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Nephrology and Dialysis: Comprehensive Guide, Exams of Laboratory Practices and Management

A.T. Still University of Health Sciences (ATSU)Laboratory Practices and Management

This comprehensive document covers a wide range of topics related to nephrology and dialysis, including the function of the kidney, causes of kidney disease, dialysis principles and techniques, water treatment, vascular access, patient monitoring, and laboratory tests. It provides detailed information on the structure and function of the nephron, the leading cause of chronic kidney disease, the components of a nephron, symptoms of uremia, fluid and electrolyte balance, dialysis modalities, dialyzer performance, water treatment standards, vascular access management, patient assessment, and laboratory tests used to monitor dialysis adequacy and nutritional status. The document also addresses important aspects of patient education and the role of the dialysis technician. This resource would be valuable for healthcare professionals, students, and individuals interested in understanding the complexities of kidney function and the management of end-stage renal disease.

Typology: Exams

2023/2024

Available from 08/23/2024

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CCHT PRACTIC E EXAM DAVITA QURSTIONS &
ANSWERS.
nephron - Correct Answer the function unit of the kidney, or the structure in the kidney
that does the work, is the
diabetes - Correct Answer the leading cause of chronic kidney disease for adults in the
united states:
A glomerulus and a tubule system - Correct Answer a nephron is made up
Elevated hematocrit - Correct Answer which of the following is not a symptom of uremia
5,540ml - Correct Answer Mrs. smith's dry weight is 62 kg. Her pretreatment weight
when she came in for treatment on Monday was 67kg. The priming saline amount is
240ml, fluid from medication is 100 ml, and she is not allowed any fluids during
treatment. What is the total amount of fluid weight to be removed during her treatment?
1,385 ml/hr. - Correct Answer based on Mrs. Smith’s total amount of fluids to be
removed, what is the ultrafiltration rate per hour (ml/hr.)For her 4-hour treatment?
Removing too much fluids - Correct Answer which of the following is a cause of
hypotension during and after dialysis treatments?
154 - Correct Answer the scale says a patient weights 70 kg. This the same as
weighting how many points (lb.)?
7.35-7.45 - Correct Answer normal body ph. is
Hypertension - Correct Answer one sigh and symptoms of fluids overload is
Potassium - Correct Answer abnormal levels of this electrolyte can cause cardiac
arrhythmias and even death
Osmosis - Correct Answer water moves across a membrane from an area of lower
solute concentration to an area of higher solute concentration by which principle
Diffusion - Correct Answer waste products are removed during dialysis by which
principle
Ultrafiltration - Correct Answer excess fluid is forced out of the blood and into the
dialysis by which principle
Osmosis - Correct Answer the movement of the fluid from the tissue toward a higher
concentration of sodium in the blood is an example of
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CCHT PRACTICE EXAM DAVITA QURSTIONS &

ANSWERS.

nephron - Correct Answer the function unit of the kidney, or the structure in the kidney that does the work, is the diabetes - Correct Answer the leading cause of chronic kidney disease for adults in the united states: A glomerulus and a tubule system - Correct Answer a nephron is made up Elevated hematocrit - Correct Answer which of the following is not a symptom of uremia 5,540ml - Correct Answer Mrs. smith's dry weight is 62 kg. Her pretreatment weight when she came in for treatment on Monday was 67kg. The priming saline amount is 240ml, fluid from medication is 100 ml, and she is not allowed any fluids during treatment. What is the total amount of fluid weight to be removed during her treatment? 1,385 ml/hr. - Correct Answer based on Mrs. Smith’s total amount of fluids to be removed, what is the ultrafiltration rate per hour (ml/hr.)For her 4-hour treatment? Removing too much fluids - Correct Answer which of the following is a cause of hypotension during and after dialysis treatments? 154 - Correct Answer the scale says a patient weights 70 kg. This the same as weighting how many points (lb.)? 7.35-7.45 - Correct Answer normal body ph. is Hypertension - Correct Answer one sigh and symptoms of fluids overload is Potassium - Correct Answer abnormal levels of this electrolyte can cause cardiac arrhythmias and even death Osmosis - Correct Answer water moves across a membrane from an area of lower solute concentration to an area of higher solute concentration by which principle Diffusion - Correct Answer waste products are removed during dialysis by which principle Ultrafiltration - Correct Answer excess fluid is forced out of the blood and into the dialysis by which principle Osmosis - Correct Answer the movement of the fluid from the tissue toward a higher concentration of sodium in the blood is an example of

