Dialysis Technician Practice Test Multiple Choise

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86 terms · I'm studying for my BONENT exam next week. I'm using this practice test. I got these questions from the "Core Curriculum for the Dialysis Technician: Proceptor Module" I hope this is helpful to many fellow dialysis pcts

What are the two main types of dialysis?

a) Continuous renal replacement therapy and peritoneal dialyis
b) Hemodialysis and peritoneal dialysis
c) Hemofiltration and peritoneal dialysis
d) Hemodialysis and continuous renal replacement therapy

b) Hemodialysis and peritoneal dialysis

Which of these developments in dialysis history came first?

a) Dr. Kolff's rotating drum device
b) Shunt
c) Dr. Kolff's coil dialyzer
d) Arteriovenous fistula

a) Dr. Kolff's rotating drum device

How are clinics paid by Medicarse for dialysis treatment?

a) Separate billing
b) Contract pricing
c) Composite rate
d) Fee-for-service

c) Composite rate

Which of the following is covered by the standards of the Association for the Advancement of Medical Instrumentation (AAMI)?

a) Dialyzer reprocessing
b) Clinical performance measures
c) Hemodialysis machine maintenance
d) Safety of hemodialysis machines

a) Dialyzer reprocessing

Which of the following is a step of the CQI (Continuous Quality Improvement) process?

a) Implement the PDCA cycle
b) Write a long article about the problem
c) Develop a hypothesis
d) Consult an expert

a) Implement the PDCA cycle

Which of the following actions shows that you have a conscientious manner?

a) Running through the dialysis clinic
b) Getting to work on time
c) Talking about patients in front of other patients
d) Talking about your personal problems in front of patients

b) Getting to work on time

Which of the following is an example of a boundary that should be kept between you and your patients?

a) It is okay to ask a patient for a date
b) You may take gifts, money, or tips from patients
c) You can borrow money from patients
d) You should not invite patients to your home

d) You should not invite patients to your home

What is the minimum number of months of experience you need to take a certification exam?

a) 3
b) 6
c) 9
d) 12

b) 6

The functional unit of the kidney, or the structure in the kidney that does the work, is?

a) Medulla
b) Cortex
c) Calyx
d) Nephron

d) Nephron

A nephron is made up of?

a) A glomerulus and a tubule
b) The nephrons and a capsule
c) The loop of Henle and the capillary ball
d) The bladder and the water

b) A glomerulus and a tubule

The leading cause of chronic kidney disease for adults in the United States is?

a) Hypertension
b) Glomerulonephritis
c) Diabetes
d) Urinary obstruction

c) Diabetes

The endocrine functions of the kidney include?

a) Regulating growth hormone and making thyroid hormone
b) Making erythropoietin and the active form of vitamin D
c) Making estrogen and testosterone
d) Regulating body temperature and sleep rhythms

b) Making erythropoietin and the active form of vitamin D

The primary cause of the anemia of ESRD is?

a) Erythropoietin deficiency
b) Calcium deficiency
c) Iron deficiency
d) Cholecalciferol deficiency

a) Erythropoeitin deficiency

Which of the following are hemodialysis treatment options?

a) CAPD, nocturnal, short daily
b) CCPD and transplantation
c) In-center, nocturnal, short daily
d) Short daily, CAPD

c) In-center, nocturnal, short daily

Which is the best definition for dry weight?

a) Postdialysis weight at which all or most excess fluid has been removed
b) Weight gained between treatments
c) Predialysis weight
d) Amount of weight to be removed during treatment

a) Postdialysis weight at which all or most excess fluid has been removed

What is the Health Insurance Portability and Accountability Act (HIPAA)?

a) A law about how to treat patients
b) A law that created rules about how to document dialysis treatments
c) A law that created national rules about the security and privacy of health data
d) Standards on how to manage healthcare information

c) A law that created national rules about the security and privacy of health data

Mrs. M., a 72-year-old widow, asks to have her treatment shortened by 20 minutes today so she can get home and watch her favorite soap opera. You explain that:

a) This will be okay because a few minutes here and there don't make any difference
b) Center policy does not permit patients to discontinue treatment early
c) It is very important to get the prescribed time, every dialysis treatment, to avoid medical complications
d) She can leave, but she must a sign a release

c) It is very important to get the prescribed time, every dialysis treatment, to avoid medical complications

