CCHT practice questions & Answers Correct 100%

when using the buttonhole technique for vascular access for hemodialysis, the needles are placed in. - ANSWER the same site in a fistula when inserting a needle for hemodialysis, which of the following increases the risk of infiltration? - ANSWER rotating the needle 180 degrees the legal document that assigns a heal care proxy to make decisions in the event that a person is unable to do so is called - ANSWER durable power of attorney carbon filters in the water system are necessary to remove - ANSWER chlorine, chloramine, and organic material backwashing to free residue from sediment filters in the water system should be done at least - ANSWER once daily with the formula for urea kinetic modeling (UKM), the K in the Kt/V formula stands for - ANSWER urea clearance (mL/ min) plus residual urinary output when inserting needles into a graft for hemodialysis, the needle tips be should be at least how far apart? - ANSWER 2.0 inches if a patient is undergoing hemodialysis and the technician notes that a bloodlines has separated and blood has pooled beneath the access site, the first intervention should be to - ANSWER stop the blood pump during hemodialysis, the technician would expect a patient's temperature to rise by about. - ANSWER 0.5 C approximately what percentage of the total blood volume circulate in the veins? - ANSWER 65% to 80% patient should be advised to avoid eating during hemodialysis because ingestion of food may result in - ANSWER hypotension prior to using a reprocessed dialyzer, a recirculating rinse with NS should be completed with recirculating flow rate through the blood compartment and the dialysate compartment of at least. - ANSWER 200 mL/min for BFR and 200 mL/ min for DFR. if a hemodialysis patient test positive for hepatitis C virus (HCV), which of the following interventions does the KDIGO guidelines recommend when proving hemodialysis treatment? - ANSWER adherence to strict infection-control procedures if a dialyzer is to be reprocessed in 3 hours, the dialyzer must be - ANSWER refrigerated when documenting observations about a patient, which of the following is the most appropriate description? - ANSWER patient is sighing and rubbing hands together which of the following is the most common cause of hypotension developing during hemodialysis? - ANSWER removing excessive volume of fluid which of the following interventions is most likely to decrease hypotension that occurs during hemodialysis? - ANSWER decreasing the ultrafiltration rate if an air sector alarm sounds during hemodialysis, the technician should initially - ANSWER stop the blood pump and clamp the patients venous line if outflow stenosis of an AV fistula occurs, the thrill usually - ANSWER is loud and higher pitched and then discontinuous when reviewing a patient's food dairy, the technician advise the patient that which of the following protein sources is of low biological value? - ANSWER dried bean which of the following vitamins may be removed by hemodialysis - ANSWER vitamin B the renal nutritionist has advised the patient to have a diet high in fiber, but the patient is unsure which foods to choose. which of the following foods per serving is highest in insulate fibers? - ANSWER kidney beans the primary purification process of the dialysis water is - ANSWER filtering with activated carbon if the dialysis center uses hemoclips on dialysis tubing to prevent disconnection, what other precautions should be utilized? - ANSWER visible access sites/line connections and documentation of integrity every 30 minutes if during hemodialysis, blood is evident in the used dialysate, this probably indicates - ANSWER tear in the membrane if a patient asks a question to which the technician does not know the answer, an appropriate response is - ANSWER I 'll find out for you '' during routine hemodialysis, a patient's blood pressure should monitored every - ANSWER 30 to 60 minutes if a patient develops painful muscle cramps in the hands, feet, and abdomen shortly after hemodialysis begins, the most likely interventions is - ANSWER saline bolus and/or decreased ultrafiltration rate. if a hemodialysis patient's temperature per tympanic membrane thermometer is 37C in order to reduce incidendence of intradialytic ( during dialysis ) hypotension, the temperature of the dialysate solution should ideally be set at - ANSWER 36.5 C foam in the venous bloodline of a dialyzer may indicate - ANSWER air embolism prior to initiating hemodialysis, the ph of the dialyste usually ranges from - ANSWER 7.0 to 7.4 the number one cause of kidney failure in the US is - ANSWER diabetes mellitus, type 2 the use of topical anesthetic, such as EMLA, to reduce discomfort during cannulation is contraindicated with - ANSWER buttonhole sites a patient who has been very alert and shown no sign of cognitive impairment seems confused during dialysis and repeatedly asks the same question. the best initial response is