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CCHT PRACTICE QUESTIONS ACCURATE AND
WELL DETAILED ANSWERS
1.which of the following terms indicates a solution that has the same concen- tration of solutes as blood?: isotonic 2.a patient's potassium levels has been running high between dialysis treat- ment, 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?- : bananas 3.during osmosis, which of the following movements takes place?: 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.: 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: cold compresses 6.which of the following actions by a patient increases the risk of blood clots in a venous access?: wearing a top with very tight- fitting long sleeves 7.a patient is very anxious during an initial hemodialysis treatment and re- quires extra attention. when the treatment is completed, the patient offers a $20 tip. the technician should: politely decline the tip 8.which of the following statements by a hemodialysis patient suggests that the patient needs more education?: i should stay on a low protein diet. 9.the inner part of the kidney is the: medulla 10.a nephron is comprised of a glomerulus and a: tubule 11.how much urine does a patient with healthy kidneys usually excrete in 24 hours?: 1000 to 2000mL 12.when removing soiled gloves, the first glove removed should be.: grasped in the opposite gloved hand
19.generally, the optimal dialysate flow rate for hemodialysis should be: 1.5 to 2 times the blood flow rate 20.a patient is receiving hemodialysis with a dialyzer with an ultrafiltration coefficient [ kuf ] of 10 and a transmembrane pressure [TMP] of 100 mm hg. how much fluid should the patient lose per hour of treatment: 1000 mL 21.under what circumstances can needle be reused for hemodialysis?: under no circumstances 22.if a emergency ( such as a tornado ) occurs and patients need to be evac- uated, which group of patient should be disconnected from dialysis machine first?: patients able to ambulate independently 23.for patients on hemodialysis a, 1 kg (2.2 lb.) increased in weight in 24 hours is approximately equivalent to fluid retention of: 1.0 L. 24.a patient has been advised to avoid foods high in phosphorus. food that the patient should be advised to limit include.: dairy products
25.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.: avoid excessive exercise 26.which of the following ethnic group is most at risk for development of kidney failure?: african american 27.a patient has buttonhole tracts for access. after the access is cleaned and prepped for treatment, what is the next step?: 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: 5 to 10 minutes 29.if a buttonhole access frequently has long clots that are very difficult to remove, the most likely reason is: 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?: bicep curl
38.the purpose of the negative germicide test is to ensure that: the re- processed dialyzer is free of germicides 39.if a patient develops angina (chest pain) radiating to the neck, jaw, and left arm and the patient's blood pressure drops during treatment, the technician should notify the nurse and: decreased blood flow rate and ultrafiltration
- the technician is reinforcing a patient's training regarding management of fluid intake. the patient, who still urinates, has a base of 1000 ml intake per day. if the patient urinates 500 ml in a 24-hour period , how much fluid is the patient allowed the following day?: 1500ml 41.the greatest risk of bacteremia (infection in the blood) is associated with which type of vascular access?: dialysis catheter 42.the external surface of the hemodialysis machine should be cleaned and disinfected at least.: after every patient
- when checking the water temperature in the system, the technician records the temperature at 78 F (25.5 C). in order for the reverse osmosis (RO) equip- ment that is partof the
water treatment system to work properly, the water temperature must be maintained at: 77' F to 82'F ( 25' C to 28'C ) 44.when testing the chlorine levels in the water system, the water sample should be taken from the.: first carbon tank
- when considering the chain of infection, the three most common reservoirs of interest include humans, environment and: animals 46.a solution is a mixture of: solute and solvent 47.when reinforcing education about weight gain, a patient should be advised that the usual goal for interdialytic weight gain is less than: 1.0 kg/d 48.if a high-pressure alarm for arterial pressure (pre-pum ) sounds during hemodialysis, this could indicate.: drop in speed of blood pump 49.if a low- pressure alarm for venous sounds during hemodialysis, this could indicate.: clotting in the access 50.according to KDOQI guidelines, when administering hemodialysis to a patient a, facemark should be worn: for all access connection
- when using the buttonhole technique for vascular access for hemodialysis, the needles are placed in.: the same site in a fistula 57.when inserting a needle for hemodialysis, which of the following increases the risk of infiltration?: 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: durable power of attorney 59.carbon filters in the water system are necessary to remove: chlorine, chlo- ramine, and organic material 60.backwashing to free residue from sediment filters in the water system should be done at least: once daily
