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Davita Final Exam: Questions and Answers, Exams of Nursing

A set of multiple-choice questions and answers related to davita's policies and procedures, covering topics such as patient care, dialysis procedures, infection control, and medication administration. It can be a valuable resource for students preparing for a final exam in a healthcare program or for professionals seeking to refresh their knowledge on davita's practices.

Typology: Exams

2024/2025

Available from 01/07/2025

Nursing-100
Nursing-100 🇺🇸

4.6

(13)

339 documents

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DAVITA FINAL EXAM | QUESTIONS & ANSWERS |ALREADY

GRADED A+| VERIFIED & UPDATED| 2024

Per Davita policy, fever and chills is defined as a. Any temperature greater than 99°F or increase over baseline of 1°F with symptoms b. Any temperature greater than 99°F or increase over baseline of 1°F without symptoms c. Any temperature greater than 100°F or increase over baseline of 2°F with symptoms d. Any temperature greater than 100°F or increase over baseline of 2°F without symptoms – answer c. Any temperature greater than 100°F or increase over baseline of 2°F with symptoms Documentation in the medical record a. Includes caregiver opinion. b. Belongs to the patient.

c. Is a permanent legal record of the care provided d. Is not subject to review by surveyors – answer c. Is a permanent legal record of the care provided The PCT notes that a patient still has considerable edema in her legs when performing the post-treatment data collection. In addition to informing the nurse, what should the PCT document? a. Leave the data collection entry blank b. Document "RN to assess" c. Document the noted swelling and that the RN was informed d. Document "N/A" since the nurse will assess and document – answer c. Document the noted swelling and that the RN was informed When the patient's calculated UF Goal exceeds the maximum UFR ordered by the nephrologist a. The calculated UF Goal should be entered into Snappy and the UFR adjusted once the patient shows signs of becoming hypotensive

b. The patient must give permission to exceed the ordered maximum UFR since fluid overload is

harmful and every effort should be made to reach the ordered target weight c. The calculated UF Goal must be adjusted to not exceed the ordered maximum UFR and the reason documented d. The charge nurse must assess the patient prior to treatment initiation to determine a safe UF Goal for the patient – answer c. The calculated UF Goal must be adjusted to not exceed the ordered maximum UFR and the reason documented DQI (Davita Quality Index) is achieved by a. Managing individual patients first and allowing scores to follow b. Knowing each team member's role in improving DQI scores c. Using the CQI process to help identify trends and make improvements d. All of the above – answer d. All of the above Per the CDC, which is the most common factor contributing to bacteremias in dialysis patients? a. Inappropriate skin preparation prior to vascular access needle insertion

b. The use of catheters for hemodialysis c. Poor needle site rotation when cannulating an internal vascular access d. Exposing needle insertion sites to unclean environment areas, e.g. contaminated chair side tables during dialysis – answer b. The use of catheters for hemodialysis Which statement is true about sinks used for hand washing? a. Patients may not use sinks that are dedicated for teammate hand washing, but should have their own sinks b. Hand washing sinks may be used to discard clean solution such as left-over normal saline in a sterile bag c. Hand washing sinks must be dedicated for hand washing purposes only and should remain clean d. Hand washing sinks may be used to discard bleach solution since the solution kills germs and has the added benefit of disinfecting the sink – answer c. Hand washing sinks must be dedicated for hand washing purposes only and should remain clean

If a patient presents with dialysis associated pericarditis, treatment includes more frequent dialysis and a. Heparin restriction to prevent bleeding into the pericardium and tamponade b. A higher potassium bath to prevent dysrhythmias c. A lower BFR and DFR to prevent dialysis disequilibrium syndrome d. An increased BFR and DFR to increase toxin removal - answera. Heparin restriction to prevent bleeding into the pericardium and tamponade If your facility dialyzes Hepatitis B positive patients, which assignment would NOT be an appropriate patient care assignment a. Caring for HBsAg positive and Hepatitis B immune patients at the same time b. Caring for HBsAg and Hepatitis B susceptible patients at the same time c. Caring for Hepatitis B susceptible patients and those in the process of receiving the vaccination at the same time