to - ANSWER notify the nurse when determining if a new AV fistula is maturing the three factors to assess by palpation are the - ANSWER thrill, vessel growth, and vessel firmness which of the following antiseptics used for skin pre for a fistula site has the broadest spectrum antibacterial activity? - ANSWER 2% chlorhexidine gluconate while a patient is undergoing hemodialysis, chloramine testing of the water system should be conducted every - ANSWER 4 hours if a patient is to undergo heparin-free dialysis, the optimal blood flow rate is - ANSWER 300 to 400 ml/min before cannulating An AV fistula for a hemodialysis treatment, the technician examines the patient's access arm and finds that the access arm appears slightly edamatous, and the skin is pale. on further examination, the technician notes that there are small purple veins evident on the chest wall near where the arm meets the body. the technician should suspect - ANSWER stenosis in order to increase survival rates. the ultrafiltration rate for hemodialysis patients should be maintained at least than - ANSWER 12 ml/kg/m as part of fistula assessment before cannulation, the technician evaluates the thrill and then applies acclusion by placing a finger across the body of the fistula. while the fistula is acceded, the technician palpates and feels both a thrill and a pulse. this probably signifies a (n) - ANSWER accessory pathway ( collateral circulation ) how much additional proteins should a patient on hemodialysis ingest every day in comparison to a health person - ANSWER 50% weight gain between hemodialysis treatments should not exceed - ANSWER 5% of dry weight the technician has calculate the target weight loss for a patent's hemodialysis session, but the patient insists that the technician has made an error and the target is 1 kg too high. the technician should - ANSWER recalculate the target weight loss. the most important reason for placing hemodialysis needles in antegrade position ( in direction of blood flow) is because - ANSWER it causes less scarring when preparing dialysate with a 45x concentrate, if the proportioning ratio contains 1.0 part acid and 1.72 parts bicarbonate, how many parts of water are needed? - ANSWER 42.28 if conductivity monitoring stops dialysate from flowing to the dialyzer but instead sends it to the drain (bypass), this means that - ANSWER the conductivity monitor is malfunctioning when using a portable digital dialysate meter, such as the D6 (myron L meter ) , to verify that inline meters are accurate regarding conductivity and ph, the technician must - ANSWER obtain an unused dialysate sample the target ultrafiltration goal set for the patient is based on the patient's - ANSWER dry weight a patient is to receive a bolus of ulfrationated heparin (25 IU/kg ) at the onset of dialysis and 800 U at one-hour intervals during treatment, which is scheduled from 1 to 5 PM. the first dose is given at 1 Pm and the last dose at - ANSWER 4 pm when checking the pump occlusion for the blood pump, the technician nots, that the rollers appear to may result in - ANSWER cracking of the blood pump segment of tubing in the hemodialysis machine, a separate air detector is usually placed - ANSWER between the venous pressure gauge and the venous access at the completion of dialysis treatment, it is important to rinse back as much blood as possible in order to - ANSWER reduce the severity anemia if a power outage occurs and backup power fails, before using the hand crank to return the patient's blood, the technician must - ANSWER remove the venous line for the air detector if a patient's blood pressure is 142/88 before dialysis and 108/72 at the completion of dialysis, the most likely intervention is - ANSWER infusion of normal saline to increase blood pressure prior to opening a sterile packing, the technician spills sterile normal saline on the package. the technician should - ANSWER discard the package when washing the hands, the hands should be wet and soap applied and then the hands rubbed together for at least - ANSWER 15 seconds how long can hepatitis B virus live on surfaces if they are not properly disinfected? - ANSWER 7 days in the event that a fire occurs in a dialysis center, the RACE method of response includes - ANSWER rescue, active alarm, contain/confine fire, and extinguish/evacuate if the technician needs to move boxes of supplies from the floor to elevated shelves, the technician should - ANSWER bend down at the knees and keep the back straight while lifting for documentation in the medical record, which of the following includes a correct - ANSWER 0.5 kg for a hemodialysis cannulation with a blood flow rate of fewer than 300mL/ min, which of the following needle gauge sizes is usually recommended? - ANSWER 17 if the nephrologist has ordered a pre-dialytic and post-dialytic BUN ( blood urea nitrogen) for a patient with an AV fistula, the pre-dialytic blood sample should be obtained from the. - ANSWER arterial needle