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c) universal precautions

1.Which of the following
best describes the reason for wearing gloves when handling machine prior to blood?
a) patient comfort
b) asepsis
c) universal precautions
d) HIV

b) needs further rinsing

2 You test for sterilant levels in a
hemodialysis machine prior to patient use. The test
is positive for sterilant. This means the machine:
a) is sterile & bacteria free
b) needs further rinsing
c) needs more sterilant
d) is in conductivity

a) creatinine, BUN, &
phosphorus are elevated

3.Choose the correct
statement regarding
serum abnormalities in
renal failure:
a) creatinine, BUN, &
phosphorus are elevated
b) creatinine BUN creatinine, BUN, &
phosphorus are depressed
c) calcium & bicarbonate are
elevated
d) calcium & bicarbonate are
depressed

a) vascular access

4.Hemodialysis requires
a means to channel the
patient's blood to the
hemodialyzer & then back to the body. It's
called:
a) vascular access
b) hemodialyzer
c) dialyzing fluid delivery system
d) infusion pump

b) usually created in the
forearm, near the wrist

5.Which of the following is correct regarding a fistula?
a) usually created in the leg, near the ankle
b) usually created in the
forearm, near the wrist
c) are made of salastic tubing
d) none of the above

c) blood leakage immediately

6.Blood leak detectors are extremely sensitive
& can determine:
a) blood type
b) amount of blood loss
c) blood leakage immediately
d) volume changes
e) serum potassium levels

d) bananas, tomatoes, oranges

7.Which of the following foods are high in
potassium?
a) milk, ice cream, yogurt
b) legumes, cheese, pizza
c) chips, colas, canned meat
d) bananas, tomatoes, oranges

a) calcium, phosphorus &
PTH

8.What lab values are monitored for
assessing bone disease?
a) calcium, phosphorus &
PTH
b) calcium, phosphorus &
albumin
c) calcium, phosphorus &
potassium
d) calcium, phosphorus &
magnesium

a) diabetes

9.Which is the most common cause of chronic kidney failure in the US?
a) diabetes
b) hypertension
c) polycystic kidney smaller molecular
disease
d) glomerulonephritis

b) potassium has a smaller molecular weight

10.The reason potassium dialyzes and
RBC's do not is:
a) potassium has a larger molecular weight
b) potassium has a smaller molecular weight
c) RBC's are not water soluble
d) RBC's have a negative charge

a) less than 0 .1mg/L (ppm)

11.Acceptable limits for total chlorines in water for hemodialysis are?
a) less than 0 .1mg/L (ppm)
b) 0.5 mg/L to 1 mg/L(ppm)
c) 3.5 mg/L to 5.5 mg/L to 5.5 mg/L(ppm)
d) greater than 6.0 mg/L(ppm)

b) dialysis disequilibrium syndrome

12.If a new patient starts with a very high
BUN, dialysis is purposely made less efficient to prevent:
a) rapid decrease in hct
b) dialysis disequilibrium syndrome
c) cardiac arrhythmia's
d) excessive coagulation

c) low hematocrit

13.The following are factors in poor clearance during
dialysis except:
a) poor dialyzer reuse
b) access recirculation
c) low hematocrit
d) low blood flow rate

b) osmosis

14.The movement of water from an area of low solute
concentration to an area of high solute
concentration is called:
a) diffusion
b) osmosis
c) ultrafiltration
d) dialysis

d) dialyzer

15.Potting compound, casing, fibers and headers are part of a:
a) dialysis machine
b) water treatment system
c) R. O. system
d) dialyzer

c) 4.0 liters or 4000 ml

16.Mr. Jones has a dry weight of 72 kg. He weighed 73 kg after last treatment. Today he weighs 75.5 kg. Assume prime and rinse back =500 ml total. What is Mr.Jones' fluid removal goal for today?
a) 2.5 liters or 2500 ml
b) 3.0 liters or 3000 ml
c) 4.0 liters or 4000 ml
d) 4.5 liters or 4500

c) concentration of red blood cells in the blood

17.A hematocrit test indicates which of the
following?
a) concentration of platelets
b) concentration of creatinine in the blood
c) concentration of red blood cells in the blood
d) concentration of white blood cells in the blood

d) all of the above

18.What factors should be considered when
establishing a patient's dry weight?
a) blood pressure
b) patient well being
c) evidence of dehydration or fluid overload
d) all of the above

c) appropriately mix the dialysate concentrates
with water

19.In a dialysis machine, the
proportioning system does what?
a) prepare the dialysate to the proper pH
b) warm the dialysate to the proper temperature
c) appropriately mix the dialysate concentrates
with water
d) to monitor the dialysate flow rate

c) hemolysis

20.The complication in which blood has a
"cherry pop"appearance is:
a) blood leak
b) air embolism
c) hemolysis
d) none of the above

d) all of the above

21.The use of high a sodium dialysate may
predispose a patient to:
a) fluid overload
b) hypertension
c) thirst
d) all of the above

a) UF Coefficient

22.The capability of a dialyzer to remove fluid, expressed as ml/mmHg/hr is:
a) UF Coefficient
b) clearance
c) surface area
d) priming volume

b) resistance to blood flow out of the access
through the dialyzer

23.A pre-pump arterial pressure reading is
measuring:
a) the pressure required to pump the blood
through the dialyzer
b) resistance to blood flow out of the access
c) pressure within the dialyzer
d) none of the above

d) all of the above

24.What determines the surface area of a
hollow fiber dialyzer?
a) number of fibers
b) internal diameter of fibers
c) length of fibers
d) all of the above

b) increase the rate of waste removal

25.The purpose of using counter-current flow is to:
a) increase the rate of fluid removal
b) increase the rate of waste removal
c) decrease the amount of dialysate used
d) decrease the surface area of the membrane