Diffusion - Correct Answer decreasing the patient's prescribed blood flow affects the rate of Using a bath that will provide a greater concentration gradient - Correct Answer which of the following actions would increase diffusion during dialysis? Urea - Correct Answer which of the following diffusion diffuses from the patients’ blood during dialysis? Tran’s membrane pressure - Correct Answer ultrafiltration is influenced by Peritonitis - Correct Answer the most common complication in peritoneal dialysis is Hyperglycemia - Correct Answer the dextrose used in the dialysate for peritoneal dialysis can cause Immunosuppressive medication - Correct Answer if a patient develops an infection post- transplant, the largest contributing factor would most likely be: Infection - Correct Answer the most frequent cause of death in the first year post transplant is Performance of the dialyzer - Correct Answer total cell volume (TCV) is an indirect measure of the 80% - Correct Answer the TCV should be no less than 11 hours - Correct Answer the minimum dwell time to achieve sterilization with the chemical renal in is Residual sterility - Correct Answer the reprocessed dialyzer is carefully rinsed prior to patient use to remove Inadequate dialyzer priming - Correct Answer germicide rebound occurs due to AAMI - Correct Answer which organization set the standards and recommendations for dialyzer reprocessing? 10 mph - Correct Answer the blood path integrity is tested to eliminate the possibility of a blood leak. The drop in pressure should not exceed: Increase the rate of waste removal - Correct Answer the purpose of using counter- current flow is to

Ph. and conductivity - Correct Answer the hemodialysis machine continuously monitors May parameters. Which of the parameters must be verified by an external measuring device? Kinking of the venous blood line - Correct Answer which of the following is most likely to cause a high venous pressure alarm? Notify the equipment technician - Correct Answer during the set-up of a hemodialysis machine, the alarm test for conductivity fails. Which of these actions should the dialysis technician take? Clotting of the extracorporeal circuit - Correct Answer rinse in Trans membrane pressure in a low flux dialyzer during hemodialysis is indicative of Air - Correct Answer one reason that normal saline is used to rinse and prime the extracorporeal circuit prior to treatment is to remove Device inside the machine that converts air pressure into electronic signal - Correct Answer which of the following best describes the transducer protector? Venous needle is against the wall of the vessels - Correct Answer which of the following would cause a high venous pressure alarm? Blood pump has stopped - Correct Answer the air detector alarms during treatment. If the machine is working properly, the dialysis technician should expect which of these events to have occurred Blood lines and the dialyzer - Correct Answer the extracorporeal circuit consists of the Discard the needle - Correct Answer before a hemodialysis treatment, treatment, the technician removes the cap from the fistula needle and accidentally touches the chair with the tip of the needle. Which of these actions should the technician take first? A thrill - Correct Answer to determine the potency of an arteriovenous vascular access, the dialysis technician should initially feel for the presence of An infiltration - Correct Answer a patient complaints of pain at the venous needle site. The dialysis technician observes there is swelling distal to the venous needle site and that the venous pressure is rising. The dialysis technician should suspect Numbness and tingling - Correct Answer all the following may be signs and symptoms of an infection access EXCEPT:

Stop the blood pump - Correct Answer during a hemodialysis treatment, a patient's venous needle infiltrates. Which of these actions should the dialysis technician take first? An arteriovenous fistula - Correct Answer which of these types of vascular access has the fewest complication In time to mature - Correct Answer one disadvantage of a fistula is an increase in Poor rotation of sites - Correct Answer one cause of aneurysm and pseudo aneurysm is Enlargement of the vein - Correct Answer what is the desired outcome when the patient performs fistula exercise? Listening with a stethoscope - Correct Answer the bruit in an AV fistula or graft is detected by 2.0 inches apart - Correct Answer when cannula ting, the tips of the needles should be at least Should point in the direction of the blood flow - Correct Answer the venous needle in an AV fistula May rupture and cause the patient to bleed profusely - Correct Answer a true aneurysm can be dangerous because it An artery to a vein - Correct Answer a fistula connects Infection - Correct Answer prior to annulation a technician notices the skin over the patient's fistula is reddened and warm to touch. These symptoms are most likely due to How have you been since your last dialysis treatment? - Correct Answer during predialysis data collection, it would be best for the technician to ask the patient which of these questions? Notify the nurse - Correct Answer Mrs. Pruitt’s temperature is elevated post- hemodialysis treatment. Which of these actions should the dialysis technician take? Notify the nurse of the need for an assessment - Correct Answer Mrs. smith arrives for dialysis treatment complaining of shortness of breath. Her pre-dialysis weight is 4. kilograms above the last post-treatment weight. The dialysis technician reweighed and verified the weight. Which of the actions should the dialysis technician take next? Bradycardia - Correct Answer slow pulse of 54 beats/minute would indicate the patient has:

Clean the machine surface immediately - Correct Answer a dialysis technician observes a drop of blood on the surface of a patient's hemolysis machine. Which of these actions should the dialysis technician take? The absence of disease producing organism - Correct Answer asepsis is defined as Hemoglobin - Correct Answer if the extracorporeal circuit clots and it must be discarded, it would be most important to monitor the patient's serum levels of Edema and shortness of breath - Correct Answer what are the typical signs of fluids overload Cardiac arrest - Correct Answer hyperkalemia can lead to Tighten all connections - Correct Answer which of the following is used to prevent air in the bloodlines? Hypotension - Correct Answer fifteen minutes before the end of a hemodialysis treatment, a patient complains of dizziness and nausea. These symptoms are most likely due to Take the patient's temperature - Correct Answer during the hemodialysis treatment, a patient complains of feeling chilled. In addition to getting the blanket, which of these actions should the technician take? Dialysis disequilibrium syndrome - Correct Answer short frequent hemodialysis treatment in patients with high BUN (blood urea nitrogen) are performed to prevent Call for assistance - Correct Answer during hemolysis a patient goes into cardiac arrest. The first action of the dialysis technician should be? Dialysis disequilibrium syndrome - Correct Answer a patient who is to receive their first dialysis treatment is prone to The ultrafiltration rate - Correct Answer fluid to be removed divided by the treatment time tells us 12-20 breaths per minute - Correct Answer the normal range of resting respirations in an adult is: Anaphylaxis (severe allergic reaction) - Correct Answer hives, itching, tightness of the chest and respiratory distress may be signs and symptoms of: Sterility infusion - Correct Answer pain at the venous needle site, along with respiratory difficulty and chest pain could be an indicator of:

Tachycardia - Correct Answer a rapid pulse of 104 beats/minute would indicate that the patient has: Vitamin B12 - Correct Answer a marker used to determinate the middle molecule clearance of a dialyzer is 65% - Correct Answer the national standard, based on the KDOQI (kidney disease outcomes quality initiative) guidelines, for the urea reduction rate (URR) is a ratio greater than: Hemoglobin/hematocrit - Correct Answer what lab tests are used to monitor anemia in the ESRD patient? Indicators of the adequacy of the renal replacement therapy - Correct Answer ESRD specific tests such us as BUN, creatinine, and URR are At the right time, right site, and right order - Correct Answer the accuracy of lab results depends on adherence to proper lab draw technique. You must ensure that labs are drawn: Nutritional - Correct Answer albumin is an important test that tells about the patient------------status Kit/V - Correct Answer which of the following is the most accurate measure of dialysis adequacy? Blood - Correct Answer bio hazardous waste includes any material exposed to Was the predialysis sample draw from the venous port? - Correct Answer a patient laboratory results indicate that the predialysis BUN levels was lower than the post dialysis BUN levels. When interpreting these findings the technician should seek the answer to which of these questions KDOQI - Correct Answer the organization that has as a goal to '' improve the care and outcomes of all individuals with kidney disease'' is called About one ounce (30ml) fluid is on the floor - Correct Answer a dialysis technician observes all of the below on the treatment floor, which one poses an environment risk? Hand washing - Correct Answer what is the most important activity that the dialysis technician can perform to prevent the spread of infectious disease in the dialysis clinic? AAMI - Correct Answer the organization that sets the standards for dialysis water quality is called

Refers the patient to the social worker - Correct Answer a female dialysis technician has been caring for a male patient for several months. The patient tells the dialysis technician that he is lonely and depressed. He asked the dialysis technician to go out to dinner with him. In addition to politely declining the patient's invitation, which of these actions, if any, should the dialysis technician take? Draw one line through it, date, time, signature/credentials, with the works “error" - Correct Answer you have documented incorrectly on a patient's chart. How do you correct this? Never document something that someone else did - Correct Answer a teammate asks you to document the normal saline he just gave to Mr. Smith you would Psychomotor - Correct Answer Mr. jones demonstrates how to wash his access. This is a an example of which adult learning principle Reinforce information provided by other teammates - Correct Answer the dialysis technician's role in patient education is to Technician - Correct Answer the most important member of the patient care team is the Teammate - Correct Answer the most important monitor in the dialysis setting is Affective - Correct Answer which learning domain is behavioral based Cognitive - Correct Answer which learning domain is knowledge based Cognitive - Correct Answer Mr. Roberts verbalizes how to hand crank his blood pump in the event of an emergency. This is an example of which adult principle? Describe the activities in the immediate environment - Correct Answer a 58-year old patient who is blind comes to treatment accompanied by his wife. Which of these approaches should the dialysis technician use when interacting with the patient? 04/15/2010 - Correct Answer according to the new conditions for coverage, all dialysis technicians are to be certified by a national certifying agency or state specific certification by 6 months - Correct Answer the minimum amount of experience required to take the NNCC certifying exam is It’s a new federal regulation - Correct Answer a reason why a dialysis technician is to be certified is