annually
AAMI Chemical Analysis of water used for hemodialysis is tested
Clean the machine surface immediately
A dialysis technician observes a drop of blood on the surface of a patient’s hemodialysis machine. Which of these actions should the dialysis technician take?
About one ounce (30 ml) fluid is on the floor
A dialysis technician observes all of the below on the treatment floor, which one poses an environment risk?
An artery to a vein
A fistula connects
Vitamin B12
A marker used to determine the middle molecule clearance of a dialyzer is
Cations and anions
A mixed- bed DI tank contains
A glomerulus and a tubule system
A nephron is made up of
An infiltration
A patient complains of pain at the venous needle site. The dialysis technician observes there is swelling distal to the venous needle site and that the venous pressure is rising. The dialysis technician should suspect
Dialysis Disequilibrium Syndrome
A patient who is to receive their first dialysis treatment is prone to?
bananas
A patient tells the technician that the dietician reviewed high potassium foods with her. During the conversation she states she routinely eats the following foods. Which one is highest in potassium?
It’s a new Federal regulation
A reason why a dialysis technician is to be certified is
Clotting of extracorporeal circuit
A rise in transmembrane pressure in a low flux dialyzer during hemodialysis is indicative of
Never document something that someone else did
A teammate asks you to document the normal saline he just gave to Mr. Smith. You would:
May rupture and cause the patient to bleed profusely
A true aneurysm can be dangerous because it
Was the predialysis sample drawn from the venous port?
A patient’s laboratory results indicate that the predialysis BUN level was lower than the post dialysis BUN level. When interpreting these findings the technician should seek the answer to which of these questions?
Tachycardia
A rapid pulse of 104 beats/minute would indicate that the patient has:
500
A patient’s dry weight is 154.0 (70kg) and the patient’s pre treatment weight is 158.4. (72kg). For a four- hour treatment, how many mL/ hour must the patient lose to reach dry weight?
200 CFU/mL
AAMI standards for the total microbial count of dialysate shall not exceed:
3-5% of EDW
Acceptable interdialytic weight gains are
Less than two (2) EU/mL
According to AAMI the standard level for endotoxins levels is
4/15/2010
According to the new Conditions for Coverage, all dialysis technicians are to be certified by a national certifying agency or state specific certification by:
Nutritional
Albumin is an important test that tells about the patient’s
Vitamin B12
All of the following are phosphate binders except:
numbness and tingling
All of the following may be signs and symptoms of an infected access except:
The absence of disease producing organisms
Asepsis is defined as
1,385 mL/hr
Based on Mrs Smith’s total amount of fluid to be removed, what is the ultrafiltration rate per hour (mL/hr) for her 4 hour treatment?
Discard the needle
Before a hemodialysis treatment, the technician removes the cap from the fistula needle and accidentally touches the chair with the tip of the needle. Which of these actions should the technician take first?
Hemolysis
Dialysate that is too hot will cause
Weight at which the patient has no edema or fluid in the lungs and BP is normal
Dry weight is defined as the
Disconnection of the bloodline
During a hemodialysis treatment the technician responds to a low venous pressure alarm. The most likely cause for this alarm is:
Blood
Biohazardous waste includes any material exposed to:
Diffusion
Decreasing the patient’s prescribed blood flow rate affects the rate of
Stop the pump
During a hemodialysis treatment, a patient’s venous needle infiltrates. Which of these actions should the dialysis technician take first?
Between 7.0 and 7.4
Dialysate pH should be:
Clamp the venous line
During hemodialysis, the air detector on Ms. Foster’s machine alarms and foam is visible in the venous drop chamber. The immediate action of the dialysis technician should be to:
How have you been since your last dialysis treatment?
During predialysis data collection, it would be best for the technician to ask the patient which of these questions?
Take the patient’s temperature
During the hemodialysis treatment, a patient complains of feeling chilled. In addition to getting the patient a blanket, which of these actions should the technician take?
