PCT Certification Exam Review: Hemodialysis Questions and Answers, Exams of Nursing

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PCT Certification Exam Review Exam

2024 - 2025

AAMI Chemical Analysis of water used for hemodialysis is tested - ANSWER>>annually. 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? Avoid using phrases that refer to sight, such as "It looks like..." Describe the activities in the immediate environment Give instructions to his wife instead of him Touch the patient before speaking to him - ANSWER>>Describe the activities in the immediate environment A dialysis technician observes a drop of blood on the surface of a patient's hemodialysis machine. Which of these actions should the dialysis technician take? Clean the machine surface at the end of treatment Clean the machine surface immediately Notify the equipment technician Notify the nurse - ANSWER>>Clean the machine surface immediately A dialysis technician observes all of the below on the treatment floor, which one poses an environmental risk? About one ounce (30ml) fluid is on the floor A patient's family member is present during initiation of treatment Charts are lying on bedside tables The wheels of the hemodialysis machine are locked - ANSWER>>About one ounce (30ml) fluid is on the floor 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 asks 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? No further action is needed Recommend an over-the-counter mood stimulant, such as St. John's Wort Refer the patient to the social worker Share the patient's need for socialization with other patients - ANSWER>>Refer the patient to the social worker

A fistula connects - ANSWER>>an artery to a vein. A marker used to determine the middle molecule clearance of a dialyzer is - ANSWER>>vitamin B12. A mixed-bed DI tank contains - ANSWER>>Cations and anions. A nephron is made up of: - ANSWER>>A glomerulus and a tubule system A patient complains 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 - ANSWER>>an Infiltration. A patient who is to receive their first dialysis treatment is prone to? - ANSWER>>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 foods. Which one is highest in potassium? Bananas Ice Cream Pasta Rice - ANSWER>>Bananas A slow pulse of 54 beats/minute would indicate the patient has - ANSWER>>Bradycardia A reason why a dialysis technician is to be certified is: - ANSWER>>It is a CMS requirement A rise in transmembrane pressure in a low flux dialyzer during hemodialysis is indicative of: - ANSWER>>Clotting of the extracorporeal circuit A teammate asks you to document the normal saline he just gave to Mr. Smith. You would: - ANSWER>>never document something that someone else did A true aneurysm can be dangerous because it - ANSWER>>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 machine in bypass during the post sampling? Was the patient's heparin pump turned off when the post sample was drawn? Was the post dialysis sample drawn correctly? Was the port used for predialysis sampling cleaned with disinfectant? - ANSWER>>Was the post dialysis sample drawn correctly? A rapid pulse of 104 beats/minute would indicate that the patient has: - ANSWER>>tachycardia A patient's target weight is 154.0 lb (70 kg) and the patient's pre treatment weight is 158.4 lb (72 kg). For a four-hour treatment, how many mL/hour must the patient lose to reach dry weight? - ANSWER>> AAMI standard for conventional dialysate requires the total microbial count be less than

• ANSWER>>100 CFU/mL Abnormal levels of this electrolyte can cause cardiac arrhythmias and even death. - ANSWER>>Potassium Acceptable interdialytic weight gains are - ANSWER>>3 - 5% of TW. The AAMI standard for endotoxin levels in conventional dialysate is - ANSWER>>less than 0.50 EU/mL Albumin is an important test that tells about the patients' __________ status. - ANSWER>>nutritional All of the following are phosphate binders EXCEPT : Renagel Phos-Lo Tums Vitamin B12 - ANSWER>>Vitamin B All of the following may be signs and symptoms of an infected access EXCEPT : fever and swelling of the access numbness and tingling redness and warmth

