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DAVITA PCT FINAL EXAM ACTUAL EXAM
2024 | 2 DIFFERENT VERSIONS | ALL EXAM
QUESTIONS AND CORRECT ANSWERS
(ALREADY GRADED A+) | LATEST
VERSIONS
DAVITA PCT FINAL EXAM (VERSION 1)
Attention to infection control, proper hand hygiene, cleaning and disinfection procedures are of utmost importance in the dialysis setting. Which of the following statement is true? a. Only items taken to a clean dialysis station prior to initiation of a patient treatment can be returned to a common clean area without being disinfected b. If a hemodialysis patient performs self-care at the facility, common supply carts used to store clean supplies may be placed within the patient's reach c. Viable MRSA bacteria can remain on surfaces for days with plastic and vinyl being most favorable to their survival d. Red disposal bags are to be closed with a tight "dog eared" knot to prevent leakage of fluid from the bag ------CORRECT ANSWER----------------c. Viable MRSA bacteria can remain on surfaces for days with plastic and vinyl being most favorable to their survival Teammates decrease the risk of infection when working with a central venous catheter (CVC) by: a. Wearing a facemask b. Washing hands and wearing clean gloves c. Avoiding touching dirty surfaces when providing CVC care d. All of the above ------CORRECT ANSWER----------------d. All of the above When sodium loading is present during the dialysis treatment a. It leads to an increase in thirst and larger fluid weight gains between treatments and can contribute to post dialysis hypertension and headaches b. It is corrected by the end of the treatment as sodium diffuses from the blood into the dialysate c. It has no effect on fluid management as its impact is much smaller than dietary sodium intake d. Its long-term beneficial effects include adequate vascular refilling and the prevention of intradialytic hypotension ------CORRECT ANSWER----------------a. It leads to an
increase in thirst and larger fluid weight gains between treatments and can contribute to post dialysis hypertension and headaches Practicing meticulous infection control to prevent healthcare-associated infections (HAIs) in dialysis patients is of utmost importance because a. Kidney failure weakens a person's immune system, making these patients much more vulnerable to infections b. Infections are the second most common cause of death in this population c. The hemodialysis procedure requires prolonged access to the patient's blood d. All of the above ------CORRECT ANSWER----------------d. All of the above Poor or incomplete documentation a. Can open an attack on your care b. Can be excused during times of working short staffed c. Can be amended in a court of law through a verbal recollection of what happened d. Has no impact on quality patient care ------CORRECT ANSWER----------------a. Can open an attack on your care You administer a 100 ml saline bolus to your patient during the treatment. What would be important to include in your documentation? a. The reason for administering the saline and the patient response b. The time and amount of saline given only c. That you checked the patient's medication allergies prior to administering normal saline d. The rate at which you administered the saline ------CORRECT ANSWER---------------- a. The reason for administering the saline and the patient response Your immediate intervention for a patient experiencing an anaphylactic reaction is a. Discontinue the medication, administer a saline bolus to prevent hypotension b. Discontinue the medication and the treatment, return the blood c. Discontinue the medication, decrease BFR, administer oxygen d. Stop the blood pump, discontinue the treatment, do not return the blood ------ CORRECT ANSWER----------------d. Stop the blood pump, discontinue the treatment, do not return the blood
b. Have no effect on the Kt/V reading c. Cause the Kt/V reading to be either falsely high or low d. Cause the Kt/V reading to be falsely high ------CORRECT ANSWER----------------d. Cause the Kt/V reading to be falsely high In the event of a patient experiencing a seizure, the dialysis treatment should be a. Discontinued if the seizure is severe or the patient does not respond to treatment b. Discontinued immediately and the patient transferred to the ER c. Continued, but the blood flow rate (BFR) and dialysate flow rate (DFR) should be reduced d. Interrupted for at least 30 minutes to allow the patient to recover ------CORRECT ANSWER----------------a. Discontinued if the seizure is severe or the patient does not respond to treatment The left side Trendelenburg position is to be used for a. A patient who is experiencing a seizure b. A patient with severe abdominal cramps c. A patient with loss of consciousness due to hypotension d. A patient who experienced an air embolism ------CORRECT ANSWER----------------d. A patient who experienced an air embolism Which of the following factors would decrease the K of the Kt/V formula? a. Increased blood flow rate b. Patient receiving full treatment time c. Correct dialyzer d. Inadequate anticoagulation ------CORRECT ANSWER----------------d. Inadequate anticoagulation As you initiate the treatment, your patient complaints of pain a the venous needle site, tingling around the lips and difficulty breathing. These are signs and symptoms of a. An air embolus b. A disinfectant infusion c. Impending cardiac arrest d. A dialyzer reaction ------CORRECT ANSWER----------------b. A disinfectant infusion In states that do not mandate a pre-dialysis patient assessment by the registered nurse