Notify the equipment technician
During the set up of a hemodialysis machine, the alarm test for conductivity fails. Which of these actions should the dialysis technician take?
Indicators of the adequacy of the renal replacement therapy
ESRD specific tests such as BUN, Creatinine, and URR are
Ultrafiltration
Excess fluid is forced out of the blood and into the dialysate during dialysis by which principle
Percent rejection
Feed conductivity- product conductivity divided by x 100 is the formula calculation of
The ultrafiltration rate
Fluid to be removed divided by the treatment time tells us
Inadequate dialyzer priming
Germicide rebound occurs due to:
Anaphylaxis (severe allergic reaction)
Hives, itching, tightness of the chest and respiratory distress may be signs and symptoms of:
Cardiac arrest
Hyperkalemia can lead to
Hemoglobin
If the extracorporeal circuit clots and it must be discarded, it would be most important to monitor the patient’s serum level of:
Check dialyzer for total cell volume
In reuse, the blood path integrity is tested to
Subcutaneous
Lidocaine is administered
Higher hospitalization and death rates
Low albumin levels in the dialysis patient have been linked with:
Digoxin
Medications that dialyze easily are all except
Psychomotor
Mr. Jones demonstrates how to wash his aces. This is an example of which adult learning principle?
Milk of Magnesia
Mr. Jones suffers from constipation. He goes to the drug store to buy a laxative. Mr Jones should avoid which medication?
Cognitive
Mr. Roberts verbalized how to hand crank his blood pump in the event of an emergency. This is an example of which adult principle?
Notify the nurse of the need for an assessment
Mrs. Smith arrives for dialysis treatment complaining of shortness of breath. Her pre dialysis weight is 4.7 kilograms above the last post treatment weight. The dialysis technician reweighed and verified the weight. Which of the actions should the dialysis technician take next?
5,540 mL
Mrs Smith dry weight is 62 kg. Her pretreatment weight when she came in for treatment on Monday was 67 kg. The priming saline amount is 240 mL, the rinseback amount is 200mL, fluid from medication is 100 mL, and she is not allowed any fluids during treatment. What is the total amount of fluid weight to be removed during her treatment?
Trendelenburg position on left side
Ms Foster complains of shortness of breath. While calling for the nurse the dialysis technician notices there is air in the extracorporeal circuit she/he should place Ms Foster in:
Air
One reason that normal saline is used to rinse and prime the extracorporeal circuit prior to treatment is to remove:
7.0-7.25
Normal body pH is
Time to mature
One disadvantage of a fistula is an increase in
Poor rotation of sites
One cause of aneurysms and pseudoaneurysms is
Blood pump has stopped
The air detector alarms during treatment. If the machine is working properly, the dialysis technician should expect which of these events to have occurred?
Sterilant infusion
Pain at the venous needle site, along with respiratory difficulty and chest pain could be an indicator of:
Hypertension
One sign and symptom of fluid overload is
Hypo-osmole
Solutions that have a higher similarity than body fluids are called?
Numbness and tingling
Symptoms of hyperkalemia (high potassium) may include
Before treatment, after treatment, and after giving heparin
The accuracy of lab results depends on adherence to proper lab draw technique. You must ensure that labs are drawn:
Dialysis Disequilibrium Syndrome
Short frequent hemodialysis treatments in patient’s with high BUN (blood Urea Nitrogen) are performed to prevent:
An infection
Prior cannulation a technician notices the skin over the patient’s fistula is reddened and warm to touch. These symptoms are most likely due to:
Epogen
A medication used to treat anemia is
Teammate
The most important monitor in the dialysis setting is:
Infection
The most frequent cause of death in the first year post transplant is:
12-20 breaths per min
The normal range of resting respirations in an adult is
Diabetes
The leading cause of chronic kidney disease for adults in the United States:
24 hours
The minimum dwell time to achieve sterilization with the chemical Renalin is
Cleansing of the hands
The most important intervention to prevent the spread of infection is
Osmosis
The movement of fluid from the tissue towards a higher concentration of sodium in the blood is an example of
Nephron
The functional unit of the kidney, or the structure in the kidney that does the work, is the
Listening with a stethoscope
The bruit in a Av fistula or graft is detected by
Temperature and transmembrane pressure
The hemodialysis machine continuously monitors many parameters. Which of these parameters must be verified by an external measuring device?