d. Caring for Hepatitis B immune and susceptible patients at the same time - answerb. Caring for HBsAg and Hepatitis B susceptible patients at the same time The best way to help patients successfully change behaviors is to a. Scare them through describing serious health risks of the current behavior b. Tell them how to accomplish the desired change c. List medically sound reasons why change is necessary d. Inspire behavior change through support, compassion, and empathy - answerd. Inspire behavior change through support, compassion, and empathy Your patient complains of dry itchy skin. You would advise her to a. Take frequent hot showers b. Rub skin completely dry after a bath

c. Use hyper-fatted soaps and lotions d. Eat foods rich in fatty acids - answerc. Use hyper-fatted soaps and lotions Which statement is true regarding the stages of grief? a. To come to a place of "Acceptance" one must follow the right way to work through the stages b. Some people can get stuck in a stage c. Once acceptance is achieved even complications like access problems cannot start the grief process anew d. Patients go through a common stepwise progression through each stage of grieving process - answerb. Some people can get stuck in a stage The acronym DARN stands for a. Desire, Ability, Reason, Need b. Deficiency, Ambition, Rationality, Neediness c. Design, Aspiration Requirement, Negativity

d. Demand, Accomplishment, Requisite, Necessary - answera. Desire, Ability, Reason, Need Convection is defined as a. Solutes are dragged across the semipermeable membrane along with fluid b. Controlled fluid removal by manipulation of hydrostatic pressure c. Particles move from an area of higher solute concentration to an area of lower solute concentration d. Fluid moves from an area of lower solute concentration to an area of higher solute concentration - answera. Solutes are dragged across the semipermeable membrane along with fluid The three core communication skills used in motivational interviewing are a. Monitoring, persuading, advising

b. Explaining, comprehending, adapting c. Asking, listening, informing d. Inquiring, directing, informing - answerc. Asking, listening, informing hemodialysis helps normalize body pH through a. Diffusion of acids from the blood into the dialysate b. Convection of bicarbonate during backfiltration c. Diffusion of bicarbonate from the dialysate into the blood d. Stimulation of the respiratory system to increase exhalation of acids - answerc. Diffusion of bicarbonate from the dialysate into the blood The excretory function of the kidney is: a. Erythropoietin production b. To bind to phosphorus c. To absorb vitamins

d. To normalize electrolytes - answerd. To normalize electrolytes Unless otherwise directed by the manufacturer or state specific pharmacy regulations, when must medications containing a preservative be discarded? a. At 28 days after opening b. At 25 days after opening c. At 23 days after opening d. At 21 days after opening - answera. At 28 days after opening Educational tips for visual learners include a. Providing soft background music b. Selecting quiet surroundings

c. Using lively hand gestures when delivering long lectures d. Allowing plenty of time for the patient to talk - answerb. Selecting quiet surroundings An optimal nutrition status is evidenced by a. An appropriate amount of energy, ability to sleep well at night, serum potassium of no greater than 5.5 mEq/L, and a BUN of 60-80 mg/dl b. A 30 minute exercise tolerance, calcium 8.4-10.2 mg/dl, phosphorus 3-5. mg/dl and PTH intact 150-600 pg/ml c. Patient report of feeling well, no excess fluid weight gains, bringing appropriate snacks to dialysis, and taking phosphate binders with every meal d. A stable, desirable target weight, adequate fat stores and muscle mass, appropriate appetite and intake, and a serum albumin of equal to or greater than 4 gm/dl - answerd. A stable, desirable target weight, adequate fat stores and muscle mass, appropriate appetite and intake, and a serum albumin of equal to or greater than 4 gm/dl When comparing the FMC dialysis machine's conductivity reading to your manual reading, policy states that the difference between these two readings is to be

a. No greater than +/- 0. b. No greater than +/- 0. c. No greater than +/- 0. d. No greater than +/- 0.1 - answera. No greater than +/- 0. Which statement is true regarding the "Reasonable and Prudent" Standard of Care? a. The Standard of Care is based on providing highly specialized care after a caregiver is certified b. Caregivers who are doing it "their way" without regard to DaVita P&P can easily defend their actions in the event of an adverse patient outcome c. The Standard of Care only includes actions a nephrology nurse would do, but not those the nurse would avoid doing d. When supervising patient care technicians an other non-licensed personnel, it is the responsibility of the licensed nurse to ensure these teammates also meet the Standard of Care -

