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CCHT PRACTICE EXAM REVISED STANDARD EXAM
which of the following terms indicates a solution that has the
same concentration of solutes as blood? - ANSWER -isotonic
a patient's potassium levels has been running high between dialysis treatment, so the patient has been working with the renal dietician to restrict potassium in the diet. which of the following
fruits should the patient avoid? - ANSWER -bananas
during osmosis, which of the following movements takes place? -
ANSWER -fluid moves from an area of lower concentration to
higher. a patient's granddaughter calls the dialysis center and asks for a progress report on her father, who is a patient in the center. the
technician should. - ANSWER -state that patient information
cannot be divulged if a hematoma forms at the access site where a needle infiltrated,
the usual intervention is to apply - ANSWER -cold compresses
which of the following actions by a patient increases the risk of
blood clots in a venous access? - ANSWER -wearing a top with
very tight- fitting long sleeves a patient is very anxious during an initial hemodialysis treatment and requires extra attention. when the treatment is completed,
the patient offers a $20 tip. the technician should - ANSWER -
politely decline the tip
which of the following statements by a hemodialysis patient
suggests that the patient needs more education? - ANSWER -i
should stay on a low protein diet.
the inner part of the kidney is the - ANSWER -medulla
a nephron is comprised of a glomerulus and a - ANSWER -tubule
how much urine does a patient with healthy kidneys usually
excrete in 24 hours? - ANSWER -1000 to 2000mL
when removing soiled gloves, the first glove removed should be. -
ANSWER -grasped in the opposite gloved hand
which of the following hormones is produced by the kidneys? -
ANSWER -erythropoietin
at which stages of chronic kidney disease should a patient being
dialysis? - ANSWER -
which of the following is a genetic disorder that can lead to kidney
failure? - ANSWER -polycystic kidney disease
which of the following complains by a patient may be an
indication of uremia? - ANSWER -itching
a patient has been advised to avoid foods high in phosphorus. food that the patient should be advised to limit include. -
ANSWER -dairy products
a patient is scheduled for serum creatinine test and asks the technician about preparation the day before the test. the patient
should be advised to. - ANSWER -avoid excessive exercise
which of the following ethnic group is most at risk for
development of kidney failure? - ANSWER -african american
a patient has buttonhole tracts for access. after the access is cleaned and prepped for treatment, what is the next step? -
ANSWER -use a crab picker/ aseptic tweezer to remove the
scabs with buttonhole tracts, the technician should apply pressure as
the needle are removed and then for - ANSWER -5 to 10 minutes
if a buttonhole access frequently has long clots that are very
difficult to remove, the most likely reason is - ANSWER -failure
to use 2-finger hold for needle removal a patient who had an AV fistula in the forearm developed an aneurysm and has had to have a new AV fistula created in the upper arm. the patient has a temporary catheter in place for dialysis until the fistula has matured. which of the following
exercise may help strengthen the AV fistula? - ANSWER -bicep
curl
with buttonhole access sites, what should the technician do to
prevent '' hubbing "? - ANSWER -leave 1/16 th to 1/8 inch of the
needle exposed if a patient has a dialyzer clearance rate of 250 mL/ min with 4-
hour treatment, the total volume of blood cleared is - ANSWER -
60 L.
what is the most important factor in preventing exsanguination
from dialysis line separation? - ANSWER -access site visible
if a patient states that she has been skipping lunch because she is
too tired to eat after dialysis, the best solution is to. - ANSWER -
report to the nurse and renal dietician if a patient exhibits signs and symptoms of hemolysis during
dialysis, the immediate action should be to - ANSWER -stops the
blood pump and clamp the blood lines the amount of dialysis that a hemodialysis patient is prescribed is
based on the removal of - ANSWER -urea
maturation of a prosthetic arteriovenous graft usually takes -
ANSWER -3 to 6 weeks
the purpose of the negative germicide test is to ensure that -
ANSWER -the reprocessed dialyzer is free of germicides
when considering the chain of infection, the three most common reservoirs of interest include humans, environment and -
ANSWER -animals
a solution is a mixture of - ANSWER -solute and solvent
when reinforcing education about weight gain, a patient should be advised that the usual goal for interdialytic weight gain is less
than - ANSWER -1.0 kg/d
if a high-pressure alarm for arterial pressure (pre-pum ) sounds
during hemodialysis, this could indicate. - ANSWER -drop in
speed of blood pump if a low- pressure alarm for venous sounds during hemodialysis,
this could indicate. - ANSWER -clotting in the access
according to KDOQI guidelines, when administering hemodialysis
to a patient a, facemark should be worn - ANSWER -for all
access connection the most common complication associated with poor needle site
rotation in a graft is - ANSWER -pseudoaneurysm
in hemodialysis, ultrafiltration refers to extraction of - ANSWER -
fluid
the patient has develop a small aneurysm and asks the technician to cannulate the aneurysm for the hemodialysis treatment because another patient told this patient that it would be less painful that cannulation of the fistula. the best response is to -
ANSWER -advise the patient that cannulating an aneurysm may
result i rupture. a patient experience a cardiac arrest with no pulse or respiration during hemodialysis. after the technician calls for help, the next
action should be to - ANSWER -stop dialysis, return blood, and
flush access lines with normal saline. when auscultating a patient's AV fistula to listen for the bruit, if the technician notes that the bruit is very high pitched, this may
indicate - ANSWER -stenosis
when using the buttonhole technique for vascular access for
hemodialysis, the needles are placed in. - ANSWER -the same
site in a fistula when inserting a needle for hemodialysis, which of the following
increases the risk of infiltration? - ANSWER -rotating the needle
180 degrees the legal document that assigns a heal care proxy to make decisions in the event that a person is unable to do so is called -
ANSWER -durable power of attorney
carbon filters in the water system are necessary to remove -
ANSWER -chlorine, chloramine, and organic material
blood compartment and the dialysate compartment of at least. -
ANSWER -200 mL/min for BFR and 200 mL/ min for DFR.