65%
The National standard, based on the KDOQI (kidney Disease Outcomes Quality Initiative) guidelines, for the Urea Reduction Rate (URR) is a ratio greater than:
Peritonitis
The most common complication in Peritoneal dialysis is:
Patient
The most important member of the patient care team is the
Zemplar
The medication used to improve calcium absorption is:
6 months
The minimum amount of experience required to take the NNCC certifying exam is:
1.0 to 1.5 liters per day
The usual fluid allowance for a person with kidney failure is
AAMI
The organization that sets the standards for dialysis water quality is called
Performance of the dialyzer
Total cell volume (TCV) is an indirect measure of the:
Before each patient shift or every four hours
Total chlorine levels in the water are tested
Increase the rate of waste removal
The purpose of using counter-current flow is to
Osmosis
Water moves across a membrane from an area of lower solute concentration to an area of higher solute concentration by which principle
Operates on the principle of ion exchange
The water softener
80%
The TCV should be no less than
Edema and shortness of breath
What are the typical signs of fluid overload
A thrill
To determine the latency of an arteriovenous vascular access, the dialysis technician should initially feel for the presence of
Transmembrane pressure
Ultrafiltration is influenced by
Diffusion
Waste products are removed during dialysis by which principle
Calcium and magnesium
The water softener removes
Residual Sterilant
The reprocessed dialyzer is carefully rinsed prior to patient use to remove
Endotoxin
The part of the cell wall of bacteria that, when released, can cause fever in hemodialysis patient’s is:
Should point in the direction of the blood flow
The venous needle in an AV fistula
Transmembrane pressure
The total pressure that exists across the dialyzer membrane is called
Aluminum
The substance that may be added to the municipal drinking water to make it clearer is:
Kt/V
Which of the following is the most accurate measure of dialysis adequacy?
Bicarbonate
Which of the following component in dialysate is used to correct metabolic acidosis?
Kinking of the venous blood line
Which of the following is most likely to cause a high venous pressure alarm?
Hemoglobin/Hematocrit
What lab tests are used to monitor anemia in the ESRD patient?
Cognitive
Which learning domain is knowledge based?
Cranberry juice colored blood in the venous line
Which of the following is the classic sign of hemolysis?
Ice Cream
Which food below is highest in phosphorus?
O.9% normal saline
When fluid replacement is necessary during the hemodialysis treatment, which of the following solutions is used?
Elevated hematocrit
Which of the following is not a symptom of uremia?
Removing too much fluid
Which of the following is a cause of hypotension during and after dialysis treatments?
Dialysis quality water
Which of the following is considered to be safe water for dialysis?
18 gauge
Which of the following is the largest needle?
Using a bath that will provide a greater concentration gradient
Which of the following actions would increase diffusion during dialysis?
Urea
Which of the following diffuses from the patient’s blood during dialysis?
Handwashing
What is the most important activity that the dialysis technician can perform to prevent the spread of infectious disease in the dialysis clinic?
2.0 inches apart
When cannulating. The tips of the needles should be at least
Hypotension and cramping
Which of the following symptoms would indicate a need to increase the estimated dry weight (EDW)?
2.0
Your patient is to receive 2000 units of heparin. The vial you are using is 1000 u/ml heparin. How many mls will you draw up for this patient?
An arteriovenous fistula
Which of these types of vascular accesses has the fewest complications?
Tighten all connections
Which of the following is used to prevent air in the bloodlines?
