COMPLETE SOLUTION
jYou have been asked by the charge nurse to cannulate the new AV fistula of a patient, but the patient
comes into treatment 15 min late and it's time to take your break. Can you ask a fellow PCT to cannulate
the patient? - No. A task delegated by the licensed nurse to a non-licensed teammate cannot be
redelegated by this teammate.
Poor or incomplete documentation: - will open an attack on your care in the event of an adverse patient
outcome.
What is the purpose of professional boundaries? - They keep the relationship between you and your
patient appropriate and safe.
Discussing personal problems with your patients: - is considered unprofessional behavior.
Attempting to remove a large amount of fluid weight gain from the patient: - can lead to hypovolemia
during the treatment which is associated with an increased mortality rate.
When sodium loading occurs during the dialysis treatment: - It leads to an increase in thirst and larger
fluid weight gains with hypertension between treatments and can contribute to headaches after the
treatment.
During data collection, a patient mentions her bowel movements have been looking quite dark the last
two days and asks if this could be caused by something she ate. You: - inform the nurse to assess the
patient prior to treatment initiation.
How long prior to initiating the hemodialysis treatment should the initial loading dose of heparin be
administered through the venous fistula needle or venous port of the central venous catheter (CVC) to
anticoagulated the patient? - At least 3 to 5 minutes prior to treatment initiation.
Are patients allowed to take over the counter medications? - They do not require a physician order but
should be approved by the nephrologist.
Prior to each medication preparation, the medication preparation surface should be disinfected with
what? - 1:100 Bleach solution or approved disinfectant
An opened multidose vial may be kept for how many days? - 28
What is NOT an acceptable assignment for a PCT working in a facility that cares for patients with
Hepatitis B infection (HBV+)? - Caring for HBV+ and susceptible patients at the same time
What is the standard on fingernails? - Fingernail length should not exceed more than 1/4 inch and
traditional nail polish that is not chipped may be worn.
, To make a 1:10 bleach solution for cleaning gross blood spills, you would combine: - 1 part bleach with 9
parts water
Cleaning blood pressure cuffs between patients: - Removes microorganisms such as MRSA or VRE that
may be colonized in a patient's axillary area.
Cleaning and disinfecting priming buckets after each treatment is needed for what reason? - It is
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? - No, because the surface can no longer allow for effective cleaning and provides a potential
for microbial growth.
Hand hygiene is required when gloves are removed: - Always, even gloved hands can become
contaminated through microscopic holes in the gloves.
Attention to infection control, proper hand hygiene, cleaning and disinfection procedures are of the
utmost importance in the dialysis setting. Why is this? - MRSA bacteria can survive on surfaces especially
plastic or vinyl for days.
What is the most common infectious complication in hemodialysis patients? - Vascular access infections
What is the single most important intervention in preventing healthcare associated infections (HAIs)? -
Hand hygiene
A patient's heart rate is irregular. Which method of taking her blood pressure will provide the most
accurate reading? - Taking manual blood pressure is more accurate.
During initial data collection, the PCT notices a patient has an irregular pulse. What action should she
take? - Report the irregular pulse to the nurse prior to initiating the treatment.
How does One determine if a blood pressure cuff is the right size for a patient? - When wrapping the cuff
around the patient's arm, verify the index mark is within the "OK range" markings.
A patient complains of shortness of breath. Her pre-dialysis weight is 4.7kg over the last post-treatment
weight. What action should the PCT take first? - Inform the nurse to assess the patient prior to treatment
initiation.
A patient comes for treatment after the long weekend and complains of having trouble moving, his legs
"feel paralyzed", and his heart rate is 37. These symptoms should be related to: - Elevated Serum
Potassium
A patient tells you she is drinking low-fat milk to "kill two birds with one stone": she gets the needed
protein and controls phosphorous at the same time. What would you tell her? - You tell her that the
phosphorous content is the same in regular and low-fat milk and refer her to the dietician to discuss
better food choices.
A patient is eating a piece of pizza during the last half-hour of his treatment. When you ask him if he
remembered to bring his phosphate binder, he tells you he'll be home soon enough to take the binder
then. What should you tell him? - You should explain the binders should be taken with a meal to be
effective.