b) hemolysis

26.Chloramine exposure in dialysis can result in:
a) hypernatremia
b) hemolysis
c) pericarditis
d) bleeding

d) the dialyzer fibers are free of leaks

27.Part of the reuse process involves the reuse machine testing the dialyzer to verify:
a) the dialyzer is free of sterilant
b) the dialyzer is free of bacteria
c) the dialyzer is free of endotoxins
d) the dialyzer fibers are free of leaks

c) 200 CFU's

28.According to AAMI RD52, what is the
maximum allowable level of bacteria in dialysate?
a) 1,000 CFU's
b) 50 CFU's
c) 200 CFU's
d) 500 CFU's

b) monthly

29.According to AAMI RD52, how often
should bacterial cultures be sampled?
a) weekly
b) monthly
c) quarterly
d) annually

a) 50 CFU's

30.According to AAMI RD52, what is the action level for bacteria in dialysate?
a) 50 CFU's
b) 75 CFU's
c) 100 CFU's
d) 200 CFU's

b) fever/chills

31.Bacterial exposure from water may cause which of the following symptoms?
a) hemolysis
b) fever/chills
c) bone disease
d) hypotension

a) Scribner and Quinton

32.Who developed the first permanent blood access, the "Shunt"?
a) Scribner and Quinton
b) Kolff
c) Brescia and Cimino
d) Turner

b) mm/Hg

33.Venous pressure meters are calibrated in:
a) PSI
b) mm/Hg
c) mL/hour
d) mg%

b) mm/Hg

34.TPM is measured as:
a) mL/hr
b) mm/Hg
c) mL/min
d) none of the above

c) pH and conductivity

35.The hemodialysis machine continuously monitors many parameters. Which of these parameters must be verified by an external measuring
device?
a) blood flow
b) dialysate flow
c) pH and conductivity
d) temperature and transmembrane pressure

b) chlorine and chloramine

36.Prior to each patient shift, it would be essential to
perform a water quality check for which of these substances?
a) calcium and magnesium
b) chlorine and chloramine
c) organic contaminants
d) inorganic contaminants

b) hydrogen ions

37.The term pH is a measurement of the
concentration of:
a) all ions in solution
b) hydrogen ions
c) bicarbonate ions
d) acetate ions

c) determine the patient's learning needs

38.The technician's role in patient teaching
should be to:
a) assess the patient"s barriers to learning
b) check the patient's readiness to learn new
information
c) determine the patient's learning needs
d) Reinforce teaching that the patient has received
from other team members

d) all of the above

39.What can dialysis staff do to reduce the
risk of being infected with a blood borne pathogen?
a) proper hand washing
b) universal precautions
c) proper sharps disposal
d) all of the above

d) all of the above

40.Which of the following are ways to
handle chemicals safely?
a) wash hands before eating or drinking
b) wear protective clothing
c) don't eat or drink in the work area
d) all of the above

b) 25-35 degrees

41.What is the correct angle in which to cannulate a fistula?
a) 10-15 degrees
b) 25-35 degrees
c) 35-45 degrees
d) it dosen't matter

d) all of the above

42.Which of the following affects access recirculation?
a) distance between the tips of the needles
b) presence of stenosis
c) direction of needles
d) all of the above

a) salt

43.The technician observes that the hardness reading after the water softener isabove the acceptable
limit. The technician should check the softener tank's level of:
a) salt
b) chlorine
c) carbon
d) sand

c) about one ounce (30 ml) of fluid is on the floor

44. A technician observes all of the following in
the hemodialysis unit. Which one poses an environmental risk?
a) the wheels of the hemodialysis machines are locked
b) charts are lying on bedside tables
c) about one ounce (30 ml) of fluid is on the floor
d) a patient's family member is present during treatment

a) Material Safety Data Sheet (MSDS)

45. When preparing a bleach solution for cleaning
equipment, the technician accidentally spills undiluted
bleach on the floor. Which of these resources will provide the technician with information about how to
properly handle spill of the chemical?
a) Material Safety Data Sheet (MSDS)
b) Centers for Disease Control & Prevention (CDC)
c) Association for the Advancement of Medical Instrumentation (AAMI)
d) State Department of Health (DOH)

d) the dialyzer was bypassed

46. A conductivity alarm sounds during a
hemodialysis treatment. The technician should expect which of these events to have occurred?
a) the blood pump has stopped
b) the dialysate flow rate has increased
c) the electrical power source was interrupted
d) the dialyzer was bypassed

c) obtain a sample after the second

47. During routine water testing, the technician notes
that the chloramine level after the first carbon tank is 0.2mg/L. Which of these actions should the technician
take next?
a) bypass the carbon tanks
b) descale the reverse osmosis membranes
c) obtain a sample after the second
d) immediately terminate hemodialysis treatments

a) refer the patient to the social worker

48. A female technician has been caring for a male patient for several months. The patient tells the technician that he is lonely and depressed. He asks the
technician to go out to dinner with him. In addition to politely declining the patient's invitation, which of these actions, if any, should be taken:
a) refer the patient to the social worker
b) recommend an over-the-counter mood stimulant, such as St. John's wort
c) share the patient's need for socialization with other patients
d) no further action is needed

d) left-sided trendelenberg

49. A hemodialysis technician suspects that a patient who is receiving a hemodialysistreatment has an air embolus. After stopping the blood pump, the patient
should be placed in which of these positions?
a) low-fowlers
b) high-fowlers
c) right-sided trendelenberg
d) left-sided trendelenberg

b) call for help

50. During hemodialysis a patient goes into
cardiac arrest. Which of these actions shouldbe taken first?
a) apply a precordial thump to the patient
b) call for help
c) return the patient's blood
d) stop ultrafiltration

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