PCT DaVita (RN)Final Exam from 3 latest versions Questions and Answers (Verified Answers), Exams of Nursing

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PCT DaVita (RN)Final Exam from 3 latest versions

Questions and Answers (VerifiedAnswers)

When dialyzing a patient with acute kidney injury, one task of the patient care teammates is to monitor blood pressure and weight closely. Why is it important? - correct answer ✅hypovolemia and hypotensive episodes cancause renal ischemia and can further damage the kidneys.

CKD can have its origin pre-renal , intra-renalm or post renal. Which of the following conditions is an intra-renal cause of CKD - correct answer ✅HTN.

Knowing what caused your patient's CKD - correct answer ✅is important because the underlying disease could cause health complications that canimpact the dialysis treatment.

When a PCT documents the extent of a patient's edema, for example as +3 - correct answer

✅the PCT is preforming an assessment which is not allowedlegally.

When a patient has an irregular heartbeat, - correct answer ✅theautomatic BP reading may not be accurate.

Which of the following is a data collection - correct answer ✅HR 72. at what time

should the post treatment data collection be completed -

correct answer ✅after the treatment has been completed.

the A in smart communication stands for - correct answer ✅actual- justreport the facts.

which of the following events is defined as a near miss - correct answer

✅the wrong dialyzer was set up and primed for a patient, but it was caught before dialysis was 3 initiated and the dialyzer was replaced.

using the approach is one way to fill out an REM - correctanswer ✅SBAR.

What is your main priority when returning a patient's blood with the hand crank during a

power outage? - correct answer ✅you must be vigilant in watching for air in the blood lines.

what problem will cause an increase in the patient's VP - correct answer

✅a clot in the venous drip chamber.

Which blood test must be performed at regular intervals on patientssusceptible to HPB - correct answer ✅HBsAg.

who is accountable for appropriate patient and teammate scheduling in theacute setting - correct answer ✅ you are dialyzing a patient and the onlyavailable HPB surveillance test is a HBsAb of 8. What are the machine disinfection requirements after dialyzing this patient? - correct answer ✅the machine must be heat disinfected at the end of each day.

What is the most common factor contributing to bacteremia in dialysispatients? - correct answer ✅use of catheters for HD.

which infectious disease requires frequent hand washing instead of using alcohol-based hand gels - correct answer ✅active clostridioides difficile infection.

What precautions must be used when handling lab specimens? - correct answer ✅universal precautions.

waiting only five seconds between lowering the blood pump speed and drawing the post treatment blood sample could - correct answer ✅causethe post treatment BUN reading to be falsely low (wait 15 seconds)

which may cause a decrease in the hemoglobin of a patient with ESRD - correct answer ✅infection/inflammation.

fluid overload and HTN lead to LVH, this means - correct answer ✅hypotensive episodes are more likely to occur during the dialysistreatment.

your role in CKD-MBD management includes - correct answer ✅remindingthe patient who is eating a snack during dialysis to take his phosphate binder.

your role in anemia management includes - correct answer ✅rinsing backas much of the patient's blood as you can at the termination of each treatment

the licensed nurse has delegated a specific task to a PCT, but the PCT gets called away before

performing this task. Can the PCT asek another PCT to take over? - correct answer ✅no, a task delegated by the licensed nurse toa non-licenced teammate cannot be re-delegated by this teammate

the licensed nurse delegated a task to the PCT, Nicole, but Nicole has notperformed this task during the last 2.5 months. What is Nicole's responsibility in the delegation communication process? - correct answer ✅Nicole is to inform the nurse that she performed the task onlyinfrequently

what is the nurse's responsibility in the delegation supervision process? - correct answer ✅to determine the level of supervision needed and to monitor the NAP's performance of the task accordingly

the transport mechanism when particles move from an area of higher soluteconcentration to an area of lower solute concentration is called - correct answer ✅diffusion

during dialysis, the movement of bicarb from the dialysate into the blood - correct answer ✅helps normalize body pH

the kidneys excretory functions include - correct answer ✅normalizingelectrolytes

