CCHT Exam 2022 Questions with correct Answers

Peritoneal Dialysis (PD) differs from hemodialysis in which of the following ways? - ANSWER PD access is by an intra-abdominal catheter The main difference between an arteriovenous shunt (AVS) and an arteriovenous fis ...

Peritoneal Dialysis (PD) differs from hemodialysis in which of the following ways? - ANSWER PD access is by an intra-abdominal catheter The main difference between an arteriovenous shunt (AVS) and an arteriovenous fistula (AVF) is an: - ANSWER AVF is entirely within the arm Which of the following dialyzers is used currently? - ANSWER hollow tube Which of the following kidney structures connects with and delivers urine directly to the ureter? - ANSWER pelvis The glomerular filtration rate is an important index of renal function and in the normal adult is approximately: - ANSWER 125 ml/min/1.73 m2 All of the following substances are produced by the kidney EXCEPT: - ANSWER aldosterone The most likely cause of post-renal failure is: - ANSWER benign prostatic hypertrophy The most common cause of chronic kidney disease in the united states is: - ANSWER diabetes Uremia may cause which of the following conditions? - ANSWER Itching, edema (swelling)of the extremities, anemia All of the following conditions are associated with chronic kidney failure EXCEPT: - ANSWER hypoparathyroidism What percentage of transplanted kidneys is functional 1 year after transplantation? - ANSWER 90% Which hemodialysis schedule is likely to be most efficient? - ANSWER Short daily home hemodialysis, 2-3 hours a session, 5-7 days a week the fluid restriction for most patients undergoing in-center hemodialysis is equal to urine volume/day plus: - ANSWER 1L Failure to excrete beta2- microglobulin in patients with kidney failure predisposes to: - ANSWER amyloidosis Blood tests for ferritin are performed in hemodialysis patients: - ANSWER to check for iron stores Which of the following phosphate binders would best control hyperphosphatemia with the fewest side effects in patients with end stage kidney disease/ - ANSWER lanthanum carbonate Hemodialysis patients should be taught to: - ANSWER put in their own needles, weigh themselves and record it, check their dialyzer settings and dialysate All of the following statements about vitamins in dialysis patients are true EXCEPT: - ANSWER megadose fat-or- watersoluble vitamins should not be given. Osmosis is best defined as - ANSWER diffusion of solvent through a semipermeable membrane from low-to high-solute concentration In hemodialysis, blood and dialysate have which of the following properties? - ANSWER they flow in opposite directions In the dialyzer, water may be removed from: - ANSWER the intravascular compartment Which site in the hemodialysis pathway has the highest positive pressure? - ANSWER blood entering the dialyzer fibers The term "sieving coefficient of a membrane" refers to the: - ANSWER fraction of solute that passes through the membrane by convection What moves from one body compartment to another by: - ANSWER osmotic forces Biocompatibility is best illustrated by: - ANSWER reprocessed dialyzers that have a better biocompatibility than new ones The amount of fluid to be taken from the patient during hemodialysis: - ANSWER may be calculated by subtracting the patient's estimated dry weight from the predialysis weight and adding any fluid the patient receives during treatment. The ultrafiltration coefficient of a dialyzer refers to the : - ANSWER fluid that passes through the membrane in 1 hour The molecular weight cutoff of a dialyzer is 12,000 daltons. Which of the following molecules would not pass through the membrane in to the dialysate? - ANSWER albumin Clearance of low-molecular-weight molecules by dialysis is accomplished mostly by: - ANSWER diffusion A hollow fiber dialyzer has which of the following properties? - ANSWER very fine fiber tubes held in place by polyurethane material Synthetic membranes have which of the following properties? - ANSWER The have thick fiber walls If a dialyzer has a urea clearance rate (K) of 200 ml/min and a blood flow rate (Qb) of 200 ml/min, what volume of the blood will be cleared of urea in 1 minute? - ANSWER 200 ml To determine the most accurate clearance rate of a particular solute, one should: - ANSWER measure the solute concentrations of blood going into and out of the dialyzer All of the following substances are added to the dialysate EXCEPT: - ANSWER phosphate Sodium modeling refers to: - ANSWER changing the concentration of the dialysate sodium during the course of dialysis Conductivity is best defined as: - ANSWER a method of checking electrolyte levels in the dialysate Which of the following statements about the proportioning system is correct? - ANSWER it relies on a continuous supply of fresh concentrate and treated water. An advantage of high-flux dialysis is: - ANSWER fast removal of fluid A disadvantage of high-flux dialysate is: - ANSWER pyrogen reactions are common All of the following statements regarding home dialysis are true EXCEPT: - ANSWER it cannot be done during sleep In