a. The nurse should always perform the pre-treatment assessment for patient safety b. The PCT must inform the nurse of unusual data collection findings prior to treatment initiation c. The nurse can perform the patient assessment as time permits d. A patient assessment is not necessary as long as the PCT does a thorough data collection ------CORRECT ANSWER----------------b. The PCT must inform the nurse of unusual data collection findings prior to treatment initiation For patients' with AKI a. No nursing assessment is required b. A pre-treatment nursing assessment is always required c. Treatment and prescription is the same as if diagnosed with end stage kidney disease d. No labs are drawn ------CORRECT ANSWER----------------b. A pre-treatment nursing assessment is always required Intradialytic hypotension a. Is common during the hemodialysis treatment and can easily be corrected with saline infusion b. Is only of concern if it happens on a regular basis, e.g. once every treatment c. Can have many adverse effects including impaired tissue perfusion of vital organs and organ injury d. Has no adverse effects unless the systolic blood pressure drops below 60 mmHg -----
- CORRECT ANSWER----------------c. Can have many adverse effects including impaired tissue perfusion of vital organs and organ injury The nephrologist orders a BFR of 300 for a patient with a two-month-old AV fistula. What needle gauge would be appropriate for this BFR? a. 17 gauge b. 16 gauge c. 15 gauge d. 14 gauge ------CORRECT ANSWER----------------b. 16 gauge V-tags for CSM surveys state specific regulations to be met within a condition such as Infection Control, provide interpretive guidance for each regulation, and cite deficiencies by tag number. How can knowledge of these V-tags affect the practice of patient care providers? a. Provide patient care within CMS Conditions for Coverage
What does CKD-MBD lead to? a. Abnormalities in gastrointestinal mucosa interfering with adequate nutrition b. Abnormalities in erythropoiesis with pallor, weakness, and fatigue c. Abnormalities in the peripheral nervous system with muscle weakness, burning feet and decreased sensation d. Abnormalities in Ca, PO4, PTH, and Vitamin D metabolism with soft tissue calcification and bone disease ------CORRECT ANSWER----------------d. Abnormalities in Ca, PO4, PTH, and Vitamin D metabolism with soft tissue calcification and bone disease Ultrafiltration is defined as a. Solutes are dragged across the semipermeable membrane along with fluid b. Controlled fluid removal by manipulation of hydrostatic pressure c. Particles move from an area of higher solute concentration to an area of lower solute concentration d. Fluid moves from an area of lower solute concentration to an area of higher solute concentration ------CORRECT ANSWER----------------b. Controlled fluid removal by manipulation of hydrostatic pressure Osmosis is defined as a. Controlled fluid removal by manipulation of hydrostatic pressure b. Fluid moves from an area of lower solute concentration to an area of higher solute concentration c. Solutes are dragged across the semipermeable membrane along with fluid d. Particles move from an area of higher solute concentration to an area of lower solute concentration ------CORRECT ANSWER----------------b. Fluid moves from an area of lower solute concentration to an area of higher solute concentration The waiting time after administration of the initial heparin loading dose prior to initiation of hemodialysis is a. 4-6 minutes b. 3-5 minutes c. 1-2 minutes d. No waiting is needed ------CORRECT ANSWER----------------b. 3-5 minutes Educational tips for auditory learners include a. Using word associations and mnemonics
b. Providing loud background music of the patient's choice c. Incorporating the patient's secondary learning style d. Minimizing use of written materials ------CORRECT ANSWER----------------a. Using word associations and mnemonics A surveyor discovers that the chlorine checks have not been done correctly. What kind of deficiency would the surveyor give the facility? a. Standard Deficiency b. Condition c. Immediate Jeopardy d. Grave Violation ------CORRECT ANSWER----------------c. Immediate Jeopardy To prevent the formation of aneurysms and pseudo aneurysms the following should be practiced a. Appropriate skin cleansing techniques prior to needle insertion b. Good needle site rotation and complete needle site clotting techniques c. Needle insertion at least 1 inch away from the anastomosis d. Keeping needle tips of the arterial and venous needle at least 3 inches apart ------ CORRECT ANSWER----------------b. Good needle