what distance should be observed between needle tips and away from each other when cannulating an internal vascular access? - correct answer ✅1.5 inches

the nephrologist has ordered 16 gauge needles and a 400 BFR for your patient. You - correct answer ✅ask the nephrologist to order a 15 gaugeneedles for the ordered BFR

your patient prefers two places on her AVG to insert the needles becausethey hurt a lot less than when you cannulate different sites. You tell the patient - correct answer ✅inserting the needles into the same small areacan over time damage your graft

what is the appropriate intervals for total chlorine testing? - correct answer

✅prior to the first patient shift and within every 4 hours

what is acceptable limit for total chlorine in the water leaving the carbonfilter - correct answer ✅0.1 or less

which is the primary device for purifying the water used in dialysis - correctanswer ✅the RO

ICEBOAT? - correct answer ✅2 IdentifiersConsent valid

Equipment is functioningHep B

status

Orders are complete Access is

patent Documentation is

timely

? any questions/concerns

Your patient complains of ringing in the ears, being nauseated and having cold clammy skin. The most likely causes is - correct answer ✅Hypotension

What is a likely cause for dysrhythmias? - correct answer ✅Hypotension,heart disease, or rapid changes in K

In what position should you place a patient who experiences intradialytichypotension? - correct answer ✅Supine

What do you do for a patient with an air emblolism? - correct answer ✅Clamp lines, put patient on left side, Trendelenburg, attempt to aspirate the air, administer O2 per MD, monitor VS closely, initiate CPR if needed, notify code team

Why is thirst control and limiting interdialytic weight gains a shared responsibilyt between the

healthcare team and the patient? - correct answer ✅Caregivers can contribute to Na loading during dialysis causing anincreased thirst and fluid intake between treatments

Preventing hypotensive episodes during dialysis treatment is important because they are associated with - correct answer ✅a higher mortality rate

The mortality risk for patient who experience two or more episodes of intradialytic hypotension per week increases to - correct answer ✅70%

which condition may impair a patient's increase in pulse rate as a responseto hypovoilemia - correct answer ✅autonomic neuropathy

a patient's protein status is affected by nutritional and non-nutritional factors. what can you do to prevent a drop in your patient's albumin? - correct answer ✅prevent HAIs

Calciphylaxis (soft tissue calcification) is a consequence of which out or rangelabs? - correct answer ✅Ca, PTH, Phosphorus

How do phosphate binders work? - correct answer ✅they prevent the phosphorus in food from being absorbed when taken with meals

The method to protect against infection by pathogenic microorganisms when preparing and administering medications is called - correct answer ✅aseptic technique

Why must you wait 3-5 minutes after administering the initial heparin bolusbefore initiating treatment? - correct answer ✅takes 3-5 minutes for heparin to become systemic

When do you take PO4 binders? - correct answer ✅with meals and snacks #1 thing we do -

correct answer ✅patient safety

Conductivity acceptable rrange - correct answer ✅13-15.5 and +/- 0.4 ofthe machine

pH of dialysate - correct answer ✅6.9-7.6blood pH -

correct answer ✅7.35-7.

When is the RO checked? - correct answer ✅before the first patient andevery 4 hours afterwards

Bicarb lasts for how long once opened? - correct answer ✅24 hours

Acid lasts for how long when opened? - correct answer ✅30 daysif additives

discard after treatment

lifespan of a RBC for dialysis patient - correct answer ✅60 days Ultrafiltration - correct answer

✅fluid passing thru a membrane

Convetion - correct answer ✅solute being dragged across thesemipermeable membrane

Diffusion - correct answer ✅particles from high to low concentrationsOsmosis - correct

answer ✅fluid from lower to higher concentration How much air can cause a patient

harm? - correct answer ✅10mL

What is the solution of bleach to clean up a spill? - correct answer ✅1:

2 independent nursing functions - correct answer ✅patient care andtechnical skills

2 common routes for CVC infection - correct answer ✅into cath via contactof the insertion site and via cath lumen- scrub the hub for 60 seconds each limb