AAMI
Which organization set the standards and recommendations for dialyzer reprocessing?
Venous needle is against the wall of the vessel
Which of the following would cause a high venous pressure alarm?
Clotting in the extracorporeal circuit
Which of the following might indicate a need to increase heparin?
The patient just had surgery yesterday
Which of the following might indicate a need to decrease the heparin dose?
Ensuring accurate documentation
Which of these technician activities contributes to data collection used to measure quality outcomes?
Draw one line through it, date, time, signature/credentials, with the words “error”
You have documented incorrectly on a patient’s chart. How do you correct this?
Phosphorus, potassium, and calcium
What’s the normal lab value?
The movement of particles across a semipermeable membrane from an area of higher solute concentration to an area of lower solute concentration, until the concentration on both sides of the membrane is equal
What is diffusion?
The process of passing fluid through a filter or semipermeable membrane
What is filtration?
A medication(synthetic erythropoietin) used to stimulate production of red blood cells
What is epogen?
2 hours
How long can a used dialyzer sit out before reprocessing?
11 hours
How long can a reprocessed dialyzer sit out to dry before use?
14 days
What is a reused dialyzer shelf life?
80%
What is a reuse dialyzer (TCV) percentage
Association for the Advancement of Medical Instrumentation
What does AAMI stand for?
Bicarbonate
The base used to maintain an acceptable dialysate pH(acid/base balance). A buffer
Blood urea nitrogen, the end product of protein metabolism
What is BUN?
A ballooning of the AV fistula, sometimes caused by improper rotation of needle sites
What is a aneurysm?
dysrhythmia
An irregular heart beat
Dyspnea
Difficulty breathing
Edema
Abnormal accumulation of fluid in the body tissues causing swelling. Fluid accumulated in the interstitial space
A medication (synthetic erythropoietin) used to stimulate production of red blood cells
What is Epogen given for?
The circuit “outside body” that carries blood from the patient through dialyzer and back to the patient. The dialyzer and blood lines make up the circuit
What is extracorporeal circuit?
The process of passing fluid through a filter or semipermeable membrane.
What is filtration?
A tuft of capillaries in the nephron that act as filters to remove waste products, fluid and excess electrolytes from the blood as it passes through the kidney.
What is glomerulus?
Hematocrit (HCT)
The measurement of the percentage of red blood cells in a sample of whole blood. This measure is affected by vascular volume.
Hematoma
A localized mass of clotted or partially clotted blood confined within an organ or tissue, which may be discolored (bruised).
Hemoglobin (HB)
A protein that carries oxygen from the lung to the body tissue and transports carbon dioxide from the tissues to the lungs.
Hemolysis
What is the rupture of red blood cells? ( lysis is cell rupture)
Hemostasis
The cessation of bleeding due to clotting. In dialysis, hemostasis refers to the cessation of bleeding from a needle site.
hyperkalemia
An excess of potassium in the blood caused by dietary indiscretion, certain medications, internal bleeding, cellular injury or blood transfusion.
Muscle weakness, nausea, and vomiting
What are symptoms of hyperkalemia?
Hypertension
High blood pressure is signs of?
Movement of blood from a needle site into the surrounding tissue that occurs when the needle pierces the vessel wall.
What is infiltration?
Swelling around the insertion site and pain
Symptoms of infiltration?
A mathematical measurement of the adequacy or dialysis treatment, which considers protein intake and the amount of urea removed from the patient.
What is kt/v?
Nephron
The functional unit of the kidney
Osmosis
The movement of fluid across a semipermeable membrane from an area of lower solute concentration to an area of higher solute concentration. Movement occurs until equilibrium is reached:
pH
The measure of the acid-base status of a solution. PH stands for potential of hydrogen
An electrolyte necessary for bone formation, energy transfer, andneuromuscular function
What is phosphorus?
