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Davita practice ex2
Practice exam 2
| Question | Answer |
|---|---|
| During predialysis data collection, it would be best for the technician to ask the patient which of these questions? | How have you been since your last dialysis treatment? |
| A nephron is made up of: | A glomerulus and a tubule system |
| During hemodialysis a patient goes into cardiac arrest. The first action for the dialysis technician is | call for assistance |
| A patient complains of pain at the venous needle site. The dialysis technician observes there is rising. The dialysis technician should suspect | an infiltration |
| A female dialysis technician has been caring for a male patient for several months. The patient tells the dialysis technician that he is lonely and depressed. He asks the dialysis technician to go out to dinner with him. Decline next action should be? | Refer the patient to the social worker |
| A mixed-bed DI tank contains | Cations and anions |
| Dialysate pH should be: | between 6.9 and 7.6 |
| A reason why a dialysis technician is to be certified is: | It is a CMS requirement |
| A patient's target weight is 154.0 lbs (70kg) and the patient's pre treatment weight is 158.4 lb (72 kg). For a four-hour treatment, how many mL/hour must the patient lose to reach dry weight? | 500 |
| During the hemodialysis treatment, a patient complains of feeling chilled, In addition to getting the patient a blanket, which of the following of these actions should the technician take? | Take the patient's temperature |
| A patient's laboratory results indicate that the predialysis BUN level was lower than the post dialysis BUN level. When interpreting these findings the technician should seek the answer to which of these questions | was the post dialysis sample drawn correctly? |
| Abnormal levels of this electrolyte can cause cardiac arrhythmias and even death | Potassium |
| AAMI Chemical Analysis of water used for hemodialysis is tested | Annually |
| A dialysis technician observes a drop of blood on the surface of patient's hemodialysis machine. Which of these actions should the dialysis technician take? | Clean the machine surface immediately |
| Fifteen minutes before the end of a hemodialysis treatment, a patient complains of dizziness and nausea. These symptoms are most likely due to: | Hypotension |
| ESKD specific tests such as BUN, Creatinine, and URR are | Indicators of the adequacy of the renal replacement therapy |
| Excess fluid is forced out of the blood and into the dialysis during dialysis by which prinicple? | Ultrafiltration |
| Germicide rebound occurs due to: | Inadequate dialyzer priming |
| A marker used to determine the middle molecule clearance of a dialyzer is | vitamin B12 |
| A slow pulse of 54 beats/minute would indicate the patient has | Bradycardia |
| Before a hemodialysis treatment, the technician removes the cap from the fistula needle and accidentally touches the chair with the tip of the needle. Which of these actions should the technician take first? | Discard the needle |
| Acceptable interdialytic weight gains are | 3-5% of TW. |
| Feed conductivity minus product conductivity divided by feed conductivity X 100 is the formula for calculating | percent rejection |
| All of the following may be signs and symptoms of an infected access EXCEPT: | numbness and tingling |
| Fluid to be removed divided by the treatment time tells us | the ultrafiltration rate |
| During a hemodialysis treatment, a patient says to the technician, Three hours of time have passes according to the clock on the wall, but the machine shows that only 2.5 hours have passed. What could be the problem? The technician should understand that | machine was in bypass for 30 minutes |
| Decreasing the patient's prescribed blood flow rate affects the rate of | Diffusion |
| A patient tells the technician that the dietitian reviewed high-potassium foods with her. During the conversation she states she routinely eats the following foods. Which one is highest in potassium? | Bananas |
| During a hemodialysis treatment the technician responds to a low venous pressure alarm, The most likely cause of this alarm is: | Disconnection of the bloodline |
| A patient who is to receive their first dialysis treatment is prone to? | Dialysis disequilibrium syndrome |
| Asepsis is defined as | the absence of disease producing organisms |
| During a hemodialysis treatment, a patient's venous needle infiltrates. Which of these actions should the dialysis technician take first? | Stop the blood pump |
| All of the following are phosphate binders EXCEPT: | Vitamin B12 |
| A 58-year old patient who is blind comes to treatment accompanied by his wife. Which of these approaches should the dialysis technician use when interacting with the patient? | Describe the activities in the immediate environment |
| AAMI standard for conventional dialysate requires the total microbial count be less than | 100 CFU/mL |
| A rapid pulse of 104 beats/minute would indicate that the patient has: | tachycardia |
| Albumin is an important test that tells about the patient's _________ status. | nutritional |
| A teammate asks you to document the normal saline he just gave to Mr. Smith, you would: | never document something that someone else did |
| A true aneurysm can be dangerous because it | may rupture and cause the patient to bleed profusely |
| Biohazardous waste includes any material exposed to: | blood |
| A semipermeable membrane is a porous barrier that: | Allows only certain sized particles to cross |
| A fistula connects | an artery to a vein |
| Target weight is defined as the | weight at which the patient has no edema or fluid in the lungs and BP is normal |