most dialysate systems, the temperature: - ANSWER is maintained by a thermistor-controlled heater Dialysate flow rate has which of the following properties? - ANSWER Low water pressure may set off an alarm Which of the following statements about blood leaks in the dialysis system is correct? - ANSWER They are detected by use of a light source and photocell Dialysate pH is kept within the following ranges? - ANSWER 7.0-7.4 Which of the following statements about fluid removal from the blood is correct? - ANSWER it depends on the transmembrane pressure (TMP) Dialysis machines control the rate of fluid removal by: - ANSWER volume control and flow control Drip chambers in the extracorporeal circulation do all the following EXCEPT: - ANSWER pump blood into the dialyzer Which of the following statements about extracorporeal circulation is correct? - ANSWER approximately 100-250 ml are outside the patient's body at any time Which of the following statements about transducer protectors is correct? - ANSWER They use hydrophobic membranes to keep fluid from passing through Blood flow into the dialyzer is usually: - ANSWER done by manual hand cranking Which pressure in the dialysis circuit is usually negative? - ANSWER arterial pressure Which of the following will set off the prepump high-pressure alarm? - ANSWER a decrease in the blood pump speed A low-pressure alarm in the venous (postdialyzer) line is likely to be set off by? - ANSWER a blockage in the blood tubing before the monitoring site Which of the following statements about an air detector is correct? - ANSWER it uses an ultrasonic device to detect air in the blood path How is the anticoagulant heparin given during the dialysis treatment? - ANSWER intermittently, as a single bolus, by continuous infusion A sorbent is best described as a: - ANSWER continuous dialysate disinfection system that removes bacteria and endotoxins Which of the following statements about sorbent dialysis is correct? - ANSWER In preparing the dialysate, 6 liters of water are added to premixed chemicals Which type of arteriovenous fistula is likely to result in high blood flow with the fewest complications? - ANSWER artery side to vein end For which type of dialysis patient is a central venous catheter blood access appropriate? - ANSWER A patient waiting for a fistula to mature, a patient with acute renal failure, a patient waiting for a peritoneal dialysis catheter Which of the following statements about arteriovenous grafts is correct? - ANSWER they are prone to thrombosis than arteriovenous fistulae Care of a new arteriovenous fistula should include all of the following EXCEPT: - ANSWER cannulating the vessel to see if the blood flow is adequate An antiseptic that kills bacteria when wet is: - ANSWER 70% alcohol Which of the following arteries is most commonly used for an arteriovenous fistula? - ANSWER place the needle in to a previous cannulation spot The hemodialysis technician who is bout to insert a needle into the arteriovenous fistula should first do all of the following EXCEPT: - ANSWER place the needle into a previous cannulation spot During needle insertion it is important for the hemodialysis technician to always: - ANSWER cannulate the venous access in an antegrade manner (with the blood flow) Using the buttonhole technique for blood access, the technician should: - ANSWER use a sharp following by a blunt need To diminish vasovagal reactions and needle phobia in the dialysis patient, the technician should ask the patient to: - ANSWER lie down in a recumbent position, tense the muscles in the nonaccess hand for 10-20 seconds during needle insertion, cannualte his or her own vessels Recirculation refers to: - ANSWER mixing dialyzed venous blood with blood entering the arterial needle A diabetic patient undergoing dialysis complains of tingling, numbness, and cold in the hand below the access site. The most likely cause is : - ANSWER steal syndrome Common sites of stenosis in patients with an arteriovenous fistula include all the following EXCEPT: - ANSWER the artery next to the anastomosis A thrombosis is LEAST likely to develop with which of the following vascular access methods? - ANSWER An arteriovenous fistula High-output cardiac failure is a complication of arteriovenous fistula or grafting. All of the following actions are a part of this condition EXCEPT: - ANSWER decreased cardiac workload Which of the following statements about grafts used for arteriovenous shunts for dialysis patients is correct? - ANSWER They can be made collagen or expanded polytetrafluoroethylene When placing a needle into a graft, a hemodialysis technician may do which of the following? - ANSWER use three sides to cannulate the graft, not just the top Which of the following veins is most suitable for hemodialysis catheter placement? - ANSWER right internal jugular To prevent infection in catheters, hemodialysis technicians should be sure to: - ANSWER wash hands and use sterile gloves, wear a mask, and ask the patient to wear a mask as well, remove wet dressing, dry around the site, and replace with fresh dressing