site rotation and complete needle site clotting techniques What problem will cause an increase in venous pressure? a. Clotting of the venous drip chamber b. Severely clotted dialyzer c. Blockage in the blood tubing before the monitoring site d. Separation of blood tubing from the venous needle ------CORRECT ANSWER---------- ------a. Clotting of the venous drip chamber Performing a procedure "your way" rather than following DaVita's P&Ps a. Carriers no risk of being considered outside the Ordinary Standard of Care as long as "your way" achieves the same results b. Can lead to civil liability in the event of an adverse patient outcome c. May be defended in court by demonstrating that your way is as good as DaVita's P&Ps d. Is accepted practice since there is no one right way to performing most procedures --- ---CORRECT ANSWER----------------b. Can lead to civil liability in the event of an adverse patient outcome
DQI (Davita Quality Index) is achieved by a. Managing individual patients first and allowing scores to follow b. Knowing each team member's role in improving DQI scores c. Using the CQI process to help identify trends and make improvements d. All of the above ------CORRECT ANSWER----------------d. All of the above Per the CDC, which is the most common factor contributing to bacteremias in dialysis patients? a. Inappropriate skin preparation prior to vascular access needle insertion b. The use of catheters for hemodialysis c. Poor needle site rotation when cannulating an internal vascular access d. Exposing needle insertion sites to unclean environment areas, e.g. contaminated chair side tables during dialysis ------CORRECT ANSWER----------------b. The use of catheters for hemodialysis Which statement is true about sinks used for hand washing? a. Patients may not use sinks that are dedicated for teammate hand washing, but should have their own sinks b. Hand washing sinks may be used to discard clean solution such as left-over normal saline in a sterile bag c. Hand washing sinks must be dedicated for hand washing purposes only and should remain clean d. Hand washing sinks may be used to discard bleach solution since the solution kills germs and has the added benefit of disinfecting the sink ------CORRECT ANSWER------- ---------c. Hand washing sinks must be dedicated for hand washing purposes only and should remain clean If a patient presents with dialysis associated pericarditis, treatment includes more frequent dialysis and a. Heparin restriction to prevent bleeding into the pericardium and tamponade b. A higher potassium bath to prevent dysrhythmias c. A lower BFR and DFR to prevent dialysis disequilibrium syndrome d. An increased BFR and DFR to increase toxin removal ------CORRECT ANSWER------ ----------a. Heparin restriction to prevent bleeding into the pericardium and tamponade
If your facility dialyzes Hepatitis B positive patients, which assignment would NOT be an appropriate patient care assignment a. Caring for HBsAg positive and Hepatitis B immune patients at the same time b. Caring for HBsAg and Hepatitis B susceptible patients at the same time c. Caring for Hepatitis B susceptible patients and those in the process of receiving the vaccination at the same time d. Caring for Hepatitis B immune and susceptible patients at the same time - ----- CORRECT ANSWER----------------b. Caring for HBsAg and Hepatitis B susceptible patients at the same time The best way to help patients successfully change behaviors is to a. Scare them through describing serious health risks of the current behavior b. Tell them how to accomplish the desired change c. List medically sound reasons why change is necessary d. Inspire behavior change through support, compassion, and empathy ------CORRECT ANSWER----------------d. Inspire behavior change through support, compassion, and empathy Your patient complains of dry itchy skin. You would advise her to a. Take frequent hot showers b. Rub skin completely dry after a bath c. Use hyper-fatted soaps and lotions d. Eat foods rich in fatty acids ------CORRECT ANSWER----------------c. Use hyper-fatted soaps and lotions Which statement is true regarding the stages of grief? a. To come to a place of "Acceptance" one must follow the right way to work through the stages b. Some people can get stuck in a stage c. Once acceptance is achieved even complications like access problems cannot start the grief process anew d. Patients go through a common stepwise progression through each stage of grieving process ------CORRECT ANSWER----------------b. Some people can get stuck in a stage The acronym DARN stands for a. Desire, Ability, Reason, Need b. Deficiency, Ambition, Rationality, Neediness c. Design, Aspiration Requirement, Negativity