Very thin flexible sheets of material, such as cellophane, with pores that allow smaller particles or molecules to pass through while blocking larger ones.
What is semipermeable membrane?
A condition caused when the surgical diversion of the arterial blood supply through the vascular access deprives the distal portion of the access extremity of oxygenated blood.
What is steal syndrome?
A narrowing of blood vessels due to the build up of hypertrophic tissue, anatomical narrowing if the vessels, or surgical technique problems.
What is stenosis?
Rapid heart beat
What is Tachycardia?
Controlled fluid removal achieved by increasing or decreasing the amount of fluid moves across a semipermeable membrane by controlling hydrostatic pressure
What is ultrafiltration?
A waste product of protein metabolism affected by dietary intake.
What is urea?
A vitamin that helps the body produce normal size cells with strong cell walls.
What is vitamin B-12?
A vitamin that, in its active form helps maintain the balance of blood calcium and phosphorus with calcium and phosphorus stored in the bones.
What is vitamin D?
A slow heart rate
What is bradycardia?
Hypertension
One sign and symptom of fluid overload?
Osmosis
Water moves across a membrane from an area of lower solute concentration to an area of higher solute concentration by which principle?
Diffusion
Waste products are removed during dialysis by which principle?
Ultrafiltration
Excess fluid is forced out of the blood and into the dialysate during dialysis by which principle?
Osmosis
The movement of fluid from the tissue towards higher concentration of sodium in the blood is an example of
Diffusion
Decreasing the patient’s prescribed blood flow rate affects the rate of?
Transmembrane pressure
Ultrafiltration is influenced by
11 hours
The minimum dwell time to achieve sterilization with the chemical renalin is?
Residual Sterilant
The reprocessed dialyzer is carefully rinsed prior to patient use to remove:
Box port behind the machine
The patient’s machine alarms blood leak, where would you draw the sample from to determine if there is a blood leak?
Pyrogen Reaction
What causes symptoms of fever and chills?
arteriovenous (AV) fistula
Which of the following types of vascular access has the lowest incidence of infection?
Hypotention
During Mrs. King’s hemodialysis treatment, she starts actively yawning. The technician suspects she may be experiencing
Salt level in brine tank
While performing the end-of-day water hardness check, the technician notes that the hardness exceeds the allowable limit. In addition to notifying the equipment technician, the technician should check which component of the water system?
A life-threatening condition
Chloramine levels in treated water that are in excess of the standards of the Association for the Advancement of Medical Instrumentation (AAMI) could result in
Salt
A patient is experiencing large weight gains between hemodialysis treatments. The technician should remind the patient that the best dietary measure to control weight gain is to decrease the intake of
Notify the equipment technician
When doing a routine patient check, the technician notices a puddle of clear liquid underneath a dialysis machine. After wiping it up, which of these actions, if any, should the technician take?
Rope and ladder technique
A patient has an arteriovenous (AV) fistula in his lower left arm. When choosing a cannulation site, the technician observes where previous needles were placed and chooses to use alternate sites for arterial and venous needle insertion. This practice is an example of
Hypertonic
A solution with higher osmolarity than body fluid?
Call the bio-med
If during a set up, a machine test fails what would be the next step after re-testing?
Operates in the principle of ion exchange
What does the water softener do?
Dialysis Equilibrium Syndrome
Shortened frequent treatments in patient’s with high BUN prevent?
1:100
What is the ratio for bleach wipes?
1:10
What is the ratio for bleach clamps?
1:10
What ratio do you use for blood spills?
1:10
What is the ratio for bleach water?
Numbness and tingling
Symptoms of hyperkalemia?
Endotoxins
What part of the cell wall when released can cause fever in hemodialysis patients?
Hemoglobin
If the extracorporeal circuit clots we must monitor the patient’s serum level of?
Using a bath with a greater concentration
Which action increases diffusion during dialysis?
Residual Sterilant
Dialyzers are carefully rinsed prior to use to remove:
Hecterol
Vitamin given to patients by the nurse?
