CCHT practice questions & Verified Answers

which of the following terms indicates a solution that has the same concentration of solutes as blood? -ANSWER isotonic a patient's potassium levels has been running high between dialysis treatment, so the patient has been working with the renal dietician to restrict potassium in the diet. which of the following fruits should the patient avoid? -ANSWER bananas during osmosis, which of the following movements takes place? -ANSWER fluid moves from an area of lower concentration to higher. a patient's granddaughter calls the dialysis center and asks for a progress report on her father, who is a patient in the center. the technician should. -ANSWER state that patient information cannot be divulged if a hematoma forms at the access site where a needle infiltrated, the usual intervention is to apply -ANSWER cold compresses which of the following actions by a patient increases the risk of blood clots in a venous access? -ANSWER wearing a top with very tight- fitting long sleeves a patient is very anxious during an initial hemodialysis treatment and requires extra attention. when the treatment is completed, the patient offers a $20 tip. the technician should -ANSWER politely decline the tip which of the following statements by a hemodialysis patient suggests that the patient needs more education? -ANSWER i should stay on a low protein diet. the inner part of the kidney is the -ANSWER medulla a nephron is comprised of a glomerulus and a -ANSWER tubule how much urine does a patient with healthy kidneys usually excrete in 24 hours? -ANSWER 1000 to 2000mL when removing soiled gloves, the first glove removed should be. -ANSWER grasped in the opposite gloved hand which of the following hormones is produced by the kidneys? -ANSWER erythropoietin at which stages of chronic kidney disease should a patient being dialysis? -ANSWER 5 which of the following is a genetic disorder that can lead to kidney failure? -ANSWER polycystic kidney disease which of the following complains by a patient may be an indication of uremia? -ANSWER itching a patient with a right-sided radiocephalic A fistula (above the wrist) needs to have blood test in the lab for a number of different lab test. the blood should be drawn from the -ANSWER left hand when setting up hemodialysis equipment, the four thing that need to be checked are [ 1 ] dialysate, [ 2] extracorporeal circuit, [ 3] dialyzer and, [ 4] -ANSWER machine alarm generally, the optimal dialysate flow rate for hemodialysis should be -ANSWER 1.5 to 2 times the blood flow rate a patient is receiving hemodialysis with a dialyzer with an ultrafiltration coefficient [ kuf ] of 10 and a transmembrane pressure [TMP] of 100 mm hg. how much fluid should the patient lose per hour of treatment -ANSWER 1000 mL under what circumstances can needle be reused for hemodialysis? -ANSWER under no circumstances if a emergency ( such as a tornado ) occurs and patients need to be evacuated, which group of patient should be disconnected from dialysis machine first? -ANSWER patients able to ambulate independently for patients on hemodialysis a, 1 kg (2.2 lb.) increased in weight in 24 hours is approximately equivalent to fluid retention of -ANSWER 1.0 L. a patient has been advised to avoid foods high in phosphorus. food that the patient should be advised to limit include. -ANSWER dairy products a patient is scheduled for serum creatinine test and asks the technician about preparation the day before the test. the patient should be advised to. -ANSWER avoid excessive exercise which of the following ethnic group is most at risk for development of kidney failure? -ANSWER african american a patient has buttonhole tracts for access. after the access is cleaned and prepped for treatment, what is the next step? -ANSWER use a crab picker/ aseptic tweezer to remove the scabs with buttonhole tracts, the technician should apply pressure as the needle are removed and then for -ANSWER 5 to 10 minutes if a buttonhole access frequently has long clots that are very difficult to remove, the most likely reason is -ANSWER failure to use 2-finger hold for needle removal a patient who had an AV fistula in the forearm developed an aneurysm and has had to have a new AV fistula created in the upper arm. the patient has a temporary catheter in place for dialysis until the fistula has matured. which of the following exercise may help strengthen the AV fistula? -ANSWER bicep curl with buttonhole access sites, what should the technician do to prevent '' hubbing " ? -ANSWER leave 1/16 th to 1/8 inch of the needle exposed if a patient has a dialyzer clearance rate of 250 mL/ min with 4- hour treatment, the total volume of blood cleared is -ANSWER 60 L. what is the most important factor in preventing exsanguination from dialysis line separation? -ANSWER access site visible if a patient states that she has been skipping lunch because she is too tired to eat after dialysis, the best solution is to. -ANSWER report to the nurse and renal dietician if a patient exhibits signs and symptoms of hemolysis during dialysis, the immediate action should be to -ANSWER stops the blood pump and clamp the blood lines the amount of dialysis that a hemodialysis patient is prescribed is based on the removal of -ANSWER urea maturation of a prosthetic arteriovenous graft usually takes -ANSWER 3 to 6 weeks the purpose of the negative germicide test is to ensure that -ANSWER the reprocessed dialyzer is free of germicides if a patient develops angina (chest pain) radiating to the neck, jaw, and left arm and the patient's blood pressure drops during treatment, the technician should notify the nurse and -ANSWER decreased blood flow rate and