Most common cause for CKD in USA - correct answer ✅DM

What is the percent of kidney function lost before going on dialysis - correctanswer ✅75%

HD replaces what percent of kidney function - correct answer ✅15% What is the direct

result of intravascular fluid overload - correct answer ✅HTN

Patient with cardiac disease are 10x more likely to develop intra HTN - correct answer ✅LVH

Offer a patient of this is an example of oral sodium loading - correct answer

✅broth

this electrolyte is often elevated with patients with severe itching - correctanswer ✅phosphorus

kidneys regulate BO by realeasing - correct answer ✅renin

hormone stimulated in bone marrow production - correct answer

✅erythropoeitin

Excess of this electrolyte causes slowing of the hearts electrical system -

correct answer ✅k

mucosal alteration in the stomach of patients with AKI can lead to this - correct answer ✅anorexia

what is the inflammation aroudn the heart called - correct answer ✅pericarditis

restless leg syndrome is a complication of - correct answer ✅peripheralneropathy

measures the RBC by weight - correct answer ✅HgB

what is the diminished quality and quality of RBC - correct answer

✅anemia

what is classified as bone disease associated with renal failure - correctanswer ✅CKD-MBD

the vitamin converts vit d into which hormone - correct answer ✅Calictrol

these procedures can causes significant blood loss in our patients - correctanswer ✅access procedures

maintaining a normal serum Ca levels are the primary function of thishormone - correct answer ✅PTH

this disease is the leading cause of death at all stages in CKD - correctanswer ✅cardiac

this skin color is associated with the decrease circulation of RBC fromsecondary anemia - correct answer ✅pale

it is important to use this team approach when dealing with psychologicalpatients - correct answer ✅multidisplinary

What is the reason for a meerCAT audit - correct answer ✅to prepare forsurvey readiness

one thing to improve CAT audit scores - correct answer ✅practice goodhand hygiene

one thing to improve meerCAT score - correct answer ✅store look-a-like,sound-a-like products appropriately

Why is the order of lab draw important - correct answer ✅samples in subsequent tubes are not contaminated with additives from the previous

what do you want the level of albumin to be - correct answer ✅>

if drawing labs during dialysis how do you label them? - correct answer

✅DRAWING DURING DIALYSIS

BUN lab draws post dialysis - correct answer ✅turn off or decrease UR to

decrease DFR to 300 or place machine in bypassreduce BFR to 100

wait 15 seconds for AVG/AVF and CVC (WAIT 15 seconds!!)Obtain from A Line

Why is drawing the correct amount for blood cultures improtant - correctanswer ✅too much blood may create a false positive

When do we test Hep B - correct answer ✅need to have it every 28 days drawn for negative and susceptible, if negative and immune every 365 days.if unknown draw patient

Rule of 6 is good for? - correct answer ✅new AVF to guide

what is LOOK LISTEN AND FEEL? - correct answer ✅assessment withoutneedles

inflow stenosis is - correct answer ✅with AVF, venous stenosis, waterhammer pulse

outflow stenosis - correct answer ✅with AVG, whistling sound

How do you identify disinfectant infusion is happening - correct answer ✅burning or pain at that access site

What do you do for disinfectant infusion? - correct answer ✅stop pump,clamp lines, DO NOT RETURN blood, O2, NS via A Line and collect blood specimens

what is hemolysis - correct answer ✅destruction of RBC

what is S/S of hemolysis - correct answer ✅anxiety, restlessness, n/v,dyspenea, chest tightness, hyperkalemia, blood will look cranberry

what do we do for hemolysis - correct answer ✅stop treatment, clamp lines, DO NOT RETURN BLOOD, assess patient, draw labs, obtain samples forhypotonic dialysate, check dialysate temp, give o

what are s/s of air embolism - correct answer ✅dyspnea, coughing, chesttightness/pain, cyanosis, confusion, visual disturbances

hypotension - correct answer ✅a drop in BP by 20decrease in MAP

by 10

if pre SBP less than 90 drop of 10

with symptoms

Intervention for hypotension - correct answer ✅take BP, minimum UFR, give NS, elevate feet, supine position

