CCHT Practice Exam 148 Questions with Verified Answers,100% CORRECT

CCHT Practice Exam 148 Questions with Verified Answers Peritoneal dialysis differs from hemodialysis in which of the following ways? - CORRECT ANSWER pd access is by an intraabdominal catheter the main difference between an arteriovenous shunt and an arteriovenous fistula? - CORRECT ANSWER AVF is entirely within an arm which of the following dialyzers is currently used? - CORRECT ANSWER hollow tube which of the following kidney structures connects with and delivers urine directly to the ureter? - CORRECT ANSWER pelvis the glomerular filtration rate is an important index of renal function and in the normal adult is approximately - CORRECT ANSWER 75mlmin/1.73m2 all of the follow substances are produced by the kidney except - CORRECT ANSWER aldosterone the most like cause of post renal failure is - CORRECT ANSWER benign prostatic hypertrophy the most common cause of chronic kidney disease in the US is - CORRECT ANSWER diabetes which of the following conditions is least likely to be caused uremia? - CORRECT ANSWER urinary tract infection all of the following conditions are associated with chronic kidney failure except? - CORRECT ANSWER hypoparathyroidism what percentage of transplanted kidneys are functional 1 year after transplantation? - CORRECT ANSWER 90% the fluid restriction for most patients undergoing incenter hemodialysis is equal to urine volume/day plus - CORRECT ANSWER 1L failure to excrete beta 2 microglobulin in pts with kidney failure predisposes the patient to - CORRECT ANSWER amyloidosis blood tests for ferritin are performed in hemodialysis pts - CORRECT ANSWER to check for iron stores which of the following phosphate binders would best control hyperphosphatemia with the fewest side effects in patients with end stage kidney disease? - CORRECT ANSWER lanthanum carbonate hemodialysis pts should be taught to - CORRECT ANSWER put in their own needles, weigh and record themselves, and check their dialyzer settings and dialysate osmosis is best defined as - CORRECT ANSWER diffusion of a solvent through a semipermeable membrane from low to high solute concentration all of the following statements about vitamins in dialysis pts are true except - CORRECT ANSWER dialysis does not remove water soluble vitamins in hemodialysis blood and dialysate have which of the following properties? - CORRECT ANSWER the flow in opposite directions in the dialyzer water may be removed from - CORRECT ANSWER the intravascular compartment which site in the hemodialysis pathway has the highest positive pressure? - CORRECT ANSWER blood entering the dialyzer fibers the term "sieving coefficient of a membrane" refers to the - CORRECT ANSWER fraction of solute that passes through the membrane by convection water moves from one body compartment to another by - CORRECT ANSWER osmotic forces biocompatibility is best illustrated by - CORRECT ANSWER reprocessed dialyzers that have a better biocompatibility than new ones the amount of fluid to be taken from the pt during hemodialysis - CORRECT ANSWER may be calculated by subtracting the pt's estimated dry weight from the pre dialysis weight and adding any fluid the pt receives during tx the ultrafiltration coefficient of a dialyzer refers to the - CORRECT ANSWER fluid that passes through the membrane in 1 hour the molecular weight cutoff of a dialyzer is 12000 daltons which of the following molecules would not pass through the membrane into the dialysate? - CORRECT ANSWER albumin clearance of low molecular weight molecules by dialysis is accomplished mostly by - CORRECT ANSWER diffusion a hollow fiber dialyzer has which of the following properties? - CORRECT ANSWER very fine fiber tubes held in place by polyurethane material synthetic membranes have which of the following properties? - CORRECT ANSWER they have thick fiber walls if a dialyzer has a urea clearance rate of 200ml/min and a blood flow rate of 300ml/min what volume of the blood will be cleared of urea in 1 minute? - CORRECT ANSWER 200ml to determine the most accurate clearance rate of a particular solute, one should - CORRECT ANSWER measure the solute concentrations of blood going into and out of the dialyzer all of the following substances are added to the dialysate except - CORRECT ANSWER phosphate sodium modeling refers to - CORRECT ANSWER changing the concentration of the dialysate sodium during the course of dialysis conductivity is best defined as - CORRECT ANSWER a method of checking electrolyte levels in the dialysate which of the following statements about the proportioning system is correct? - CORRECT ANSWER it relies on a continuous supply of fresh concentrate and treated water an advantage of high flux dialysis is - CORRECT ANSWER fast removal of fluid a disadvantage of high flux dialysis is - CORRECT ANSWER pyrogen rxns are common all of the following statements regarding home dialysis are true except - CORRECT ANSWER it cannot be done during sleep in most dialysate systems, the temperature - CORRECT ANSWER is maintained by a thermistor controlled heater dialysate flow rate has which of the following properties? - CORRECT ANSWER low water pressure may set off an alarm which of the following statements about blood leaks in the dialysis system