tenderness and drainage - ANSWER>>numbness and tingling Asepsis is defined as - ANSWER>>the absence of disease producing organisms. Before a hemodialysis 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? Continue to cannulate with the needle Discard the needle Place the needle in alcohol for five minutes Put on new PPE - ANSWER>>Discard the needle Dialysate that is too hot will cause - ANSWER>>hemolysis. Target weight is defined as the - ANSWER>>weight at which the patient has no edema or fluid in the lungs and BP is normal. During a hemodialysis treatment the technician responds to a low venous pressure alarm. The most likely cause for this alarm is: Clot in the venous drip chamber Disconnection of the blood line Kinking of the blood line Venous needle infiltration - ANSWER>>Disconnection of the blood line During a hemodialysis treatment, a patient says to the technician, 'Three hours of time have passed according to the clock on the wall, but the machine shows that only 2. hours have passed. What could be the problem?' The technician should understand that the - ANSWER>>machine was in bypass for 30 minutes. Biohazardous waste includes any material exposed to: - ANSWER>>blood Decreasing the patient's prescribed blood flow rate affects the rate of - ANSWER>>Diffusion During a hemodialysis treatment, a patient's venous needle infiltrates. Which of these actions should the dialysis technician take first? Apply ice to the area Draw blood for a hematocrit Insert another needle Stop the blood pump - ANSWER>>Stop the blood pump

During hemodialysis a patient goes into cardiac arrest. The first action for the dialysis technician is Apply a pericardial thump to the patient Call for assistance Return the patient's blood Stop ultrafiltration - ANSWER>>Call for assistance Dialysate pH should be: - ANSWER>>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: - ANSWER>>Clamp the venous line During predialysis data collection, it would be best for the technician to ask the patient which of these questions? Have you had any problems since your last dialysis treatment? How have you been since your last dialysis treatment? You haven't had any problems since your last treatment, have you? You've been feeling fine since your last treatment, haven't you? - ANSWER>>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? Decrease the blood flow rate Increase the bicarbonate concentration in the dialysate Put the patient in Trendelenburg Take the patient's temperature - ANSWER>>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? Change the manufacturer's default settings Clear the alarm and initiate treatment as prescribed Notify the equipment technician Re-bed the carbon tanks and postpone the treatment - ANSWER>>Notify the equipment technician

ESKD specific tests such as BUN, Creatinine, and URR are - ANSWER>>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? - ANSWER>>Ultrafiltration. Feed conductivity minus product conductivity divided by feed conductivity X 100 is the formula for calculating - ANSWER>>percent rejection. Fifteen minutes before the end of a hemodialysis treatment, a patient complains of dizziness and nausea. These symptoms are most likely due to: - ANSWER>>Hypotension Fluid to be removed divided by the treatment time tells us - ANSWER>>the ultrafiltration rate. Germicide rebound occurs due to: - ANSWER>>Inadequate dialyzer priming A semipermeable membrane is a porous barrier that: - ANSWER>>Allows 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? - ANSWER>>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? - ANSWER>>1,385 mL/hr Hives, itching, tightness of the chest and respiratory distress may be signs and symptoms of: - ANSWER>>Hives, itching, tightness of the chest and respiratory distress may be signs and symptoms of: Hyperkalemia can lead to - ANSWER>>cardiac arrest If a patient develops an infection post transplant, the largest contributing factor would most likely be: immunosuppressive medication

placement of the kidney close to the intestines poor patient hygiene surgical incisions - ANSWER>>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: - ANSWER>>Hemoglobin During dialyzer reprocessing, the blood compartment is tested to - ANSWER>>Check dialyzer for total cell volume Infection control protocols for hemodialysis equipment should include which of these actions by the caregiver? Changing the machine between patients Culturing the ports of the machine after each patient Using gloves when touching the machine Wiping the machine with a bleach solution after an alarm sounds - ANSWER>>Using gloves when touching the machine Lidocaine is administered - ANSWER>>intradermally Low albumin levels in the dialysis patient have been linked with: - ANSWER>>Higher hospitalization and death rates A medication that dialyzes off easily is Digoxin Gentamycin Tobramycin Vitamin C - ANSWER>>Digoxin Mr. Jones demonstrates how to wash his access. This is an example of which adult learning principle? Affection Cognitive Motor Skill Psychomotor - ANSWER>>Psychomotor