what is a fever - correct answer ✅temp >100 or increase in 2 degrees frombaseline

what will hyperkalemic patients have - correct answer ✅peaked T waves

what do we do for pericarditis patients - correct answer ✅more frequentdialysis

what do we avoid with pericarditis patients - correct answer ✅heparin

what is the K bath we give for digoxin patients - correct answer ✅2kheparin is considered

what - correct answer ✅systemic

vitamins should be given when? - correct answer ✅post treatment so theydont dialyze out

what is the half life of heparin - correct answer ✅30-90 minutes

How long should Vanc be administered? - correct answer ✅over 60minutes

UF profiling - correct answer ✅MD must order

Linear profile - correct answer ✅fluid gainers, fluid overload, patients havehypotension toward the end of treatment

Stepped profile - correct answer ✅hypotension happens midway may startat 800 then reduce down

intermittent - correct answer ✅up and down approach

Weight gain over 5% of patient's target weight is - correct answer ✅fluidexcess

what medication must be given on an IV pump - correct answer ✅IV

FeWhat happens with mannitol? - correct answer ✅It dialyzes off

how long do you scrub the hub of a CVC? - correct answer ✅ 60 secondseach limb

Platelets should be adminstered how - correct answer ✅thru venous medlock on the venous drip chamber using an IV pump

how often do you rotate sites? - correct answer ✅every 14 days

How often do you draw Hepatitis B - correct answer ✅draw every 28 daysthey are good for 30 days

Final Exam davita_With Questions and Answers/davita Final Exam

what is the difference between data collection and assessment?who does what? (Correct)- ✅data collection:yes or no

assessment: the extend.

what is the role of pct prior to treatment initiation? (Correct)- ✅data collection notify nurse of any abnormalities

what is the role of the licensed nurse prior to treatmentinitiation? (Correct)- ✅nurse assessment

when us a pre-treatment assessment by the licensed nurserequired? (Correct)- ✅if vitals were abnormal

when is post treatment assessment by the licensed nurse required?(Correct)- ✅up normalities during treatment.

note about bp (Correct)- ✅squeezing the auto blood pressurecuff to speed deflation can damage machine internal bp module.

why do we document in the medical record? 4 reasons (Correct)- ✅1.proof that care was rendered

2.provide data continuity

3.permnent legal record

4.communication tool

list 6 occurrences when to chart? (Correct)- ✅1.change from baseline assessment

2.change in patient condition

3.procedure for treatment 4.medication

given

5. patient teaching
6. care plan review and intervention

pre-treatment data collection/ assessment (Correct)- ✅before treatment intuition

assessment within one hour if pt is stable for nurse

post treatment data collection/assessment (Correct)- ✅post treatment only what are possible consequence of proof or incomplete documentation? (Correct)- ✅poor or incomplete documentationcan open an attack on your care

what are the 6 items included in charting administered(Correct)- ✅1.medication dosage

2. data and time
3. route for administeration4.pt

response

5. signiture of teammate adminsteration
6. allergies always check the allergy screen in screen in falconfor a list of your pt.

how do you document charting errors (Correct)- ✅single linesign and date

what does SMART communication stand for (Correct)- ✅Simple andclear

Meaningful

Actual Read

Teach

what are the 5 w's to be used when completing an AOR (Correct)- ✅what

where

who

when

why

what are the four consequence of sodium loading during dialysis(Correct)- ✅.thirst

2. fuid intalle
3. idwg;headaches +hypertenstion

4.ufr

what treatment factors decreases K? (Correct)- ✅not waiting 3- 5 minutes after giving Heprin

what factors influence V? (Correct)- ✅on average a personsbody composed of 50-55 % water.

a person height weight sex,age and amputation are included incalculating V

lab draw mistakes that would falsely increase kt/v? (Correct)- ✅not waiting 15 second

when is post treatment blood sample draw too high? (Correct)- ✅waiting only 5 seconds between lowering the blood pump speedand drawing post treatment blood sample would cause the kt/v reading to be too high

is it okay for pt to come off early on lab day? (Correct)- ✅If pt wants to get off early educate pt risk involved.and still drawlab and re-draw on full treatment (every time)

what is important when monitoring weight and bp? (Correct)- ✅acute patient only-keep pt wet and avoid hypotensive episodes.

