CCHT Practice 300 Questions with Verified Answer,100% CORRECT

CCHT Practice 300 Questions with Verified Answers Which of the following terms indicates a solution that has the same concentration of solutes as blood? - CORRECT 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? - CORRECT ANSWER bananas during osmosis, which of the following movements takes place? - CORRECT 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. - CORRECT 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 - CORRECT ANSWER cold compresses which of the following actions by a patient increases the risk of blood clots in a venous access? - CORRECT 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 - CORRECT ANSWER politely decline the tip which of the following statements by a hemodialysis patient suggests that the patient needs more education? - CORRECT ANSWER i should stay on a low protein diet. the inner part of the kidney is the - CORRECT ANSWER medulla a nephron is comprised of a glomerulus and a - CORRECT ANSWER tubule how much urine does a patient with healthy kidneys usually excrete in 24 hours? - CORRECT ANSWER 1000 to 2000mL when removing soiled gloves, the first glove removed should be. - CORRECT ANSWER grasped in the opposite gloved hand which of the following hormones is produced by the kidneys? - CORRECT ANSWER erythropoietin at which stages of chronic kidney disease should a patient being dialysis? - CORRECT ANSWER 5 which of the following is a genetic disorder that can lead to kidney failure? - CORRECT ANSWER polycystic kidney disease which of the following complains by a patient may be an indication of uremia? - CORRECT 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 - CORRECT 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] - CORRECT ANSWER machine alarm generally, the optimal dialysate flow rate for hemodialysis should be - CORRECT 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 - CORRECT ANSWER 1000 mL under what circumstances can needle be reused for hemodialysis? - CORRECT 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? - CORRECT 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 - CORRECT 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. - CORRECT 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. - CORRECT ANSWER avoid excessive exercise which of the following ethnic group is most at risk for development of kidney failure? - CORRECT ANSWER african american a patient has buttonhole tracts for access. after the access is cleaned and prepped for treatment, what is the next step? - CORRECT 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 - CORRECT ANSWER 5 to 10 minutes if a buttonhole access frequently has long clots that are very difficult to remove, the most likely reason is - CORRECT 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? - CORRECT ANSWER bicep curl with buttonhole access sites, what should the technician do to prevent '' hubbing " ? - CORRECT 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 - CORRECT ANSWER 60 L. what is the most important factor in preventing exsanguination from dialysis line separation? - CORRECT 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. - CORRECT 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 - CORRECT 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 - CORRECT ANSWER urea maturation of a prosthetic arteriovenous graft usually takes - CORRECT ANSWER 3 to 6 weeks the purpose of the negative germicide test is to ensure that - CORRECT 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 - CORRECT 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? - CORRECT ANSWER 1500ml the greatest risk of bacteremia (infection in the blood) is associated with which type of vascular access? - CORRECT ANSWER dialysis catheter the external surface of the hemodialysis machine should be cleaned and disinfected at least. - CORRECT 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 - CORRECT 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. - CORRECT ANSWER first carbon tank when considering the chain of infection, the three most common reservoirs of interest include humans, environment and - CORRECT ANSWER animals a solution is a mixture of - CORRECT 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 - CORRECT ANSWER 1.0 kg/d if a high-pressure alarm for arterial pressure (pre-pum ) sounds during hemodialysis, this could indicate. - CORRECT ANSWER drop in speed of blood pump if a low- pressure alarm for venous sounds during hemodialysis, this could indicate. - CORRECT ANSWER clotting in the access according to KDOQI guidelines, when administering hemodialysis to a patient a, facemark should be worn - CORRECT ANSWER for all access connection the most common complication associated with poor needle site rotation in a graft is - CORRECT ANSWER pseudoaneurysm in hemodialysis, ultrafiltration refers to extraction of - CORRECT 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 - CORRECT 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 - CORRECT 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 - CORRECT ANSWER stenosis when using the buttonhole technique for vascular access for hemodialysis, the needles are placed in. - CORRECT ANSWER the same site in a fistula when