Mr. Jones suffers from constipation. He goes to the drug store to buy a laxative. Mr. Jones should avoid which medication? Colace Dulcolax Metamucil Milk of Magnesia - ANSWER>>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? Affective Cognitive Motor Skill Psychomotor - ANSWER>>Cognitive Mrs. Pruitt's temperature is elevated post-hemodialysis treatment. Which of these actions should the dialysis technician take? Administer Tylenol Discharge the patient No action is needed Notify the nurse - ANSWER>>Notify the nurse Mrs. Smith arrives for dialysis treatment complaining of shortness of breath. Her pre- dialysis weight is 4.7 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? Advise patient to meet with the dietitian Immediately initiate treatment Instruct the patient to decrease fluid intake between treatments Notify the nurse of the need for an assessment - ANSWER>>Notify the nurse of the need for an assessment Ms. Foster complains of shortness of breath. While calling for the nurse the dialysis technician notices there is air in the extracorporeal circuit she/he should place Ms. Foster in: - ANSWER>>trendelenburg position on left side

One reason that normal saline is used to prime and perform recirculation for the extracorporeal circuit prior to treatment is to remove: - ANSWER>>Air Normal body pH is - ANSWER>>7.35 - 7.45. One disadvantage of a fistula is an increase in - ANSWER>>time to mature. One cause of aneurysms and pseudoaneurysms is: - ANSWER>>poor rotation of sites. 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 flow rate has been increased Blood pump has stopped Dialysate temperature has increased Dialyzer was bypassed - ANSWER>>Blood pump has stopped Pain at the venous needle site, along with respiratory difficulty and chest pain could be an indicator of: - ANSWER>>Sterilant infusion Patient exposure to chloramines during the hemodialysis treatment may cause: - ANSWER>>hemolysis One sign and symptom of fluid overload is - ANSWER>>hypertension. Solutions that have a higher osmolarity than body fluids are called? - ANSWER>>hypertonic Sam's TW is 70 kilograms (kg). He arrives for treatment today at a weight of 70 kg. He complains of shortness of breath and you notice his ankles are swollen. You notify the charge nurse. What do you think will be the plan for Sam's treatment today? - ANSWER>>The nurse will get an order to decrease the TW Symptoms of hyperkalemia may include hypertension. hypotension. numbness and tingling. ringing in the ears. - ANSWER>>numbness and tingling.

The accuracy of lab results depends on adherence to proper lab draw technique. You must ensure that labs are drawn: anytime during the treatment, using any tube, and from the venous port at the right time, right site, and right order before the start of the treatment only before treatment, after treatment, and after giving heparin - ANSWER>>at the right time, right site, and right order Short frequent hemodialysis treatments in patients with high BUN (blood urea nitrogen) are performed to prevent: - ANSWER>>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: - ANSWER>>an infection The medication used to treat anemia is: Epogen Heparin Lidocaine Zemplar - ANSWER>>Epogen The most important monitor in the dialysis setting is: - ANSWER>>staff The extracorporeal circuit consists of the - ANSWER>>blood lines and the dialyzer. The normal range of resting respirations in an adult is: - ANSWER>>12 - 20 breaths per minute The dextrose used in the dialysate for peritoneal dialysis can cause: - ANSWER>>hyperglycemia The leading cause of chronic kidney disease for adults in the United States: - ANSWER>>Diabetes The organization that has as a goal to 'improve the care and outcomes of all individuals with kidney disease' is called: - ANSWER>>KDOQI The dialysis technician's role in patient education is to: - ANSWER>>Reinforce educational information provided