Blood electrolyte levels
Changing the composition of the dialysis solution can influence the patient’s
Remove the line from the venous line clamp
Blood flow is manually maintained during power outage. The technician must take which of the following actions?
Countercurrent flow
The technician observes that a patient’s dialysate lines were incorrectly placed on the dialyzer. The technician corrects the line placement. The principle underlying the technicians’ actions is that the clearance is maximized by
Treatment time
Mrs. Miller’s calculated kt/V urea is 0.9 one of the factors that affects her kt/V urea is her?
As far apart as possible
In order to maximize access recirculation. The technician should place Mrs. Miller’s fistula needle:
Clot formation
Heparin is given during Mrs. Miller’s dialysis treatment to lower risk for
We need to ensure early detection of needle dislodgement
Mrs. Miller asks the technician”why can’t I completely cover up with a blanket during my hemodialysis”? “I’m cold” which of these responses by the technician would be best?
Make sure the blood pump stopped
During a treatment, Mrs. Miller’s venous needle infiltrates. Which of the actions should the technician take first?
It is not permitted by the current ESRD regulations
A patient is busy with a patient when a machine across the room alarms. The dietician standing nearby mutes the alarm. The technician should have which of these understandings concerning this action?
Steal
A patient who recently had an Av fistula placed in the left forearm is experiencing numbness and tingling of the left hand. The patient’s left is cold and fingernail beds are blue. The patient most likely had which of of these symptoms?
Thrombosis
Holding needle puncture sites instead of using spring loaded clamps fistula clamps is recommended to avoid access
Disinfecting
The greatest reduction in microorganism in the dialysis machine is accomplished by
Teaching patients how to meet nutrition needs
The role of the renal dietician includes
Hypotension
During Mrs. King’s hemodialysis treatment, she starts actively yawning. The technician suspects she may be experiencing
First- use syndrome
A patient who is receiving an initial hemodialysis treatment on a non- reusable dialyzer should be observed for signs of
Creatinine
A substance that is cleared from the body by healthy kidney is?
Whether other patients are having similar symptoms
During a dialysis treatment, a patient suddenly develops fever and chills. The initial action that should be taken is to determine
Air detector
Which of the following components of the dialysis machine is designed to protect the patient from bubble/foam?
Remove disinfectant
One purpose of priming the bloodlines and extracorporeal circuit pre-dialysis is to?
Adequately rinseback as much of the patient’s blood as possible at each treatment
Which of the following actions can the dialysis technician take to help minimize anemia?
7 days
The hepatitis B virus is able to survive on environmental surfaces for as long as:
Change the DNA of microbes so they die or cannot multiply
A new technician is being oriented to the water treatment system. The equipment technician explains that the purpose of the ultraviolet (UV) light is to?
Falls
For pain management, Mr Rivera is taking narcotic pills as prescribed by his doctor. The dialysis technician knows that taking this medication puts Mr Rivera at increases risk for
Time required to mature
What is a disadvantage of an AV fistula as hemodialysis access compared to other types of access?
Prevent prolonged bleeding
A patient who has an arteriovenous fistula receives a bonus dose of heparin at the beginning of a hemodialysis treatment and a continuous heparin infusion during the treatment. The patient’s heparin administration should be terminated 30-60 minutes before the end of treatment in order to
Vascular surgeon
A patient with a right Av fistula arrives at the dialysis facility complaining of pain, tingling, and cold fingers in his right hand. The technician would expect the nurse will notify which of the following physicians for possible corrective action?
No additional precautions are necessary for the patient
A patient is diagnosed with hepatitis C beyond standard precautions. What additional measures. If any, should be taken for the patient?
You don’t have enough red blood cells to carry oxygen
A patient tells the technician. “The doctor told me I’m anemic what does that mean”? Which response by the technician would be correct?
