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NNCC CCHT Certification Exam
AAMI standard for conventional dialysis requires the total microbial count to be less than - 200 CFU/mL abnormal levels of this electrolyte can cause cardiac arrhythmias and even death - Potassium Acceptable interdialytic weight gains are - 3-5% of TW The AAMI standard for endotoxin levels in conventional daily's are is - Less than 2 EU/mL albumin is an important test that tells about the patient------------status - nutritional All of the follow are phosphate binders EXCEPT - Vitamin B numbness and tingling - Not a sign or symptom of an infected access Asepsis - Absence of disease producing organisms AAMI chemical analysis of water used for hemodialysis is tested - Annually A 58- year old patient who is blind comes to treatment accompanied by his wife. What approach should the dialysis tech use when interacting with the patient? - Describe the activities in the immediate environment A dialysis technician observed a drop of blood on the surface of a patient's machine. What action should the tech take? - Clean the machine surface immediately About one ounce (30 ml) fluid is on the floor - A dialysis technician observes all of the below on the treatment floor, which one poses an environment risk? A females dialysis technician has been caring for a male patient for several months. The patient tells the dialysis tech that he is lonely and depressed. He asks the tech to go out to dinner with him. In addition to politely declining the patients invitation, what action should the dialysis technician take?
- Refer the patient to the social worker A fistula connects - an artery to a vein
A marker used to determine the middle molecule clearance of a dialyzer is - Vitamin B A mixed bed DI tank contains - cations and anions Nephron is made up of - A glomerulus and a tubule system A patient complains of pain at venous needle site. The dialysis technician observes there is swelling distal to the venous needle site and that the venous pressure is rising. The tech should suspect - An infiltration A patient who is to receive their first dialysis treatment is prone to - dialysis disequilibrium syndrome a patient tells the technician that the dietitian reviewed high-potassium foods with her. during the conversation she states she routinely eats the following food. which one is highest in potassium? - bananas slow pulse of 54 beats/minute would indicate the patient has: - bradycardia A reason why a dialysis technician is to be certified is: - It's a CMS requirement A rise in transmembrane pressure in a low flux dialyzer during hemodialysis is indicative of - clotting in the extracorporeal circuit A teammate asks you to document the normal saline he just gave to Mr. Smith. You would - never document something that someone else did A true aneurysm can be dangerous because it - may rupture and cause the patient to bleed profusely A patient's laboratory results indicate that the predialysis BUN level was lower than the post dialysis BUN level. When interpreting these findings the technician should seek the answer to which of these questions. - Was the post dialysis sample drawn correctly a rapid pulse of 104 beats/minute would indicate that the patient has: - tachycardia A patient's target weight is 154.0 lb (70 kg) and the patient's pre treatment weight is 158.4 lb ( kg). For a four-hour treatment, how many mL/hour must the patient lose to reach dry weight? - 500 AAMI standard for conventional dialysate requires the total microbial count be less than - 100 CFU/mL abnormal levels of this electrolyte can cause cardiac arrhythmias and even death - Potassium
During a hemodialysis treatment, a patient's venous needle infiltrates. Which of these actions should the dialysis technician take first? - stop the blood pump During hemodialysis a patient goes into cardiac arrest. The first action for the dialysis technician is
- Call for assistance Dialysate pH should be - Between 6.9 and 7. During hemodialysis, the air detector on Ms. Foster's machine alarms and foam is visible in the venous drip chamber. The immediate action of the dialysis technician should be to: - Clamp the venous line during predialysis data collection, it would be best for the technician to ask the patient which of these questions? - How have you been since your last dialysis treatment? During the hemodialysis treatment, a patient complains of feeling chilled. In addition to getting the patient a blanket, which of these actions should the technician take? - take the patient's temperature during the set-up of a hemodialysis machine, the alarm test for conductivity fails. which of these actions should the dialysis technician take? - Notify the equipment technician ESRD specific tests such as BUN, Creatinine, and URR are - indicators of the adequacy of the renal replacement therapy excess fluid is forced out of the blood and into the dialysate during dialysis by which principle? - ultrafiltration Feed conductivity minus product conductivity divided by feed conductivity X 100 is the formula for calculating - percent resistivity Fifteen minutes before the end of a hemodialysis treatment, a patient complains of dizziness and nausea. These symptoms are most likely due to: - hypotension Fluid to be removed divided by the treatment time tells us - the ultrafiltration rate Germicide rebound occurs due to - Inadequate dialyzer priming A semipermeable membrane is a porous barrier that: - Allows for only certain sized particles to cross Mrs. Smith's target weight is 62 kg. Her pretreatment weight when she came in for treatment on Monday was 67 kg. The priming saline amount is 240 mL, the rinseback amount is 200 mL, fluid
from medications 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? - 5,540 mL Based on Mrs. Smith's total amount of fluid to be removed, what is the ultrafiltration rate per hour (mL/hr) for her 4-hour treatment? - 1,385 ml/hr Hives, itching, tightness of the chest and respiratory distress may be signs and symptoms of - anaphylaxis (severe allergic reaction) Hyperkalemia can lead to - cardiac arrest if a patient develops an infection post transplant, the largest contributing factor would most likely be: - immunosuppressive medication If the extracorporeal circuit clots and it must be discarded, it would be most important to monitor the patient's serum level of - hemoglobin During dialyzer reprocessing, the blood compartment is tested to - Check dialyzer for total cell volume Infection control protocols for hemodialysis equipment should include which of these actions by the caregiver? - using gloves when touching the machine Lidocaine is administered - intradermally Low albumin levels in the dialysis patient have been linked with - Higher hospitalization and death rates A medication that dialyzes off easily is - Digoxin Mr. jones demonstrates how to wash his access. this is a an example of which adult learning principle - psychomotor Mr. jones suffers from constipation. he goes to the drug store to buy a laxative. Mr. jones should avoid which medication? - milk of magnesia Mr. Roberts verbalizes how to hand crank his blood pump in the event of an emergency. this is an example of which adult principle? - cognitive Mrs. pruitt's temperature is elevated post-hemodialysis treatment. which of these actions should the dialysis technician take? -