answerd. When supervising patient care technicians an other non-licensed personnel, it is the responsibility of the licensed nurse to ensure these teammates also meet the Standard of Care What is an important action prior to returning a patient's blood using the hand crank in the event of a power failure? a. Take the patient's blood pressure b. Check for a blood leak c. Place the machine into bypass d. Remove the venous line from the line clamp - answerd. Remove the venous line from the line clamp The KDOQI (Kidney Disease Outcomes Quality) Rule of 6s a. Provides guidelines for use of a new AV fistula b. Provides guidelines for use of a new AV graft c. Provides guidelines for use of a new AV fistula and a new AV graft

d. Provides guidelines for use of a tunneled CVC - answera. Provides guidelines for use of a new AV fistula During cannulation of all AV fistulas a. A tourniquet is to be applied to increase vein engorgement and stabilize vessel b. A tourniquet may be applied to increase vein engorgement if deemed necessary by the cannulator c. A tourniquet to increase vein engorgement is not necessary if the AVF is well developed d. Tourniquets should not be applied to decrease the risk of AVF clotting - answera. A tourniquet is to be applied to increase vein engorgement and stabilize vessel At what time do you perform water hardness testing? a. At the beginning of each day prior to the first treatment

b. About halfway through your treatment day c. Every four hours d. At the end of the treatment day - answerd. At the end of the treatment day Why should the patient be in a comfortable supine position when you perform pre-dialysis CVC care? a. The supine position allows easier visualization of the CVC exit site b. The supine position decreases blood flow through the catheter and diminishes the risk of hemorrhage c. The supine position prevents clean barriers from dropping off d. The supine position increases pressure within central veins and diminishes the risk of an air embolism - answerd. The supine position increases pressure within central veins and diminishes the risk of an air embolism What is your immediate response to a final water quality alarm on the treatment floor? a. Place all machines into bypass

b. Terminate treatments c. Notify your biomed technician d. Perform manual water testing to verify results - answera. Place all machines into bypass What complication would you expect to see if a patient is exposed to chlorine/chloramines? a. Bone disease b. Hemolysis c. Hypertension d. Muscle weakness - answerb. Hemolysis The nephrologist has ordered the use of hemostatic sponges, such as SureSeal, for your patient. What is the correct procedure when using these sponges?

a. Apply a sterile band aid over the hemostatic sponge to keep it in place b. Tape a folded sterile gauge over the hemostatic sponge to create a pressure dressing c. Remove the hemostatic sponge after hemostasis has been achieved and dress the needle sites with sterile gauge or band aid d. After hemostasis has been achieved, observe the needle site for 5 minutes. If no further bleeding is noted, advise the patient to remove the hemostatic sponge at home - answerc. Remove the hemostatic sponge after hemostasis has been achieved and dress the needle sites with sterile gauge or band aid Why do we measure the pH of the dialysis solution? a. To verify its conductivity is within the acceptable range b. To verify the correct amount of dialysis quality water has been added c. To verify its acid-base balance within the acceptable range d. To verify no residual disinfectant is present - answerc. To verify its acid-base balance within the acceptable range

You listen to your patient's AV graft and hear a whistling sound a. This could be inactive of an inflow stenosis b. This could be indicative of an outflow stenosis c. This could be indicative of advanced access thrombosis d. This is a normal sounding bruit - answerb. This could be indicative of an outflow stenosis Your patients pull out her snack during dialysis. As she savors the first bite of her banana she smiles and tells you she always waits to eat food in high in potassium during dialysis so it won't harm her. What is your appropriate response? a. You congratulate the patient on her understanding that too much potassium can be dangerous b. You explain to the patient that the potassium in food eaten during dialysis is not dialyzed off c. You ask the patient if she remembered to bring her phosphate binders too d. You ask the Charge RN to change the amount of potassium in the dialysate to a lower level so it