inserting a needle for hemodialysis, which of the following increases the risk of infiltration? - CORRECT 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 - CORRECT ANSWER durable power of attorney carbon filters in the water system are necessary to remove - CORRECT ANSWER chlorine, chloramine, and organic material backwashing to free residue from sediment filters in the water system should be done at least - CORRECT ANSWER once daily with the formula for urea kinetic modeling (UKM), the K in the Kt/V formula stands for - CORRECT 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? - CORRECT 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 - CORRECT ANSWER stop the blood pump during hemodialysis, the technician would expect a patient's temperature to rise by about. - CORRECT ANSWER 0.5 C approximately what percentage of the total blood volume circulate in the veins? - CORRECT ANSWER 65% to 80% patient should be advised to avoid eating during hemodialysis because ingestion of food may result in - CORRECT 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. - CORRECT 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? - CORRECT ANSWER adherence to strict infection-control procedures if a dialyzer is to be reprocessed in 3 hours, the dialyzer must be - CORRECT ANSWER refrigerated when documenting observations about a patient, which of the following is the most appropriate description? - CORRECT ANSWER patient is sighing and rubbing hands together which of the following is the most common cause of hypotension developing during hemodialysis? - CORRECT ANSWER removing excessive volume of fluid which of the following interventions is most likely to decrease hypotension that occurs during hemodialysis? - CORRECT ANSWER decreasing the ultrafiltration rate if an air sector alarm sounds during hemodialysis, the technician should initially - CORRECT ANSWER stop the blood pump and clamp the patients venous line if outflow stenosis of an AV fistula occurs, the thrill usually - CORRECT 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? - CORRECT ANSWER dried bean which of the following vitamins may be removed by hemodialysis - CORRECT 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? - CORRECT ANSWER kidney beans the primary purification process of the dialysis water is - CORRECT ANSWER filtering with activated carbon if the dialysis center uses hemoclips on dialysis tubing to prevent disconnection, what other precautions should be utilized? - CORRECT 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 - CORRECT ANSWER tear in the membrane if a patient asks a question to which the technician does not know the answer, an appropriate response is - CORRECT ANSWER I 'll find out for you '' during routine hemodialysis, a patient's blood pressure should monitored every - CORRECT 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 - CORRECT 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 - CORRECT ANSWER 36.5 C foam in the venous bloodline of a dialyzer may indicate - CORRECT ANSWER air embolism prior to initiating hemodialysis, the ph of the dialyste usually ranges from - CORRECT ANSWER 7.0 to 7.4 the number one cause of kidney failure in the US is - CORRECT ANSWER diabetes mellitus, type 2 the use of topical anesthetic, such as EMLA, to reduce discomfort during cannulation is contraindicated with - CORRECT 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 - CORRECT ANSWER notify the nurse when determining if a new AV fistula is maturing the three factors to assess by palpation are the - CORRECT 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? - CORRECT ANSWER 2% chlorhexidine gluconate while a patient is undergoing hemodialysis, chloramine testing of the water system should be conducted every - CORRECT ANSWER 4 hours if a patient is to undergo heparin-free dialysis, the optimal blood flow rate is - CORRECT 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 - CORRECT ANSWER stenosis in order to increase survival rates. the ultrafiltration rate for hemodialysis patients should be maintained at least than - CORRECT 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) - CORRECT ANSWER accessory pathway ( collateral circulation ) how much additional proteins should a patient on hemodialysis ingest every day in comparison to a health person - CORRECT ANSWER 50% weight gain between hemodialysis treatments should not exceed - CORRECT 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 - CORRECT ANSWER recalculate the target weight loss. the most important reason for placing hemodialysis needles in antegrade position ( in direction of blood flow) is because - CORRECT 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? - CORRECT ANSWER 42.28 if conductivity monitoring stops dialysate from flowing to the dialyzer but instead sends it to the drain (bypass), this means that - CORRECT 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 - CORRECT ANSWER obtain an unused dialysate sample the target ultrafiltration goal set for the patient is based on the patient's - CORRECT 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 - CORRECT ANSWER 4 pm when checking the pump occlusion for the blood pump, the technician nots, that the rollers appear to may