| During the set-up of a hemodialysis machine, the alarm test for conductivity fails. Which of these actions should the dialysis technician take? | Notify the equipment technician |
| The AAMI standard for endotoxin levels in the conventional dialysate is | less than 0.50 EU/mL |
| A dialysis technician observes all of the below on the treatment floor, which one poses an environmental risk? | about one ounce (30ml) fluid is on the floor |
| During hemodialysis, the air detector on Ms. Foster's machine alarms and foam is visible in the venous drip chamber. The immediate action of the dialysis technician should be to: | Clamp the venous line |
| A rise in transmembrane pressure in a low flux dialyzer during hemodialysis is indicative of: | Clotting of the extracorporeal circuit |
| Dialysate that is too hot will cause | Hemolysis |
| All of the following are benefits of using a tourniquet when cannulating an arteriovenous fistula except: | Reduces risk of infection |
| One disadvantage of a fistula is an increase in | time to mature |
| Normal body pH is | 7.35 - 7.45 |
| The dialysis technician's role in patient education is to: | Reinforce educational information provided |
| The medication used to treat anemia is: | Epogen |
| If a patient develops an infection post transplant, the largest contributing factor would most likely be: | immunosuppressive medication |
| Short frequent hemodialysis treatments in patients with high BUN are performed to prevent: | Dialysis disequilibrium syndrome |
| Hives, itching, tightness of the chest and respiratory distress may be signs and symptoms of: | Anaphylaxis |
| Pain at the venous needle site, along with respiratory difficulty and chest pain could be an indicator of: | Sterilant infusion |
| The air detector alarms during treatment. If the machine is working properly, the dialysis technician should expect which of these events to have occurred? | Blood pump has stopped |
| A medication that dialyzes off easily is | Digoxin |
| The most important intervention to prevent the spread of infection is: | Performing hand hygiene |
| Mr. Roberts verbalizes how to hand crank his blood pump in the event of an emergency. This is an example of which adult principle? | Cognitive |
| The most important monitor in the dialysis setting is: | staff |
| Lidocaine is administered | intradermally |
| Sam's TW is 70kg. He arrives for treatment today at a weight of 70 kg. He complains of shortness of breath and you notice his ankles are swollen. You notify the charge nurse. What do you think will be the plan for Sam's treatment today? | the nurse will get an order to decrease the TW |
| Dialysate conductivity measures: | The total electrical charge of a solution |
| Infection control protocols for hemodialysis equipment should include which of these actions by the caregiver? | Using gloves when touching the machine |
| If the extracorporeal circuit clots and it must be discarded, it would be most important to monitor the patient's serum level of: | Hemoglobin |
| Solutions that have a higher osmolarity than body fluids are called? | Hypertonic |
| One reason that normal saline is used to prime and perform recirculation for the extracorporeal circuit prior to treatment is to remove: | Air |
| Symptoms of hyperkalemia may include | numbness and tingling |
| The medication used to improve calcium absorption is: | Zemplar |
| The functional unit of the kidney, or the structure in the kidney that does the work is the: | Nephron |
| The normal range of resting respirations in an adult is: | 12-20 breaths per minute |
| How do you know if a patient can safely disconnect themselves in an emergency | Let the patient show you after a treatment |
| The organization that has as a goal to improve the care and outcomes of all individuals with kidney disease is called: | KDOQI |
| Mrs. Pruitt's temperature is elevated post-hemodialysis treatment. Which of these actions should the dialysis technician take? | Notify the nurse |
| The National standard, based on the KDOQI guidelines, of the Urea Reduction Rate is a ratio greater than: | 65% |
| The movement of fluid from the tissues toward a higher concentration of sodium in the blood is an example of | Osmosis |
| One sign and symptom of fluid overload is | Hypertension |
| The extracorporeal circuit consists of the | blood lines and dialyzer |
| Hyperkalemia can lead to | Cardiac arrest |
| The accuracy of the lab results depends on adherence to proper lab draw technique. You must ensure that labs are drawn: | at the right time, right site, and right order |
| Mr. Jones demonstrates how to wash his access. This is an example of which adult learning principle? | Psychomotor |
| One cause of aneurysms and pseudoaneurysms is: | poor rotation of sites |
| The most important member of the patient care team is the: | patient |
| The leading cause of chronic kidney disease for adults in the United States: | Diabetes |
| Mr. Jones suffers from constipation. He goes to the drug store to buy a laxative. Mr. Jones should avoid which medication? | Milk of Magnesia |
| Name the two compartments of the dialyzer: | Blood and dialysate |
| Ms. Foster complains of shortness of breath. While calling for the nurse the dialysis technician notices there is air in the extracorporeal circuit she/he should place Ms. Foster in: | Trendelenburg position on the left side |
| Patient exposure to chloramines during the hemodialysis treatment may cause: | hemolysis |
| Low albumin levels in the dialysis patient have been linked with: | Higher hospitalization and death rates |
| Which statement is true about kidney transplantation? | There is a shortage of available kidney donors |
| The dextrose used in the dialysate for peritoneal dialysis can cause: | hyperglycemia |
| Dwell time in peritoneal dialysis is defined as: | The amount of time the peritoneal fluid remains in the abdomen |
