CCHT PRACTICE EXAM DAVITA

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the function unit of the kidney, or the structure in the kidney that does the work, is the
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the function unit of the kidney, or the structure in the kidney that does the work, is the
nephron
the leading cause of chronic kidney disease for adults in the united states:
diabetes
a nephron is made up
a glomerulus and a tubule system
which of the following is not a symptom of uremia
elevated hematocrit
Mrs. smith's dry weight is 62 kg. her pretreatment weight when she came in for treatment on monday was 67kg. the priming saline amount is 240ml, fluid from medication is 100 ml , and she is not allowed any fluids during treatment. what is the total amount of fluid weight to be removed during her treatment?
5,540ml
based on Mrs. smith's total amount of fluids to be removed, what is the ultrafiltration rate per hour (ml/hr)for her 4-hour treatment?
1,385 ml/hr
which of the following is a cause of hypotension during and after dialysis treatments?
removing too much fluids
the scale says a patient weights 70 kg. this the same as weighting how many points (lb)?
154
normal body ph is
7.35-7.45
one sigh and symptoms of fluids overload is
hypertension
abnormal levels of this electrolyte can cause cardiac arrhythmias and even deathpotassiumwater moves across a membrane from an area of lower solute concentration to an area of higher solute concentration by which principleosmosiswaste products are removed during dialysis by which principlediffusionexcess fluid is forced out of the blood and into the dialysis by which principleultrafiltrationthe movement of the fluid from the tissue toward a higher concentration of sodium in the blood is a example ofosmosisdecreasing the patient's prescribed blood flow affects the rate ofdiffusionwhich of the following actions would increase diffusion during dialysis?using a bath that will provide a grater concentration gradientwhich of the following diffusion diffuses from the patients blood during dialysis?ureaultrafiltration is influenced bytransmembrane pressurethe most common complication in peritoneal dialysis isperitonitisthe dextrose used in the dialysate for peritoneal dialysis can causehyperglycemiaif a patient develops an infection post transplant, the largest contributing factor would most likely be:immunosuppressive medicationthe most frequent cause of death in the first year post transplant isinfectiontotal cell volume (TCV) is a indirect measure of theperformance of the dialyzerthe TCV should be no less than80%the manimum dwell time to achieve sterilization with the chemical renalin is11 hoursthe reprocessed dialyzer is carefully rinsed prior to patient use to removeresidual sterilantgermicide rebound occurs due toinadequate dialyzer primingwhich organization set the standards and recommendations for dialyzer reprocessing?AAMIthe blood path integrity is tested to eliminate the possibility of a blood leak. the drop in pressure should not exceed:10 mmhgthe purpose of using counter-current flow is toincrease the rate of waste removalthe total pressure that exists across the dialyzer membrane is calledtransmembrane pressuredialyser ph should bebetween 7.0 and 7.4dialyzer that is too hot will causehemolysiswhich of the following component in dialysate is used to correct metabolic acidosis?bicarbonatetotal chlorine levels in the water are testedbefore each patient shift or every four hourthe water softener removescalcium and magnesiumAAMI standars for the total microbial count of dialysate shall not exceed200 CFU/MLthe water softeneroperates on the principle of ion exchangewhich of the following is considered to be safe water for dialysisdialysis quality waterpatient expose to chloramines during the hemodialysis treatment may causehemolysisaccording to AAMI the standard levels for endotoxin levels isless than two (2) EU/ML.feed conductivity- product conductivity divided by x 100 is the formula calculation ofpercent rejectiona mixed-bed DI tank containscations and anionsthe substance that may be added to the municipal drinking water to make it clearer isaluminumAAMI chemical analysis of water used for hemodialysis is testedannuallythe part of the cell wall of bacteria that, when released, can cause fever in hemodialysis patients isendotoxinduring a hemodialysis treatment the technician responds to a low venous pressure alarm. the most likely cause for this alarmdisconnection of the blood linethe hemodialysis machine continuously monitors may parameters. which of the these parameters must be verified by an external measuring device?ph and conductivitywhich of the following is most likely to cause a high venous pressure alarm?kinking of the venous blood lineduring 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 technicianrinse in transmembrane pressure in a low flux dialyzer during hemodialysis is indicative ofclotting of the extrecorporeal circuitone reason that normal saline is used to rinse and prime the extracorporeal circuit prior to treatment is to removeairwhich of the following best describes the transducer protector?device inside the machine that converts air pressure into electronic signalwhich of the following