CCHT PRACTICE EXAM 96 Questions with Verified Answers,100% CORRECT

CCHT PRACTICE EXAM 96 Questions with Verified Answers True or False: Peritoneal dialysis (PD) differs from hemodialysis in that PD access is by an intra-abdominal catheter - CORRECT ANSWER TRUE The term :sieving coefficient of a membrane" refers to the: a. fraction of solute that passes through the membrane by convection b. amount of water required for solute drag through the membrane c. concentration of pores in the membrane d. seize of the pores in the membrane - CORRECT ANSWER a. fraction of solute that passes through the membrane by convection Water moves from one body compartment to another by: a. ultrafiltration b. active transport c. osmotic forces d. all of the above - CORRECT ANSWER c. osmotic forces Which of the following will set off the prepump high-pressure alarm? a. an increase in the blood pump speed b. kinking of the arterial bloodline c. a decrease in the blood pump speed d. infiltration of the arterial needle - CORRECT ANSWER c. a decrease in the blood pump speed A low-pressure alarm in the venous (postdialyzer) line is likely to be set off by: a. a blockage in the blood tubing between the monitoring site and the venous needle b. an infiltration of the venous needle c. a clot in the venous access d. a blockage in the blood tubing before the monitoring site - CORRECT ANSWER d. a blockage in the blood tubing before the monitoring site Which of the following statements about an air detector is correct? a. it is present in the predialyzer blood tubing b. it uses an ultrasonic device to detect air in the blood path c. it sets off an alarm and clamps the predialyzer blood tubing d. all of the above statements are correct - CORRECT ANSWER b. it uses an ultrasonic device to detect air in the blood path How is the anticoagulant heparin given during the dialysis treatment? a. intermittently b. as a single bolus c. by continuous infusion d. by all of the above ways - CORRECT ANSWER d. by all of the fabove ways The main difference between an arteriovenous shunt (AVS) and an arteriovenous fistula (AVF) is... - CORRECT ANSWER AVF is entirely within the arm Biocompatibility is best illustrated by: a. synthetic membranes that do not absorb blood proteins as well as cellulose membranes b. independence from protein adsorption of the membrane c. reprocessed dialyzers that have a lower biocompatibility than new ones d. reprocessed dialyzers that have a better biocompatibility than new ones - CORRECT ANSWER d. reprocessed dialyzers that have a better biocompatibility than new ones The amount of fluid to be taken from the patient during hemodialysis: a. is independent of the filtration pressure b. requires the dialysate to have a higher pressure than the blood c. may be calculated by subtracting the patient's estimated dry weight from the predialysis weight and adding any fluid the patient receives during treatment d. may be calculated by adding the patient's predialysis weight and the amount of fluid the patient receives during treatment - CORRECT ANSWER c. may be calculated by subtracting the patient's estimated dry weight from the predialysis weight and adding any fluid the patient receives during treatment The ultra filtration coefficient of a dialyzer refers to the: a. fluid that passes through the membrane in 1 hour b. pressure in the blood compartment needed to force fluid through the membrane c. pressure difference across the membrane d. fluid that passes through the membrane in 1 minute - CORRECT ANSWER a fluid that passes through the membrane in 1 hour A sorbent is best described as a: a. material that moisturizes the dialysis membrane b. material that is added to the dialysate to buffer it and keep the pH constant c. continuous dialysate disinfection system that removes bacteria and endotoxins d. type of electronic device that measures blood pressure - CORRECT ANSWER c. continuous dialysate disinfection system that removes bacteria and endotoxins Which of the following statements about sorbent dialysis is correct? a. it needs a continuous supply of fresh water to add to new dialysate b. in preparing the dialysate, 6 liters of water are added to premixed chemicals c. the duration of the dialysis procedure cannot be altered d. it requires a six-layered cartridge - CORRECT