Which of the following medical problems may occur due to chronic kidney diseases (choose all that apply)?

a) Anemia
b) Indigestion
c) Sleeping problems
d) Pericarditis

a) Anemia
c) Sleeping problems
d) Pericarditis

Kidney failure is a chronic illness that causes many changes for the person with the disease and his or her family and friends. The dialysis team member with special training in helping people adjust to these changes is the?

a) Nurse
b) Physician
c) Social worker
d) Technician

c) Social worker

A solution is a mixture of?

a) Water and blood
b) Dialysate
c) A solvent and a solute
d) Water and sodium

c) A solvent and a solute

A semipermeable membrane is a filter that?

a) Allows only certain sized particles to cross
b) Prevents fungal between particles
c) Can distinguish between particles
d) Is biocompatible, non toxic, and hypoallergenic

a) Allows only certain sized particles to cross

Diffusion is movement of particles... ?

a) By filtration through a biocompatible membrane
b) From an area of higher concentration to an area of lower concentration
c) Into a vacuum created when fluids are forced through a membrane
d) Into a space made by solutions moving in a countercurrent flow

b) From an area of higher concentration to an area of lower concentration

Negative pressure is pressure created when?

a) Larger amounts of filtration exist in a closed space
b) Fluids separated by a membrane flow in the same direction
c) Larger molecules drag smaller molecules across a membrane
d) Fluid is pulled through a restriction

d) Fluid is pulled through a restriction

During dialysis, ultrafiltration occurs when?

a) Water is removed from blood because there is a pressure gradient across a membrane
b) Phosphorus is removed from blood because dialysate is low on phosphorus
c) A higher concentration of sodium causes water to move from body compartments into the dialysate
d) A suction device is applied to the venous trap and a Harvard Clamp is applied to the arterial side of the blood set

a) Water is removed from blood because there is a pressure gradient across a membrane

Which of the following best describes the "intravascular" fluid compartment?

a) Fluid inside the cells
b) Blood inside the blood vessels
c) Fluid between cells
d) Fluids inside and between cells

b) Blood inside the blood vessels

During dialysis, levels of waste in the blood should?

a) Remain the same
b) Decrease
c) Increase
d) Fluctuate

b) Decrease

Which of the following factors affects the rate of diffusion?

a) Pressure gradient
b) Flow rate
c) Hydraulic pressure
d) Surface area of the membrane

b) Surface area of the membrane

Which of the following is not a dialyzer characteristic?

a) Capacity
b) Clearance
c) Biocompatibility
d) Molecular weight cutoff

a) Capacity

Which of the following is a way to remove solutes?

a) Convection
b) Suction
c) Surface area
d) Irradiation

a) Convection

Name the two compartments of the dialyzer:

a) Conventional and high flux
b) Convection and adsorption
c) Blood and dialysate
d) Hollow fiber and flat plate

c) Blood and dialysate

Dialysate is the fluid that helps remove waste products from the body. It contains a number of substances. Choose the group below that might be prescribed for a dialysate solution:

a) Bicarbonate, sodium, potassium
b) Magnesium, creatinine, calcium
c) Choloride, glucose, urea
d) Beta-2-microglobulin, calcium, sodium

a) Bicarbonate, sodium, potassium

What is the purpose of a proportioning system?

a) Monitors the dialysate flow rate
b) Monitors for blood leaks
c) Checks the conductivity of the dialysate
d) Make dialysate by mixing fresh concentrate with fixed amounts of treated water

d) Make dialysate by mixing fresh concentrate with fixed amounts of treated water

Dialysate conductivity measures?

a) The total electrical charge of a solution
b) The total number of thermistors in a solution
c) The total number of mL per solution
d) The total number of gradients in a solution

a) The total electrical charge of a solution

What condition occurs due to dialysate that is too hot?

a) Hypersensitivity reaction
b) Hemolysis
c) Pyrogenic reaction
d) Septicemia

b) Hemolysis

What are the two types of ultrafiltration systems?

a) Volumetric UF control and flow control
b) Flow rate and UFR
c) TMP and UFR
d) Proportioning system and flow control

a) Volumetric UF control and flow control

Which of the following is not a component of the extracorporeal circuit?

a) Blood leak detector
b) Blood pump
c) Heparininfusion line
d) Drip chamber

a) Blood leak detector

Which of the following best describes the transducer protector?

