DaVita Competency Exam
Attempting to remove a large amount of fluid weight gain from the patient: - ANSCan lead to
hypovolemia during the treatment which is associated with an increased mortality rate
When sodium loading occurs during the dialysis treatment: - ANSIt leads to an increase in
thirst and larger fluid weight gains with hypertension between treatments and can contribute
to headaches after the treatment
How long before initiating the hemodialysis treatment should the initial loading dose of
heparin be administered through the venous needle or venous port of the central venous
catheter (CVC) to anticoagulate the patient? - ANSA minimum of 3-5 minutes prior to
treatment initiation
Over-the-counter medications: - ANSDo not require a physician order but should be
approved by the nephrologist
Per DaVita policy, prior to each medication preparation, the medication preparation surface
area: - ANSIs to be disinfected with a 1:100 bleach solution or approved disinfectant
What is NOT an acceptable assignment for a PCT working in a facility that cares for patients
with Hepatitis B infection (HBV+)? - ANSCaring for HBV+ and susceptible patients at the
same time.
What is the policy regarding fingernails? - ANSFingernail length should not extend more than
1/4 inch and traditional nail polish that is not chipped may be worn
Cleaning blood pressure cuffs between patients: - ANSRemoves microorganisms such as
MRSA or VRE that may be colonized in a patient's axillary area
Cleaning and disinfecting priming buckets after each treatment: - ANSIs required to
decrease gram-negative bacterial growth which may occur in solutions such as water
The foot rest of a patient chair is torn and the inner foam is exposed. Can it still be used for
patient treatments? - ANSNo, because the torn surface no longer allows for effective
cleaning and provides a potential for microbial growth
Attention to infection control, proper hand hygiene, cleaning and disinfection procedures are
of utmost importance in the dialysis setting. Which of the following statement is true?
A) MRSA bacteria can survive on surfaces, especially plastic and vinyl, for days
B) Only items taken to a clean dialysis station prior to initiation of a patient treatment can be
returned to a common clean area without being disinfected
C) If a hemodialysis patient performs self-care at the facility, common supply carts used to
store clean supplies may be placed within the patient's reach
, D) Red disposal bags are to be closed with a tight "dog eared" knot to prevent leakage of
fluid from the bag - ANSMRSA bacteria can survive on surfaces. especially plastic and vinyl,
for days.
How do you determine if a blood pressure cuff is the right size for a patient? - ANSWhen
wrapping the cuff around the patient's arm, verify the index mark is within the "ok range"
markings
Mrs. Boomerstein pulls out a 2-cup size container with fresh strawberries during dialysis. As
she savors the first fruit, she smiles and tells you she can eat a lot more potassium during
dialysis because it won't harm her. What is your appropriate response? - ANSYou explain to
Mrs. Boomerstein that the potassium in food eaten during dialysis is not dialyzed off.
To prevent the formation of aneurysms and pseudoaneurysms, what should be practiced? -
ANSGood needle site rotation and complete needle site clotting techniques
The rope ladder cannulation method allows cannulation sites to heal and increases the
longevity of the access. How long does it take a cannulation site to heal? - ANS2 weeks
What is the primary reason the patient should be in a comfortable supine position when you
perform pre-dialysis CVC care? - ANSThe supine position increases pressure within central
veins and diminishes the risk of an air embolism
The nephrologist has ordered the use of hemostatic sponges, such as SureSeal, for your
patient. What is the correct procedure when using these sponges? - ANSRemove the
hemostatic sponge after hemostasis has been achieved and dress the needle sites with
sterile gauze or band-aid
Which statement is true regarding the flipping of needles?
