Dialysis Unit Procedures and Protocols, Exams of Nursing

Download Dialysis Unit Procedures and Protocols and more Exams Nursing in PDF only on Docsity! Davita pct Final Exam 2023-2024 Questions and Answers-Guaranteed A+ 1. Water and dialysate cultures are drawn every month in the dialysis unit to monitor - Correct Answer bacteria and endotoxins 2. what problems will cause a more positive (less negative) pre-pump arterial pressure. - Correct Answer blockage of arterial blood flow from the vascular access. 3. what is the most likely reason for a blood leak detector alarm during recirculation - Correct Answer -air bubbles in the dialysate, dirty sensor 4. -check dialysate connections, bleach machine 5. what is an appropriate interventions with an air/foam detector alarm? - Correct Answer look at circuit for blood in the system. DO NOT return blood with air in the system. 6. what will cause a more negative pre-pump arterial pressure? - Correct Answer Kinking of the arterial blood line between the vascular access and arterial monitor 7. if clotting occurs in a high flux dialyzer, the transmembrane pressure (TMP) will - Correct Answer decrease 8. what could be the reasons for a conductivity alarm on the dialysis machine - Correct Answer when the dialysate is mixed incorrectly or there is no water acid or bicarb. 9. the person responsible for implementation, adherence, and training of the facility specific emergency management plan (EMP) and applicable policy and procedures is - Correct Answer Fa or designee 10.Teammates MUST be able to readily identify patients who may require additional assistance in the event of an emergency evacuation. This will include patients who need help with or are unable to - Correct Answer both b and c 11.what is an important action prior to returning a patients blood using the hand crank in the event of a power failure ? - Correct Answer remove the venous line for the line clamp 12.Per physician order and based on individual patient needs, Chronic Kidney Disease Mineral and Bone Disorder (MBD) is treated with - Correct Answer phosphate binders, Vit D (Hectorol), and Cinacalcet 13.Poor wound healing is directly related to - Correct Answer low protein intake 14.Phosphate binders are prescribed to prevent phosphorus in meals from being absorbed. When is the best time to take them ? - Correct Answer with meal 15.The definition of Health Literacy is - Correct Answer ability to obtain, read, understand, and use healthcare information in order to make appropriate health decisions and follow instructions for treatment 16. If you notice that a patient's caretaker is struggling to meet the demands of the patients treatment regime you should - Correct Answer contact social worker 17.The Psychosocial Assessment completed by the social worker - Correct Answer an evaluation of a person's mental health, social status, and functional capacity within the communityCompeted initially and annually 18.The Clinical Pyramid includes : - Correct Answer • The Fundamentals: Immunizations, Iron, Dialysis Access, Calcium, Phosphorus, Hb, Kt/V, Target Weight, Access,PTH, etc.• Complex Programs: Fluid Management, Infection Management, Diabetes Management, Med Management, CVCManagement, Palliative / EOL Care, Infection Surveillance, Transition of Care, CKDEducation, Depression, Missed Treatments, etc.• Measures of Effectiveness • Mortality, Hospitalization /Re-hospitalization, Patient Experience of Care• What Matters Most • Our patient's health-related Quality of Life 19.DaVita Quality Index (DQI) success is achieved - Correct Answer encourage continuous improvement across aboard range of disease management processes (all of the above ) 20.What can be the most likely result if the surveyor sees a patient with a covered vascular access - Correct Answer immediate jeopardy 21.A surveyor asks you a question. Which of the following statements would be a good answer ? - Correct Answer I do not know the answer but I will find out. 22. Intra-renal causes of AKI - Correct Answer Ischemic ATN, Sepsis, SIRS, Septic Shock, Anaphylaxis Drugs, Goodpasture Syndrome, Acute Glomerulonephritis, Trauma, Open Heart Surgery 23.Knowing what caused your patients kidney failure - Correct Answer can cause complications to treatment 24.A patient with acute kidney injury dialyzes in the out-patient facility. With regards to the patients target weight, why is being "wet" better that being too dry? - Correct Answer 52.what are the three things you should not include in a Risk Event Management (REM) report - Correct Answer personal opinions 53.documentation in the medical record - Correct Answer Is a permanent legal record of the care provided 54.all documentation on machine set up and pre treatment patient information - Correct Answer Must be entered into the computer before the treatment is initiated 55.post treatment data collection and assessment is performed - Correct Answer After the tx was terminated 56. the pct notes that a patient still has considerable in edma in her legs when performing the post treatment data collection, in addition to informing the nurse, what should the pct document? - Correct Answer Document the swelling and that RN was informed. 