When the low-pressure alarm rings, signaling inadequate flow, the technician should be sure to: - ANSWER flush the catheter with saline An advantage of catheter and port catheter devices is: - ANSWER needle entry is not required A heavyset patient arrives for dialysis in a wheelchair. He has difficulty standing without assistance. Which technique would be most appropriate to transfer him to the dialysis chair? - ANSWER Portable lift device If a small fire breaks out in the dialysis center which of the following safety sequences is correct? - ANSWER when using a fire extinguisher, pull the pin, aim the nozzle at the base of the flames, squeeze the handle, and spray from side to side at the base of the flames Using sterile technique, a hemodialysis technician should avoid all the following EXCEPT: - ANSWER washing hands and using sterile gloves Use of protective equipment and techniques are intended to protect both patient and staff member. Examples of include all of the following EXCEPT: - ANSWER always recapping used needles Which of the following pathogens is most likely to be spread during dialysis treatment? - ANSWER Hepatitis B Which of the following should be avoided when drawing up medication into a syringe? - ANSWER Changing needles after half the volume is drawn up Correct statements concerning the charting of patient data include all of the following EXCEPT: - ANSWER entries must be printed for legibility After a treatment, a patient below dry weight may have? - ANSWER muscle cramping Which of the following alarms must be checked before dialysis begins? - ANSWER blood leak detector, Conductivity alarm, the pH alarm In a patient with a fistula in one arm and an intravenous line in the other, manual blood pressure should be take in the - ANSWER arm above fistula Which of the following vital signs is abnormal before dialysis in a 30-year old male patient? - ANSWER 145/95 mm Hg to calculate the amount of fluid removal from the patient during dialysis, all of the following values are used EXCEPT: - ANSWER volume of urine output When drawing blood samples for laboratory testing, the hemodialysis technician should draw samples: - ANSWER from the arterial blood line injection port The urea reduction ratio has which of the following properties? - ANSWER it requires measurement of both pre- and post dialysis blood urea nitrogen What is the urea kinetic modeling calculation? - ANSWER It gives both minimum delivered and prescribed doses For patients in whom the priming solution is to be discarded, what should the hemodialysis technician do next? - ANSWER connect the arterial tubing, and allow the priming solution to drain before connecting the venous tubing A dialysis patient has a history of heparin-induced thrombocytopenia (low platelets) and severe bleeding. What would be a good method of performing dialysis safely? - ANSWER Use a regional citrate technique A dialysis patient develops a purulent discharge at the exit site of a central catheter. Which of the following pathogens is the most likely to be cultured? - ANSWER an anaphylactic reaction A hemodialysis patient suddenly trouble breathing, hives, itching, and hypotension. The most likely cause is : - ANSWER An anaphylactic reaction A patient undergoing hemodialysis complains of muscle cramps in the calves and feet. All of the following are likely causes EXCEPT: - ANSWER hypercalcemia (high calcium level) Which of the following may cause hemolysis of red blood cells during dialysis? - ANSWER Kinked blood lines, warm dialysis fluid, and inadequate water treatment For centers that reuse dialyzers, reprocessing includes: - ANSWER disinfecting the clamps and the outside of the dialysis machine Which of the following statements about the "first-use syndrome" is correct? - ANSWER it may be reduced by repeated rinsing of the dialyzer Which of the following statements about reprocessing dialyzers is correct? - ANSWER it can be done manually or by machine Which of the following statements about new dialyzers is correct - ANSWER They may be preprocessed to reduce noxious chemicals or materials At the end of treatment, which of the following actions should be done first? - ANSWER blood rinse back Grounds for discarding a dialyzer include which of the following? - ANSWER it has been exposed to more than one germicide Which of the following germicides is most commonly used to disinfect dialyzers in the united states? - ANSWER peracetic acid What is an endotoxin? - ANSWER it is a toxin produced by certain bacteria Federal regulations require a center that reuses dialyzers to have: - ANSWER a system of quality assurance and a system of quality control Which of the following substances is the most common impurity in tap water? - ANSWER calcium carbonate the average hemodialysis patient is exposed to ow many liters of water a week? - ANSWER 350L A return loop recycles water through the water treatment system because: - ANSWER it reduces the amount of water required and it prevents stagnant spots In a water treatment system, feed water is adjusted to a temperature of: - ANSWER 77-82F, using