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CCHT Practice
Questions and Answers (Verified Answers)
- which of the following terms indicates a solution that has the same con- centration of solutes as blood? ANS> isotonic 2. a patient's potassium levels has been running high between dialysis treat- ment, so the patient has been working with the renal dietician to restrict potassium in the diet. which of the following fruits should the patient avoid?- ANS> bananas
- during osmosis, which of the following movements takes place? ANS> fluid moves from an area of lower concentration to higher.
- a patient's granddaughter calls the dialysis center and asks for a progress report on her father, who is a patient in the center. the technician
should. ANS> - state that patient information cannot be divulged
- if a hematoma forms at the access site where a needle infiltrated, the usual intervention is to apply ANS> cold compresses
- which of the following actions by a patient increases the risk of blood clots in a venous access? ANS> wearing a top with very tight- fitting long sleeves
- a patient is very anxious during an initial hemodialysis treatment and requires extra attention. when the treatment is completed, the patient offers a $20 tip. the technician should ANS> politely decline the tip
- which of the following statements by a hemodialysis patient suggests that the patient needs more education? ANS> i should stay on a low protein diet.
ANS> polycystic kidney disease 16.which of the following complains by a patient may be an indication of uremia? ANS> itching
17.a patient with a right-sided radiocephalic A fistula (above the wrist) needs to have blood test in the lab for a number of different lab test. the blood should be drawn from the ANS> left hand
18. when setting up hemodialysis equipment, the four thing that need to be checked are [ 1 ] dialysate, [ 2] extracorporeal circuit, [ 3] dialyzer and, [ 4] ANS> machine alarm 19.generally, the optimal dialysate flow rate for hemodialysis should be ANS> 1.5 to 2 times the blood flow rate 20.a patient is receiving hemodialysis with a dialyzer with an ultrafiltration coefficient [ kuf ] of 10 and a transmembrane pressure [TMP] of 100 mm hg. how much fluid should the patient lose per hour of treatment ANS> 1000 mL 21.under what circumstances can needle be reused for hemodialysis? ANS> un- der no circumstances 22.if a emergency ( such as a tornado ) occurs and patients need to be
27.a patient has buttonhole tracts for access. after the access is cleaned and prepped for treatment, what is the next step? ANS> use a crab picker/ aseptic tweezer to remove the scabs 28.with buttonhole tracts, the technician should apply pressure as the nee- dle are removed and then for ANS> 5 to 10 minutes 29.if a buttonhole access frequently has long clots that are very difficult to remove, the most likely reason is ANS> failure to use 2-finger hold for needle removal
30. a patient who had an AV fistula in the forearm developed an aneurysm and has had to have a new AV fistula created in the upper arm. the patient has a temporary catheter in place for dialysis until the fistula has matured.
which of the following exercise may help strengthen the AV fistula? ANS> bicep curl 31.with buttonhole access sites, what should the technician do to prevent '' hubbing "? ANS> leave 1/16 th to 1/8 inch of the needle exposed 32.if a patient has a dialyzer clearance rate of 250 mL/ min with 4- hour treatment, the total volume of blood cleared is ANS> 60 L. 33.what is the most important factor in preventing exsanguination from dialysis line separation? ANS> access site visible 34.if a patient states that she has been skipping lunch because she is too tired to eat after dialysis, the best solution is to. ANS> report to the nurse and renal dietician 35.if a patient exhibits signs and symptoms of hemolysis during dialysis, the immediate action should be to
ANS> after every patient 43.when checking the water temperature in the system, the technician records the temperature at 78 F (25.5 C). in order for the reverse osmosis (RO) equipment that is partof the water treatment system to work properly, the water temperature must be maintained at ANS> 77' F to 82'F ( 25' C to 28'C )
44.when testing the chlorine levels in the water system, the water sample should be taken from the. ANS> first carbon tank 45.when considering the chain of infection, the three most common reser- voirs of interest include humans, environment and ANS> animals 46.a solution is a mixture of ANS> solute and solvent 47.when reinforcing education about weight gain, a patient should be ad- vised that the usual goal for interdialytic weight gain is less than ANS> 1.0 kg/d 48.if a high-pressure alarm for arterial pressure (pre-pum ) sounds during hemodialysis, this could indicate. ANS> drop in speed of blood pump 49.if a low- pressure alarm for venous sounds during hemodialysis, this could indicate. ANS> clotting in the access 50.according to KDOQI guidelines, when administering hemodialysis to a patient a, facemark should be worn ANS> for all access connection 51.the most common complication associated with poor needle site rotation in a graft is ANS> pseudoaneurysm
ANS> durable power of attorney 59.carbon filters in the water system are necessary to remove ANS> chlorine, chloramine, and organic material