57.which statement is true regarding the "Reasonable and Prudent" Standard of care - Correct Answer When supervising pt care technicians an other non- licensed personnel, it is the resposibility of the licensed nurse to ensure these teammates 58.Performing a procedure "your way" rather than following DaVita's P&Ps a. Carriers no risk of being considered outside the Ordinary Standard of Care as long as "your way" achieves the same results b. Can lead to civil liability in the event of an adverse patient outcome c. May be defended in court by demonstrating that your way is as good as DaVita's P&Ps d. Is accepted practice since there is no one right way to performing most procedures - Correct Answer b 59. the maximum ultrafiltration rate should not exceed ___ because it may lead to hypotensive episodes which increase the risk of organ stunning or mortality. - Correct Answer An UFR >13 ml/hr/Kg 60.what amount of fluid weight is considered excessive - Correct Answer 5% of target weight is considered excessive 61.The patients target weight is - Correct Answer Both a and B prescribed and determined by physicians order 62.what are the three steps included in the vascular access assessment - Correct Answer look, listen and feel 63.Scrubbing of each hub as part of CVC care is done for: - Correct Answer 15 seconds 64. the nephrologist has prescribed a 400 bfr for your patient. you would expect the physician order to also include - Correct Answer 15 gauge needle for the prescribed BFR 65.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 - Correct Answer b 66. to prevent the formation of aneurisms and pseudo aneurysms the following should be practiced - Correct Answer Good needlesites rotation and complete needle site clotting techniques 67. the neuprologist has ordered the use of hemostatic sponges, sureseal, for your patient. what is the correct procedure when using these sponges ? - Correct Answer Remove the hemostatic sponge after hemostasis has been achieved and dress the needle site with sterile gauge or band-aid. 68. flipping the artireal vascular access needle - Correct Answer s not necessary since all arterial needles now have a back eye 69. the sign that numbing has taken affect and it is time to stop spraying topical anastetic on the vascular access canulation sites is when - Correct Answer Blanching of skin 70.when a patient is prescribed topical anastatic spray, the appropriate time to clean the canulation site is - Correct Answer is prior to applying spray 71. the nephrologist orders a blood flow rate of 450 ml/min for a patient with established AV fistula. what needle gage would be appropriate for this BFR - Correct Answer 15 72. the urea reduction ratio calculates - Correct Answer The amount of urea removed during the dialysis treatment 73.which of the following factors would influence the; t of the kt/v formula - Correct Answer Shortened treatment time 74.which of the following factors would decrease the; k of the kt/v formula - Correct Answer Inadequate anticoagulation 75.When the lab receives a laboratory test tube with double labeling: - Correct Answer The double labed specimen will be rejected at the laboratory for pt safety 76. the blood flow rate is reduced to 100 ml-min for ___________ before obtaining post dialysis blood specimen for kt/v - Correct Answer 15 seconds 77.what steps are performed during the recirculation of blood in the extracorporeal circuit when there has been a treatment interruption (restroom?) - Correct Answer return patients blood and recirculate the extracorporeal circuit with normal saline 78. intredialytic treatment monitoring the data collection is performed every - Correct Answer 30 minutes 79.The waiting time after administration of the initial heparin loading dose prior to initiation of hemodialysis is - Correct Answer 3-5 minutes 80.which statement is true regarding the administration of normal saline - Correct Answer the teammate must remain with the patient to monitor their progress until administration is complete and lines are securely clamp. 81.Prior to use, how should the medication preparation surface area be disinfected ? - Correct Answer with 1:100 bleach solution and disposible wipes 82.what must be completed prior to medication preparation ? - Correct Answer All of the above 83.water treatment is needed in the dialysis setting to - Correct Answer Meet renal networks standards 84.what is the acceptable mg/L or parts per million (ppm) limit for total chlorine in the water leaving the carbon filter - Correct Answer less than or equal to 0.1 85.which is the primary device for purifying the water used in dialysis - Correct Answer reverse osmosis 86.what complication would you expect to see if a patient is exposed to chlorine/chloramines - Correct Answer Hemodialysis 87.what time do you perform water harness testing? - Correct Answer at the end of each treatment day 88. left ventricular hypertrophy leads to - Correct Answer Hypertension