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Temple University
Fresenius Medical Care Patient Care
Technician PCT Certification
Fresenius Hemodialysis Technician
Certification Exam
Course Title and Number: CPCT Certification Exam Exam Title: CPCT Certification Exam Exam Date: Exam 2024- 2025 Instructor: [Insert Instructor’s Name] Student Name: [Insert Student’s Name] Student ID: [Insert Student ID]
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180 minutes
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Fresenius Medical Care Patient Care
Technician PCT Certification
Fresenius PCT Certification Exam Review
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Read All Instructions Carefully and Answer All the Questions Correctly Good Luck: - How long can mix bicarbonate be kept for use without Medical Director approval and validation procedures? - =Answer>> Must be used the same day it is mixed Which of these findings noted on a safety check would indicate that an intervention is needed? - =Answer>> HemoSafe is in place and secure on the arterial lines When removing needles from an internal access the needle safety device - =Answer>> should be engaged while removing needles from patient's access A major factor affecting ultrafiltration is - =Answer>> Pressure Source water is - =Answer>> received from the water supplier to make product water for dialysis Which group of solutes may be present in the prescribed dialysis solution - =Answer>> Sodium bicarbonate, potassium and calcium Need Writing 🤔Help? We've Got You Covered! ✍ 100% NO A I or Plagiarism Guaranteed🤔
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What reading on the reverse osmosis ( RO ) machine indicates the level of water quality? - =Answer>> Total Dissolved Solids Pre-treatment evaluation of an internal vascular access includes - =Answer>> palpating for a thrill The purpose of the QAI program is to improve the quality and appropriateness of patient care. This is accomplished by - =Answer>> identifying opportunities and resolving problems through the use of the QAI process Oral Nutritional supplements (ONS) are given to FMS in- center dialysis patients who are malnourished while they are at the dialysis facility for which for these reasons - =Answer>> to improve nutritional status and ensure compliance with oral intake and reduce the risk of morbidity and mortality In addition to air embolism, what complication may potentially occur if the saline bag is left unclaimed with the blood pump running during the dialysis treatment? - =Answer>> dialyzer clotting The patients venous needle has infiltrated and another needle will need to be inserted, the caregiver would? - =Answer>> insert the new needle above the infiltrated and apply ice to the area A potential hazard or incident that has NOT resulted in any patient injury, but the potential to do so is referred to as a - =Answer>> potential miss Need Writing 🤔Help? We've Got You Covered! ✍ 100% NO A I or Plagiarism Guaranteed🤔
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What is the correct blood flow rate for priming a dialyzer - =Answer>> 150 ml/min A fistula is considered the access of choice because fistulas - =Answer>> A. may be cannulated immediately B. allows higher blood flow C. have higher access flow rates D. have the lowest complication rate The following KECNs are noted. These results indicate a TIME KECN TIME KECN 00:15 268 01:45 243 00:45 254 02:15 240 01:15 242 02:45 238 - =Answer>> Low clearance, need for further heparinization According to FMS policy, the safe level for total chlorine is - =Answer>> less than 0.10ppm If the second GAC ( carbon) filter exceeds the acceptable limit for total chlorine, what is the next step? - =Answer>> notify nurse in charge to stop treatment The ratio of bleach to water in the solution used to disinfect external surfaces and equipment is - =Answer>> 60 mls of bleach to 6 liters of water What notification process would alert the staff of poor water quality during the dialysis treatment? - =Answer>> remote total dissolved solids (TDS) alarms in the treatment room Need Writing 🤔Help? We've Got You Covered! ✍ 100% NO A I or Plagiarism Guaranteed🤔
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respond to a verbal question and vital signs are trending down arterial lines - =Answer>> Red Venous - =Answer>> Blue CMS - =Answer>> Centers for Medicare and Medicaid Services AAMI - =Answer>> Association for the Advancement of Medical Instrumentation List signs and symptoms of vascular access infection? - =Answer>> chills, fever, drainage and pain, redness, swelling and warmth at the site List four things you can teach a patient to prevent their access from clotting? - =Answer>> 1. not to wear tight fitting clothing or jewelry on the access arm,
- not to sleep on the access arm,
- not to let anyone draw labs or check blood pressures in their access arm and,
- not to carry heavy objects in their access arm. Why is it important to determine which side is arterial and which side is venous? - =Answer>> If the needles are connected to the wrong blood line, recirculation will prevent the clearance to deliver an adequate treatment. Need Writing 🤔Help? We've Got You Covered! ✍ 100% NO A I or Plagiarism Guaranteed🤔