60.backwashing to free residue from sediment filters in the water system should be done at least ANS> once daily 61.with the formula for urea kinetic modeling (UKM), the K in the Kt/V formula stands for ANS> urea clearance (mL/ min) plus residual urinary output 62.when inserting needles into a graft for hemodialysis, the needle tips be should be at least how far apart? ANS> 2.0 inches 63.if a patient is undergoing hemodialysis and the technician notes that a bloodlines has separated and blood has pooled beneath the access site, the first intervention should be to ANS> stop the blood pump 64.during hemodialysis, the technician would expect a patient's temperature to rise by about. ANS> 0.5 C 65.approximately what percentage of the total blood volume circulate in the veins? ANS> 65% to 80% 66.patient should be advised to avoid eating during hemodialysis because ingestion of food may result in ANS> hypotension 67.prior to using a reprocessed dialyzer, a recirculating rinse with NS
74.if outflow stenosis of an AV fistula occurs, the thrill usually ANS> is loud and higher pitched and then discontinuous 75.when reviewing a patient's food dairy, the technician advise the patient that which of the following protein sources is of low biological value? ANS> dried bean 76.which of the following vitamins may be removed by hemodialysis ANS> vitamin B 77.the renal nutritionist has advised the patient to have a diet high in fiber, but the patient is unsure which foods to choose. which of the following foods per serving is highest in insulate fibers? ANS> kidney beans 78.the primary purification process of the dialysis water is ANS> filtering with activated carbon 79.if the dialysis center uses hemoclips on dialysis tubing to prevent discon- nection, what other precautions should be utilized? ANS> visible access sites/line connections and documentation of integrity every 30 minutes 80.if during hemodialysis, blood is evident in the used dialysate, this prob- ably indicates ANS> tear in the membrane 81.if a patient asks a question to which the technician does not know the answer, an appropriate response is ANS> I 'll find out for you ''
82.during routine hemodialysis, a patient's blood pressure should moni- tored every ANS> 30 to 60 minutes 83.if a patient develops painful muscle cramps in the hands, feet, and abdomen shortly after hemodialysis begins, the most likely interventions is ANS> saline bolus and/or decreased ultrafiltration rate. 84.if a hemodialysis patient's temperature per tympanic membrane ther- mometer is 37C in order to reduce incidendence of intradialytic ( during dialysis ) hypotension, the temperature of the dialysate solution should ideally be set at ANS> 36.5 C 85.foam in the venous bloodline of a dialyzer may indicate ANS> air embolism 86.prior to initiating hemodialysis, the ph of the dialyste usually ranges from ANS> 7.0 to 7. 87.the number one cause of kidney failure in the US is ANS> diabetes mellitus, type 2
ANS> stenosis 95.in order to increase survival rates. the ultrafiltration rate for hemodialysis patients should be maintained at least than ANS> 12 ml/kg/m 96.as part of fistula assessment before cannulation, the technician evaluates the thrill and then applies acclusion by placing a finger across the body of the fistula. while the fistula is acceded, the technician palpates and feels both a thrill and a pulse. this probably signifies a (n) ANS> accessory pathway ( collateral circulation ) 97.how much additional proteins should a patient on hemodialysis ingest every day in comparison to a health person ANS> 50% 98.weight gain between hemodialysis treatments should not exceed ANS> 5% of dry weight 99.the technician has calculate the target weight loss for a patent's he- modialysis session, but the patient insists that the technician has made an error and the target is 1 kg too high. the technician should ANS> recalculate the target weight loss.
- the most important reason for placing hemodialysis needles in ante- grade position ( in direction of blood flow) is because ANS> it causes less scarring
- when preparing dialysate with a 45x concentrate, if the proportioning ratio contains 1.0 part acid and 1.72 parts bicarbonate, how many parts of water are needed? ANS> 42.
- if conductivity monitoring stops dialysate from flowing to the dialyzer but instead sends it to the drain (bypass), this means that ANS> the conductivity monitor is malfunctioning
- when using a portable digital dialysate meter, such as the D (myron L meter ) , to verify that inline meters are accurate regarding conductivity and ph, the technician must ANS> obtain an unused dialysate sample 104. the target ultrafiltration goal set for the patient is based on the patient's- ANS> dry weight
- a patient is to receive a bolus of ulfrationated heparin (25 IU/kg ) at the onset of dialysis and 800 U at one-hour intervals during treatment, which is scheduled from 1 to 5 PM. the first dose is given at 1 Pm and the last dose at ANS> 4 pm
- when checking the pump occlusion for the blood pump, the technician nots, that the rollers appear to loose.this may result in ANS> cracking of the blood pump segment of tubing 107. in the hemodialysis machine, a separate air detector is usually