ANSWER b. in preparing the dialysate, 6 liters of water are added to premixed chemicals Which dialyzer is used currently? - CORRECT ANSWER Hollow tube Which type of arteriovenous fistula is likely to result in high blood flow with the fewest complications? a. Artery side to vein side b. Artery side to vein end c. Artery end to vein side d. Artery end to vein end - CORRECT ANSWER b. Artery side to vein end For which type of dialysis patient is a central venous catheter blood access appropriate? a. a patient waiting for fistula to mature b. a patient with acute renal failure c. a patient waiting for a peritoneal dialysis catheter d. all of the above patients - CORRECT ANSWER d. all of the above patients Drip chambers in the extracorporeal circulation do all the following EXCEPT: a. monitor arterial and venous pressure by attached gauges b. trap air c. prevent blood clots from reaching the patient d. pump blood into the dialyzer - CORRECT ANSWER d. pump blood into the dialyzer Which of the following statement about extracorporeal circulation is correct? a. Approximately 100-250 mL are outside the patient's body at any time b. The arterial tubing is blue, and the venous tubing is red c. Heparin infusion line is connected to the tubing at the venous exit d. The use hydrophobic membranes to keep fluid from passing through - CORRECT ANSWER d. They use hydrophobic membranes to keep fluid from passing through Blood flow into the dialyzer is usually: a. controlled by a piston type pump b. inversely proportional to the pump speed c. limited to less than 250 mL/min d. done by manual hand cranking - CORRECT ANSWER d. done by manual hand cranking Which pressure in the dialyzer is usually negative? - CORRECT ANSWER Arterial pressure Which of following statements about arteriovenous grafts is correct? a. they are more prone to thrombosis than arteriovenous fistulae b. they are less prone to cause stenosis than arteriovenous fistulae c. they are less prone to infection than arteriovenous fistulae d. they have a longer lifespan than arteriovenous fistuale - CORRECT ANSWER a. they are more prone to thrombosis than arteriovenous fistulae An antiseptic that kills bacteria when wet is: - CORRECT ANSWER 70% alcohol Which of the following arteries is mostly commonly used for an arteriovenous fistula? a. ulnar artery b. radial artery c. brachial artery d. femoral artery - CORRECT ANSWER b. radial artery For patients in whom the priming solution is to be discarded, what should the hemodialysis technician do next? a. connect the arterial and venous tubing before beginning dialysis b. connect the arterial tubing, and allow the priming solution to drain before connecting the venous tubing c. connect the blood lines only after the primer is discarded d. do none of the above - CORRECT ANSWER b. connect the arterial tubing, and allow the priming solution to drain before connecting the venous tubing A dialysis patient has a history of heparin-induced thrombocytopenia (low platelets) and severe bleeding. What would be a good method of performing dialysis safely? a. skip the bolus dose of heparin, and give the infusion at a lower dose rate b. increase the time between bolus doses of heparin c. substitute warfarin for heparin d. use a regional citrate technique - CORRECT ANSWER d. use a regional citrate technique A dialysis patient develops a purulent discharge at the exit site of a central catheter. Which of the following pathogens is the most likely to be cultured? a. Staphylococcus aureus b. Clostridium difficile c. Enterococcus d. Mycoplasma - CORRECT ANSWER a. Staphylococcus aureus The venous needle insertion should always go which way? - CORRECT ANSWER it should always go with the blood flow A diabetic patient undergoing dialysis complains of tingling, numbness, and cold in the hand below the access site. The most likely cause is: a steal syndrome b. recirculation c. infiltration d. an aneurysm - CORRECT ANSWER a. steal syndrome Common sites of stenosis in patients with an arteriovenous fistula include all the following EXCEPT: a. the vein next to the anastomosis b. along the outflow vein c. the large draining vein of the arm near the shoulder d. the artery next to the anastomosis - CORRECT ANSWER d. the artery next to the anastomosis TRUE or FALSE: A thrombosis is