CCHT Study Guide 151 Questions with Verified Answers,100% CORRECT

CCHT Study Guide 151 Questions with Verified Answers You are the PCT taking care of Mr. Smith. He tells you that he has no ride today to go home after treatment. You - CORRECT ANSWER Refer him to the Social Worker ...

CCHT Study Guide 151 Questions with Verified Answers You are the PCT taking care of Mr. Smith. He tells you that he has no ride today to go home after treatment. You - CORRECT ANSWER Refer him to the Social Worker While taking the pulse you find that the patient has arrhythmia. You know that one of the causes of arrhythmia is - CORRECT ANSWER Elevated potassium level The patient is complaining that he is cold. He requests to be totally covered. You explain to the patient that the access has to remain undercover because: - CORRECT ANSWER The fistula needle could be dislodged and you will be able to intervene right away. Mr. Wonder is new to dialysis, his schedule is M-W-F at 6 am. He used to run every morning and he is upset that he has to give his running to accommodate the dialysis schedule. You - CORRECT ANSWER Tell the patient that you will make every effort possible to adjust his schedule so he can continue to run every morning. The functional unit of a kidney is - CORRECT ANSWER Nephron A healthy kidney excretes - CORRECT ANSWER Phosphorus Renagel is a medication that is a - CORRECT ANSWER Phosphate binder Which one is the highest in Potassium - CORRECT ANSWER 2 cups of raisins What are some of the foods that are high in phosphorus - CORRECT ANSWER Milk and Cheese Water softener removes: - CORRECT ANSWER Magnesium and Calcium Chlorine and Chloramines are removed by: - CORRECT ANSWER Carbon Tanks Endotoxins are removed by: - CORRECT ANSWER Ultrafilter Anastomosis is the surgical connection between the: - CORRECT ANSWER Artery and vein A A M I Standards for cultured water is: - CORRECT ANSWER 200 cfu A A M I Standards for dialysis is: - CORRECT ANSWER 50 cfu Hemodialysis is accomplished by which principles? - CORRECT ANSWER Ultra filtration, diffusion, counter-current dialysis flow While assessing an access before cannulation you note an aneurysm. You should: - CORRECT ANSWER Avoid cannulating the area and notify the nurse or physician. Your patient complains of mild to moderate pain in access limb. The limb is note to be colder distally and paler than the other limb. The patient states that the pain increases in intensity while he is on dialysis. The patient could be experiencing: - CORRECT ANSWER Steal syndrome Patient has a bilateral amputation. How do you determine that the patient is fluid overloaded? - CORRECT ANSWER Listen to the lungs If it is not documented: - CORRECT ANSWER It is not done What is a high risk of safety and a hazard: - CORRECT ANSWER A small amount of water on the floor Your patient came in for dialysis accompanied by his daughter. He is hard of hearing. You have to assess his complaints. You: - CORRECT ANSWER Speak clearly in front of him. Your patient comes to dialysis accompanied by his wife. She tells you that since he started dialysis, he is not the same, and has been very depressed. You: - CORRECT ANSWER Refer him to the administrator and social worker Dialysis pH average is: - CORRECT ANSWER 6.8-7.4 The reuse tech spilled germicide on the floor. The first place you would look to see how to deal with the chemical spill is: - CORRECT ANSWER M S D S Book Your patient is complaining of feeling dizzy while on dialysis. You suspect that he has an episode of hypotension. The first thing you would do is place the patient: - CORRECT ANSWER Shoulders and head lower that the legs Machine blood leak is alarming. The hemastix text came out negative. What do you do next? - CORRECT ANSWER Continue dialysis and monitor system Dialysis patients are diagnosed with anemia. Epogen is given to the patients to: - CORRECT ANSWER Increase red blood cell production Kt/V is a measurement used to determine: - CORRECT ANSWER Adequacy of dialysis The use of saline to prove the lines and dialyzer is necessary because: - CORRECT ANSWER Sterilant has to be removed from the dialyzer Air in the lines during the treatment are usually due to: - CORRECT ANSWER Loose connections on the dialysis lines Which organization sets the standards and recommendations for water