is correct? - CORRECT ANSWER they are detected by use of a light source and photocell dialysate pH is kept in which of the following ranges? - CORRECT ANSWER 7.0-7.4 which of the following statements about fluid removal from the blood is correct? - CORRECT ANSWER it depends on the transmembrane pressure (tmp) dialysis machines control the rate of fluid removal by - CORRECT ANSWER either volume or flow control drip chambers in the extracorporeal circulation do all of the following except - CORRECT ANSWER pump blood into the dialyzer which of the following statements about transducer protectors is correct? - CORRECT ANSWER they use hydrophobic membranes to keep fluid from passing through blood flow into the dialyzer is usually - CORRECT ANSWER done by manual hand cranking which pressure in the dialysis circuit is usually negative? - CORRECT ANSWER arterial pressure which of the following will set off the pre pump high pressure alarm? - CORRECT ANSWER a decrease in the blood pump speed a low pressure alarm in the venous (post dialyzer) line is likely to be set off by - CORRECT ANSWER a blockage in the blood tubing before the monitoring site which of the following statements about an air detector is correct? - CORRECT ANSWER it uses an ultrasonic device to detect air in the blood path how is the anticoagulant heparin given during the dialysis treatment? - CORRECT ANSWER intermittently, as a single bolus, by continuous infusion a sorbent is best defined as a - CORRECT ANSWER continuous dialysate disinfection system that removes bacteria and endotoxins which of the following statements about sorbent dialysis is correct? - CORRECT ANSWER in preparing the dialysate, 6 liters of water are added to premixed chemicals which type of arteriovenous fistula is likely to result in high blood flow with the fewest complications? - CORRECT ANSWER artery side to vein end for which type of dialysis patient is a ventral venous catheter blood access appropriate? - CORRECT ANSWER a pt waiting for a fistula to mature, a pt with acute renal failure, a pt waiting for a PD catheter which of the following statements about arteriovenous grafts is correct? - CORRECT ANSWER they are more prone to thrombosis than AVF care of a new AVF should include all of the following except - CORRECT ANSWER cannulating the vessel to see if the blood flow is adequate an antiseptic that kills bacteria when wet is - CORRECT ANSWER 70% alcohol which of the following arteries is most commonly used for an arteriovenous fistula? - CORRECT ANSWER radial artery the hemodialysis technician who is about to insert a needle into the arteriovenous fistula should first do all of the following except? - CORRECT ANSWER place the needle into a previous cannulation spot during needle insertion it is important for the hemodialysis technician to always - CORRECT ANSWER cannulate the venous access in an antegrade manner (w/blood flow) using a buttonhole technique for blood access the technician should - CORRECT ANSWER use a sharp followed by a blunt needle to diminish vasovagal reactions and needle phobia in pts the technician should ask the pt to - CORRECT ANSWER lie down in a recumbent position, tense the muscles in the nonaccess hand for 10-20 seconds during needle insertion, cannulate their own vessels recirculation refers to - CORRECT ANSWER mixing dialyzed venous blood with blood entering the arterial needle a diabetic pt undergoing dialysis complains of tingling, numbness, and cold in the hand below the access site, the most likely cause is - CORRECT ANSWER steal syndrome common sites of stenosis in pts with an AVF include all of the following except - CORRECT ANSWER the artery next to the anastomosis a thrombosis is least likely to develop with which of the following vascular access methods? - CORRECT ANSWER an AVF high output cardiac failure is a complication of AVF or AVG. all of the following actions are a part of this condition except - CORRECT ANSWER decreased cardiac workload which of the following statements about grafts used for arteriovenous shunts for dialysis pts is correct? - CORRECT ANSWER they can be made from collagen or expanded polytetrafluorethylene when placing a needle into a graft, a hemodialysis technician may do which of the following? - CORRECT ANSWER use three sides to cannulate the graft, not just the top which of the following veins is most suitable for hemodialysis catheter placement? - CORRECT ANSWER right internal jugular to prevent infection in catheters, hemodialysis technicians should be sure to - CORRECT ANSWER wash hands and use sterile gloves, wear a mask and ask the pt to wear a mask as well, remove wet dress, dry around the site, and replace with fresh dressing when low pressure alarm rings signaling inadequate flow, the technician should be sure to - CORRECT ANSWER flush the catheter with saline an advantage of catheter and port catheter devices is - CORRECT ANSWER needle entry is not required a heavyset pt arrives for dialysis in a wheelchair, he has difficulty standing without assistance. which technique would be most appropriate to transfer him to the dialysis chair? - CORRECT ANSWER portable lift device if a small fire breaks out in the dialysis center which of the following safety sequences is correct? - CORRECT ANSWER