least likely to develop with an arteriovenous fistula - CORRECT ANSWER TRUE High-output cardia failure is a complication of arteriovenous fistula or grafting. All of the following actions are a part of this condition EXCEPT: a. increased venous return to the heart b. decreased cardiac workload c. reduced resistance in the arterial bed d. activation of the renin-angiotensin system - CORRECT ANSWER b. decreased cardiac workload Which of the following statements about grafts used for arteriovenous shunts for dialysis patients is correct? a. they cannot be made from human or animal blood vessels b. they can be made from collagen or expanded polytetrafluoroethylene c. they take longer to mature than fistulas d. they have a lower rate of clotting than fistulas - CORRECT ANSWER b. they can be made from collagen or expanded polytetrafluoroethylene When the low-pressure alarm rings, signaling inadequate flow, the technician should be sure to: a. reset the pressure alarm b. switch arterial and venous lines c. flush the catheter with saline d. give a thrombolytic enzyme through the catheter - CORRECT ANSWER c flush the catheter with saline Which of the following pathogens is most likely to be spread during dialysis treatment? a. Hepatitis B b. Hepatitis C c. Human immunodeficiency virus d. Tuberculosis - CORRECT ANSWER a. Hepatitis B Correct statements concerning the charting of patient data include all of the following EXCEPT: a. each entry must be followed by the writer's name and title b. entries must be printed for legibility c. approved abbreviations may be used d. errors must have a line through them, marked error, and initialed - CORRECT ANSWER b. entries must be printed for legibility Which of the following vital signs is abnormal before dialysis in a 30-year-old male patient? a. Blood pressure: 145/95 mm Hg b. Pulse: 90/min and regular c. Temperature: 98.6o F d. Respirations: 16/min - CORRECT ANSWER a. Blood pressure: 145/95 mm Hg The molecular weight cutoff of a dialyzer is 12,000 daltons. Which molecules will pass through the membrane into the dialysate? - CORRECT ANSWER Phosphate, Urea, Sodium To calculate the amount of fluid removal from the patient during dialysis, all of the following values are used EXCEPT: a. priming saline volume b. saline rinse back c. dietary intake d. volume of urine output - CORRECT ANSWER d. volume of urine output The urea reduction ratio has which of the following properties? a. it requires measurement of both pre- and postdialysis blood urea nitrogen b. it accounts for the production of urea during dialysis c. it allows calculation of time needed for dialysis d. it allows calculation of urea removed by ultrafiltration - CORRECT ANSWER a. it requires measurement of both pre- and postdialysis blood urea nitrogen What is the urea kinetic modeling calculation? a. it gives the minimum delivered dose b. it gives the minimum prescribed dose c. it gives both minimum delivered and prescribed doses d. it is independent of dialyzer type - CORRECT ANSWER c. it gives both minimum delivered and prescribed doses For patients in whom the priming solution is to be discarded, what should the hemodialysis technician do next? a. connect the arterial and venous tubing before beginning dialysis b. connect the arterial tubing, and allow the priming solution to drain before connecting the venous tubing c. connect the blood lines only after the primer is discarded d. do none of the above - CORRECT ANSWER b. connect the arterial tubing, and allow the priming solution to drain before connecting the venous tubing The kidney structure that connects with and delivers urine directly to the ureter is called - CORRECT ANSWER Pelvis The glomerular filtration rate is an important index of renal function and in the normal adult is approximately: a. 50 mL/min/1.73 m2 b. 75 mL/min/1.73 m2 c. 125 mL/min/1.73 m2 d. 200 mL/min/1.73 m2 - CORRECT ANSWER c. 125 mL/min/1.73 m2 A hemodialysis patient suddenly develops trouble breathing, hives, itching, and hypotension. The most likely cause is: a. an air embolism b. an anaphylactic reaction c. angina d. disequilibrium syndrome - CORRECT ANSWER b. an anaphylactic reaction A patient undergoing hemodialysis complains of muscle cramps in the calves and feet. All of the following are likely causes EXCEPT: a. hypernatremia (high-sodium level) b. excess fluid removal c. hypercalcemia (high-calcium level) d. hypokalemia (low potassium) - CORRECT ANSWER c. hypercalcemia (high-calcium level) Substances that are produced by the kidney - CORRECT ANSWER renin, erythropoietin, and calcitriol The most likely cause of post-renal failure is: a. severe dehydration b. nephrotoxic drug c. glomerulonephritis d. benign prostatic hypertrophy - CORRECT ANSWER d. benign prostatic hypertrophy Which of the following may cause hemolysis of red blood cells during dialysis? a. kinked blood lines b. warm dialysis fluid c. inadequate water treatment d. all of the above - CORRECT ANSWER d. all of the above Which of the following statements about the "first-use syndrome" is correct? a. it may be reduced by repeated rinsing of the dialyzer b. it is less common in dialyzers treated with ethylene oxide c. both a and b are true d. neither a nor b are true - CORRECT ANSWER a. it may be reduced by repeated rinsing of the dialyzer Which of the following statements about preprocessing dialyzers is correct? a. it must be done manually b. it can be done manually or by machine c. it may be done on all commercial dialyzers d. it may be done according to the local center's protocol - CORRECT ANSWER b. it can be done manually or by machine Which of the following statements about new dialyzers is correct a. they should not be preprocessed b. the total cell volume (TCV) does not need checking until after reprocessing c. they may be preprocessed to reduce noxious chemicals or materials d. the TCV needs to be checked against other dialyzers after reprocessing - CORRECT ANSWER c. they may be preprocessed to reduce noxious chemicals or materials The most common cause of chronic kidney disease in the United States is: - CORRECT ANSWER diabetes Uremia may cause which of the following conditions: a. Itching b. Edema (swelling) of the extremities c. Anemia d. All of the above - CORRECT ANSWER d. All of the above Grounds for discarding a dialyzer include which of the following? a. the total cell volume is 85% of the original b. it has been exposed to more than one germicide c. clearance is only 95% d. a few residual streaks of blood are seen on inspection - CORRECT ANSWER b. it has been exposed to more than one germicide Which of the following germicides is most commonly used to disinfect dialyzers in the US? a. Formaldehyde b. Glutaraldehyde c. Heat with citric acid d. Peracetic acid - CORRECT ANSWER d. Peracetic acid What is an endotoxin? a. it is a germicide b. it is not absorbed by dialysis membranes c. it is a toxin produced by certain bacteria d. it is a substance that is not harmful to the patient - CORRECT ANSWER c. it is a toxin produced by certain bacteria These conditions are associated with chronic kidney failure - CORRECT ANSWER low hemoglobin, hyperkalemia, hyperphosphatemia Federal regulations require a center that reuses dialyzers to have: a. a system of quality assurance b. a system of quality control c. both a and b d. neither a nor b - CORRECT ANSWER c. botha and b The average hemodialysis patient is exposed tohow many liters of water a week? a. 10 L b. 100 L c. 350 L d. 1000L - CORRECT ANSWER c. 350 L A return loop recycles water through the water treatment system because: a. it reduces the amount of water required b. it prevents stagnant spots c. of both a and b d. of neither a nor b - CORRECT ANSWER c. of both a and b The pH of feed water is 9.0 at a certain center. Which of the following would be the best water treatment? a. No treatment is required b. Add hydrochloric acid to the feed water, using a mixing chamber c. Add sulfuric acid by direct injection into the water line d. Add sodium hydroxide to the feed water, using a mixing chamber - CORRECT ANSWER b. Add hydrochloric acid to the feed water, using a mixing chamber What percentage of transplanted kidney is functional 1 year after transplant? - CORRECT ANSWER 90% True or False: Short daily home hemodialysis, 2-3 hours a session, 5-7 days a week is likely to be most efficient hemodialysis - CORRECT ANSWER True Which of the following statements about multimedia filter is correct? a. they trap successively smaller particles b. they trap successively larger particles c. they are backwashed with added solvent d. they are not