reprocessing? - CORRECT ANSWER A A M I Which organization sets the standards for water in the dialysis setting? - CORRECT ANSWER C M S The leading cause of chronic kidney disease for adults in the USA is: - CORRECT ANSWER Diabetes A nephron is made up of: - CORRECT ANSWER The glomerulus and the tubule system Waste productions in hemodialysis are removed by: - CORRECT ANSWER Diffusion The movement of fluid from a lower solute concentration to a higher concentration is called: - CORRECT ANSWER Osmosis Increasing the blood flow rate affects: - CORRECT ANSWER Diffusion The ultrafiltration rate (UF) is: - CORRECT ANSWER The rate of fluid removed from the patient per hour The flow geometry for hemodialysis which provides optimum clearance of products from the blood is: - CORRECT ANSWER Countercurrent flow What condition occurs due to dialysis being too hot? - CORRECT ANSWER Hemolysis Fever and chills develop midway through the patients treatment are most likely cause by: - CORRECT ANSWER A. Pyrogenic reaction Normal temperature for adults is - CORRECT ANSWER 98.6 degrees Normal respirations for a patient are - CORRECT ANSWER 12 - 16 The minimum delivered Kt/V according to KDOQI guidelines is: - CORRECT ANSWER 1.2 Post BUN (blood urea nitrogen) is used to determine the adequacy for dialysis for the patient. You know that drawing accurate post BUN is important and you should draw it: - CORRECT ANSWER At the beginning of the treatment by slowing down the Blood Floow to 200 ml/min. At the end of treatment from the arterial line or needle. At the end of the treatment by the dialysis flow off. Buttonhole technique is preferred because: - CORRECT ANSWER Reduce pain at needle insertion site. It is easier for the tech to stick the needles. It does not require anesthesia at insertion site. In order to establish a track for buttonhole technique: - CORRECT ANSWER The same staff will have to cannulate the site until track is established The best way to assess the patient for fluid overload is except: - CORRECT ANSWER Determining pulse rate To confirm the direction of the blood flow in an access you: - CORRECT ANSWER Compress in the middle of the access and feel the pulse on both sides of the area being compressed Asking "How do your shoes fit you today?" is a great way to determine: - CORRECT ANSWER Has edema in the feet and is fluid overload R.A.C.E stads for: - CORRECT ANSWER Rescue, Activate alarm, Contain fire, Evacuate The doctor calls and gives you an order to change the bath for Mr. Garcia from 2K to 3K. You will: - CORRECT ANSWER Refuse to take the order and ask him to hold for the nurse You finished the chemical disinfection of the machine and you are about to prime. What do you do next? - CORRECT ANSWER Test the machine for presence of disinfectant About 1 hour in the treatment patient is complaining that is cold. Your first reaction is to: - CORRECT ANSWER Check patient temp. After you evacuate the patients in case of emergency you will - CORRECT ANSWER Call 911 A patient complains of fever and chills about 1 hour within the treatment. You suspect - CORRECT ANSWER Pyrogen Reaction A patient complains of chest pain and coughing. You look at the dialysis system and see that saline bag is emptying the air detector was not armed allowing air to enter into the dialysis system. The first step you will do is - CORRECT ANSWER Clamp both arterial and venous needle After stopping an accidental air infusion in a patient undergoing dialysis, you will - CORRECT ANSWER position the patient on his left side with head down Normal saline concentration is - CORRECT ANSWER 0.9% Seizures are most likely to occur during hemodialysis due to ... EXCEPT - CORRECT ANSWER Sudden increase in dialyzer clearance A patients phosphorus is 5.9. He is placed on phosphorus binders. What instructions should he be given regarding phosphate binders? - CORRECT ANSWER Take with meals When lifting a patient from the wheel chair to the chair you: - CORRECT ANSWER Bend at the knees and use your leg muscles to lift You receive a call in the morning that Mr. Garcia received a kidney transplant. You know that according to HIPPA regulations you can not: - CORRECT ANSWER Announce to all the patients that he received a transplant While you start the treatment for your patient you see that there is water under the