DaVita Kidney Care
2 LANIF · TCP
DV Patient Care Technician (PCT) Final Examination — Part 2
★ ★
EST. 1999
B U I L D I N G T H E G R E AT E S T H E A LT H C A R E C O M M U N I T Y
DaVita PCT Final Examination — Extended Review
M E D I C AT I O N S , VA S CU L A R ACC E SS , W AT E R , E M E R G E N CY, PAT I E N T C A R E &
T RA N S P L A N T
INSTITUTION DaVita Kidney Care PROGRAM Patient Care Technician (PCT)
Training
EXAM PCT Final Examination — Part 2 ACADEMIC YEAR
EXAM TYPE Extended Review — Verified TOTAL QUESTIONS 138 Questions
Answers
CONTENT AREAS Medications, Access, Water, FORMAT Multiple Choice — Select the
Emergency, Education, Single Best Answer
Transplant
EXAMINATION INSTRUCTIONS
▸ Select the single best answer for each question.
▸ Topics: Medication administration, vascular access, water treatment, emergency procedures, patient
education, transplant, and quality improvement.
▸ All content derived from DaVita PCT training curriculum and policy/procedure guidelines.
▸ Correct answers and detailed rationales appear below each question.
SECTION I — DAVITA PCT FINAL EXAMINATION —
Questions 1 – 138
EXTENDED REVIEW
,1. If the patient's condition requires a decrease in intravascular volume loss to treat
complications such as hypotension, cramps, or nausea and vomiting, what should be
done with the ultrafiltration rate (UFR)?
A. Increase the UFR to remove fluid faster
B. Decrease the UFR or turn it off until the patient recovers
C. Continue at the same rate and administer pain medication
D. Stop the dialysis treatment completely
CORRECT ANSWER B — Decrease the UFR or turn it off until the patient recovers
RATIONALE When a patient experiences intradialytic complications (hypotension, cramps,
nausea/vomiting) related to excessive fluid removal, the UFR should be
DECREASED or turned OFF temporarily until the patient recovers. Continuing
aggressive ultrafiltration worsens hypovolemia and can cause organ stunning.
2. What condition during treatment can cause suboptimal blood and oxygen delivery to
organs, known as "organ stunning" and can cause irreversible organ damage?
A. Hypertension
B. Hypotension
C. Hyperglycemia
D. Dialysate temperature elevation
CORRECT ANSWER B — Hypotension
RATIONALE Intradialytic hypotension causes inadequate perfusion to vital organs (heart,
brain, kidneys), leading to ischemic injury known as "organ stunning." Repeated
episodes can cause irreversible organ damage, particularly myocardial stunning.
,3. If the heart rate is too slow, too fast, or the rhythm is irregular, what should the PCT do?
A. Ignore it if the patient reports feeling fine
B. Count the apical pulse to confirm the rate and rhythm
C. Increase the blood flow rate to compensate
D. Stop treatment immediately without assessment
CORRECT ANSWER B — Count the apical pulse to confirm the rate and rhythm
RATIONALE When the radial pulse is irregular or the rate is abnormal, auscultate the APICAL
pulse for a full 60 seconds for the most accurate heart rate. Peripheral pulses may
not reflect every heartbeat in arrhythmias.
4. A healthy person will respond to hypovolemia with what compensatory mechanism?
A. Decrease in pulse rate and cardiac output
B. Increase in pulse rate leading to increased cardiac output and improved blood pressure
C. No change in pulse or cardiac output
D. Decrease in respiratory rate only
CORRECT ANSWER B — Increase in pulse rate leading to increased cardiac output and
improved blood pressure
RATIONALE The body's normal compensatory response to hypovolemia is tachycardia to
maintain cardiac output and blood pressure. Dialysis patients may have blunted
compensatory responses due to autonomic neuropathy or medications.
, 5. A 17-gauge needle is recommended for what blood flow range and maximum arterial
pressure?
A. 350-450 mL/min, AP no more than -220 mmHg
B. 200-250 mL/min, AP no more than -150 mmHg
C. 250-350 mL/min, AP no more than -200 mmHg
D. Greater than 450 mL/min, AP no more than -260 mmHg
CORRECT ANSWER B — 200-250 mL/min, AP no more than -150 mmHg
RATIONALE 17G → 200–250 mL/min (AP ≤−150 mmHg), 16G → 250–350 (AP ≤−200), 15G →
350–450 (AP ≤−220), 14G → >450 (AP ≤−260). Using too small a gauge creates
excessive negative pressure causing hemolysis.
6. A newly created arteriovenous fistula will require what needle considerations?
A. Larger needle size and higher BFR
B. Smaller needle size and lower BFR
C. Same needle size as a mature AVF
D. Only CVC access until maturation
CORRECT ANSWER B — Smaller needle size and lower BFR
RATIONALE A newly created AV fistula requires smaller gauge needles and lower BFRs to
protect the fragile vessel walls that have not yet matured (arterialized). Premature
cannulation with large needles can cause infiltration.