- with the formula for urea kinetic modeling (UKM), the K in the Kt/V formula stands for: urea clearance (mL/ min) plus residual urinary output 62.when inserting needles into a graft for hemodialysis, the needle tips be should be at least how far apart?: 2.0 inches
63.if a patient is undergoing hemodialysis and the technician notes that a bloodlines has separated and blood has pooled beneath the access site, the first intervention should be to: stop the blood pump 64.during hemodialysis, the technician would expect a patient's temperature to rise by about.: 0.5 C 65.approximately what percentage of the total blood volume circulate in the veins?: 65% to 80% 66.patient should be advised to avoid eating during hemodialysis because ingestion of food may result in: hypotension 67.prior to using a reprocessed dialyzer, a recirculating rinse with NS should be completed with recirculating flow rate through the blood compartment and the dialysate compartment of at least.: 200 mL/min for BFR and 200 mL/ min for DFR. 68.if a hemodialysis patient test positive for hepatitis C virus (HCV), which of the following interventions does the KDIGO
- when reviewing a patient's food dairy, the technician advise the patient that which of the following protein sources is of low biological value?: dried bean 76.which of the following vitamins may be removed by hemodialysis: vitamin B 77.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?: kidney beans 78.the primary purification process of the dialysis water is: filtering with acti- vated carbon 79.if the dialysis center uses hemoclips on dialysis tubing to prevent discon- nection, what other precautions should be utilized?: visible access sites/line connections and documentation of integrity every 30 minutes 80.if during hemodialysis, blood is evident in the used dialysate, this probably indicates: tear in the membrane
81.if a patient asks a question to which the technician does not know the answer, an appropriate response is: I 'll find out for you '' 82.during routine hemodialysis, a patient's blood pressure should monitored every: 30 to 60 minutes 83.if a patient develops painful muscle cramps in the hands, feet, and ab- domen shortly after hemodialysis begins, the most likely interventions is: - saline bolus and/or decreased ultrafiltration rate. 84.if a hemodialysis patient's temperature per tympanic membrane ther- mometer is 37C in order to reduce incidendence of intradialytic ( during dialysis ) hypotension, the temperature of the dialysate solution should ideally be set at: 36.5 C 85.foam in the venous bloodline of a dialyzer may indicate: air embolism 86.prior to initiating hemodialysis, the ph of the dialyste usually ranges from-
93.if a patient is to undergo heparin-free dialysis, the optimal blood flow rate is: 300 to 400 ml/min 94.before cannulating An AV fistula for a hemodialysis treatment, the techni- cian 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: stenosis 95.in order to increase survival rates. the ultrafiltration rate for hemodialysis patients should be maintained at least than: 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): accessory pathway ( collateral circulation )
97.how much additional proteins should a patient on hemodialysis ingest every day in comparison to a health person: 50% 98.weight gain between hemodialysis treatments should not exceed: 5% of dry weight
- the technician has calculate the target weight loss for a patent's hemodial- ysis session, but the patient insists that the technician has made an error and the target is 1 kg too high. the technician should: recalculate the target weight loss. 100.the most important reason for placing hemodialysis needles in antegrade position ( in direction of blood flow) is because: it causes less scarring 101.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?: 42.
- in the hemodialysis machine, a separate air detector is usually placed: - between the venous pressure gauge and the venous access
- at the completion of dialysis treatment, it is important to rinse back as much blood as possible in order to: reduce the severity anemia
- if a power outage occurs and backup power fails, before using the hand crank to return the patient's blood, the technician must: remove the venous line for the air detector
- if a patient's blood pressure is 142/88 before dialysis and 108/72 at the completion of dialysis, the most likely intervention is: 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: discard the package
- when washing the hands, the hands should be wet and soap applied and then the hands rubbed together for at least: 15 seconds
- how long can hepatitis B virus live on surfaces if they are not properly disinfected?: 7 days
- in the event that a fire occurs in a dialysis center, the RACE method of response includes: rescue, active alarm, contain/confine fire, and extinguish/evac- uate
- if the technician needs to move boxes of supplies from the floor to elevated shelves, the technician should: 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: 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?: 17
- 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.: arterial needle