dialysis machine. What is your next step? - CORRECT ANSWER Wipe the water and continue the treatment Causes for hemolysis are all except: - CORRECT ANSWER Low dialysate temp. Besides the "cranberry juice color" blood, patient may exhibit the following symptoms in case of hemolysis ... EXCEPT - CORRECT ANSWER Chills Dialysis machine is alarming low conductivity while patient is dialyzing. What do you expect: - CORRECT ANSWER bicarb solution has run out You answer the phone and find out that Mr. Wang's friend is calling because he heard that Mr. Wang is doing very poorly on dialysis and he would like to have his home phone number. You tell him: - CORRECT ANSWER That you are not allowed to give him the phone number or any information related to Mr. Wang's health A patient has to have 6.6 lb removed over 3 hours treatment time. What is the UFR? - CORRECT ANSWER 2.2 Mrs. Yon came in for regular treatment. She is diabetic and takes insulin at home. One hour into the treatment she is confused and feels clammy: - CORRECT ANSWER hypotension- Low blood sugar Main symptoms of air embolism complication are - CORRECT ANSWER Chest pain and coughing Patient comes to dialysis with food that is not allowed to eat. When you ask her she responds that nobody told her. Why do you think she responds with "nobody told her". - CORRECT ANSWER Patient suffered memory loss Machine is alarming and you assume that the lines and dialyzer are clotted. What is your action? - CORRECT ANSWER Flush saline though the lines and kidney While you return the blood at the end of the treatment you see that the system has streak of clots. What do you suggest to do next time? - CORRECT ANSWER Increase Heparin Which drink is considered high in phosphorus: - CORRECT ANSWER Orange Juice Measurement of the total cell volume (TCV) is used to determine: - CORRECT ANSWER Performance of the dialyzer What is CQI? - CORRECT ANSWER A way to improve care by selecting an area that needs improvement Crenation is - CORRECT ANSWER Shriveling of the red cells About one hour into the treatment, you see that the blood line and dialyzer are turning dark color. You check conductivity is above normal. You suspect that the red dark color is because of: - CORRECT ANSWER Crenation When does HIV dies? - CORRECT ANSWER Does not live outside the body Active listening is a skill used to give patients undivided attention. Active listening involves all, except: - CORRECT ANSWER Use short open-ended questions The minimum dwell time to achieve sterilization with Renalin is: - CORRECT ANSWER 11 Patient exposure to chloramines during the treatment will cause - CORRECT ANSWER Hemolysis DI Tank contains - CORRECT ANSWER Cations and anions The air detector alarms. You would expect - CORRECT ANSWER Blood pump is stopped The extracorporeal system consists of - CORRECT ANSWER Blood lines and dialyzer One cause of aneurysm and pseudoaneurysm is - CORRECT ANSWER poor rotation sites The bruit is detected by - CORRECT ANSWER listening with the stethoscope The venous needle - CORRECT ANSWER Should point in the direction of the flow A true aneurysm is dangerous because - CORRECT ANSWER May rupture and cause severe bleeding Victor's EDW is 72 kg. He arrives for the treatment today at of 72 kg. He is short of breath and has signs of edema on his feet. The charge nurse is notified. What should be the plan for Victor's treatment? - CORRECT ANSWER The nurse will notify MD to decrease EDW When you observe a spot of blood on the patient chair, in order to observe proper infection control guidelines you should - CORRECT ANSWER Wipe the blood immediately with bleach solution Hives, itching, respiratory distress and tightening of the chest are major signs of - CORRECT ANSWER Severe allergic reaction The best monitoring system during dialysis is - CORRECT ANSWER Technician All of the following are Phosphate Binders except - CORRECT ANSWER Folic Acid The most important member of the team is the - CORRECT ANSWER Patient What factors need to be considered when evaluating recirculation in an internal access - CORRECT ANSWER A. Direction of the flow B. The distance between the needles C. Stenosis development Answer is: *(D.) All of the above * Which one is the lowest in phosphorus: - CORRECT ANSWER 5 unsalted crackers Which of the following patients should be