b. At 25 days after opening c. At 23 days after opening d. At 21 days after opening ------CORRECT ANSWER----------------a. At 28 days after opening Educational tips for visual learners include a. Providing soft background music b. Selecting quiet surroundings c. Using lively hand gestures when delivering long lectures d. Allowing plenty of time for the patient to talk ------CORRECT ANSWER----------------b. Selecting quiet surroundings An optimal nutrition status is evidenced by a. An appropriate amount of energy, ability to sleep well at night, serum potassium of no greater than 5.5 mEq/L, and a BUN of 60-80 mg/dl b. A 30 minute exercise tolerance, calcium 8.4-10.2 mg/dl, phosphorus 3-5.5 mg/dl and PTH intact 150-600 pg/ml c. Patient report of feeling well, no excess fluid weight gains, bringing appropriate snacks to dialysis, and taking phosphate binders with every meal d. A stable, desirable target weight, adequate fat stores and muscle mass, appropriate appetite and intake, and a serum albumin of equal to or greater than 4 gm/dl ------ CORRECT ANSWER----------------d. A stable, desirable target weight, adequate fat stores and muscle mass, appropriate appetite and intake, and a serum albumin of equal to or greater than 4 gm/dl When comparing the FMC dialysis machine's conductivity reading to your manual reading, policy states that the difference between these two readings is to be a. No greater than +/- 0. b. No greater than +/- 0. c. No greater than +/- 0. d. No greater than +/- 0.1 ------CORRECT ANSWER----------------a. No greater than +/-
Which statement is true regarding the "Reasonable and Prudent" Standard of Care? a. The Standard of Care is based on providing highly specialized care after a caregiver is certified b. Caregivers who are doing it "their way" without regard to DaVita P&P can easily defend their actions in the event of an adverse patient outcome
c. The Standard of Care only includes actions a nephrology nurse would do, but not those the nurse would avoid doing d. When supervising patient care technicians an other non-licensed personnel, it is the responsibility of the licensed nurse to ensure these teammates also meet the Standard of Care ------CORRECT ANSWER----------------d. When supervising patient care technicians an other non-licensed personnel, it is the responsibility of the licensed nurse to ensure these teammates also meet the Standard of Care What is an important action prior to returning a patient's blood using the hand crank in the event of a power failure? a. Take the patient's blood pressure b. Check for a blood leak c. Place the machine into bypass d. Remove the venous line from the line clamp ------CORRECT ANSWER----------------d. Remove the venous line from the line clamp The KDOQI (Kidney Disease Outcomes Quality) Rule of 6s a. Provides guidelines for use of a new AV fistula b. Provides guidelines for use of a new AV graft c. Provides guidelines for use of a new AV fistula and a new AV graft d. Provides guidelines for use of a tunneled CVC ------CORRECT ANSWER---------------- a. Provides guidelines for use of a new AV fistula During cannulation of all AV fistulas a. A tourniquet is to be applied to increase vein engorgement and stabilize vessel b. A tourniquet may be applied to increase vein engorgement if deemed necessary by the cannulator c. A tourniquet to increase vein engorgement is not necessary if the AVF is well developed d. Tourniquets should not be applied to decrease the risk of AVF clotting ------ CORRECT ANSWER----------------a. A tourniquet is to be applied to increase vein engorgement and stabilize vessel At what time do you perform water hardness testing? a. At the beginning of each day prior to the first treatment b. About halfway through your treatment day c. Every four hours
hemostasis has been achieved and dress the needle sites with sterile gauge or band aid Why do we measure the pH of the dialysis solution? a. To verify its conductivity is within the acceptable range b. To verify the correct amount of dialysis quality water has been added c. To verify its acid-base balance within the acceptable range d. To verify no residual disinfectant is present ------CORRECT ANSWER----------------c. To verify its acid-base balance within the acceptable range You listen to your patient's AV graft and hear a whistling sound a. This could be inactive of an inflow stenosis b. This could be indicative of an outflow stenosis c. This could be indicative of advanced access thrombosis d. This is a normal sounding bruit ------CORRECT ANSWER----------------b. This could be indicative of an outflow stenosis Your patients pull out her snack during dialysis. As she savors the first bite of her banana she smiles and tells you she always waits to eat food in high in potassium during dialysis so it won't harm her. What is your appropriate response? a. You congratulate the patient on her understanding that too much potassium can be dangerous b. You explain to the patient that the potassium in food eaten during dialysis is not dialyzed off c. You ask the patient if she remembered to bring her phosphate binders too d. You ask the Charge RN to change the amount of potassium in the dialysate to a lower level so it will remove more potassium ------CORRECT ANSWER----------------b. You explain to the patient that the potassium in food eaten during dialysis is not dialyzed off A new AV fistula has received its post op exam, meets the criteria listed in the KDOQI Rule of 6s and the nephrologist writes orders to begin cannulation. Which teammates can cannulate the AVF? a. The NFACT Beginner Cannulator b.The NFACT Intermediate Cannulator c. The NFACT Advanced Cannulator d. Any teammate who has completed vascular access cannulation training ------ CORRECT ANSWER----------------c. The NFACT Advanced Cannulator