a) Pump that moves blood through the extracorporeal cicuit
b) Device inside the machine that converts air pressure into an electronic signal
c) Tubing that carries blood from the patient's access to the dialyzer and back to the access
d) System that removes water from the blood

b) Device inside the machine that converts air pressure into an electronic signal

Although dialysate delivery systems have back-up monitoring systems, it is critical that?

a) The monitoring systems be checked and calibrated on a schedule recommended by the manufacturer
b) Conductivity and pH be verified by independed meters before each dialysis treatment and whenever the dialysate is changed
c) All alarm systems be tested prior to each dialysis treatment
d) All of the above

d) All of the above

Choose the group below that contains the dialysate delivery system monitors:

a) Temperature, venous pressure, flow rate
b) Blood and dialysate flow rates
c) Conductivity, pH, flow rate
d) Blood leak, pH, arterial pressure

c) Conductivity, pH, flow rate

Which of the following is a negative pressure?

a) Venous
b) Venous and arterial
c) Arterial
d) Predialyzer pressure

Arterial

Mrs. Phyliis R. is a 40-year-old woman whose kidneys are failing due to hypertension. She does not have diabetes or cardiac problems. If her blood vessels are in good condition, what type of access is preferable?

a) A femoral catheter
b) A forearm loop graft
c) An arteriovenous fistula
d) A cuffed, tunneled catheter

c) An arteriovenous fistula

When assessing a fistula or graft, which of the following needs to be listened for prior to starting dialysis?

a) Bruit
b) Stenosis
c) Thrill
d) Steal syndrome

a) Bruit

Which of the following are possible complications of "flipping" the needle in AVF cannulation (choose as many as apply)?

a) Stenosis
b) Infiltration
c) Steal syndrome
d) Stretching the needle hole
e) Tearing the lining of the vessel

b) Infiltration
d) Stretching the needle hole
e) Tearing the lining of the vessel

Which direction should the venous needle be placed?

a) Antegrade
b) Next to the anastomosis
c) Retrograde
d) Into the flow of the blood

a) Antegrade

Which of the following is the reason for rotating needle sites on a fistula?

a) Prevent infiltration
b) Prevent stenosis
c) Prevent steal syndrome
d) Prevent aneurysm

d) Prevent aneurysm

Infiltration refers to which of the following definitions?

a) A pocket of blood inside the blood vessel
b) A needle tip that punctures a vessel and goes out the other side, so blood escapes into the tissues
c) The colonization of bacteria in a graft anastomosis
d) Mixing of already dialyzed blood with arterial blood in the patient's access

b) A needle tip that punctures a vessels and goes out the other side, so blood escapes in the tissues

Which of the following is a long term complication of fistulae?

a) Infiltration
b) Thrombosis
c) Bruit
d) Reciculation

b) Thromosis

When assessing a fistula or graft, which of the follow need to be felt prior to starting dialysis?

a) Pulse and deep access
b) Bruit and deep access
c) Bruit and pulse
d) Pulse and thrill

c) Bruit and pulse

Which of the following is the complication that can happen to grafts if the needle sites are not rotated?

a) Stenosis
b) Pseudoanuerysm
c) Steal syndrome
d) Infiltration

b) Pseudoanuerysm

Which of the following will help prevent infection in catheters?

a) Wash hands and change gloves prior to touching the catheter
b) Palpate the skin along the catheter from the blood vessel down to the exit site looking for drainage at the exit
c) Change the catheter dressing
d) Assess the catherter blood flow

a) Wash hands and change gloves prior to touching the catheter

Which of the following is a step in the port/catheter predialysis assessment?

a) Cleansing the catheter site
b) Connecting the catheter to the bloodlines
c) Assessing the blood flow rate through the catheter
d) Assessing the ease of heparin removal and saline flushing before connecting the bloodlines

d) Assessing the ease of heparin removal and saline flushing before connecting the bloodlines

The instrument used for measuring blood pressure is called?

a) Sphygmonanometer
b) Spirometer
c) Bronchoscope
d) Tachometer

a) Sphygmonanometer

A rapid pulse of 104 beats/min would indicate that the patient has?

a) Bradycardia
b) Tachycardia
c) An arrhythmia
d) Artial flutter

b) Tachycardia

The normal range of resting respirations in an adult is?