what do you need to consider in regards to their vascular access? (Correct)- ✅follow p and p to prevent infection

why is it important to know what caused your patients CRF? (Correct)- ✅its important to know to help inquire about possibleproblem during data collection and assessment.

what is the purpose of uf profilling? (Correct)- ✅purpose ofuf profiling the way fluid removed during treatment allow timefor vascular refilling

what are consequence if patient is consistently fluid overloaded(hypervolemia)? (Correct)- ✅hypertension, leftventricular hypertrophy, cardiovascular disease

what can cause hypovolemia? (Correct)- ✅attempting to remove large amount of fluid weight for patient can lead to hypovolemia

what are conductivity and ph alarm causes? (Correct)- ✅machine conductivity ad manual reading can be no greater or less then 0.4difference.

after test use phenix meter to: (Correct)- ✅measure ph in dialysate to verify acid base balance with acceptable range

what are temperature alarm causes? (Correct)-^ ✅hemolysis

occurs at 42 Celsius or higher. power appropriate intervention (Correct)- ✅1.remove venousline from air detector clamp before starting Hand cracked.

2.be delight watching for air venous pressure high alar causes (Correct)- ✅more positivecinck in tubing/clamp,infilteration,venous stenosis.

clotting in venous drip chamber the reasonable and prudent standard of care for nephrology nursing: key concept (Correct)- ✅when supervising non licensepersonal.it is the responsibility of the license nurse to ensurealso teammate meet standard of care.

what role does Davita p&P play? (Correct)- ✅policy is guidelines principle "the why"

what are the risk of doing it your way? (Correct)- ✅civilliability

what makes dialysis patient more susceptible to HAIs?(Correct)- ✅weakened immune system

prolong accès to pt blood

why are dialysis pt at increased risk for acquiring a HAI at thefacility? (Correct)- ✅contact transmition wha tis the most common transmition route for HAIs? (Correct)- ✅contact transition

what is the most important intervention you can do to preventHAIs? (Correct)- ✅hand hygiene

wha tis the most common infectious complication in hemodialysispt? (Correct)- ✅1.vascular access infection

2. per cdc the most common factor contributing to bacteriumia isuse of cvc.

what germ causes the most common infections in hemodialysis pt?(Correct)- ✅MRSA

MRSA can remain on service for days.being most

favorable to survival

why is wearing gloves important? (Correct)-^ ✅function^ of

gloves decrease the risk of hand contamination.

successful lab draws know the 20 tips (Correct)- ✅follow theorder of draw

to prevent specimens from being contaminated with other tubeadditive

double labeling tubes prohibits processing

what is rule of spinning samples? (Correct)- ✅balance, spin tubes of same kind size fill level and should be placed oppositeof each other.

what are signs and symptoms of hyperkalemia (Correct)- ✅high potassuim-muscle weakness, abnormal heart rate

what are signs and symptoms of hypokalemia (Correct)- ✅low potassium-muscle cramp abnormal heart rate cold

how can you prevent contributing to blood loss? (Correct)- ✅1.adequte heparinzation

giving heprin

why are patients anemic? (Correct)- ✅lack of (ego)erythropoietin

what is pericarditis? what is included in its treatment ?(Correct)- ✅no heparin

hold or decrease heparin

peripheral neuropathy (Correct)- ✅check temperature of bathwater

don't walk bare feet

frequent foot check

what are the 4 key elements affected in CKD-MBD? (Correct)- ✅1.calcium

2.phosphorous 3.parathyroid

hormone4.vitment D

what does the acronym DARN stand for? (Correct)- ✅desire

ability

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reason

need

when should the communication style directing be used?(Correct)- ✅when training to perform procedure

what are the 3 core communication skills to be used within thecommunication styles (Correct)- ✅asking, lisening,involving what is the best way to help pt successful change behavior? (Correct)- ✅the best way to help pt successfully change behavioris to inspire behavioral change through support, compassion and empathy.