Which of the following is a basic principle of patient self-management? a. Focusing primarily on dialysis prescription and adherence to treatment b. Taking on responsibility of the medical management of the illness c. Dealing with the consequences of illness, rather than just the physical disease d. Allowing care providers to help with the day-to-day management of the disease ------ CORRECT ANSWER----------------c. Dealing with the consequences of illness, rather than just the physical disease Diffusion is defined as a. Particles move from an area of higher solute concentration to an area of lower solute concentration b. Controlled fluid removal by manipulation of hydrostatic pressure c. Solutes are dragged across the semipermeable membrane along with fluid d. Fluid moves from an area of lower solute concentration to an area of higher solute concentration ------CORRECT ANSWER----------------a. Particles move from an area of higher solute concentration to an area of lower solute concentration When an AV access is cannulated via the rope ladder method, cannulated sites are rotated with each treatment to allow healing and increase longevity of the access. How long does it take for a cannulation site to heal? a. One week b. Two weeks c. Three weeks d. Four weeks ------CORRECT ANSWER----------------b. Two weeks The two types of peritoneal dialysis are: a. Drain and Fill b. CAPD and CCPD c. Solo and Conventional d. None of the above ------CORRECT ANSWER----------------b. CAPD and CCPD Educational tips for kinesthetic learners include a. Allowing the patient to doodle during long lectures b. Using outlines, pictures, graphs, charts, and diagrams whenever possible
d. Is an optional assessment - -----CORRECT ANSWER----------------c. Is completed initially and annually Hemodialysis replaces _____% of normal kidney function a. 25 b. 15 c. 10 d. 50 ------CORRECT ANSWER----------------b. 15 The endocrine functions of the kidneys are a. Excreting acids and reabsorbing bicarbonates b. Elimination of waste products c. Normalizing electrolytes d. Renin and erythropoietin secretion, activation of vitamin D ------CORRECT ANSWER- ---------------d. Renin and erythropoietin secretion, activation of vitamin D Peripheral neuropathy is a complication in chronic renal failure which affects sensory and motor nerve fibers. If your patient complains of a burning sensation in the feet, you should advise him a. That short cold foot baths once or twice a day numb the feet and provide relief from the burning b. Not to walk barefoot, be careful with foot care, and check the bath water temperature with thermometer c. Not wearing socks or shoes at home might make him more comfortable as long as he is walking on soft carpet d. To take two or three short brisk walks each day to strengthen the affected nerves in the feet ------CORRECT ANSWER----------------b. Not to walk barefoot, be careful with foot care, and check the bath water temperature with thermometer What problem will cause a more negative pre-pump arterial pressure? a. Separation of blood tubing from arterial access b. Kinking of the arterial blood line between the vascular access and arterial monitor c. Increase in blood pump speed d. Arterial needle properly positioned ------CORRECT ANSWER----------------b. Kinking of the arterial blood line between the vascular access and arterial monitor
Phosphate binders are prescribed to prevent phosphorus in meals from being absorbed. When is the best time to take them? a. 60 minutes prior to a meal b. 30 minutes prior to a meal c. With a meal d. 60 minutes after a meal ------CORRECT ANSWER----------------c. With a meal A surveyor asks you a question. Which of the following statements would be a good answer? a. This is the way we have always done it b. Nobody showed me how to do this c. I do not know the answer but I will find out d. This is a faster way ------CORRECT ANSWER----------------c. I do not know the answer but I will find out What complication occurs if blood is exposed to dialysate that is too hot? a. Hypersensitivity reaction b. Seizures c. Hemolysis d. Pyrogenic reaction ------CORRECT ANSWER----------------c. Hemolysis Flipping the arterial vascular access needle a. Is standard practice to improve blood flow rates b. Is dependent on a patient preference c. Carries no risks of harming the access d. Is not necessary since all arterial needles have a back eye ------CORRECT ANSWER----------------d. Is not necessary since all arterial needles have a back eye Benefits of peritoneal dialysis and home hemodialysis include: a. Home based b. Flexible schedule c. Fewer dietary restrictions d. All of the above ------CORRECT ANSWER----------------d. All of the above The sign that numbing has taken effect and it is time to stop spraying topical anesthetic onto vascular access cannulation sites is