result in - CORRECT ANSWER cracking of the blood pump segment of tubing in the hemodialysis machine, a separate air detector is usually placed - CORRECT 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 - CORRECT 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 - CORRECT 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 - CORRECT 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 - CORRECT ANSWER discard the package when washing the hands, the hands should be wet and soap applied and then the hands rubbed together for at least - CORRECT ANSWER 15 seconds how long can hepatitis B virus live on surfaces if they are not properly disinfected? - CORRECT ANSWER 7 days in the event that a fire occurs in a dialysis center, the RACE method of response includes - CORRECT ANSWER rescue, active alarm, contain/confine fire, and extinguish/evacuate if the technician needs to move boxes of supplies from the floor to elevated shelves, the technician should - CORRECT ANSWER bend down at the knees and keep the back straight while lifting for documentation in the medical record, which of the following includes a correct - CORRECT ANSWER 0.5 kg for a hemodialysis cannulation with a blood flow rate of fewer than 300mL/ min, which of the following needle gauge sizes is usually recommended? - CORRECT ANSWER 17 if the nephrologist has ordered a pre-dialytic and post-dialytic BUN ( blood urea nitrogen) for a patient with an AV fistula, the pre-dialytic blood sample should be obtained from the. - CORRECT ANSWER arterial needle the primary focus of the life safety code is on - CORRECT ANSWER protection of people the dialysis prescription is for a 3- hour treatment with 1.5 kg to be removed. during treatment 250 mL is used as saline prime and 200 mL as saline rinseback. the patient ingested 150 mL of fluid that contains oral proteins supplement. the ultrafiltration rate to be removed per hour is - CORRECT ANSWER 700 ml if the ultrafiltration rate to be removed per hour is 600 ml and the dialyzer kuf is 40 what is the transmembrane pressure (TMP)? - CORRECT ANSWER 15 mm hg if using a combination chlorhexidine gluconate and alcohol skin prep (such as chloraprep before cannulation, how much skin contact time is required? - CORRECT ANSWER 30 seconds which of the following preventive measures is usually the best approach for patients who routinely experience hypotension during dialysis because of volume-related problems associated with large weight gain between treatments? - CORRECT ANSWER increasing restrictions of sodium intake if a patient undergoing hemodialysis and in the care of the technician has a persistent cough, standards precautions require that the - CORRECT ANSWER patient wear a mask what color is arterial blood tubing for hemodialysis most often color-coded? - CORRECT ANSWER red during hemodialysis, how much blood is usually outside of a patient's body at one time? - CORRECT ANSWER 100 to 250mL during the first week of treatment with a new AV fistula, the initial needle size and blood flow rate are usually ~ - CORRECT ANSWER 17-gauge needle and blood flow of 200 to 250 mL/min. with an AV fistula, cannulation should usually be done at an angle of - CORRECT ANSWER 25-35 a hemodialysis system includes blood volume monitoring to assess changes in the patients the hematocrit increases rapidly, this means - CORRECT ANSWER blood volume is decreased a patient has a newly created AV fistula. when assessing the fistula, the technician raises the patients involved arm above the head. in this position, the fistula should - CORRECT ANSWER collapse during cannulation, a tourniquet should be used - CORRECT ANSWER while placing needles in all AV fistula the difference between a buttonhole needle and a standard needle for hemodialysis is that the buttonhole needle has a - CORRECT ANSWER blunt tip if a hemodialysis patient has an extreme fear of needle and the physician describe EMLA cream to prevent pain, the cream must be applied - CORRECT ANSWER 60 minutes prior to treatment following formation of an AV fistula and beginning of hemodialysis, the technician notes that the patient's nailed and skin on the hand below the fistula are cyanotic during hemodialysis, and the patient complains of pain in the hand. this is likely an indication of - CORRECT ANSWER steal syndrome after a hemodialysis needle is removed at the end of treatment, the correct procedure is to apply pressure to - CORRECT ANSWER each access site with two fingers for up to 20 minutes a patient who wants to learn self-cannulation may do so if - CORRECT ANSWER the patient receives appropriate training thrombosis is newly-created access may be caused by - CORRECT ANSWER low blood pressure if a new patient has Hero (hemodialysis reliable outflow) graft, the cannulation site is generally in the - CORRECT ANSWER proximal upper arm (below the axilla). if effluent (used dialysate ) spills into the floor, the technician should - CORRECT ANSWER notify staff trained in hazardous waste removal a patient is recovering hemodialysis with 17-gauge needle, but his blood flow rate has been increased to 450ml/min. the patient complains of symptoms consisten with hemodialysis ( breakdown of red blood cells) sudden onset of chest tightness, back