would cause a high venous pressure alarm?venous needle is against the wall of the vesselsthe air detector alarms during treatment. if the machine is working properly, the dialysis technician should expect which of these events to have occurredblood pump has stoppedthe extracorporeal circuit consists of theblood lines and the dialyzerbefore a hemodialysis treatment , 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 firstdiscard the needleto determine the potency of a arteriovenous vascular access, the dialysis technician should initially feel for the presence ofa thrilla patient complaints of pain at the venous needle site. the dialysis technician observes there is swelling distal to the venous needle site and that the venous pressure is rising. the dialysis technician should suspectan infiltrationall the following may be signs and symptoms of an infection access EXCEPT:numbness and tinglingduring a hemodialysis treatment, a patient's venous needle infiltrates. which of these actions should the dialysis technician take first?stop the blood pumpwhich of these types of vascular access has the fewest complicationan arteriovenous fistulaone disadvantage of a fistula is an increase inin time to matureone cause of aneurysm and pseudo aneurysm ispoor rotation of siteswhat is the desired outcome when the patient performs fistula exercise?enlargement of the veinthe bruit in an AV fistula or graft is detected bylistening with a stethoscopewhen cannulating, the tips of the needles should be at least2.0 inches apartthe venous needle in an AV fistulashould point in the direction of the blood flowa true aneurysm can be dangerous because itmay rupture and cause the patient to bleed profuselya fistula connectsan artery to a veinprior to cannulation a technician notices the skin over the patient's fistula is reddened and warm to touch. these symptoms are most likely due toinfectionduring 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?Mrs. pruitt's temperature is elevated post-hemodialysis treatment. which of these actions should the dialysis technician take?notify the nurseMrs. smith arrives for dialysis treatment complaining of shortness of breath. her pre-dialysis weight is 4.7 kilograms above the last post-treatment weight. the dialysis technician reweighed and verified the weight. which of the actions should the dialysis technician take next?notify the nurse of the need for an assessmentslow pulse of 54 beats/minute would indicate the patient has:bradycardiaduring 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 linedry weight is defined as theweight at which the patient has no edema or fluids in the lungs and bp is normalwhich of the following symptoms would indicate a need to increase the estimated dry weight (EDW)?hypotension and crampingSam's EDW is 70 kilograms (KG). he arrives for treatments today at a weight of 70kg. 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 treatments todays?the nurse will get an order to decrease the EDWwhich of the following is not a possible cause of an increased temperature pre-dialysis?the patient has fluid overloadwhich of the following is the classic sign of hemolysiscranberry juice colored blood in the venous lineMs. foster complication 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 left sidesolution that have a higher osmolarity than body fluids are called?hypertonicthe most important intervention to prevent the spread of infection is:cleansing of the handsinfection control protocol for hemolysis equipment should include which of these actions by the caregiver?using gloves when touching the machinewhen fluid replacement is necessary during the hemodialysis treatment, which of the following solution is used?0.9% normal salinea patient's dry weigh is 154.0 lb (70 kg) and the patient's pre treatment weight is 158.4 lb (72kg). four-hours treatment, how many ml/hour must the patient lose to reach dry weight?500during a hemodialysis treatment, a patient says to the technician, three hours of time have passed 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 the.machine was in bypass for 30 minutesa dialysis technician observes a drop of blood on the surface of a patient's hemolysis machine. which of these actions should the dialysis technician take?clean the machine surface immediatelyasepsis is defined asthe absence of disease producing organismif the extracorporeal circuit clots and it must be discarded, it would be most important to monitor the patient's serum levels ofhemoglobinwhat are the typical signs of fluids overloadedema and shortness of breathhyperkelemia can lead tocardiac arrestwhich of the following is used to prevent air in the bloodlines?tighten all connectionsfifteen minutes before the end of a hemodialysis treatment, a patient complains of dizziness and nausea. these symptoms are most likely due tohypotensionduring the hemodialysis treatment, a patient complains of feeling chilled. in addition to getting the blanket, which of these actions should the technician take?take the patient's temperatureshort frequent hemodialysis treatment in patients with high BUN ( blood urea nitrogen ) are performed to preventdialysis disequilibrium syndromeduring hemolysis a patient goes into cardiac arrest. the first