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How long should you clean the patients skin before cannulation with alcohol pad or betadine? - =Answer>> 30 seconds, if betadine is use allow for it to dry 3-5 mins What insertion angle should I use for cannulation? - =Answer>> Bevel up - AV graft 45 degree angle - AV fistula 20-30 degree angle also depends on depth of access What direction should the needles be placed for dialysis? - =Answer>> Arterial needle can go with or against the flow, and Venous needle has to go with the flow. What is an infiltration and how is it treated? - =Answer>> An infiltration is fluid seepage into the surrounding tissue resulting in pain and swelling. Infiltrations are treated with intermittent ice for 24 hours followed by intermittent heat and ice as needed. Where should you place an arterial and a venous needle if it has infiltrated? - =Answer>> A new venous needle should be placed above the infiltration site. For an arterial infiltration the needle may be placed either above or below the infiltrated site. What is Heparin and why is it used in hemodialysis? - =Answer>> Heparin is an anticoagulant that prevents clotting After the Heparin has been given, how long must you wait before initiating the treatment? - =Answer>> 3 - 5- minute Need Writing 🤔Help? We've Got You Covered! ✍ 100% NO A I or Plagiarism Guaranteed🤔
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during treatment; most frequently observed mid to late in the treatment. Cramping can occur in any muscle and is most frequently found in the extremities How is cramping treated? - =Answer>> Pressure against cramping muscle. DO NOT MASSAGE Which additional check is performed weekly and before the first treatment after disinfection? - =Answer>> Residual bleach Normal Temp Range for dialysate? - =Answer>> 35.5-39 'c Normal PH range for dialysate? - =Answer>> 6.9-7. Normal conductivity range for dialysate? - =Answer>> 12.6-15. List three blood borne pathogens that may be found in a dialysis unit. - =Answer>> Hepatitis B, Hepatitis C and HIV What is an adverse event? - =Answer>> This is a patient event reporting system. Any time there is a failure to follow established clinical procedure or a treatment prescription or when a serious or unexpected equipment event occurs at an outpatient, in-patient or home program, an adverse event occurs. What is a serious adverse event? - =Answer>> An event that causes serious patient injury, hospitalization or death. Need Writing 🤔Help? We've Got You Covered! ✍ 100% NO A I or Plagiarism Guaranteed🤔
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Diffussion - =Answer>> Movement of solutes from an area of higher concentration to an area of lower concentration. Osmosis - =Answer>> Movement of fluid from a lower concentration to a higher concentration Ultrafiltration - =Answer>> The use of pressure across a semi permeable membrane What are two things that change with PT's prescription?
- =Answer>> Calcium and Potassium hemolysis - =Answer>> the rupture or destruction of red blood cells. Hypotonic solution causes RBC's to do what? - =Answer>> Swell Hypertonic solution causes RBC's to do what? - =Answer>> Shrink Elements that affect the clearance? - =Answer>> Dialyzer, Tx time, Needle size, BFR, Heparin, temperature, DFR Formula to determine available weight? - =Answer>> Pre- weight - EDW Formula to determine fluid gain? - =Answer>> Pre wt - Last post wt Formula to determine target wt? - =Answer>> Available wt
- rinse back Need Writing 🤔Help? We've Got You Covered! ✍ 100% NO A I or Plagiarism Guaranteed🤔
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prime bucket with _________________ end caps. - =Answer>> bloodlines, open caps How often should staff clean the dialysis machine with acid? - =Answer>> daily An arterial pressure reading of negative _____ can cause blood to hemolyze. - =Answer>> 270 Angia - =Answer>> chest pain disequilibrium syndrome - =Answer>> fluid imbalance between blood and brain tissue Dyspnea - =Answer>> difficulty breathing Exsanguination - =Answer>> severe loss of blood Excessive fluid removal during dialysis, combined with the patient's taking an antihypertensive medication may result in the patient having: - =Answer>> hypotension The three types of errors associated with a "Just Culture" are - =Answer>> At risk, simple human, and reckless Near misses, are sometimes referred to as _________________because they help diagnose a ________________ and reduce __________________________________> - =Answer>> good catches, system problem, and reduce patient injury Need Writing 🤔Help? We've Got You Covered! ✍ 100% NO A I or Plagiarism Guaranteed🤔
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Thrombosis - =Answer>> No blood flow in the vascular access; blood inside the access is clotted -stenosis - =Answer>> abnormal narrowing of a blood vessel How long must RO machine run before performing any total chlorine testing? - =Answer>> 15 mins Total chlorine testing for a central water system must be performed and documented by? - =Answer>> 2 staff members one being the nurse in charge How much water must you collect for the total chlorine test? - =Answer>> 100 ml How long do you allow the RPC to immerse in a sample? - =Answer>> 60 secs How long must you wait before you can read the RCP chlorine strip once you removed it from the water? - =Answer>> 20 secs How often is total chlorine tested? - =Answer>> Prior to the initiation of treatment in the morning and every 4 hours. Safe range for total chlorine is - =Answer>> less than 0. ppm (0.00-0.09) Do not initiate any patients treatment if the total chlorine is greater than? - =Answer>> 0.1 ppm or greater Need Writing 🤔Help? We've Got You Covered! ✍ 100% NO A I or Plagiarism Guaranteed🤔