The most important intervention to prevent the spread of infection is: - ANSWER>>Performing hand hygiene The movement of fluid from the tissues toward a higher concentration of sodium in the blood is an example of - ANSWER>>Osmosis. The functional unit of the kidney, or the structure in the kidney that does the work, is the:

• ANSWER>>Nephron The bruit in an AV fistula or graft is detected by - ANSWER>>listening with a stethoscope. The National standard, based on the KDOQI (Kidney Disease Outcomes Quality Initiative) guidelines, for the Urea Reduction Rate (URR) is a ratio greater than: - ANSWER>>65% The most important member of the patient care team is the: - ANSWER>>patient The medication used to improve calcium absorption is: - ANSWER>>Zemplar How do you know if a patient can safely disconnect themselves in an emergency? - ANSWER>>Let the patient show you after a treatment 'Dwell time' in peritoneal dialysis is defined as: - ANSWER>>The amount of time the peritoneal fluid remains in the abdomen Dialysate conductivity measures: - ANSWER>>The total electrical charge of a solution Name the two compartments of the dialyzer: - ANSWER>>Blood and dialysate Which statement is true about kidney transplantation? There is a shortage of available kidney donors. Transplantation is the best option for everyone. Mortality rate is high for transplanted patients. Transplantation is the only way to cure kidney failure. - ANSWER>>There is a shortage of available kidney donors.

All of the following are benefits of using a tourniquet when cannulating an arteriovenous fistula except: Makes fistula more visible Decreases the risk of infiltration Reduces risk of infection Reduces pain with needle insertion - ANSWER>>Reduces risk of infection The usual fluid allowance for a person with kidney failure is - ANSWER>>1.0 to 1. liters per day. The scale says a patient weights 70 kg. This is the same as weighing how many pounds (lb)? - ANSWER>> The organization that sets the standards for dialysis water quality is called: - ANSWER>>AAMI Total cell volume (TCV) is an indirect measure of the: - ANSWER>>Performance of the dialyzer Total chlorine levels in the water are tested - ANSWER>>before each patient shift and every four hours. The purpose of using counter-current flow is to - ANSWER>>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 - ANSWER>>Osmosis. The water softener - ANSWER>>operates on the principle of ion exchange. What are the typical signs of fluid overload? - ANSWER>>edema and shortness of breath The usual heparin sodium concentration for anticoagulation during hemodialysis is: - ANSWER>>1,000u/ml To determine the patency of an arteriovenous vascular access, the dialysis technician should initially feel for the presence of - ANSWER>>a thrill.

Ultrafiltration is influenced by - ANSWER>>transmembrane pressure. Waste products are removed during dialysis by which principle - ANSWER>>Diffusion. The water softener removes - ANSWER>>calcium and magnesium. The reprocessed dialyzer is carefully rinsed prior to patient use to remove: - ANSWER>>residual germicide The part of the cell wall of bacteria that, when released, can cause fever in hemodialysis patients is: - ANSWER>>Endotoxin The venous needle in an AV fistula - ANSWER>>Should be placed antegrade The total pressure that exists across the dialyzer membrane is called - ANSWER>>transmembrane pressure. The substance that may be added to the municipal drinking water to make it clearer is: - ANSWER>>Alum Which of the following is the most accurate measure of dialysis adequacy? Creatinine Clearance Creatinine Generation Kt/V URR - ANSWER>>Kt/V Which component in dialysate is used to correct metabolic acidosis? - ANSWER>>Bicarbonate Which of the following is most likely to cause a high venous pressure alarm? Disconnection of the blood line High water pressure Kinking of the venous blood line Low water pressure - ANSWER>>Kinking of the venous blood line What lab tests are used to monitor anemia in the ESKD patient? - ANSWER>>Hemoglobin/Hematocrit Which learning domain is knowledge based? - ANSWER>>Cognitive