| The bruit in an AV fistula or graft is detected by | Listening with a stethoscope |
| Prior to cannulation a technician notices the skin over the patient's fistula is reddened and warm to the touch. These symptoms are most likely due to: | an infection |
| Mrs. Smith arrives form dialysis treatment complaining of shortness of breath. Her pre-dialysis weight is 4.7 kg above the last post-treatment weight. The dialysis technician reweighed and verified the weight. Which of the actions should take next? | Notify the nurse of the need for an assessment |
| During dialyzer reprocessing, the blood compartment is tested to | Check dialyzer for total cell volume |
| Which of the following is the most accurate measure of dialysis adequacy? | Kt/V |
| To determine the patency of an arteriovenous vascular access, the dialysis technician should initially feel for the presence of | a thrill |
| Which of the following is NOT a symptom of uremia? | Elevated hematocrit |
| Which learning domain is behavioral based? | Cognitive domain |
| Which of the following symptoms would indicate a need to increase the target weight? | Hypotension and cramping |
| A decrease in transmembrane pressure in a high flux dialyzer during hemodialysis is indicative of: | clotting of the extracorporeal circuit |
| When cannulating, the tips of the needles should be at least | 1.5 inches apart |
| Which of the following is used to prevent air in the bloodlines? | Tighten all connections |
| Which component in dialysate is used to correct metabolic acidosis? | Bicarbonate |
| Which of the following might indicate a need to decrease the heparin dose? | The patient had surgery yesterday |
| The water softener | operates on the principle of ion exchange. |
| Which of the following might indicate the need to increase heparin? | Clotting in the extracorporeal circuit |
| The usual heparin sodium concentration for anticoagulation during hemodialysis is: | 1,000u/ml |
| The water softener removes | calcium and magnesium. |
| The reprocessed dialyzer is carefully rinsed prior to patient use to remove: | residual germicide |
| The total pressure that exists across the dialyzer membrane is called | transmembrane pressure. |
| Which of these technician activities contributes to data collection used to measure quality outcomes? | Ensuring accurate documentation |
| Ultrafiltration is influenced by | transmembrane pressure. |
| What is the most important activity that the dialysis technician can perform to prevent the spread of infectious disease in the dialysis clinic? | Hand hygiene |
| Which food below is highest in phosphorus? | Ice Cream |
| The purpose of using counter-current flow is to | increase the rate of waste removal. |
| Total chiorine levels in the water are tested | before each patient shift and every four hours. |
| What are the typical signs of fluid overload? | edema and shortness of breath |
| What lab tests are used to monitor anemia in the ESKD patient? | Hemoglobin/Hematocrit |
| You have documented incorrectly on a patient's chart. How do you correct this? | draw line through wrong entry, write error, initial/date entry |
| The usual fluid allowance for a person with kidney failure is | 3.0 to 3.5 liters per day. |
| The part of the cell wall of bacteria that, when released, can cause fever in hemodialysis patients is: | Endotoxin |
| A decrease in transmembrane pressure in a high flux dialyzer during hemodialysis is indicative of: | Venous needle malposition |
| Which of the following is most likely to cause a high venous pressure alarm? | Kinking of the venous blood line |
| Which of the following is a cause of hypotension during and after dialysis treatments? | Removing too much fluid |
| Your patient is to receive 2000 units of heparin. The vial you are using is 1000u/ml heparin. How many mis will you draw up for this patient? | 2.0 |
| Which of the following is NOT a possible cause of an increased temperature pre dialysis? | The patient has fluid overload |
| Which of the following is the classic sign of hemolysis? | Cranberry juice colored blood in the venous line |
| The venous needle in an AV fistula | Should be placed antegrade |
| Water moves across a membrane from an area of lower solute concentration to an area of higher solute concentration by which principle | Osmosis |
| When fluid replacement is necessary during the hemodialysis treatment, which of the following solutions is used? | 0.9% normal saline |
| Which of the following is considered to be safe water for dialysis? | dialysis quality water |
| Which organization establishes the standards and recommendations for dialyzer reprocessing? | AAMI |
| Which of the following symptoms would indicate a need to increase the target weight? | Edema and hypertension |
| Which learning domain is behavioral based? | Psychomotor |
| The substance that may be added to the municipal drinking water to make it clearer is: | Alum |
| Which of the following would cause a high venous pressure alarm? | Venous needle is against the wall of the vessel |
| Which of the following diffuses from the patient's blood during dialysis? | Urea |
| The organization that sets the standards for dialysis water quality is called: | AAMI |
| Total cell volume (TV) is an indirect measure of the: | Performance of the dialyzer |
| The scale says a patient weights 70 kg. This is the same as weighing how many pounds (Ib)? | 154 |
| Which of the following actions would increase diffusion during dialysis? | using a bath that will provide a greater concentration gradient |
| Which of the following is the largest gauge? | 18 gauge |
| Which of these types of vascular accesses has the fewest complications? | An arteriovenous fistula |
| Waste products are removed during dialysis by which principle | Diffusion |
Created by:
Villaneday