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Erythropoietin - =Answer>> stimulates the bone marrow to produce red blood cells (RBSc). Why must the kidney activate Vitamin D? - =Answer>> The kidney converts Vitamin D to Calcitriol, its activated form. This activated form of Vitamin D helps to maintain good bone health by helping absorb calcium from foods eaten What causes renal osteodystrophy (bone disease)? - =Answer>> No longer produce calcitriol - the active form of Vitamin D o Inadequate or lacking calcitriol causes demineralization of the bone - bone begins to break down to release the calcium needed for body functioning No longer excrete excess phosphorus (PO4) o Phosphorus is found in most foods and beverages o Increased PO4 levels cause further calcium bone loss What are the body fluid compartments? - =Answer>> Intracellular-inside the cells • Extracellular-outside the cells • Intravascular-inside the blood vessels • Interstitial-between the cells What is homeostasis? - =Answer>> Maintaining a stable internal environment uremia - =Answer>> build up of waste What is a semi-permeable membrane? - =Answer>> A membrane made from protein, with small pores or holes. Only certain molecules can fit through. Need Writing 🤔Help? We've Got You Covered! ✍ 100% NO A I or Plagiarism Guaranteed🤔
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At what point during the hemodialysis treatment will diffusion cease to occur? - =Answer>> Diffusion will continue throughout the dialysis treatment until the concentration of each electrolyte found in the patient's blood is equal to the electrolyte concentration in the dialysate. What is countercurrent flow? - =Answer>> Blood and dialysate flow in opposite directions What happens to diffusion when dialyzer fibers clot? - =Answer>> Clotted fibers cause the permeability of the fiber to be reduced or eliminated, causing a decrease in treatment adequacy. As a result , diffusion does not occur as particles cannot diffuse across the membrane. What are the compartments of the dialyzer and what separates them? - =Answer>> The blood compartment is separated from the dialysate compartment by a semi- permeable membrane. The blood and dialysate do not mix together. What are three types of solutions? - =Answer>> • Hypotonic-containing less particles • Isotonic- containing equal particles • Hypertonic-containing more particles When is it known that a patient has developed sensitivity to a dialyzer? - =Answer>> Patients develop mild to severe reactions in some cases, usually seen the first half hour of treatment. Sneezing, itching, pain at the access site, chest pain, rashing, hives, fever, all may be symptoms of dialyzer membrane allergy, or Need Writing 🤔Help? We've Got You Covered! ✍ 100% NO A I or Plagiarism Guaranteed🤔
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What is dialysate? - =Answer>> Dialysate is a non-sterile solution and its function is to remove waste products from the blood and balance electrolytes Dialysate is composed of - =Answer>> treated water, acid solution, and bicarbonate solution What electrolytes are found in the dialysate? - =Answer>> sodium (Na+) potassium (K+) calcium (Ca++) magnesium (Mg++) chloride (Cl-) What is conductivity? - =Answer>> Conductivity is the ability of a solution to transmit or "conduct" an electrical current Name four ways dialysate is checked to ensure that it is safe? - =Answer>> pH, conductivity, monitoring the machine temperature, and a negative residual chlorine (bleach) after routine (weekly) machine disinfection and before the first treatment after the disinfection What is Sodium Variation? - =Answer>> also called sodium modeling is a physician-ordered intervention to help prevent hypotension during dialysis treatment. There are three preprogrammed "profiles" that can be ordered by the physician based on several different comorbidities Why is dextrose added to the dialysate? - =Answer>> Dextrose, a form of glucose, is added to prevent hypoglycemia. What is TMP? - =Answer>> Transmembrane pressure is the pressure difference across the dialyzer membrane. It Need Writing 🤔Help? We've Got You Covered! ✍ 100% NO A I or Plagiarism Guaranteed🤔
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reflects the total pressure across the membrane used to achieve the desired fluid loss How can you tell if a dialyzer is clotting? - =Answer>> Indications of a clotting dialyzer are a rising TMP, rising venous pressure, dark blood in the dialyzer, and air detector alarms. A venous line that is clotting will show an increase in venous pressure. How is dialysis delivered? - =Answer>> The Hemodialysis Machine is the Delivery System. The machine has two sub-systems.
- Blood delivery system circulates the patient's blood
- Dialysate delivery Mixes & circulates dialysate What is monitored during treatment? - =Answer>> Machine alarms monitor the safe progression of the dialysis treatment. Alarms are divided into two categories. Blood related, and dialysate related What causes increased arterial pressure? - =Answer>> Kinks, clamp or occlusion on arterial line BFR exceeds vascular access flow Needle gauge size selected compared to BFR Needle placement Clotting, stenosis, vasoconstriction or vasospasms Malposition of catheter tip, constricting sutures at insertion site or CVC thrombus Hypotension Poor cardiac output Increased blood viscosity due to high hgb or ultrafiltration Need Writing 🤔Help? We've Got You Covered! ✍ 100% NO A I or Plagiarism Guaranteed🤔