pain, dyspnea, reddening ok skin color, and blood in the venous line appearing port-wine in color. what is likely cause of this complication? - CORRECT ANSWER needle too small for blood flow rate when handing off a patient to another staff person, the technician should always - CORRECT ANSWER follow the hand-off protocol established by the institution the technician should ensure when exposing the opening of a central catheter to air (such as when removing the cap or a syringe) that the - CORRECT ANSWER clamp is closed the hemodialysis center has instituted a "zero lift" policy. the primary purpose of such a policy is to - CORRECT ANSWER prevent injuries if the dialysis center has an extra hemodialysis machine that has not been used in the previous 2 weeks, how frequently does this machine need to be disinfected? - CORRECT ANSWER every 48 hours five minutes after a patient begins a hemodialysis treatment, the patient has difficulty breathing and rapidly develops generalized hives, itching and swelling about the eyes. after asking the nurse for help, the next action should be to. - CORRECT ANSWER stop the dialysis and clamps all the lines a patient routinely experiences hypotensive episodes near the end of a session and experiences malaise (tiredness), muscle cramps, and dizziness after dialysis. what is the most likely cause? - CORRECT ANSWER the dry weight is set too high an adolescent patient has required frequent hospitalization because of nonadherece to be the treatment plan. the best approach to take with the patient is to - CORRECT ANSWER ask the patient how the staff can help the patient manage better. when the first carbon tank ( the worker) in the water system is exhausted, the next step is to - CORRECT ANSWER remove the first tank, move the second tank to first position, and add a new tank in second position. following dialysis, the patient's blood pressure in semi-reclining position is 128/86. the technician takes a series of blood pressure over 3 minutes after the patient stands. at which blood pressure should the technician alert the nurse that the patient is exhibiting orthotic hypotension? - CORRECT ANSWER 108/74 the technician is able to feel no pulse or thrill along the patient's outflow vein and can detect no bruit. the technician should suspect - CORRECT ANSWER thrombosis if a dialysis patient is very large in both stature and weight, which of the following is most likely to improve the effectiveness of hemodialysis - CORRECT ANSWER increase dialyzer size the duties that the technician is allowed to carry out depend primarily on the __________ - CORRECT ANSWER state regulations/standards of practice if a dialysis center carries out dialyzer reprocessing and uses peracetic acid as the germicide, the contact time needed is _______ - CORRECT ANSWER 11 hours if a dialysis center uses electronic charting, the technician may share his/ her password with__________ - CORRECT ANSWER no one when creating a buttonhole tract, how many consecutive cannulations are usually required before the tract is adequately formed? - CORRECT ANSWER 8 to 10 if a patient complains of persistent itching, which of the following nonprescription methods may help relieve symptoms? - CORRECT ANSWER take oatmeal baths when testing water for the level of chloramine, the technician finds that the total chlorine levels is 1.1 parts per million (ppm) and the free chlorine is 0.9 ppm. therefore, the chloramine levels is - CORRECT ANSWER 0.2 ppm patient receiving hemodialysis should be advised to avoid salt substitutes because the substitutes often - CORRECT ANSWER contain potassium patients with uremia develop foamy or bubbly urine because _____________ - CORRECT ANSWER proteins leaks into the urine which of the following is a function of the end-stage Renal Disease Networks? - CORRECT ANSWER help resolve patient-staff conflicts when using a slide board to transfer a patient from the dialysis chair to a wheelchair, at what time angle should the slide board be placed between the two sitting surfaces? - CORRECT ANSWER 45- degrees when the technician is teaching a patient to self-cannulate using the tandem-hand technique the - CORRECT ANSWER patient places the thumb and finger behind the technician's thumb and finger. a patient has a right internal jagular central venous catheter for hemodialysis, but a pressure alarm sounds during treatment indicating that the blood flow rate is lower than prescribed. on checking, the technician finds that the lines appear clear and there are no signs of kinking, bleeding or air entering the system. the next intervention should be to _____________. - CORRECT ANSWER lower the patient's head and ask the patient to cough. the PDCA cycle used for continuous quality improvement refers to __________. - CORRECT ANSWER the plan- do- check -act substances that form ions (changed particles) are_____. - CORRECT ANSWER electrolytes which members of the dialysis center team are responsible for carrying out the quality assessment and performance improvement program at a dialysis center? - CORRECT ANSWER all staff a new female patient is admitted to the dialysis center in the company of a male who appears to be her spouse. if the patient's chart lists her name a mary Jo Johson, how should