if a hemodialysis patient test positive for hepatitis C virus (HCV), which of the following interventions does the KDIGO guidelines
recommend when proving hemodialysis treatment? - ANSWER -
adherence to strict infection-control procedures if a dialyzer is to be reprocessed in 3 hours, the dialyzer must be -
ANSWER -refrigerated
when documenting observations about a patient, which of the
following is the most appropriate description? - ANSWER -
patient is sighing and rubbing hands together which of the following is the most common cause of hypotension
developing during hemodialysis? - ANSWER -removing excessive
volume of fluid which of the following interventions is most likely to decrease
hypotension that occurs during hemodialysis? - ANSWER -
decreasing the ultrafiltration rate if an air sector alarm sounds during hemodialysis, the technician
should initially - ANSWER -stop the blood pump and clamp the
patients venous line if outflow stenosis of an AV fistula occurs, the thrill usually -
ANSWER -is loud and higher pitched and then discontinuous
when reviewing a patient's food dairy, the technician advise the patient that which of the following protein sources is of low
biological value? - ANSWER -dried bean
which of the following vitamins may be removed by hemodialysis
- ANSWER -vitamin B the renal nutritionist has advised the patient to have a diet high in fiber, but the patient is unsure which foods to choose. which of the following foods per serving is highest in insulate fibers? -
ANSWER -kidney beans
the primary purification process of the dialysis water is -
ANSWER -filtering with activated carbon
if the dialysis center uses hemoclips on dialysis tubing to prevent disconnection, what other precautions should be utilized? -
ANSWER -visible access sites/line connections and
documentation of integrity every 30 minutes if during hemodialysis, blood is evident in the used dialysate, this
probably indicates - ANSWER -tear in the membrane
if a patient asks a question to which the technician does not know
the ANSWER , an appropriate response is - ANSWER -I 'll find
out for you ''
the same question. the best initial response is to - ANSWER -
notify the nurse when determining if a new AV fistula is maturing the three factors
to assess by palpation are the - ANSWER -thrill, vessel growth,
and vessel firmness which of the following antiseptics used for skin pre for a fistula site has the broadest spectrum antibacterial activity? -
ANSWER -2% chlorhexidine gluconate
while a patient is undergoing hemodialysis, chloramine testing of
the water system should be conducted every - ANSWER -4 hours
if a patient is to undergo heparin-free dialysis, the optimal blood
flow rate is - ANSWER -300 to 400 ml/min
before cannulating An AV fistula for a hemodialysis treatment, the technician examines the patient's access arm and finds that the access arm appears slightly edamatous, and the skin is pale. on further examination, the technician notes that there are small purple veins evident on the chest wall near where the arm meets
the body. the technician should suspect - ANSWER -stenosis
in order to increase survival rates. the ultrafiltration rate for hemodialysis patients should be maintained at least than -
ANSWER -12 ml/kg/m
as part of fistula assessment before cannulation, the technician evaluates the thrill and then applies acclusion by placing a finger across the body of the fistula. while the fistula is acceded, the technician palpates and feels both a thrill and a pulse. this
probably signifies a (n) - ANSWER -accessory pathway
( collateral circulation ) how much additional proteins should a patient on hemodialysis
ingest every day in comparison to a health person - ANSWER -
weight gain between hemodialysis treatments should not exceed
- ANSWER -5% of dry weight the technician has calculate the target weight loss for a patent's hemodialysis session, but the patient insists that the technician has made an error and the target is 1 kg too high. the technician
should - ANSWER -recalculate the target weight loss.
