CCHT Study Guide Questions and Answers 100

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Rasmussen College, Florida *

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Course

D026

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Nursing

Date

Nov 24, 2024

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pdf

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Uploaded by MegaGalaxyPorpoise38

CCHT Study Guide Questions and Answers 100% Pass You are the PCT taking care of Mr. Smith. He tells you that he has no ride today to go home after treatment. You ✔✔ 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 ✔✔ 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: ✔✔ 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 ✔✔ 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 ✔✔ Nephron

A healthy kidney excretes ✔✔ Phosphorus Renagel is a medication that is a ✔✔ Phosphate binder Which one is the highest in Potassium ✔✔ 2 cups of raisins What are some of the foods that are high in phosphorus ✔✔ Milk and Cheese Water softener removes: ✔✔ Magnesium and Calcium Chlorine and Chloramines are removed by: ✔✔ Carbon Tanks Endotoxins are removed by: ✔✔ Ultrafilter Anastomosis is the surgical connection between the: ✔✔ Artery and vein A A M I Standards for cultured water is: ✔✔ 200 cfu

A A M I Standards for dialysis is: ✔✔ 50 cfu Hemodialysis is accomplished by which principles? ✔✔ Ultra filtration, diffusion, counter- current dialysis flow While assessing an access before cannulation you note an aneurysm. You should: ✔✔ 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: ✔✔ Steal syndrome Patient has a bilateral amputation. How do you determine that the patient is fluid overloaded? ✔✔ Listen to the lungs If it is not documented: ✔✔ It is not done What is a high risk of safety and a hazard: ✔✔ A small amount of water on the floor

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Your patient came in for dialysis accompanied by his daughter. He is hard of hearing. You have to assess his complaints. You: ✔✔ 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: ✔✔ Refer him to the administrator and social worker Dialysis pH average is: ✔✔ 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: ✔✔ 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: ✔✔ Shoulders and head lower that the legs Machine blood leak is alarming. The hemastix text came out negative. What do you do next? ✔✔ Continue dialysis and monitor system

Dialysis patients are diagnosed with anemia. Epogen is given to the patients to: ✔✔ Increase red blood cell production Kt/V is a measurement used to determine: ✔✔ Adequacy of dialysis The use of saline to prove the lines and dialyzer is necessary because: ✔✔ Sterilant has to be removed from the dialyzer Air in the lines during the treatment are usually due to: ✔✔ Loose connections on the dialysis lines Which organization sets the standards and recommendations for water reprocessing? ✔✔ A A M I Which organization sets the standards for water in the dialysis setting? ✔✔ C M S The leading cause of chronic kidney disease for adults in the USA is: ✔✔ Diabetes

A nephron is made up of: ✔✔ The glomerulus and the tubule system Waste productions in hemodialysis are removed by: ✔✔ Diffusion The movement of fluid from a lower solute concentration to a higher concentration is called: ✔✔ Osmosis Increasing the blood flow rate affects: ✔✔ Diffusion The ultrafiltration rate (UF) is: ✔✔ 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: ✔✔ Countercurrent flow What condition occurs due to dialysis being too hot? ✔✔ Hemolysis

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Fever and chills develop midway through the patients treatment are most likely cause by: ✔✔ A. Pyrogenic reaction Normal temperature for adults is ✔✔ 98.6 degrees Normal respirations for a patient are ✔✔ 12 - 16 The minimum delivered Kt/V according to KDOQI guidelines is: ✔✔ 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: ✔✔ 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: ✔✔ 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: ✔✔ 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: ✔✔ Determining pulse rate To confirm the direction of the blood flow in an access you: ✔✔ 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: ✔✔ Has edema in the feet and is fluid overload R.A.C.E stads for: ✔✔ 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: ✔✔ 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? ✔✔ Test the machine for presence of disinfectant About 1 hour in the treatment patient is complaining that is cold. Your first reaction is to: ✔✔ Check patient temp.

After you evacuate the patients in case of emergency you will ✔✔ Call 911 A patient complains of fever and chills about 1 hour within the treatment. You suspect ✔✔ 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 ✔✔ Clamp both arterial and venous needle After stopping an accidental air infusion in a patient undergoing dialysis, you will ✔✔ position the patient on his left side with head down Normal saline concentration is ✔✔ 0.9% Seizures are most likely to occur during hemodialysis due to ... EXCEPT ✔✔ Sudden increase in dialyzer clearance

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A patients phosphorus is 5.9. He is placed on phosphorus binders. What instructions should he be given regarding phosphate binders? ✔✔ Take with meals When lifting a patient from the wheel chair to the chair you: ✔✔ 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: ✔✔ 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? ✔✔ Wipe the water and continue the treatment Causes for hemolysis are all except: ✔✔ Low dialysate temp. Besides the "cranberry juice color" blood, patient may exhibit the following symptoms in case of hemolysis ... EXCEPT ✔✔ Chills

Dialysis machine is alarming low conductivity while patient is dialyzing. What do you expect: ✔✔ 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: ✔✔ 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? ✔✔ 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: ✔✔ hypotension- Low blood sugar Main symptoms of air embolism complication are ✔✔ 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". ✔✔ Patient suffered memory loss

Machine is alarming and you assume that the lines and dialyzer are clotted. What is your action? ✔✔ 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? ✔✔ Increase Heparin Which drink is considered high in phosphorus: ✔✔ Orange Juice Measurement of the total cell volume (TCV) is used to determine: ✔✔ Performance of the dialyzer What is CQI? ✔✔ A way to improve care by selecting an area that needs improvement Crenation is ✔✔ 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: ✔✔ Crenation