a) 12 to 20 breaths/min
b) 20 to 40 breaths/min
c) 30 to 50 breaths/min
c) 60 to 100 breaths/min

a) 12 to 20 breaths/min

For which of the following situations would you use the stand-and-pivot technique to transfer a patient?

a) Patient is brought into the dialysis clinic on a stretcher
b) Patient can bear weight once standing, but has trouble getting up from the dialysis chair
c) Patient can get out the dialysis chair without any problems
d) Patient is complaining of dizziness and nausea

b) Patient can bear weight once standing, but has trouble getting up from the dialysis chair

Which of the following methods kills bacteria, but will not destroy all of them completely?

a) Asepsis
b) Disinfection
c) Exposure to chemcial sterilants
d) Open-flame irradiation

b) Disinfection

What is the most important activity that you can perform to prevent the spread of infectious disease in the dialysis clinic?

a) Wearing a mask
b) Wearing gloves
c) Wearing protective equipment
d) Handwashing

d) Handwashing

Which of the following should be done to prevent needle sticks (choose all that apply)?

a) Recapping needles
b) Throwing used needles into puncture-resistant, color-coded containers
c) Break or bend the needle
d) Leaving needles on the medicine carts

b) Throwing used needles into puncture-resistant color-coded containers

The purpose of priming the extracorporeal cicuit with saline during setup is?

a) To remove air and germicide before initiating treatment
b) To be certain fibers are thoroughly filled with germicide before initiating dialysis
c) To assess ultrafilitration capacity of the dialyzers and check for leaks
d) To maintain fiber noncompliance until the dialysis begins

a) To remove air and germicide before initiating treatment

Mrs. Smith's dry weight is 62 kg. Her pretreatment weight when she came in for treatment on Monday was 67 kg. For her treatment the priming saline amount is 240 mL, the rinseback amount is 200 mL, fluid from medications is 100 mL, and she is not allowed any fluid during the treatment. What is the total amount of fluid weight to be removed during her treatment?

a) 5,000 mL
b) 5,230 mL
c) 5,540 mL
d) 5,820 mL

c) 5,540 mL

Based on Mrs. Smith's total amount of fluid to be removed, what is the ultrafiltration rate per hour (mL/hr) for her 4-hour treatment?

a) 1,220 mL/hr
b) 1,385 mL/hr
c) 1,440 mL/hr
d) 1,500 mL/hr

b) 1,385 mL/hr

A medication used to prevent blood from clotting in the extracorporeal circuit is?

a) Mannitol
b) Heparin
c) Hypertonic saline
d) Lidocaine

b) Heparin

Which of the following is used to prevent air in the bloodlines?

a) Maintain prescribed blood flow rates
b) Tighten all connections
c) Monitor patient's blood pressure
d) Allow the normal saline bad to empty

b) Tighten all connections

Which of the following is a cause of hypotension during and after dialysis treatments?

a) Uremia
b) Patient forgetting to take their blood pressure pills
c) Fluid overload
d) Removing too much fluid

d) removing too much fluid

Dialyzers reprocessed mainly because?

a) Reprocessing reduces the cost of dialysis treatments
b) Reprocessing shortens the dialysis treatment
c) Reprocessing is safer for staff
d) Reprocessing reduces the amount of plastic in landfills

a) Reprocessing reduces the cost of dialysis treatments

Which organizations sets the standards and recommendations for dialyzer reprocessing?

a) FDA - U.S. Food and Drug Administration
b) CDC - Center for Disease Control and Prevention
c) AAMI - Association for the Advancement of Medical Instrumentation
d) CMS - Centers for Medicare and Medicaid Services

c) AAMI - Association for the Advancement of Medical Instrumentation

Which of the following tests must be performed on new dialyzers?

a) Hgb - hemoglobin
b) TIBC - total iron binding capacity
c) CBC - complete blood count
d) TCV - total cell volume

d) TCV - total cell volume

What are the steps for dialyzer reprocessing after a dialysis treatment?

a) Pre-cleaning, performance test, dialyzer rejection, disinfection
b) Labeling, TCV, performance tests, disinfection
c) Pre-cleaning, TCV, dialyzer rejections, disinfection
d) Preprocessing, TCV, performance test, disinfections

a) Pre-cleaning, performance test, dialyzer rejection, disinfection

Which of the following is a germicide used for dialyzer reprocessing?