necessary if an ultrafilter is present downstream - CORRECT ANSWER a. they trap successively smaller particles Water softeners remove calcium and magnesium by: a. ion exchange b. absorption c. filtration d. osmosis - CORRECT ANSWER a. ion exchange The fluid restriction for most patients undergoing in-center hemodialysis is equal to urine volume/day plus... - CORRECT ANSWER 1 Liter Failure to excrete beta2-microglobulin in patients with kidney failure predisposes to: a. pericarditis b. amyloidosis c. neuropathy d. seizures - CORRECT ANSWER b. amyloidosis Which of the following statements about carbon tank removal of chlorine tank removal of chlorine and chloramine from feed water is correct? a. it should use activated powdered charcoal b. it requires two carbon tanks in a series c. it may be done with a continuous flow of water d. it requires backwashing when the charcoal is exhausted - CORRECT ANSWER b. it requires two carbon tanks in a series Which of the following statements about reverse osmosis is correct? a. there is a movement of water across a semipermeable membrane from a low-solute concentration to a high-solute concentration. b. prefiltration is not required c. hydraulic pressure is used to move water through the membrane d. solute concentration on both sides of the membrane becomes equal - CORRECT ANSWER c. hydraulic pressure is used to move water through the membrane Which of the following statements about the deionization of water is correct? a. it removes only cations b. it removes only anions c. it removes both anions and cations d. it uses on-site regenerated resins - CORRECT ANSWER c. it removes both anions and cations Blood tests for ferritin are preformed in hemodialysis patients to check for - CORRECT ANSWER iron stores Which of the following phosphate binders would best control hyperphosphatemia with the fewest side effects in patients with end stage kidney disease? a. Aluminum hydroxide b. Calcium carbonate c. High dairy products d. Lanthanum carbonate - CORRECT ANSWER d. Lanthanum carbonate Hemodialysis patients should be taught to: a. put in their own needles b. weigh themselves and record it c. check their dialyzer settings and dialysate d. do all the above - CORRECT ANSWER d. do all the above All of the following statements about vitamins in dialysis patients are true EXCEPT: a. dialysis does not remove water-soluble vitamins b. supplemental B-complex vitamins should be given c. vitamin D should be given to most dialysis patients d. megadose fat- or water-soluble vitamins should not be given - CORRECT ANSWER a. dialysis does not remove water-soluble vitamins Osmosis is best defined as: a. diffusion of solute through a semipermeable membrane from high- to low- solute concentration b. diffusion of solvent through a semipermeable membrane from low- to high-solute concentration c. a version of hydraulic pressure used in dialysis d. diffusion of solvent through a semipermeable membrane from high- to low-solute concentration - CORRECT ANSWER b. diffusion of solvent through a semipermeable membrane from low- to high-solute concentration TRUE OR FALSE: In hemodialysis, blood and dialysate flow in opposite directions - CORRECT ANSWER TRUE Which site in the hemodialysis pathway has the highest positive pressure? a. arterial blood in the afferent tubing b. blood entering the dialyzer fiber c. blood leaving the dialyzer fibers d. blood in the venous return - CORRECT ANSWER b. blood entering the dialyzer fiber In the dialyzer, water may be removed from: a. the intracellular compartment b. the intravascular compartment c. the interstitial compartment d. all of the above compartments - CORRECT ANSWER c. the interstitial compartment Clearance of low-molecular-weight molecules by dialysis is accomplished mostly by: a. convection b. diffusion c. absorption d. solvent drag - CORRECT ANSWER b. diffusion A hollow fiber dialyzer has which of the following properties? a. very fine fiber tubes in place by polyurethane material b. fibers about 1 cm in width c. a high-membrane compliance d. a high resistance in the fibers, enhancing ultrafiltration pressure - CORRECT ANSWER a. very fine fiber tubes in place by polyurethane material Synthetic membranes have which of the following properties? a. they are cellulose membranes in which hydroxyl groups