the patient be addressed? - CORRECT ANSWER ask the patient infections in buttonholes tracts are almost always caused by ____________ - CORRECT ANSWER improper scab removal what percentage of the water that is filtered out of the blood by the glomeruli is excreted as urine? - CORRECT ANSWER 1% which of the following hormones directs the bone to produce more red blood cells? - CORRECT ANSWER erythropoietin to reinforce teaching, the technician should remind patients with kidney failure that they should avoid. - CORRECT ANSWER smoking which of the following is a genetic (inherited ) disease that can lead to kidney failure? - CORRECT ANSWER polycystic kidney disease with uremia, as waste products build up in the blood, this can result in - CORRECT ANSWER ammonia breath the aluminum level in dialysis water should be _______. - CORRECT ANSWER < 0.01 mg/L normal saline has a sodium,m chloride concentration of - CORRECT ANSWER 0.9 % as part of anemia management for patients receiving hemodialysis, the technician should_________. - CORRECT ANSWER rinse back as much blood as possible patients receiving hemodialysis are at risk for amyloidosis. which of the following symptoms may indicate amyloidosis? - CORRECT ANSWER joint pain a patient who experiences numbness, tremors, muscle spasms, and muscle pain may have low levels of _______________-. - CORRECT ANSWER calcium which of the following laboratory tests is often done before and after hemodialysis to measure the effectiveness the dialysis in removing waste products from the body? - CORRECT ANSWER blood urea nitrogen a patient beginning hemodialysis usually has a hemoglobin test every ______________. - CORRECT ANSWER one to two weeks the most common treatment for patients with end-stage kidney disease in the united states is_______ - CORRECT ANSWER daytime in-center hemodialysis. which of the following is an indication that a patient may be losing fat and/ or muscle mass even through he or she reaches the target dry weight after treatment? - CORRECT ANSWER patient become short of breath if lying flat after treatment which member of the hemodialysis care team is responsible for setting up the plan of care for a patient? - CORRECT ANSWER nephrology if a patient coms for hemodialysis treatment but weighs less than the target dry weight before treatment, the technician should___________ - CORRECT ANSWER notify the nurse and dietitian the first step in treating malnutrition in a dialysis patients is usually to_________ - CORRECT ANSWER encourage the patient to eat more. one-half teaspoon of salt is equal to about how many milligrams of sodium? - CORRECT ANSWER 1000mg. because of increasing phosphorus levels, a patient has been prescribed a phosphate binder, but the patient is unsure when to take the medication. the best advice is to take the medication____________. - CORRECT ANSWER with meals if patient is concerned about loss of income because of the need for hemodialysis, the best person to speak to the patient about concern is the. - CORRECT ANSWER social worker when using active listening, which of the following is a good example of sort, ope-end question to use to encourage patient communication? - CORRECT ANSWER what does the pain in your abdomen feel like? if a patient has refused to participate in eduction, ask no questions, and shows no interest in learning about hemodialysis, the best approach for the technician is to __________. - CORRECT ANSWER talk through all the steps in the procedures diffusion is a process that involves ________ - CORRECT ANSWER movement of solutes though a semipermeable membrane from an area of higher a dialysis machine is set up to use 36.1x parts dialysate. if the concentrate proportioning ratio calls for 1.00 part acid and 1.10 parts bicarbonate, how many parts of water are needed? - CORRECT ANSWER 36.1 about what percentage of body water is in the intravascular space (inside blood vessels)? - CORRECT ANSWER 10% the mass transfer coefficient of a dialyzer refers to ___ - CORRECT ANSWER how well solutes pass through the dialyzer membrane when using an alcohol-based hand rub, the hand rub should be applied to one palm and the hands rubbed together________. - CORRECT ANSWER until dry the three process that affect dialyzer clearance are (1) diffusion, (2) convection, and (3)__________. - CORRECT ANSWER adsorption if a dialyzer has a sieving coefficient of 0.6 for a solute, what percentage of the solute should pass through the membrane? - CORRECT ANSWER 60% most dialyzer membrane used today are made of - CORRECT ANSWER synthetic if a dialyzer has urea clearance rate of 200 ml/min and a blood flow rate of 400 ml/ min, what percentage of the 400 ml of blood is cleared of urea in one minute? - CORRECT ANSWER 50% the storage time for a reprocessed dialyzer is ________ - CORRECT ANSWER set by the manufacturer if a low-conductivity alarm sounds, the technician should suspect- - CORRECT ANSWER lack of concentration in the proportioning system. if the blood leak alarm sounds during a hemodialysis treatment and the blood pump stops and lines clamp but the dialysate appears clear, the technician should_____________. - CORRECT ANSWER use hemastix to check the extent of the leak when using a portable ph monitor to verify