the most important reason for placing hemodialysis needles in antegrade position ( in direction of blood flow) is because -
ANSWER -it causes less scarring
when preparing dialysate with a 45x concentrate, if the proportioning ratio contains 1.0 part acid and 1.72 parts
bicarbonate, how many parts of water are needed? - ANSWER -
if a power outage occurs and backup power fails, before using the hand crank to return the patient's blood, the technician must -
ANSWER -remove the venous line for the air detector
if a patient's blood pressure is 142/88 before dialysis and 108/ at the completion of dialysis, the most likely intervention is -
ANSWER -infusion of normal saline to increase blood pressure
prior to opening a sterile packing, the technician spills sterile
normal saline on the package. the technician should - ANSWER -
discard the package when washing the hands, the hands should be wet and soap applied and then the hands rubbed together for at least -
ANSWER -15 seconds
how long can hepatitis B virus live on surfaces if they are not
properly disinfected? - ANSWER -7 days
in the event that a fire occurs in a dialysis center, the RACE
method of response includes - ANSWER -rescue, active alarm,
contain/confine fire, and extinguish/evacuate if the technician needs to move boxes of supplies from the floor to
elevated shelves, the technician should - ANSWER -bend down
at the knees and keep the back straight while lifting for documentation in the medical record, which of the following
includes a correct - ANSWER -0.5 kg
for a hemodialysis cannulation with a blood flow rate of fewer than 300mL/ min, which of the following needle gauge sizes is
usually recommended? - ANSWER -
if the nephrologist has ordered a pre-dialytic and post-dialytic BUN ( blood urea nitrogen) for a patient with an AV fistula, the pre-dialytic blood sample should be obtained from the. -
ANSWER -arterial needle
the primary focus of the life safety code is on - ANSWER -
protection of people the dialysis prescription is for a 3- hour treatment with 1.5 kg to be removed. during treatment 250 mL is used as saline prime and 200 mL as saline rinseback. the patient ingested 150 mL of fluid that contains oral proteins supplement. the ultrafiltration rate to
be removed per hour is - ANSWER -700 ml
if the ultrafiltration rate to be removed per hour is 600 ml and the dialyzer kuf is 40 what is the transmembrane pressure (TMP)? -
ANSWER -15 mm hg
if using a combination chlorhexidine gluconate and alcohol skin prep (such as chloraprep before cannulation, how much skin
contact time is required? - ANSWER -30 seconds
which of the following preventive measures is usually the best approach for patients who routinely experience hypotension during dialysis because of volume-related problems associated
during cannulation, a tourniquet should be used - ANSWER -
while placing needles in all AV fistula the difference between a buttonhole needle and a standard needle for hemodialysis is that the buttonhole needle has a -
ANSWER -blunt tip
if a hemodialysis patient has an extreme fear of needle and the physician describe EMLA cream to prevent pain, the cream must
be applied - ANSWER -60 minutes prior to treatment
following formation of an AV fistula and beginning of hemodialysis, the technician notes that the patient's nailed and skin on the hand below the fistula are cyanotic during hemodialysis, and the patient complains of pain in the hand. this
is likely an indication of - ANSWER -steal syndrome
after a hemodialysis needle is removed at the end of treatment,
the correct procedure is to apply pressure to - ANSWER -each
access site with two fingers for up to 20 minutes a patient who wants to learn self-cannulation may do so if -
ANSWER -the patient receives appropriate training
thrombosis is newly-created access may be caused by -
ANSWER -low blood pressure
if a new patient has Hero (hemodialysis reliable outflow) graft, the
cannulation site is generally in the - ANSWER -proximal upper
arm (below the axilla). if effluent (used dialysate ) spills into the floor, the technician
should - ANSWER -notify staff trained in hazardous waste
removal a patient is recovering hemodialysis with 17-gauge needle, but his blood flow rate has been increased to 450ml/min. the patient complains of symptoms consisten with hemodialysis ( breakdown of red blood cells) sudden onset of chest tightness, back pain, dyspnea, reddening ok skin color, and blood in the venous line appearing port-wine in color. what is likely cause of this
complication? - ANSWER -needle too small for blood flow rate
when handing off a patient to another staff person, the technician
should always - ANSWER -follow the hand-off protocol
established by the institution the technician should ensure when exposing the opening of a central catheter to air (such as when removing the cap or a
syringe) that the - ANSWER -clamp is closed
the hemodialysis center has instituted a "zero lift" policy. the
primary purpose of such a policy is to - ANSWER -prevent
injuries
