the kidney made up of a

glomerulus and a tubule.

236. glomerulus: A ball of capillaries surrounded by Bowman's capsule in the

nephron and serving as the site of filtration in the vertebrate kidney.

237. uremia: the build up of bodily waste products in the blood

238. thrill: thye vibration of blood flowing through the PT's fistula or graft. It can be felt by

touching a PT's access.

239. water softener: reduces the concentration of calcium and magnesium that form

scale.