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When does HIV dies? ✔✔ Does not live outside the body Active listening is a skill used to give patients undivided attention. Active listening involves all, except: ✔✔ Use short open-ended questions The minimum dwell time to achieve sterilization with Renalin is: ✔✔ 11 Patient exposure to chloramines during the treatment will cause ✔✔ Hemolysis DI Tank contains ✔✔ Cations and anions The air detector alarms. You would expect ✔✔ Blood pump is stopped The extracorporeal system consists of ✔✔ Blood lines and dialyzer One cause of aneurysm and pseudoaneurysm is ✔✔ poor rotation sites The bruit is detected by ✔✔ listening with the stethoscope

The venous needle ✔✔ Should point in the direction of the flow A true aneurysm is dangerous because ✔✔ 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? ✔✔ 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 ✔✔ Wipe the blood immediately with bleach solution Hives, itching, respiratory distress and tightening of the chest are major signs of ✔✔ Severe allergic reaction The best monitoring system during dialysis is ✔✔ Technician All of the following are Phosphate Binders except ✔✔ Folic Acid

The most important member of the team is the ✔✔ Patient What factors need to be considered when evaluating recirculation in an internal access ✔✔ 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: ✔✔ 5 unsalted crackers

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Which of the following patients should be dialyzed in the isolation area: ✔✔ Positive (+) H B s A g (+HBsAg) During a pre-treatment patient evaluation which question would be BEST for the PCT to ask? ✔✔ 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? ✔✔ 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? ✔✔ Plan, do, check, and act. What is the acid-base imbalance commonly seen in patients with chronic renal failure? ✔✔ Metabolic acidosis Which of the following is NOT a function of the kidney: ✔✔ Storage of urine

Approximately what percent of the cardiac output is received by the kidneys? ✔✔ 23% Which of the following is considered an elevated serum potassium level for a dialysis patient? ✔✔ 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 ✔✔ PTH and cholesterol Hyperkalemia may cause: ✔✔ Serious or even deadly changes in the heart rhythm Which best describes the PCT's role in patient teaching? ✔✔ Reinforce teaching the patient may have received from the nurse, physician, dietitian, or other teammates Which type of vascular access has fewest complications? ✔✔ The A/V fistula A new hemodialysis patient received his first treatment may be at high risk for which of the following problems: ✔✔ Dialysis disequilibrium syndrome

Which of the following presents a potential for environmental contamination? ✔✔ 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? ✔✔ 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: ✔✔ Immediately notify the nurse of the need for a patient assessment Risks associated with a deionization (D.I) water treatment system include ALL, EXCEPT: ✔✔ DI removes all charged particles (-) ions or (+) cations The BEST definition of asepsis is: ✔✔ The absence of pathogens

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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? ✔✔ Report the incident to the facility social worker What organization establishes dialysis water quality standards? ✔✔ 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: ✔✔ 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: ✔✔ Hemolysis Hemodialysis infection control precautions include all of the following EXCEPT: ✔✔ Always recap needles to prevent injuring others

Gloves must be warn ... ✔✔ 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 ... ✔✔ 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? ✔✔ Immediately before initiating treatment If the extracorporeal circuit clots, it would be most important to monitor the patient's... ✔✔ Hemoglobin level

One reason normal saline is used to prime the extracorporeal circuit prior to initiating treatment is to... ✔✔ Remove air What is the name of the instrument used to measure blood pressure? ✔✔ Sphygmomanometer Which of the following would improve the adequacy of the dialysis treatment? ✔✔ Increase the treatment time During a hemodialysis treatment a patient goes into cardiac arrest. What should the PCT do first? ✔✔ 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 ... ✔✔ Infection Lab results indicate the patient's pre-treatment BUN value was lower than the post treatment BUN value. A potential cause could be... ✔✔ The pre-dialysis sample was taken from the venous line after the treatment started.

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Half way through a treatment the technician notices a significant increase in transmembrane pressure. This is most likely due to... ✔✔ 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... ✔✔ 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? ✔✔ 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... ✔✔ Osmosis Foods high in POTASSIUM include all EXCEPT... ✔✔ Apple / Cranberry Which of the following potassium facts is false? ✔✔ 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? ✔✔ Water soluble vitamins B1, B2, B3, B6, B12, folic acid, C

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Which of the following is the most accurate measure of dialysis adequacy? ✔✔ Kt/V (urea) According to K/DOQI guidelines and recommendations hemodialysis patients should have Kt/V of at least .... ✔✔ 1.2 The normal blood serum pH range is ✔✔ 7.35 - 7.45 The best definition of diffusion is the movement of... ✔✔ 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... ✔✔ Inadequate dialysis prescription, missed dialysis treatment, fluid overload. the answer is... All of the above

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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... ✔✔ 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 ✔✔ Peripheral neuropathy What physician orders may be expected for a patient with pericarditis? ✔✔ Increase the patients estimated dry (target) weight Biohazards waste includes any material exposed to ✔✔ 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 ✔✔ Hypotension a 58 year old blind patient does to treatment escorted by his wife. Which approach should the technician use when interacting? ✔✔ Describe the activities in the immediate environment

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The hemodialysis machine monitors many parameters. Which of theses parameters must be verified by a second independent means? ✔✔ Conductivity

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CCHT Study Guide Questions and Answers 100

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