ultrafiltration the technician is reinforcing a patient's training regarding management of fluid intake. the patient, who still urinates, has a base of 1000 ml intake per day. if the patient urinates 500 ml in a 24-hour period , how much fluid is the patient allowed the following day? -ANSWER 1500ml the greatest risk of bacteremia (infection in the blood) is associated with which type of vascular access? -ANSWER dialysis catheter the external surface of the hemodialysis machine should be cleaned and disinfected at least. -ANSWER after every patient when checking the water temperature in the system, the technician records the temperature at 78 F (25.5 C). in order for the reverse osmosis (RO) equipment that is partof the water treatment system to work properly, the water temperature must be maintained at -ANSWER 77' F to 82'F ( 25' C to 28'C ) when testing the chlorine levels in the water system, the water sample should be taken from the. -ANSWER first carbon tank when considering the chain of infection, the three most common reservoirs of interest include humans, environment and -ANSWER animals a solution is a mixture of -ANSWER solute and solvent when reinforcing education about weight gain, a patient should be advised that the usual goal for interdialytic weight gain is less than -ANSWER 1.0 kg/d if a high-pressure alarm for arterial pressure (pre-pum ) sounds during hemodialysis, this could indicate. -ANSWER drop in speed of blood pump if a low- pressure alarm for venous sounds during hemodialysis, this could indicate. -ANSWER clotting in the access according to KDOQI guidelines, when administering hemodialysis to a patient a, facemark should be worn -ANSWER for all access connection the most common complication associated with poor needle site rotation in a graft is -ANSWER pseudoaneurysm in hemodialysis, ultrafiltration refers to extraction of -ANSWER fluid the patient has develop a small aneurysm and asks the technician to cannulate the aneurysm for the hemodialysis treatment because another patient told this patient that it would be less painful that cannulation of the fistula. the best response is to -ANSWER advise the patient that cannulating an aneurysm may result i rupture. a patient experience a cardiac arrest with no pulse or respiration during hemodialysis. after the technician calls for help, the next action should be to -ANSWER stop dialysis, return blood, and flush access lines with normal saline. when auscultating a patient's AV fistula to listen for the bruit, if the technician notes that the bruit is very high pitched, this may indicate -ANSWER stenosis when using the buttonhole technique for vascular access for hemodialysis, the needles are placed in. -ANSWER the same site in a fistula when inserting a needle for hemodialysis, which of the following increases the risk of infiltration? -ANSWER rotating the needle 180 degrees the legal document that assigns a heal care proxy to make decisions in the event that a person is unable to do so is called -ANSWER durable power of attorney carbon filters in the water system are necessary to remove -ANSWER chlorine, chloramine, and organic material backwashing to free residue from sediment filters in the water system should be done at least -ANSWER once daily with the formula for urea kinetic modeling (UKM), the K in the Kt/V formula stands for -ANSWER urea clearance (mL/ min) plus residual urinary output when inserting needles into a graft for hemodialysis, the needle tips be should be at least how far apart? -ANSWER 2.0 inches if a patient is undergoing hemodialysis and the technician notes that a bloodlines has separated and blood has pooled beneath the access site, the first intervention should be to -ANSWER stop the blood pump during hemodialysis, the technician would expect a patient's temperature to rise by about. -ANSWER 0.5 C approximately what percentage of the total blood volume circulate in the veins? -ANSWER 65% to 80% patient should be advised to avoid eating during hemodialysis because ingestion of food may result in -ANSWER hypotension prior to using a reprocessed dialyzer, a recirculating rinse with NS should be completed with recirculating flow rate through the blood compartment and the dialysate compartment of at least. -ANSWER 200 mL/min for BFR and 200 mL/ min for DFR. if a hemodialysis patient test positive for hepatitis C virus (HCV), which of the following interventions does the KDIGO guidelines recommend when proving hemodialysis treatment? -ANSWER adherence to strict infection-control procedures if a dialyzer is to be reprocessed in 3 hours, the dialyzer must be -ANSWER refrigerated when documenting observations about a patient, which of the following is the most appropriate description? -ANSWER patient is sighing and rubbing hands together which of the following is the most common cause of hypotension developing during hemodialysis? -ANSWER removing excessive volume of fluid which of the following interventions is most likely to decrease hypotension that occurs during hemodialysis? -ANSWER decreasing the ultrafiltration rate if an air sector alarm sounds during hemodialysis, the technician should initially -ANSWER stop the blood pump and clamp the patients venous line if outflow stenosis of an AV fistula occurs, the thrill usually -ANSWER is loud and higher pitched and then discontinuous when reviewing a patient's food dairy, the technician advise the patient that which of the following protein sources is of low biological value? -ANSWER dried bean which of the following vitamins may be removed by hemodialysis -ANSWER vitamin B the renal nutritionist has advised the patient to have a diet high in fiber, but the patient is unsure which