summarizing skill (Correct)- ✅includes main aspect of what thept said during the entire communication

writing reflex (Correct)- ✅in automatic intervention of healthcare practitioner who absorbs a pt doing something detrimental reflex.

is there an order to work through the 5 stages of grief?(Correct)- ✅NO what is KDQOL 36? (Correct)- ✅kidney disease quality of careof life

it is an assessment tool used for social workers to identifybarriers

what is KDQOL used for? (Correct)- ✅social worker compliesresult and develops goals with the pt

are social workers available to caregiver? (Correct)- ✅social worker available for caregivers strangling to meet demands of pttreatment regiment 4 transport machisms that play role in hemodialysis (Correct)- ✅1.ultrafilteration

2.convection

3.diffustion

4.osmosis

what is ultrafilteration? (Correct)- ✅controlled fluid removed by manipulation.removes fluid only

what is convection? (Correct)-^ ✅salutes^ are^ dragged^ with

water. saluts and water

what is diffusion? (Correct)- ✅particles move from high concentration to low construction.only particles

what is osmosis? (Correct)- ✅fluid from lower to high.zuccni

what are the kidney endocrine function? (Correct)- ✅1.produce renin.regulate

2.erythropoetin

3. activiation of fitment d which convert (calibrated bone disease

what is the function of bicarbonate? (Correct)- ✅diffusion ofbicarb from dialysate to blood helps normalize body ph

consequence of organ stunning? (Correct)- ✅hypotension can have many adverse affects includes impaired tissue prevention ofvital organs.

muscle cramps intervention (Correct)- ✅decrease or turn off ufoffer to stretch we don't want to dialoged clot.

fever and chills defention (Correct)- ✅any temperature greaterthen 100 fahernhit or increase over baseline of 2 fahrnihit withsymptoms.

pyrogen reaction definition (Correct)- ✅react are caused by pyrogen such as endotoxin in water treatment occurs with in 45-75min of treatment.

pyrogen reaction causes (Correct)- ✅break of water treatment,toxins inside bacteria

seizures intervention (Correct)- ✅discontinue treatment ifseizures is sever or pt doesn't not respond to treatment

dialysis disequiblrium syndrome prevention (Correct)- ✅encourage pt not to skip treatment

blood loss definition (Correct)- ✅tmp clotting of dialyzer,needle disloging

blood loss causes (Correct)- ✅blood leak(fiber break loss)high pressure

blood loss symptoms (Correct)- ✅blood on floor, chair orclothing, tmp alarm

disinfectant infusion symptoms (Correct)-^ ✅pain^ at^ venous

needle side, respiratory distress tingling around the mouth

chest pain/angina intervention (Correct)- ✅if mild turn ufdecrease blood flow rate give oxygen

air embolism intervention (Correct)- ✅stop pump

clamp lines

left side trenvelenburg

air taped int right atrium and venticular when pt is place intotrendlengburg postion

what are the 3 basic principle of self-managment? (Correct)- ✅1.dealing of consequence of illness

rather than physical disease alone

what is the definition of health literacy? (Correct)- ✅the degree to which individuals have the capacity to obtain processand understand basic health information

what are the educational tips for visual learners? (Correct)- ✅select quit surrounding

what are the educational tips for auditory learners? (Correct)- ✅word association and numonics

what are the educational tips for tactile learners (Correct)- ✅short lectures frequent breaks

what are the meds PCTs can administer per DaVita P&p?(Correct)- ✅1.heprin

2.lidocaine

3.saline

at what time are medications contain a preservative discarded?(Correct)- ✅28 days

how long do we wait after administering heparin bolus prior totreatment intuition (Correct)- ✅3-5 minutes

how do you administer pain ease spray? (Correct)- ✅blanchingof the skin

describe 4 AVF evaluations for maturation based on the KDOQIrules of 6s? (Correct)- ✅6-8 weeks post op