dialyzed in the isolation area: - CORRECT ANSWER Positive (+) H B s A g (+HBsAg) During a pre-treatment patient evaluation which question would be BEST for the PCT to ask? - CORRECT ANSWER How have you been since your last dialysis treatment? During the set-up of a machine the alarm test for conductivity fails. Which action would be best for the PCT to take? - CORRECT ANSWER Contact the Biomed Equipment Tech. The dialysis industry strives to improve the quality of patient outcomes. One way this is done is through the continuous quality improvement (CQI) process. Which of the following is a model of the CQI process? - CORRECT ANSWER Plan, do, check, and act. What is the acid-base imbalance commonly seen in patients with chronic renal failure? - CORRECT ANSWER Metabolic acidosis Which of the following is NOT a function of the kidney: - CORRECT ANSWER Storage of urine Approximately what percent of the cardiac output is received by the kidneys? - CORRECT ANSWER 23% Which of the following is considered an elevated serum potassium level for a dialysis patient? - CORRECT ANSWER 3.0 mEq/L , 3.5 mEq/L , 4.0 mEq/L , the answer is NONE of the ABOVE. Hormones made by the kidney include all EXCEPT - CORRECT ANSWER PTH and cholesterol Hyperkalemia may cause: - CORRECT ANSWER Serious or even deadly changes in the heart rhythm Which best describes the PCT's role in patient teaching? - CORRECT ANSWER Reinforce teaching the patient may have received from the nurse, physician, dietitian, or other teammates Which type of vascular access has fewest complications? - CORRECT ANSWER The A/V fistula A new hemodialysis patient received his first treatment may be at high risk for which of the following problems: - CORRECT ANSWER Dialysis disequilibrium syndrome Which of the following presents a potential for environmental contamination? - CORRECT ANSWER About one ounce (30 ml) of a fluid spilled on the floor next to the patient's chair A patient's pre-treatment weight is 80.0 kg. is estimated dry weight target weight is 76.0 kg. and the facility protocol for prime and rinse back is a total of 700 ml of normal saline. The prescription is for 4.0 hr treatment and the patient is to receive 100 ml of normal saline every 30 minutes as a "no heparin flush". What is the total amount of fluid that should be removed for this treatment? - CORRECT ANSWER 5,400 mL A patient arrives for her hemodialysis treatment and states she has been having nausea, vomiting, and diarrhea for the last two days. Her estimated dry weight is 78.0 kg and her pre-treatment weight is 77.0kg. The best action for the PCT to take is: - CORRECT ANSWER Immediately notify the nurse of the need for a patient assessment Risks associated with a deionization (D.I) water treatment system include ALL, EXCEPT: - CORRECT ANSWER DI removes all charged particles (-) ions or (+) cations The BEST definition of asepsis is: - CORRECT ANSWER The absence of pathogens A PCT is told by her male patient "I have been really depressed and lonely since I started coming here, but being around you makes me feel a lot better. Do you think we could go out some evening? Ill buy." After politely and professionally declining the invitation, what other actions, if any, should the PCT take? - CORRECT ANSWER Report the incident to the facility social worker What organization establishes dialysis water quality standards? - CORRECT ANSWER A A M I - Association for the Advancement of Medical Instrumentation To make public drinking water safe municipal water suppliers commonly treat water with chemical additives. These same additives must be removed from the water supply used for hemodialysis. Common drinking water additives include ALL, EXCEPT: - CORRECT ANSWER Sodium - They include Chlorine and ammonia, Fluorine and Alum (an aluminum compound) During a hemodialysis treatment a PCT notices the blood returning though the extracorporeal circuit is a translucent cherry or cranberry red color. A likely cause of blood this color is: - CORRECT ANSWER Hemolysis Hemodialysis infection control precautions include all of the following EXCEPT: - CORRECT ANSWER Always recap needles to prevent injuring others Gloves must be warn ... - CORRECT ANSWER For patient or equipment contact When troubleshooting the vascular access Handeling blood / body fluids samples answer is .... All of the above The heparin sodium concentration COMMONLY used in hemodialysis is ... - CORRECT ANSWER 1ml = 1,000 units The technician is setting up for a hemodialysis treatment with a re-processed dialyzer. When should the technician verify the absence of residual sterilant? - CORRECT ANSWER Immediately before initiating treatment If the extracorporeal circuit clots, it would be most important to monitor the patient's... - CORRECT ANSWER Hemoglobin level One reason normal saline is used to prime the extracorporeal circuit prior to initiating treatment is to... - CORRECT ANSWER Remove air What is the name of the instrument used to measure blood pressure? - CORRECT ANSWER Sphygmomanometer Which of the following would improve the adequacy of the dialysis treatment? - CORRECT ANSWER Increase the treatment time During a hemodialysis treatment a patient goes into cardiac arrest. What should the PCT do first? - CORRECT ANSWER Call for help Prior to cannulation the technician notices the patients's A/V fistula is red and warm to the touch. These symptoms are most likely due to ... - CORRECT ANSWER Infection Lab results indicate the patient's pre-treatment BUN value was lower than the post treatment BUN value. A potential cause could be... - CORRECT ANSWER The pre-dialysis sample was taken from the venous line after the treatment started. Half way through a treatment the technician notices a significant increase in transmembrane pressure. This is most likely due to... - CORRECT ANSWER Clotting of the dialyzer A technician notices a drop of blood on the surface of a patient's hemodialysis machine. The best action is to... - CORRECT ANSWER Clean the machine surface immediately when the technician accidentally spills undiluted bleach on the floor which resource will provide the PCT with the appropriate safety information on how to lean the spill? - CORRECT ANSWER The M S D S The movement of fluid from an area of low solute concentration to an area of high solute concentration is called... - CORRECT ANSWER Osmosis Foods high in POTASSIUM include all EXCEPT... - CORRECT ANSWER Apple / Cranberry Which of the following potassium facts is false? - CORRECT ANSWER The desired post treatment potassium range for a hemodialysis patient is 6.0 - 6.5 mEq/L Which of the following are dialyzed out during a hemodialysis treatment? - CORRECT ANSWER Water soluble vitamins B1, B2, B3, B6, B12, folic acid, C Which of the following is the most accurate measure of dialysis adequacy? - CORRECT ANSWER Kt/V (urea) According to K/DOQI guidelines and recommendations hemodialysis patients should have Kt/V of at least.... - CORRECT ANSWER 1.2 The normal blood serum pH range is - CORRECT ANSWER 7.35 - 7.45 The best definition of diffusion is the movement of... - CORRECT ANSWER Solutes from an area of high concentration to an area of low concentration Pericarditis is a complication seen in renal failure patients. It may be related to... - CORRECT ANSWER Inadequate dialysis prescription, missed dialysis treatment, fluid overload. the answer is... All of the above A complication of chronic renal failure may cause a patient to experience a tingling or numbness in the toes and fingers. This condition is most likely due to... - CORRECT ANSWER Peripheral neuropathy A complication of chronic renal failure may cause a patient to experience a tingling or numbness in the toes and fingers . This condition is most likely due to - CORRECT ANSWER Peripheral neuropathy What physician orders may be expected for a patient with pericarditis? - CORRECT ANSWER Increase the patients estimated dry (target) weight Biohazards waste includes any material exposed to - CORRECT ANSWER Blood and body fluid, sharps and infection waste, pathology specimen and infectious microbiology materials. All of the above 15 minutes before the end of the treatment a patient complains of being light headed, dizzy, and of nausea. This is most likely cause by - CORRECT ANSWER Hypotension a 58 year old blind patient does to treatment escorted by his wife. Which approach should the technician use when interacting? - CORRECT ANSWER Describe the activities in the immediate environment The hemodialysis machine monitors many parameters. Which of theses parameters must be verified by a second independent means? - CORRECT ANSWER Conductivity