that an in-line monitor reading is correct, the technician should first______________. - CORRECT ANSWER test a solution with a known ph if a solution has an equal number of acid and base ions is neutral, the ph is ____________. - CORRECT ANSWER 7.0 a volumetric ultrafiltration control system has _________. - CORRECT ANSWER two identical dialysate chamber the extracorporeal circuit carries blood - CORRECT ANSWER from arterial access to dialyzer and back to the venous access a drip chamber that contains a fine mesh screen should be placed ___________. - CORRECT ANSWER between the the dialyzer and the venous access if a low-pressure alarm for arterial pressure (prep ump) sounds during dialysis, this could indicate - CORRECT ANSWER infiltration of the arterial needle if a high-pressure alarm for the predialyzer (post pump ) sounds during dialysis, this could indicate____________. - CORRECT ANSWER clotted dialyzer the lifespan of an arteriovenous graft is usually _______. - CORRECT ANSWER 3 to 5 years the heart must work harder when patients have an arteriovenous fistula because the - CORRECT ANSWER blood flow is faster the technician should alert the nurse that the patient is experiencing tachycardia (rapid pulse) when the pulse exceeds - CORRECT ANSWER 100 a patient has opted to have a buttonhole tracts for hemodialysis. which of the following the most important factor for creation of a buttonhole tract? - CORRECT ANSWER the same cannulator should do treatments until the tunnel is established when a patient is utilizing home hemodialysis, the purpose of teaching the patient to "snap and tap" the tubing and filter is to _______________. - CORRECT ANSWER remove air bubbles an 85-year-old patient with end-stage kidney disease and multiple health problems has started hemodialysis, but the patient is now refusing treatment, stating that death is preference to the loss of independence and continued illness. the technician should ___________. - CORRECT ANSWER respect the patient's decision after a patient receives the initial heparin bolus for hemodialysis, when should dialysis be initiated? - CORRECT ANSWER within three to five minutes. which of the following signs and symptoms are indications of infection of an arteriovenous fistula or graft? - CORRECT ANSWER redness, tenderness, and swelling if the patients feels unsure about cannulation a patient's fistula because or irregular vessel shapes, the best solution is to__________. - CORRECT ANSWER ask a more experience staff member to cannulate which of the flowing needle sizes has the largest lumen (diameter )? - CORRECT ANSWER 14 gauge retrograde (against the blood flow) insertion of arterial dialysis needle can result in______________. - CORRECT ANSWER increasing scarring the best method to secure a dialysis needle is probably ________. - CORRECT ANSWER butterfly technique. when removing an access needle at the complication of hemodialysis, the technician completely removes the needle before applying pressure. this technique ________. - CORRECT ANSWER is the incorrect procedure if a patient is terrified of needle and often feels faint and nauseated during cannulation, the best position to place the patient in during cannulation is __________. - CORRECT ANSWER flat if the blood in the arterial line looks very dark( black blood syndrome ''), the likely cause is - CORRECT ANSWER recirculation the best method to prevent aneurysm in a fistula is to______. - CORRECT ANSWER use proper technique when inserting needles if air detector alarm sounds, the blood pump stop, and the venous line clamp, but the technician notes air in the venous line and is concerned that some air may have entered the patient's vein, the technician should immediately_____________. - CORRECT ANSWER place the patient in the trendelenburg position (head below heart ) on the left side. the heparin infusion line should generally be place - CORRECT ANSWER in the arterial line between the blood pump and the dialyzer. if the power goes out during a treatment, the blood in the bloodlines is ____________. - CORRECT ANSWER returned by hand cranking the blood pump if a technician notes a high-pitched bruit, a ''water-hammer'' (pounding ) pulse, and evidence of clotting in the extracorporeal circuit during hemodialysis, the technician should suspect__________. - CORRECT ANSWER stenosis if the skin above an arteriovenous graft appears taut and shiny, and previous needle sites are unhealed, the technician should alert the nurse to possible__________ - CORRECT ANSWER pseudoaneurysm if the rate of blood flow is low, this increases the risk of__________. - CORRECT ANSWER dialysate is made by mixing water with acid and bicarbonate concentrates. Acid concentrate contains ____________. - CORRECT ANSWER when a patient's arteriovenous graft has healed and is ready for the first cannulation, what needle size is usually indicated? - CORRECT ANSWER when placing needles in an arteriovenous graft, how far away from the previous needle sites should cannulation be done? - CORRECT ANSWER the most common site for development of stenosis in an arteriovenous graft is at ______. - CORRECT ANSWER which of the following sites for a central venous catheter may prevent future venous access in the limb on