Short frequent hemodialysis treatments in patients with high BUN (blood urea nitrogen) are performed to prevent - dialysis disequilibrium syndrome prior to cannulation a technician notices the skin over the patient's fistula is reddened and warm to touch. these symptoms are most likely due to - infection The medication used to treat anemia is - Epogen The most important monitor in the dialysis setting is - teammate The extracorporeal circuit consists of the - blood lines and the dialyzer The normal range of resting respirations in an adult is - 12-20 breaths per minute the dextrose used in the dialysate for peritoneal dialysis can cause - hyperglycemia The leading cause of chronic kidney disease for adults in the United States - diabetes The organization that has as a goal to 'improve the care and outcomes of all individuals with kidney disease' is called - KDOQI the dialysis technician's role in patient education is to - reinforce educational information provided The most important intervention to prevent the spread of infection - Perform hand hygiene The movement of fluid from the tissues toward a higher concentration of sodium in the blood is and example of - Osmosis The functional unit of the kidney, or the structure in the kidneys that does the work is the... - Nephron The bruit in a AV fistula or graft is detected by - Listening with a stethoscope The national standard, based on the KDOQI guidelines for the urea reduction rate (URR) is a ratio greater than - 65% KDOQI -
Kidney Disease Outcomes Quality Initiative The most important member of the patient care team is the - patient The medication used to improve calcium absorption is - Zemplar How do you know if a patient can safely disconnect themselves in an emergency - Let the patient show you after a treatment 'Dwell time' in peritoneal dialysis is defined as: - The amount of time the peritoneal fluid remains in the abdomen Dialysate conductivity measures - the total electrical charge of a solution name two compartments of the dialyzer - blood and dialysate Which statement is true about kidney transplantation - The is a shortage of available kidney donors The usual fluid allowance for a person with kidney failure is - 1.0 to 1.5 liters daily The scale says a patient weights 70kg this is the same as weighing how many pounds - 154 The organization that sets the standards for dialysis water quality is called - AAMI total cell volume (TCV) is a indirect measure of the - performance of the dialyzer Total chlorine levels in the water are tested - before each patient shift or every four hour The purpose of using counter currant flow is to - Increase the rate of waste removal water moves across a membrane from an area of lower solute concentration to an area of higher solute concentration by which principle - osmosis water softener - Operates on the principle of ion exchange What are the typical signs of fluid overload - edema and shortness of breath The usual heparin sodium concentration for anticoagulation during hemodialysis is -
Which food is highest in phosphorus - Ice cream when fluid replacement is necessary during the hemodialysis treatment, which of the following solution is used? - 0.9% normal saline What is not a symptom of uremia - elevated hematocrit What is a cause of hypotension during and after dialysis treatment - Removing too much fluid What is not a possible cause of an increased temperature pre dialysis - The patient has fluid overload What is considered to be safe water for dialysis - Dialysis quality water What is the largest needle gauge - 18 gauge What actions would increase diffusion during dialysis - Using a bath that will provide a greater concentration gradient Fluid - Diffuses from the patients blood during dialysis hand hygiene - the most important technique used in preventing and controlling transmission of infection What learning domain is behavioral - Affective when cannulating, the tips of the needles should be at least - 1.5" or the width of 2 fingers apart What symptoms would indicate a need to increase the target weight - Hypotension and cramping Your patient is to receive 2000 units of heparin. The vile you are using is 1000u/ml heparin. How many mls will you draw up for this patient -
What type vascular access has the fewest complications - arteriovenous fistula What is used to prevent air in bloodlines - Tighten all connections What organization establishes the standards and recommendations for dialyzer reprocessing - AAMI
What would cause a high venous pressure alarm - Venous needle is against the wall of the vessel What might indicate a need to decrease the heparin dose? - The patient just had surgery yesterday What might indicate the need to increase heparin? - clotting in the extracorporeal circuit What technician activities contributes to data collection used to measure quality outcomes - Ensuring accurate documentation A decrease in transmembrane pressure in a high flux dialyzer during hemodialysis is indicative of - Clotting of the extra corporeal circuit You have documented incorrectly on a patient's chart. How do you correct this? - Draw one line through it, date, time, sign, with the words "error" What practice helps build a patients immunity to hepatitis B - Vaccination A patient asks the technician " what does uremia mean?" The technicians response should be based on the understanding that uremia is - An increase of wastes in the blood A central venous catheter may be used as a vascular access when a - Patient has inadequate blood vessels in the limbs Before a dialysis treatment, the patient tells the technician "yesterday, I felt terrible and vomited up some blood. I feel much better today" the technician can expect the patients treatment will be modified by - Decreasing the heparin does The technician is unsure which one of a patients AV grafts anastomoses is arterial and which is venous. In order to differentiate between the two the technician should - Compress the graft in the middle and palpate each side At the end of a patient's treatment, which of these findings, if observed by the technician, should be reported to the nurse? - A pulse rate of 55 beats per minute A patient asks the dialysis technician "why am I getting vitamin D therapy?" What should the tech tell the patient - Vitamin d is needed for healthy bones Why are dialysis patients more likely to become infected with germs like MSRA - They have weak immune systems Legally, if a treatment was performed but not charted in the patient's record, it was - not done