Two red blood cells
In hemodialysis, the term anastomosis refers to the connection of?
Blood returning to the patient
Venous pressure is a result of resistance created by the
Before each patient shift
According to the standards of the Association for the Advancement of Medical Instrumentation (AAMI), pre treatment water should be checked for chloramines at which of these times?
The patient must receive dialysis in a hospital in a special isolation room
A patient on hemodialysis goes to the emergency department for persistent coughing and fever. He is diagnosed with active tuberculosis (TB) which of the following actions would the technician expect to be taken in regard to the patient’s dialysis treatment?
Anaphylaxis (severe allergic reaction)
Hives, itching, tightness of the chest and respiratory distress may be signs and symptoms of:
Ultrafiltration
Excess fluid is forced out of the blood and into the dialysate during dialysis by which principle
6-8 weeks
How long does it take a Fistula to mature
c) universal precautions
1.Which of the following
best describes the reason for wearing gloves when handling machine prior to blood?
a) patient comfort
b) asepsis
c) universal precautions
d) HIV
b) needs further rinsing
2 You test for sterilant levels in a
hemodialysis machine prior to patient use. The test
is positive for sterilant. This means the machine:
a) is sterile & bacteria free
b) needs further rinsing
c) needs more sterilant
d) is in conductivity
a) creatinine, BUN, &
phosphorus are elevated
3.Choose the correct
statement regarding
serum abnormalities in
renal failure:
a) creatinine, BUN, &
phosphorus are elevated
b) creatinine BUN creatinine, BUN, &
phosphorus are depressed
c) calcium & bicarbonate are
elevated
d) calcium & bicarbonate are
depressed
a) vascular access
4.Hemodialysis requires
a means to channel the
patient’s blood to the
hemodialyzer & then back to the body. It’s
called:
a) vascular access
b) hemodialyzer
c) dialyzing fluid delivery system
d) infusion pump
b) usually created in the
forearm, near the wrist
5.Which of the following is correct regarding a fistula?
a) usually created in the leg, near the ankle
b) usually created in the
forearm, near the wrist
c) are made of salastic tubing
d) none of the above
c) blood leakage immediately
6.Blood leak detectors are extremely sensitive
& can determine:
a) blood type
b) amount of blood loss
c) blood leakage immediately
d) volume changes
e) serum potassium levels
d) bananas, tomatoes, oranges
7.Which of the following foods are high in
potassium?
a) milk, ice cream, yogurt
b) legumes, cheese, pizza
c) chips, colas, canned meat
d) bananas, tomatoes, oranges
a) calcium, phosphorus &
PTH
8.What lab values are monitored for
assessing bone disease?
a) calcium, phosphorus &
PTH
b) calcium, phosphorus &
albumin
c) calcium, phosphorus &
potassium
d) calcium, phosphorus &
magnesium
a) diabetes
9.Which is the most common cause of chronic kidney failure in the US?
a) diabetes
b) hypertension
c) polycystic kidney smaller molecular
disease
d) glomerulonephritis
b) potassium has a smaller molecular weight
10.The reason potassium dialyzes and
RBC’s do not is:
a) potassium has a larger molecular weight
b) potassium has a smaller molecular weight
c) RBC’s are not water soluble
d) RBC’s have a negative charge
a) less than 0 .1mg/L (ppm)
11.Acceptable limits for total chlorines in water for hemodialysis are?