the same side? - CORRECT ANSWER the preferred solution to clean exit sites for central venous catheter is _________ - CORRECT ANSWER what length of needle is usually needed for a forearm arteriovenous (AV) fistula? - CORRECT ANSWER 0.6 inch ( 3/5 inch). when drawing blood sample from the injection port of the arterial bloodline, the personal protective equipment that the technician should wear is _______. - CORRECT ANSWER gloves, facemark, eye protection, and gown the first step in teaching a patient to self-cannulate is to tell the patient about _______________. - CORRECT ANSWER how the patient's graft/ fistula woks when using "touch cannulation" to cannulate a buttonhole tract the cannulator. ______________. - CORRECT ANSWER holds the tubing 1 to 2 cm behind the needle when you taking a manual blood pressure reading on a patient's nonaccess arm, the blood pressure should be checked._____________ - CORRECT ANSWER at the heart level if an item, such as a piece of equipment, s considered " clean ", this means it is _____________. - CORRECT ANSWER disinfected but not free from all germs when hanging a new bag of normal saline, the technician touches the spike to the outside of the of the bag. the technician must____________. - CORRECT ANSWER discard the spike and attached tubbing how frequently should patients and staff members of a dialysis center have tuberculosis skin tests? - CORRECT ANSWER once a year if a patient has completed a dialysis session and is walking toward the door with the technician but becomes unsteady and beings to fall, the first thing the technician should do is to _____. - CORRECT ANSWER ease the patient to the floor the first thing to do when using a portable lift device, such as hayer lift, to transfer an obese patient is to _______________. - CORRECT ANSWER check the lift's weight limit and sling size. a small fire begins in water receptacle, and the technician uses a fire extinguisher to put out the flames. if using the P.A.S.S. protocol, the technician should____________. - CORRECT ANSWER pull the pin, aim the nozzle, squeeze the handle, and spray from side to side when using reprocessed dialyzerr for treatment, the first thing that the technician should check the dialyzer for is the ___________. - CORRECT ANSWER remove air and germicide when setting up hemodialysis equipment with a reprocessed dialyzer before a treatment, the primary purpose of priming the bloodline and dialyzer with normal saline is tp _______________. - CORRECT ANSWER patient's name which of the following signs or symptoms may indicate that a patient is below dry weight following a hemodialysis treatment? - CORRECT ANSWER low blood pressure a radial pulse is accessed at the - CORRECT ANSWER wrist (thumb side) in modern dialysis machines, in order to start a treatment, the technician must enter into the machine the __________. - CORRECT ANSWER total number of milliliters to be withdrawn and the duration of treatment if a patient develops hypotension (low blood pressure) during a hemodialysis treatment, and the technician finds that the patient has developed rapid and irregular heartbeat, then the technician should notify the nurse and____________. - CORRECT ANSWER decrease the ultrafiltration rate a patient is nearing the end of the treatment and complains of headaches and nausea and appears very restless and anxious. the technician checks the vital signs and finds that the blood pressure is 180/100, and the pulse is 72 and is slightly irregular. the technician should suspect__________. - CORRECT ANSWER disequilibrium syndrome then permeability of a dialyzer membrane to wear is indicated by its __________. - CORRECT ANSWER ultrafiltration coefficient if a patient requires a blood draw for laboratory test before a hemodialysis treatment, and the laboratory has provided four vacuum tubes for the blood sample, then the technician should _______________. - CORRECT ANSWER check the order of the draw if a patient is not to receive a saline prime at the beginning of the hemodialysis treatment, and the saline prime is drained into a waste container on the side of the dialysis machine, then the technician must connect the venous line to the access when blood reaches the __________. - CORRECT ANSWER venous chamber if a patient develops a nosebleed during a hemodialysis treatment, this could indicate that the______. - CORRECT ANSWER heparin dosage is too high a patient undergoing hemodialysis for the first time does well initially, but at 15 minutes into the treatment, she begins to complain of back pain, itching, slight shortness of breath, and nausea. the most likely cause of these signs and symptoms is _________. - CORRECT ANSWER first-use syndrome the best method to prevent leg cramps during hemodialysis is to - CORRECT ANSWER correctly calculate the target ultrafiltration goal after a blood sample is collected into a blood tube, the technician should______________ - CORRECT ANSWER gently invert the tube back and forth about eight times if the dialysate is too warm, it can result in________ - CORRECT ANSWER hemodialysis after ringing and cleaning a dialyzer that is to be reprocessed, the performance test or tests that must be performed are____________. - CORRECT ANSWER total cell volume test