hot and cold water and a blending valve The pH of feed water is 9.0 at a certain center. Which of the following would be the best water treatment? - ANSWER Add hydrochloric acid to the feed water, using a mixing chamber Which of the following statements about multimedia filters is correct? - ANSWER they trap successively smaller particles Water softeners remove calcium and magnesium by: - ANSWER ion exhange Which of the following statements about carbon tank removal of chlorine and chloramine from feed water is correct? - ANSWER it requires two carbon tanks in a series Which of the following statements about reverse osmosis is correct? - ANSWER hydraulic pressure is used to move water through the membrane Which of the following statements about the deionization of water is correct? - ANSWER it removes both anions and cations Which of the following statements about an ultraviolet irradiator is correct? - ANSWER it emits light at a wavelength of 254 nanometers Which of the following statements about biofilm is correct? - ANSWER it is an aggregate of microorganisms that produce a matrix of extracellular polymeric substance (slime) Public Law 93-603, which originally passed in 1972, is concerned with which of the following? - ANSWER it covers dialysis and kidney transplants Which of the following statements best describes dialysis centers today? - ANSWER they are mostly owned by large dialysis organizations Inspections and standards for dialysis centers may be provided by: - ANSWER the food and drug administration, state health departments, and the association for advancement of medical instrumentation Continuous quality improvement refers to: - ANSWER a method for improving clinical, technical., and organizational procedures Professionalism for a hemodialysis technician includes: - ANSWER refraining from talking about a patient to a colleague the conversation may be overheard Taking the Certified Clinical Hemodialysis Technician exam requires all of the following except? - ANSWER 6 months of full-time (1000 hours) experience and triaing Which of the following statements about certification examinations in clinical nephrology technology and in biomedical nephrology technology is correct? - ANSWER they require 12 months of work experience to take the examination The National Kidney Foundation's Kidney Disease: Improving Global Outcomes includes treatment guidelines for all the following EXCEPT: - ANSWER hepatitis As part of the job of a dialysis technician, one may be required to lift equipment or assist with patient transfers.Back pain- sparing and injury prevention maneuvers include: - ANSWER lifting with the legs and holding the object close to the body One difference between peritoneal dialysis (PD) and hemodialysis (HD) is: - ANSWER the patient is subjected to constant dialysis in PD rather than intermittent dialysis in HD All of the following statements regarding kidney transplantation are correct EXCEPT: - ANSWER The diseased kidneys are usually removed Which of the following immunosuppressive drugs used in kidney transplant patients has renal toxicity? - ANSWER cyclosporine What is a sensitization test for a potential kidney transplant recipient? - ANSWER potential recipient serum tested with a multiple donor lymphocyte panel A diet restricting all of the following is approriate for a renal failure patient EXCEPT: - ANSWER calcium All of the following are indications to start hemodialysis in a renal failure patient EXCEPT: - ANSWER serum creatinine of 15mg/dl The nephrotic syndrome is characterized by all the following EXCEPT: - ANSWER hematuria Which of the following statements about administering erythropoietin to a hemodialysis patient is correct: - ANSWER give supplemental iron if ferritin is low A recent study published in the New England Journal of Medicine compared hemodialysis three times a week with hemodialysis six times a week. At the end of a 12-month follow up period, the study showed the six times a week group had: - ANSWER fewer deaths Which of the following statements about the nephron, the working unit of the kidney, is correct? - ANSWER it makes about 180 liters of glomerular filtrate a day Acute tubular necrosis may be caused by: - ANSWER shock and hypotension, rhabdomylysis, radiographic contrast material What does the expression kt/v signify with regard to hemodialysis? - ANSWER prescribed dose of dialysis Adding extra sodium chloride to the dialysate will: - ANSWER draw water out of cells and tissues into the blood Which of the following is most likely to cause problems for the patient receiving hemodialysis treatments? - ANSWER inadequate vascular access Which of the following action is most important in preventing spread of infection? - ANSWER hand washing To avoid environmental contamination, it is important to do which of the following? - ANSWER clan all srfaces a t the station and the external portion of the dialysis machine, avoid storage of food and beverages in the same refrigerator or other container with blood or body fluid samples, place all used dialyzers and tubing in leak-proof containers