will remove more potassium - answerb. You explain to the patient that the potassium in food eaten during dialysis is not dialyzed off A new AV fistula has received its post op exam, meets the criteria listed in the KDOQI Rule of 6s and the nephrologist writes orders to begin cannulation. Which teammates can cannulate the AVF? a. The NFACT Beginner Cannulator b.The NFACT Intermediate Cannulator c. The NFACT Advanced Cannulator d. Any teammate who has completed vascular access cannulation training - answerc. The NFACT Advanced Cannulator Which of the following is a basic principle of patient self-management? a. Focusing primarily on dialysis prescription and adherence to treatment b. Taking on responsibility of the medical management of the illness c. Dealing with the consequences of illness, rather than just the physical disease

d. Allowing care providers to help with the day-to-day management of the disease - answerc. Dealing with the consequences of illness, rather than just the physical disease Diffusion is defined as a. Particles move from an area of higher solute concentration to an area of lower solute concentration b. Controlled fluid removal by manipulation of hydrostatic pressure c. Solutes are dragged across the semipermeable membrane along with fluid d. Fluid moves from an area of lower solute concentration to an area of higher solute concentration - answera. Particles move from an area of higher solute concentration to an area of lower solute concentration Attention to infection control, proper hand hygiene, cleaning and disinfection procedures are of utmost importance in the dialysis setting. Which of the following statement is true?

a. Only items taken to a clean dialysis station prior to initiation of a patient treatment can be returned to a common clean area without being disinfected b. If a hemodialysis patient performs self-care at the facility, common supply carts used to store clean supplies may be placed within the patient's reach c. Viable MRSA bacteria can remain on surfaces for days with plastic and vinyl being most favorable to their survival d. Red disposal bags are to be closed with a tight "dog eared" knot to prevent leakage of fluid from the bag - answerc. Viable MRSA bacteria can remain on surfaces for days with plastic and vinyl being most favorable to their survival Teammates decrease the risk of infection when working with a central venous catheter (CVC) by: a. Wearing a facemask b. Washing hands and wearing clean gloves c. Avoiding touching dirty surfaces when providing CVC care d. All of the above - answerd. All of the above

When sodium loading is present during the dialysis treatment a. It leads to an increase in thirst and larger fluid weight gains between treatments and can contribute to post dialysis hypertension and headaches b. It is corrected by the end of the treatment as sodium diffuses from the blood into the dialysate c. It has no effect on fluid management as its impact is much smaller than dietary sodium intake d. Its long-term beneficial effects include adequate vascular refilling and the prevention of intradialytic hypotension - answera. It leads to an increase in thirst and larger fluid weight gains between treatments and can contribute to post dialysis hypertension and headaches Practicing meticulous infection control to prevent healthcare-associated infections (HAIs) in dialysis patients is of utmost importance because a. Kidney failure weakens a person's immune system, making these patients much more vulnerable to infections b. Infections are the second most common cause of death in this population

c. The hemodialysis procedure requires prolonged access to the patient's blood d. All of the above - answerd. All of the above Poor or incomplete documentation a. Can open an attack on your care b. Can be excused during times of working short staffed c. Can be amended in a court of law through a verbal recollection of what happened d. Has no impact on quality patient care - answera. Can open an attack on your care You administer a 100 ml saline bolus to your patient during the treatment. What would be important to include in your documentation? a. The reason for administering the saline and the patient response b. The time and amount of saline given only c. That you checked the patient's medication allergies prior to administering normal saline d. The rate at which you administered the saline - answera. The reason for administering the saline and the patient response

Your immediate intervention for a patient experiencing an anaphylactic reaction is a. Discontinue the medication, administer a saline bolus to prevent hypotension b. Discontinue the medication and the treatment, return the blood c. Discontinue the medication, decrease BFR, administer oxygen d. Stop the blood pump, discontinue the treatment, do not return the blood - answerd. Stop the blood pump, discontinue the treatment, do not return the blood How do you verify that the patient is stable and safe for discharge after the dialysis treatment? a. Evaluate the effectiveness of the treatment by comparing data to pre-dialysis findings b. PCTs notify the nurse if there are any unusual findings