a) Alcohol
b) Hydrogen peroxide
c) Paracetic acid
d) Acetone

c) Paracetic acid

Which of the following is the definition of "contact time"?

a) Amount of time the germicide is rinsed through the dialyzer
b) Amount of time between dialyzer uses
c) Amount of time the germicide remains in the dialyzer
d) Time it takes to reprocess the dialyzer

c) Amount of time the germicide remains in the dialyzer

AAMI standards recommend quality control activities before a reprocessed dialyzer is used on a patient. Who must check the dialyzer to verify quality control information?

a) The patient, only as long as she or she is sighted
b) Two people, one of whom should be the patient
c) The medical director and the charge nurse
d) Two registered nurses and a patient care technician

b) Two people, one of whom should be the patient

Which of the following is a problem in dialyzer reprocessing that may cause bacteria or endotoxin contamination of the dialyzer?

a) Use of proper storage conditions
b) Correct contact time used
c) Use of heat and citric acid
d) Improperly prepared germicide

d) Improperly prepared germicide

Which of the following best describes the Dialyzer Reprocessing Manual?

a) Record of the date and results of all quality assurance and quality control evaluations for the center
b) Summary of all reuse specifications, policies, procedures, training materials, manuals and methods, and samples of forms and labels
c) Log of the dates of preventive maintenance, repairs, and results of scheduled testing on all hemodialysis equipment
d) Record of testing required by regulatory agencies on any germicides or cleaning agents uded in dialyzer reuse

b) Summary of all reuse specifications, policies, procedures, training materials, manuals and methods, and sample of forms and labes

Which of the following are two criteria for rejecting a reprocessed dialyzer?

a) Less than 80% of original fiber bundle volume, aesthetic appearance
b) Label incomplete, dialyzer not heparinized
c) Patient preference, access is recirculating
d) HIV status, hyperkalemia present

a) Less than 80% of original fiber bundle volume, aesthetic appearance

Water used for dialysate must be treated because dialysis patients?

a) Have strict fluid restrictions and drink only pure water
b) Drink large amounts of water despite their restrictions
c) Are exposed to large volumes of water during dialysis
d) Are able to excrete contaminants in dialysate during dialysis

c) Are exposed to large volumes of water during dialysis

Choose the substance which may be added to municipal drinking water supplies to make the water clearer?

a) Bleach
b) Zinc
c) Potassium
d) Alum

d) Alum

The water softener performs the following activity?

a) Removes calcium and magnesium from water
b) Removes chlorine and chloramines from water
c) Adds calcium and magnesium water
d) Kills bacteria in the water

a) Removes calcium and magnesium

Which is the following is a limitation of a reverse osmosis (RO) system?

a) Removes bacteria and edotoxin
b) Removes solutes from the water
c) Thin film composite membranes break down when exposed to chlorine and chloramines
d) Produces purified water

c) Thin film composite membranes break down when exposed to chlorine and chloramines

Which is the most common way that water treatment systems are disinfected?

a) Heat
b) Oxone
c) Chemical
d) Minerals

c) Chemical

Contamination of water by bacteria/endotoxins may cause one of these reactions?

a) Blurred vision
b) Bone disease
c) Pyrogenic
d) Double vision

c) Pyrogenic

How often should the RO operating parameters be checked?

a) Weekly
b) Hourly
c) Monthly
d) Daily

d) Daily

Which of the following is an acceptable level of post softener hardness?

a) 0.8 grain per gallon
b) 1.1 grain per gallon
c) 1.5 grain per gallon
d) 2.0 grain per gallon

a) 0.8 grain per gallon

According to AAMI standards, the total microbial count of dialysate shall not exceed?

a) 200 CFU/mL
b) 400 CFU/mL
c) 800 CFU/mL
d) 1,000 CFU/mL

a) 200 CFU/mL

According to AAMI standards, the total endotoxin count of dialysate shall not exceed?

a) 1 EU/mL
b) 2 EU/mL
c) 3 EU/mL
d) 4 EU/mL

b) 2 EU/mL

How frequently should the carbon tanks be checked for chlorine and chloramines?

a) Each shift
b) Weekly
c) Monthly
d) Annually

a) Each shift

Large amounts of aluminum in water used for dialysate could cause?

a) Fever/chills
b) Liver problems
c) Bone disease
d) Diarrhea

c) Bone disease

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