foods to choose. which of the following foods per serving is highest in insulate fibers? -ANSWER kidney beans the primary purification process of the dialysis water is -ANSWER filtering with activated carbon if the dialysis center uses hemoclips on dialysis tubing to prevent disconnection, what other precautions should be utilized? -ANSWER visible access sites/line connections and documentation of integrity every 30 minutes if during hemodialysis, blood is evident in the used dialysate, this probably indicates -ANSWER tear in the membrane if a patient asks a question to which the technician does not know the answer, an appropriate response is -ANSWER I 'll find out for you '' during routine hemodialysis, a patient's blood pressure should monitored every -ANSWER 30 to 60 minutes if a patient develops painful muscle cramps in the hands, feet, and abdomen shortly after hemodialysis begins, the most likely interventions is -ANSWER saline bolus and/or decreased ultrafiltration rate. if a hemodialysis patient's temperature per tympanic membrane thermometer is 37C in order to reduce incidendence of intradialytic ( during dialysis ) hypotension, the temperature of the dialysate solution should ideally be set at -ANSWER 36.5 C foam in the venous bloodline of a dialyzer may indicate -ANSWER air embolism prior to initiating hemodialysis, the ph of the dialyste usually ranges from -ANSWER 7.0 to 7.4 the number one cause of kidney failure in the US is -ANSWER diabetes mellitus, type 2 the use of topical anesthetic, such as EMLA, to reduce discomfort during cannulation is contraindicated with -ANSWER buttonhole sites a patient who has been very alert and shown no sign of cognitive impairment seems confused during dialysis and repeatedly asks the same question. the best initial response is to -ANSWER notify the nurse when determining if a new AV fistula is maturing the three factors to assess by palpation are the -ANSWER thrill, vessel growth, and vessel firmness which of the following antiseptics used for skin pre for a fistula site has the broadest spectrum antibacterial activity? -ANSWER 2% chlorhexidine gluconate while a patient is undergoing hemodialysis, chloramine testing of the water system should be conducted every -ANSWER 4 hours if a patient is to undergo heparin-free dialysis, the optimal blood flow rate is -ANSWER 300 to 400 ml/min before cannulating An AV fistula for a hemodialysis treatment, the technician examines the patient's access arm and finds that the access arm appears slightly edamatous, and the skin is pale. on further examination, the technician notes that there are small purple veins evident on the chest wall near where the arm meets the body. the technician should suspect -ANSWER stenosis in order to increase survival rates. the ultrafiltration rate for hemodialysis patients should be maintained at least than -ANSWER 12 ml/kg/m as part of fistula assessment before cannulation, the technician evaluates the thrill and then applies acclusion by placing a finger across the body of the fistula. while the fistula is acceded, the technician palpates and feels both a thrill and a pulse. this probably signifies a (n) -ANSWER accessory pathway ( collateral circulation ) how much additional proteins should a patient on hemodialysis ingest every day in comparison to a health person -ANSWER 50% weight gain between hemodialysis treatments should not exceed -ANSWER 5% of dry weight the technician has calculate the target weight loss for a patent's hemodialysis session, but the patient insists that the technician has made an error and the target is 1 kg too high. the technician should -ANSWER recalculate the target weight loss. the most important reason for placing hemodialysis needles in antegrade position ( in direction of blood flow) is because -ANSWER it causes less scarring when preparing dialysate with a 45x concentrate, if the proportioning ratio contains 1.0 part acid and 1.72 parts bicarbonate, how many parts of water are needed? -ANSWER 42.28 if conductivity monitoring stops dialysate from flowing to the dialyzer but instead sends it to the drain (bypass), this means that -ANSWER the conductivity monitor is malfunctioning when using a portable digital dialysate meter, such as the D6 (myron L meter ) , to verify that inline meters are accurate regarding conductivity and ph, the technician must -ANSWER obtain an unused dialysate sample the target ultrafiltration goal set for the patient is based on the patient's -ANSWER dry weight a patient is to receive a bolus of ulfrationated heparin (25 IU/kg ) at the onset of dialysis and 800 U at one-hour intervals during treatment, which is scheduled from 1 to 5 PM. the first dose is given at 1 Pm and the last dose at -ANSWER 4 pm when checking the pump occlusion for the blood pump, the technician nots, that the rollers appear to may result in -ANSWER cracking of the blood pump segment of tubing in the hemodialysis machine, a separate air detector is usually placed -ANSWER between the venous pressure gauge and the venous access at the completion of dialysis treatment, it is important to rinse back as much blood as possible in order to -ANSWER reduce the severity anemia if a power outage occurs and backup power fails, before using the hand crank to return the patient's blood, the technician must -ANSWER remove the venous line for the air detector if a patient's blood pressure is 142/88 before dialysis and 108/72 at the completion of dialysis, the most likely intervention is -ANSWER infusion of normal saline to increase blood pressure prior to opening a sterile packing, the technician spills sterile normal saline on the package. the technician should -ANSWER discard the package