when using a fire extinguisher, pull the pin , aim the nozzle, at the base of the flames, squeeze the handle and spray from side to side at the base of the flames using sterile technique a hemodialysis technician should avoid all the following except - CORRECT ANSWER washing hands and using sterile gloves use of protective equipment and techniques are intended to protect both pt and staff member, examples of include all of the following except - CORRECT ANSWER always recapping needles which of the following pathogens is most likely to be spread during dialysis tx? - CORRECT ANSWER hepatitis B which of the following should be avoided when drawing up medication into a syringe? - CORRECT ANSWER changing needles after half the volume is drawn up correct statements concerning the charting of the pt data include al of the following except - CORRECT ANSWER entries must be printed for legibility after a tx a pt below dry weight may have - CORRECT ANSWER muscle cramping which of the following alarms must be checked before dialysis begins? - CORRECT ANSWER blood leak detector, conductivity alarm, pH alarm in a pt with a fistula in one arm and an intravenous line in the other, manual blood pressure should be taken in the - CORRECT ANSWER leg with the pt supine which of the following vital signs is abnormal before dialysis in a 30 yr old male pt? - CORRECT ANSWER blood pressure: 145/95 mmHg to calculate the amount of fluid removal from the pt during the dialysis, all of the following values are used except - CORRECT ANSWER volume of urine output when drawing blood samples for laboratory testing, the hemodialysis tech should draw samples - CORRECT ANSWER from the arterial injection port the urea reduction ratio has which of the following properties? - CORRECT ANSWER it requires measurement of both pre and post dialysis blood urea nitrogen what is the urea kinetic modeling calculation - CORRECT ANSWER it gives both minimum delivered and prescribed doses for pts in whom the priming solution is to be discarded, what should the HD technician do next? - CORRECT ANSWER connect the arterial tubing, and allow the priming solution to drain before connecting the venous tubing a dialysis pt has a history of heparin induced thrombocytopenia (low platelets) and severe bleeding. what would be a good method of performing dialysis safely? - CORRECT ANSWER use a regional citrate technique a dialysis pt develops a purulent discharge at the exit site of a central catheter. which of the following pathogens is the most likely to be cultured? - CORRECT ANSWER S. aureus a hemodialysis pt suddenly develops trouble breathing, hives, itching, and hypotension. the most likely cause is - CORRECT ANSWER an anaphylactic rxn a pt undergoing HD complaints of muscle cramps in the calves and feet, all of the following are likely causes except - CORRECT ANSWER hypercalcemia (high calcium level) which of the following may cause hemolysis of red blood cells during dialysis? - CORRECT ANSWER kinked blood lines, warm dialysis fluid, inadequate water tx for centers that reuse dialyzers reprocessing includes - CORRECT ANSWER disinfecting the clamps and the outside of the dialysis machine which of the following statements about the "first use syndrome" is correct? - CORRECT ANSWER it may be reduced by repeated rinsing of the dialyzer which of the following statements about preprocessing dialyzers is correct? - CORRECT ANSWER it can be done manually or by machine which of the following statements about new dialyzers is correct? - CORRECT ANSWER they may be preprocessed to reduce noxious chemicals or materials at the end of tx which of the following actions should be done first? - CORRECT ANSWER blood rinse back grounds for discarding a dialyzer include which of the following? - CORRECT ANSWER it has been exposed to more than one germicide which of the following germicides is most commonly used to disinfect dialyzers in the US? - CORRECT ANSWER peracetic acid what is an endotoxin? - CORRECT ANSWER it is a toxin produced by certain bacteria federal regulations require a center that reuses dialyzers to have - CORRECT ANSWER a system of quality assurance and a system of quality control which of the following substances is the most common impurity in tap water? - CORRECT ANSWER calcium carbonate the average HD pt is exposed to how many liters of water in a week? - CORRECT ANSWER 350L a return loop recycles water through the water treatment system because - CORRECT ANSWER it reduces the amount of water required and it prevents stagnant spots in a water treatment system feed water is adjusted to a temperature of - CORRECT ANSWER 77-82 degree F, using hot and cold water and a blending valve the pH of feed water is 9.0 at a certain center, which of the following would be the best water treatment? - CORRECT ANSWER add hydrochloric acid to the feed water, using a mixing chamber which of the following statements about multimedia filters is correct? - CORRECT ANSWER they trap successively smaller particles water softeners remove calcium and magnesium by - CORRECT ANSWER ion exchange which of the following statements about carbon tank removal of chlorine and chloramine from feed water is correct? - CORRECT ANSWER it requires two carbon tanks in a series which of the following