and test leak test if the water pressure downstream of a multimedia filter in the water system is decreased, this indicates a need to ______________ - CORRECT ANSWER backwash te filter if a dialyzer is to be reprocessed at the completion of a dialysis treatment, the dialyzer should be __________ - CORRECT ANSWER flushed with normal saline if the water distribution system uses an indirect feed system, the speed of the water flow through the distribution system should be ___________________ - CORRECT ANSWER 3 feet per second how often should colony counts and limulus amebocyte lysate tests be conducted on the water feeding the bicarbonate mixer? - CORRECT ANSWER monthly heparin B is spread through _____________. - CORRECT ANSWER contact with blood or body fluids if testing a water sample for bacteria, the sample should be reprocessed at room temperature within. - CORRECT ANSWER 1 to 2 hours if there patients having dialysis at the same time in a center that uses a central dialysate delivery system complain of sudden onset of nausea, the technician should suspect a problem with the ___________. - CORRECT ANSWER water system one fluid ounce is equal to ____________. - CORRECT ANSWER 30 ml. a patient and his and his spouse are undergoing training for in-home hemodialysis, but the patient tells the technician, '' I ' m so nervous. what happens if I can't learn to do this? the best response is ________. - CORRECT ANSWER you will only do in-home dialysis when you feel ready.'' in the estrecorporeal circuit, the highest positive pressure is found at the - CORRECT ANSWER arterial header of the dialyzer. if testing before a hemodialysis treatment shows that the patient's blood level of potassium is too low, the level of potassium in the dialysate is usually ____________ - CORRECT ANSWER increased the factor that has the most influence on a dialysis patients's level of thirst between treatments is _______. - CORRECT ANSWER salt intake the purpose of using a water softener in the water distribution system is to _______________ - CORRECT ANSWER reduce levels of calcium and magnesium patients receiving high-flux dialysis may have _________. - CORRECT ANSWER shorter treatment times. if a patient becomes nauseated and vomits during hemodialysis, the initial intervention should _________. - CORRECT ANSWER assesss for hypotension a HERO graft is indicated for ______________. - CORRECT ANSWER patient with stenosis/blockage of central veins leading to the heart. water is removed from a patient's blood during hemodialysis by _______________-. - CORRECT ANSWER osmosis the fluid velocity (speed ) of blood through tubbing is based on flow rate and - CORRECT ANSWER tube diameter when a dialysis treatment starts, the first point of restriction is the ____________. - CORRECT ANSWER needle if there is a kink in the venous bloodline between the venous pressure gauge and the venous access, what type of alarm should sound? - CORRECT ANSWER high venous pressure alarm in an arteriovenous fistula, the venous portion enlarges because of the _______________. - CORRECT ANSWER high-pressure flow of blood from an artery if an arterial venous fistula, is referred to as autogenous, this means that fistula _____________. - CORRECT ANSWER is made from the person's own blood vessels brachiocephalic arteriovenous fistula is located in the ________. - CORRECT ANSWER upper arm if using ethyl chloride spray on an access site to reduce discomfort, ________ - CORRECT ANSWER the patient should not feel the needle at all signs and symptoms of steal syndrome indicate _______. - CORRECT ANSWER the hand on side of access feel cold and painful if the technician is unable to feel a pulse or thrill or to hear a bruit in the outflow vein of an arteriovenous fistula, this may indicate___________. - CORRECT ANSWER thrombosis when preparing to administer hemodialysis through a central venous catheter, the technician is unable to flush the catheter with normal saline because of resistance. the technician should. ______________. - CORRECT ANSWER hold the treatment and notify the nurse which of the following kinds of dialysis needles can be used without a safety device to prevent needle stick injuries? - CORRECT ANSWER buttonhole needles which of the following is an extracorporeal alarm rather than a dialysate alarm? - CORRECT ANSWER air detector a normal respiration rate for most adults is ____________. - CORRECT ANSWER 12 to 16 per minutes when a patient is undergoing hemodialysis, all technical systems should be monitored at least__________ - CORRECT ANSWER every 30 minutes after the onset of hemodialysis, an anaphylactic reaction usually occurs within ______________. - CORRECT ANSWER 5 to 10 minutes if a reprocessed dialyzer has been accidentally exposed to two germicides, the dialyzer _________. - CORRECT ANSWER must be discard the most common site for placement of a straight graft is the ____________. - CORRECT ANSWER forearm which of the following is in indication of a pyrogenic reaction to hemodialysis? - CORRECT ANSWER development of chills and fever 45 minutes into treatment if a high-pressure alarm for venous pressure sounds during hemodialysis, this could indicate_______________. - CORRECT ANSWER infiltration of the venous needle