Which of the following is the classic sign of hemolysis? Black blood in the arterial line Black blood in the venous line Clear looking blood in the arterial line Cranberry juice colored blood in the venous line - ANSWER>>Cranberry juice colored blood in the venous line Which food below is highest in phosphorus? Bananas Ice Cream Pasta Rice - ANSWER>>Ice Cream When fluid replacement is necessary during the hemodialysis treatment, which of the following solutions is used? 0.45% normal saline 0.9% normal saline 5% dextrose in normal saline 5% dextrose in water - ANSWER>>0.9% normal saline Which of the following is NOT a symptom of uremia? Elevated hematocrit Decreased ability to concentrate Itching Lack of appetite - ANSWER>>Elevated hematocrit Which of the following is a cause of hypotension during and after dialysis treatments? Over the counter cold medicine Patient forgetting to take their blood pressure pills Removing too much fluid Uremia - ANSWER>>Removing too much fluid Which of the following is NOT a possible cause of an increased temperature pre dialysis? The patient has a cold The patient has an access infection The patient has fluid overload The patient has the flu - ANSWER>>The patient has fluid overload Which of the following is considered to be safe water for dialysis?

city water dialysis quality water tap water well water - ANSWER>>dialysis quality water Which of the following is the largest gauge? 18 gauge 20 gauge 25 gauge 27 gauge - ANSWER>>18 gauge Which of the following actions would increase diffusion during dialysis? decreasing the ultrafiltration rate giving more saline with treatment giving EPO to increase the hematocrit using a bath that will provide a greater concentration gradient - ANSWER>>using a bath that will provide a greater concentration gradient Which of the following diffuses from the patient's blood during dialysis? bacteria fluid protein urea - ANSWER>>urea What is the most important activity that the dialysis technician can perform to prevent the spread of infectious disease in the dialysis clinic? - ANSWER>>Hand hygiene Which learning domain is behavioral based? - ANSWER>>Affective When cannulating, the tips of the needles should be at least - ANSWER>>1.5 inches apart. Which of the following symptoms would indicate a need to increase the target weight? Edema and hypertension Fever and chills Hypotension and cramping Shortness of breath and neck vein distension - ANSWER>>Hypotension and cramping Your patient is to receive 2000 units of heparin. The vial you are using is 1000u/ml heparin. How many mls will you draw up for this patient? - ANSWER>>2.

Which of these types of vascular accesses has the fewest complications? A Scribner shunt A synthetic graft A subclavian catheter An arteriovenous fistula - ANSWER>>An arteriovenous fistula Which of the following is used to prevent air in the bloodlines? Allow the normal saline bag to run dry Maintain prescribed blood flow rates Monitor patient's blood pressure Tighten all connections - ANSWER>>Tighten all connections Which organization establishes the standards and recommendations for dialyzer reprocessing? - ANSWER>>AAMI Which of the following would cause a high venous pressure alarm? Blood flow rate is decreased Patient has pulled out the venous needle Patient just received a 200 ml normal saline bolus Venous needle is against the wall of the vessel - ANSWER>>Venous needle is against the wall of the vessel Which of the following might indicate a need to decrease the heparin dose? Clotting in the extracorporeal circuit The patient has an access infection The patient has a catheter with poor blood flow The patient had surgery yesterday - ANSWER>>The patient had surgery yesterday Which of the following might indicate the need to increase heparin? Clotting in the extracorporeal circuit Prolonged bleeding post treatment The patient is having surgery tomorrow The patient is taking aspirin every day - ANSWER>>Clotting in the extracorporeal circuit Which of these technician activities contributes to data collection used to measure quality outcomes? Attending educational programs Ensuring accurate documentation Maintaining professional boundaries

Participating in staff meetings - ANSWER>>Ensuring accurate documentation You have documented incorrectly on a patient's chart. How do you correct this? - ANSWER>>draw line through wrong entry, write error, initial/date entry A decrease in transmembrane pressure in a high flux dialyzer during hemodialysis is indicative of: - ANSWER>>Clotting of the extracorporeal circuit