2 LANIF · TCP
DV Patient Care Technician (PCT) Final Examination — Part 2
★ ★
EST. 1999
B U I L D I N G T H E G R E AT E S T H E A LT H C A R E C O M M U N I T Y
DaVita PCT Final Examination — Extended Review
M E D I C AT I O N S , VA S CU L A R ACC E SS , W AT E R , E M E R G E N CY, PAT I E N T C A R E &
T RA N S P L A N T
INSTITUTION DaVita Kidney Care PROGRAM Patient Care Technician (PCT)
Training
EXAM PCT Final Examination — Part 2 ACADEMIC YEAR
EXAM TYPE Extended Review — Verified TOTAL QUESTIONS 138 Questions
Answers
CONTENT AREAS Medications, Access, Water, FORMAT Multiple Choice — Select the
Emergency, Education, Single Best Answer
Transplant
EXAMINATION INSTRUCTIONS
▸ Select the single best answer for each question.
▸ Topics: Medication administration, vascular access, water treatment, emergency procedures, patient
education, transplant, and quality improvement.
▸ All content derived from DaVita PCT training curriculum and policy/procedure guidelines.
▸ Correct answers and detailed rationales appear below each question.
SECTION I — DAVITA PCT FINAL EXAMINATION —
Questions 1 – 138
EXTENDED REVIEW
,1. If the patient's condition requires a decrease in intravascular volume loss to treat
complications such as hypotension, cramps, or nausea and vomiting, what should be
done with the ultrafiltration rate (UFR)?
A. Increase the UFR to remove fluid faster
B. Decrease the UFR or turn it off until the patient recovers
C. Continue at the same rate and administer pain medication
D. Stop the dialysis treatment completely
CORRECT ANSWER B — Decrease the UFR or turn it off until the patient recovers
RATIONALE When a patient experiences intradialytic complications (hypotension, cramps,
nausea/vomiting) related to excessive fluid removal, the UFR should be
DECREASED or turned OFF temporarily until the patient recovers. Continuing
aggressive ultrafiltration worsens hypovolemia and can cause organ stunning.
2. What condition during treatment can cause suboptimal blood and oxygen delivery to
organs, known as "organ stunning" and can cause irreversible organ damage?
A. Hypertension
B. Hypotension
C. Hyperglycemia
D. Dialysate temperature elevation
CORRECT ANSWER B — Hypotension
RATIONALE Intradialytic hypotension causes inadequate perfusion to vital organs (heart,
brain, kidneys), leading to ischemic injury known as "organ stunning." Repeated
episodes can cause irreversible organ damage, particularly myocardial stunning.
,3. If the heart rate is too slow, too fast, or the rhythm is irregular, what should the PCT do?
A. Ignore it if the patient reports feeling fine
B. Count the apical pulse to confirm the rate and rhythm
C. Increase the blood flow rate to compensate
D. Stop treatment immediately without assessment
CORRECT ANSWER B — Count the apical pulse to confirm the rate and rhythm
RATIONALE When the radial pulse is irregular or the rate is abnormal, auscultate the APICAL
pulse for a full 60 seconds for the most accurate heart rate. Peripheral pulses may
not reflect every heartbeat in arrhythmias.
4. A healthy person will respond to hypovolemia with what compensatory mechanism?
A. Decrease in pulse rate and cardiac output
B. Increase in pulse rate leading to increased cardiac output and improved blood pressure
C. No change in pulse or cardiac output
D. Decrease in respiratory rate only
CORRECT ANSWER B — Increase in pulse rate leading to increased cardiac output and
improved blood pressure
RATIONALE The body's normal compensatory response to hypovolemia is tachycardia to
maintain cardiac output and blood pressure. Dialysis patients may have blunted
compensatory responses due to autonomic neuropathy or medications.
, 5. A 17-gauge needle is recommended for what blood flow range and maximum arterial
pressure?
A. 350-450 mL/min, AP no more than -220 mmHg
B. 200-250 mL/min, AP no more than -150 mmHg
C. 250-350 mL/min, AP no more than -200 mmHg
D. Greater than 450 mL/min, AP no more than -260 mmHg
CORRECT ANSWER B — 200-250 mL/min, AP no more than -150 mmHg
RATIONALE 17G → 200–250 mL/min (AP ≤−150 mmHg), 16G → 250–350 (AP ≤−200), 15G →
350–450 (AP ≤−220), 14G → >450 (AP ≤−260). Using too small a gauge creates
excessive negative pressure causing hemolysis.
6. A newly created arteriovenous fistula will require what needle considerations?
A. Larger needle size and higher BFR
B. Smaller needle size and lower BFR
C. Same needle size as a mature AVF
D. Only CVC access until maturation
CORRECT ANSWER B — Smaller needle size and lower BFR
RATIONALE A newly created AV fistula requires smaller gauge needles and lower BFRs to
protect the fragile vessel walls that have not yet matured (arterialized). Premature
cannulation with large needles can cause infiltration.