action of the dialysis technician should be?call for assistancea patient who is to receive their first dialysis treatment is prone todialysis disequilibrium syndromefluid to be removed divided by the treatment time tells usthe ultrafiltration ratethe normal range of resting respirations in an adult is:12-20 breaths per minutehives, itching, tightness of the chest and respiratory distress may be signs and symptoms of:anaphylaxis (severe allergic reaction)pain at the venous needle site, along with respiratory difficulty and chest pain could be an indicator of:sterilant infusiona rapid pulse of 104 beats/minute would indicate that the patient has:tachycardiaa marker used to determinate the middle molecule clearance of a dialyzer isvitamin B12the national standard, based on the KDOQI ( kidney disease outcomes quality initiative ) guidelines, for the urea reduction rate ( URR) is a ratio greater than :65%what lab tests are used to monitor anemia in the ESRD patient?hemoglobin/hematocritESRD specific tests such us as BUN, creatinine, and URR areindicators of the adequacy of the renal replacement therapythe accuracy of 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 orderalbumin is an important test that tells about the patient------------statusnutritionalwhich of the following is the most accurate measure of dialysis adequacy?Kt/Vbiohazardous waste includes any material exposed toblooda patient laboratory results indicate that the predialysis BUN levels was lower than the post dialysis BUN levels. when interpreting these findings the technician should seek the answer to which of these questionswas the predialysis sample draw from the venous port?the organization that has as a goal to '' improve the care and outcomes of all individuals with kidney disease'' is calledKDOQIa dialysis technician observes all of the below on the treatment floor, which one poses an environment risk?about one ounce (30ml) fluid is on the floorwhat is the most important activity that the dialysis technician can perform to prevent the spread of infectious disease in the dialysis clinic?hand washingthe organization that sets the standards for dialysis water quality is calledAAMIwhich of these technician activities contributes to data collection used to measure quality outcomes?ensuring accurate documentationa patient tells the technician that the dietitian reviewed high-potassium foods with her. during the conversation she states she routinely eats the following food. which one is highest in potassium?bananaswhich food below is highest in phosphorusice creamlow albumin levels in the dialysis patient have been linked with:highest hospitalization and death ratesacceptable interdialytic weight gains are3-5% of EDWthe usual fluid allowance for a person with kidney failure is1.0 to 1.5 liters per daysymptoms of hyperkalemia (high potassium) may includenumbness and tinglingwhich of the following might indicate a need to decrease the heparin dose?the patient just had surgery yesterdaywhich of the following might indicate the need to increase heparinclotting in the extracorporeal circuitthe usual heparin sodium concentration for anticoagulation during hemolysis is1,000u/mllidocaine is administeredintradermallymedications that dialyze easily are all expect:digoxinMr. jones suffers from constipation. he goes to the drug store to buy a laxative. Mr. jones should avoid which medication?milk of magnesiawhich of the following is the largest needle?18 gaugeyour 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?1.0all of the following are phosphate binders expect:vitamin B 12the medication used to treat anemia isepogenthe medication used to improve calcium absorption is:zemplara 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 asked the dialysis technician to go out to dinner with him. in addition to politely declining the patient's invitation, which of these actions, if any, should the dialysis technician take?refers the patient to the social workeryou have documented incorrectly on a patient's chart. how do you correct this?draw one line through it, date, time, signature/credentials, with the works " error"a teammate asks you to document the normal saline he just gave to Mr.smith you wouldnever document something that someone else didMr. jones demonstrates how to wash his access. this is a an example of which adult learning principlepsychomotorthe dialysis technician's role in patient education is toreinforce information provided by other teammatesthe most important member of the patient care team is thetechnicianthe most important monitor in the dialysis setting isteammatewhich learning domain is behavioral basedaffectivewhich learning domain is knowledge basedcognitiveMr. Roberts verbalizes how to hand crank his blood pump in the event of an emergency. this is an example of which adult principle?cognitivea 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 environmentaccording to the new conditions for coverage, all dialysis technicians are to be certified by a national certifying agency or state specific certification by04/15/2010the minimum amount of experience required to take the NNCC certifying exam is6 monthsa reason why a dialysis technician is to be certified isits a new federal regulation