are replaced with acetate b. they have thick fiber walls c. they have poor absorption d. they remove solute by diffusion only - CORRECT ANSWER b. they have thick fiber walls To determine the most accurate clearance rate of a particular solute, one should: a. use water instead of blood b. use a large-molecular-weight molecule c. reduce the manufacturer's stated rate by 10% d. measure the solute concentrations of blood going into and out of the dialyzer - CORRECT ANSWER d. measure the solute concentrations of blood going into and out of the dialyzer Substances that are added to the dialyzer: - CORRECT ANSWER chloride, bicarbonate, and sodium Sodium modeling refers to: a. changing the concentrate of the dialysate sodium during the course of the dialysis b. injecting sodium chloride directly into the patient's vein c. adjusting the sodium concentrate of the dialysate with normal saline d. none of the above - CORRECT ANSWER a. changing the concentrate of the dialysate sodium during the course of the dialysis Coductivity is best defined as... a. a method of checking electrolyte levels in the dialysate b. the voltage required to maintain the dialsate flow rate d. something that is measured once to check the final ionic concentrations of the dialysate - CORRECT ANSWER a. a method of checking electrolyte levels in the dialysate Which of the following statements about the proportioning system is correct? a. the concentrates are mixed manually b. it relies on a continuous supply of fresh concentrate and treated water c. the concentrates are heated after mixing d. fixed-ratio mixing is the only method used - CORRECT ANSWER b. it relies on a continuous supply of fresh concentrate and treated water An advantage of high-flux dialysis is: a. small pore size b. fast removal of fluid c. retention of beta2-microglobulin in the blood d. slow blood flow, leading to more efficient removal of toxic substances - CORRECT ANSWER b. fast removal of fluid A disadvantage of high-flux dialysis is: a. acetate must be used instead bicarbonate buffer b. membrane biocompatibility is reduced c. pyrogen reactions are common d. postdialysis fatigue is common - CORRECT ANSWER c. pyrogen reactions are common Can home dialysis be done during sleep? - CORRECT ANSWER Yes In most dialysate systems, the temperature: a. is maintained by a thermistor-controlled heater b. is maintained between 41oC-43oC c. of water is raised only after mixing with concentrate d. is decreased to increase diffusion - CORRECT ANSWER a. is maintained by a thermistor-controlled heater Dialysate flow rate has which of the following properties? a. lower flow rates improve dialysate efficiency b. it is always preset c. it may vary from 0-2000 mL/MIN d. low water pressure may set off an alarm - CORRECT ANSWER d. Low water pressure may set off an alarm Which of the following statements about blood leaks in the dialysis system is correct? a. they require more than 10 mL of blood to trigger an alarm b. they are detected by use of a light source and photocell c. the blood can be returned to the patient d. they cannot be differentiated from false alarms - CORRECT ANSWER b. they are detected by use of light source and photocell Which of the following statements about fluid removal I=froom the blood is correct? a. it is achieved with a higher dialysate pressure than blood pressure b. it depends on the transmembrane pressure 9TMP) - CORRECT ANSWER b. it depends on the transmembrane pressure (TMO) Which of the following statements about biofilm is correct? a. it is easily removed from the water treatment system b. it does not adhere to surfaces c. it does not affect the water treatment system d. it is an aggregate of microorganisms that produce a matrix of extracellular polymeric substances (slime) - CORRECT ANSWER d. it is an aggregate of microorganisms that produce a matrix of extracellular polymeric substances (slime) Inspection and standards for dialysis centers may be provided by: a. the Food and Drug Administration b. state health departments c. the Association for Advancement of Medical Instrumentation d. all of the above - CORRECT ANSWER d. all of the above Dialysis machine control the rate of fluid removal by: a. volume control b. flow control c. both a and b d. neither a nor b - CORRECT ANSWER c. both a and b