statements about reverse osmosis is correct? - CORRECT ANSWER hydraulic pressure is used to move water through the membrane which of the following statements about the deionization of water is correct? - CORRECT ANSWER it removes both anions and cations which of the following statements about an ultraviolet irradiator is correct? - CORRECT ANSWER it emits light at a wavelength of 254 nanometers which of the following statements about biofilm is correct? - CORRECT ANSWER it is an aggregate of microorganisms that produce a matric of extracellular polymeric substance (slime) public law 92-603 which originally passed in 1972 is concerned with which of the following? - CORRECT ANSWER it covers dialysis and kidney transplants which of the following statements best describe dialysis centers today? - CORRECT ANSWER they are mostly owned by large dialysis organizations inspection and standards for dialysis centers may be provided by - CORRECT ANSWER the FDA, state health departments, the association for advancement of medical instrumentation continuous quality improvement refers to - CORRECT ANSWER a method for improving clinical, technical, and organizational procedures professionalism for a HD tech includes - CORRECT ANSWER refraining from talking about a pt to a colleague if the conversation may be overheard taking the CCHT exam requires all of the following except - CORRECT ANSWER a compliance with state requirements for hemodialysis technicians which of the following statements about certification examinations in clinical nephrology technology and in biomedical nephrology is correct? - CORRECT ANSWER they require 12 months of work experience to take the examination the national kidney foundations kidney disease improving global outcomes includes treatment guidelines for all of the following except - CORRECT ANSWER hepatitis as part of the job of a dialysis technician one may be required to lift equipment or assist with pt transfers. Back pain sparing and injury prevention maneuvers include - CORRECT ANSWER lifting with the legs and holding the object close to the body one difference between PD and HD is - CORRECT ANSWER the pt is subjected to constant dialysis in PD rather than intermittent dialysis in HD all of the following statements regarding kidney transplantation are correct except - CORRECT ANSWER the diseased kidneys are usually removed which of the following immunosuppressive drugs used in kidney transplant pts has renal toxicity? - CORRECT ANSWER cyclsporine what is a sensitization test for a potential kidney transplant recipient? - CORRECT ANSWER potential recipient serum tested with a multiple donor lymphocyte panel a diet restricting all of the following is appropriate for a renal failure pt except - CORRECT ANSWER calcium all of the following are indications to start hemodialysis in a renal failure pt except - CORRECT ANSWER creatinine clearance of 25ml/min the nephrotic syndrome is characterized by all of the following except - CORRECT ANSWER hematuria which of the following statements about administering erythropoietin to a HD pt is correct? - CORRECT ANSWER give supplemental iron if ferritin is low a recent study published in the new england journal of medicine compared hemodialysis three times a week with hemodialysis six times a week. at the end of a 12 month follow up period, the study showed the six times a week group had - CORRECT ANSWER fewer deaths which of the following statements about the nephron, the working unit of the kidney is correct? - CORRECT ANSWER it makes about 180 liters of glomerular filtrate a day acute tubular necrosis may be caused by - CORRECT ANSWER shock and htn, rhabdomyolysis, radiographic contrast material what does the expression kt/v signify with regard to hemodialysis? - CORRECT ANSWER prescribed dose of dialysis adding extra sodium chloride to the dialysate will - CORRECT ANSWER draw water out of cells and tissues into the blood which of the following is most likely to cause problems for the pt receiving hemodialysis treatments? - CORRECT ANSWER inadequate vascular access which of the following action is most important in preventing spread of infection? - CORRECT ANSWER hand washing to avoid environmental contamination it is important to do which of the following? - CORRECT ANSWER clean all surfaces at the station and external portion of the dialysis machine, avoid storage of food and beverages in the same refrigerator or other container with blood or bodily fluid samples, place all used dialyzers and tubing in leak proof containers all of the following are part of a standard dialysis Rx except - CORRECT ANSWER access to cannulate a brother of a dialysis pt has blood type O and is being considered a potential kidney donor. what are the odds that he will be a complete match and a suitable donor? - CORRECT ANSWER 50% a pt with kidney disease has anemia, fatigue, elevated phosphate levels, ankle edema, and elevated blood pressure. what is the most likely range of his glomerular filtration rate? - CORRECT ANSWER 15-29ml /min which of the following physicians is credited with inventing dialysis? - CORRECT ANSWER Willem J. Kolff, MD what pattern of blood chemistries would you expect in renal osteodystrophy? - CORRECT ANSWER low calcium and high phosphate levels