A) Flipping needles may be necessary to improve arterial blood flow if the ordered BFR
cannot be achieved
B) Flipping needles is based on patient preference and will be performed if requested
C) When flipping needles, the sharp bevel of today's needles allows a clean entry into the AV
access with fewer risks of damage
D) Flipping the needle when fully threaded into the vessel risks cutting the graft or coring the
vein endothelium - ANSFlipping the needle when fully threaded into the vessel risks cutting
the graft or coring the vein endothelium
Your patient returned from a weeklong vacation and one hour into the treatment he
complains of a bad headache. His BP increased to 178/82, he is restless and asks for an
emesis basin. What is the likely cause of these symptoms? - ANSDialysis Disequilibrium
Syndrome
What is a classic sign of hemolysis? - ANSCranberry juice colored blood in the venous line
Your patient complains of pain at the venous needle site, tingling around the lips and
difficulty breathing. These are signs and symptoms of what? - ANSAn disinfectant infusion
Attempting to remove a large amount of fluid weight gain from the patient: - ANSCan lead to
hypovolemia during the treatment which is associated with an increased mortality rate
When sodium loading occurs during the dialysis treatment: - ANSIt leads to an increase in
thirst and larger fluid weight gains with hypertension between treatments and can contribute
to headaches after the treatment
How long before initiating the hemodialysis treatment should the initial loading dose of
heparin be administered through the venous needle or venous port of the central venous
catheter (CVC) to anticoagulate the patient? - ANSA minimum of 3-5 minutes prior to
treatment initiation
Over-the-counter medications: - ANSDo not require a physician order but should be
approved by the nephrologist
Per DaVita policy, prior to each medication preparation, the medication preparation surface
area: - ANSIs to be disinfected with a 1:100 bleach solution or approved disinfectant
What is NOT an acceptable assignment for a PCT working in a facility that cares for patients
with Hepatitis B infection (HBV+)? - ANSCaring for HBV+ and susceptible patients at the
same time.
What is the policy regarding fingernails? - ANSFingernail length should not extend more than
1/4 inch and traditional nail polish that is not chipped may be worn
Cleaning blood pressure cuffs between patients: - ANSRemoves microorganisms such as
MRSA or VRE that may be colonized in a patient's axillary area
Cleaning and disinfecting priming buckets after each treatment: - ANSIs required to
decrease gram-negative bacterial growth which may occur in solutions such as water
The foot rest of a patient chair is torn and the inner foam is exposed. Can it still be used for
patient treatments? - ANSNo, because the torn surface no longer allows for effective
cleaning and provides a potential for microbial growth
Attention to infection control, proper hand hygiene, cleaning and disinfection procedures are
of utmost importance in the dialysis setting. Which of the following statement is true?
A) MRSA bacteria can survive on surfaces, especially plastic and vinyl, for days
B) Only items taken to a clean dialysis station prior to initiation of a patient treatment can be
returned to a common clean area without being disinfected
C) If a hemodialysis patient performs self-care at the facility, common supply carts used to
store clean supplies may be placed within the patient's reach
, D) Red disposal bags are to be closed with a tight "dog eared" knot to prevent leakage of
fluid from the bag - ANSMRSA bacteria can survive on surfaces. especially plastic and vinyl,
for days.
How do you determine if a blood pressure cuff is the right size for a patient? - ANSWhen
wrapping the cuff around the patient's arm, verify the index mark is within the "ok range"
markings
Mrs. Boomerstein pulls out a 2-cup size container with fresh strawberries during dialysis. As
she savors the first fruit, she smiles and tells you she can eat a lot more potassium during
dialysis because it won't harm her. What is your appropriate response? - ANSYou explain to
Mrs. Boomerstein that the potassium in food eaten during dialysis is not dialyzed off.
To prevent the formation of aneurysms and pseudoaneurysms, what should be practiced? -
ANSGood needle site rotation and complete needle site clotting techniques
The rope ladder cannulation method allows cannulation sites to heal and increases the
longevity of the access. How long does it take a cannulation site to heal? - ANS2 weeks
What is the primary reason the patient should be in a comfortable supine position when you
perform pre-dialysis CVC care? - ANSThe supine position increases pressure within central
veins and diminishes the risk of an air embolism
The nephrologist has ordered the use of hemostatic sponges, such as SureSeal, for your
patient. What is the correct procedure when using these sponges? - ANSRemove the
hemostatic sponge after hemostasis has been achieved and dress the needle sites with
sterile gauze or band-aid
Which statement is true regarding the flipping of needles?
A) Flipping needles may be necessary to improve arterial blood flow if the ordered BFR
cannot be achieved
B) Flipping needles is based on patient preference and will be performed if requested
C) When flipping needles, the sharp bevel of today's needles allows a clean entry into the AV
access with fewer risks of damage
D) Flipping the needle when fully threaded into the vessel risks cutting the graft or coring the
vein endothelium - ANSFlipping the needle when fully threaded into the vessel risks cutting
the graft or coring the vein endothelium
Your patient returned from a weeklong vacation and one hour into the treatment he
complains of a bad headache. His BP increased to 178/82, he is restless and asks for an
emesis basin. What is the likely cause of these symptoms? - ANSDialysis Disequilibrium
Syndrome
What is a classic sign of hemolysis? - ANSCranberry juice colored blood in the venous line
Your patient complains of pain at the venous needle site, tingling around the lips and
difficulty breathing. These are signs and symptoms of what? - ANSAn disinfectant infusion