a) less than 0 .1mg/L (ppm)
b) 0.5 mg/L to 1 mg/L(ppm)
c) 3.5 mg/L to 5.5 mg/L to 5.5 mg/L(ppm)
d) greater than 6.0 mg/L(ppm)
b) dialysis disequilibrium syndrome
12.If a new patient starts with a very high
BUN, dialysis is purposely made less efficient to prevent:
a) rapid decrease in hct
b) dialysis disequilibrium syndrome
c) cardiac arrhythmia’s
d) excessive coagulation
c) low hematocrit
13.The following are factors in poor clearance during
dialysis except:
a) poor dialyzer reuse
b) access recirculation
c) low hematocrit
d) low blood flow rate
b) osmosis
14.The movement of water from an area of low solute
concentration to an area of high solute
concentration is called:
a) diffusion
b) osmosis
c) ultrafiltration
d) dialysis
d) dialyzer
15.Potting compound, casing, fibers and headers are part of a:
a) dialysis machine
b) water treatment system
c) R. O. system
d) dialyzer
c) 4.0 liters or 4000 ml
16.Mr. Jones has a dry weight of 72 kg. He weighed 73 kg after last treatment. Today he weighs 75.5 kg. Assume prime and rinse back =500 ml total. What is Mr.Jones’ fluid removal goal for today?
a) 2.5 liters or 2500 ml
b) 3.0 liters or 3000 ml
c) 4.0 liters or 4000 ml
d) 4.5 liters or 4500
c) concentration of red blood cells in the blood
17.A hematocrit test indicates which of the
following?
a) concentration of platelets
b) concentration of creatinine in the blood
c) concentration of red blood cells in the blood
d) concentration of white blood cells in the blood
d) all of the above
18.What factors should be considered when
establishing a patient’s dry weight?
a) blood pressure
b) patient well being
c) evidence of dehydration or fluid overload
d) all of the above
c) appropriately mix the dialysate concentrates
with water
19.In a dialysis machine, the
proportioning system does what?
a) prepare the dialysate to the proper pH
b) warm the dialysate to the proper temperature
c) appropriately mix the dialysate concentrates
with water
d) to monitor the dialysate flow rate
c) hemolysis
20.The complication in which blood has a
“cherry pop”appearance is:
a) blood leak
b) air embolism
c) hemolysis
d) none of the above
d) all of the above
21.The use of high a sodium dialysate may
predispose a patient to:
a) fluid overload
b) hypertension
c) thirst
d) all of the above
a) UF Coefficient
22.The capability of a dialyzer to remove fluid, expressed as ml/mmHg/hr is:
a) UF Coefficient
b) clearance
c) surface area
d) priming volume
b) resistance to blood flow out of the access
through the dialyzer
23.A pre-pump arterial pressure reading is
measuring:
a) the pressure required to pump the blood
through the dialyzer
b) resistance to blood flow out of the access
c) pressure within the dialyzer
d) none of the above
d) all of the above
24.What determines the surface area of a
hollow fiber dialyzer?
a) number of fibers
b) internal diameter of fibers
c) length of fibers
d) all of the above
b) increase the rate of waste removal
25.The purpose of using counter-current flow is to:
a) increase the rate of fluid removal
b) increase the rate of waste removal
c) decrease the amount of dialysate used
d) decrease the surface area of the membrane
b) hemolysis
26.Chloramine exposure in dialysis can result in:
a) hypernatremia
b) hemolysis
c) pericarditis
d) bleeding
d) the dialyzer fibers are free of leaks
27.Part of the reuse process involves the reuse machine testing the dialyzer to verify:
a) the dialyzer is free of sterilant
b) the dialyzer is free of bacteria
c) the dialyzer is free of endotoxins
d) the dialyzer fibers are free of leaks
c) 200 CFU’s
28.According to AAMI RD52, what is the
maximum allowable level of bacteria in dialysate?
a) 1,000 CFU’s
b) 50 CFU’s
c) 200 CFU’s
d) 500 CFU’s
b) monthly
29.According to AAMI RD52, how often
should bacterial cultures be sampled?
a) weekly
b) monthly
c) quarterly
d) annually
a) 50 CFU’s
30.According to AAMI RD52, what is the action level for bacteria in dialysate?
a) 50 CFU’s
b) 75 CFU’s
c) 100 CFU’s
d) 200 CFU’s
b) fever/chills
31.Bacterial exposure from water may cause which of the following symptoms?
a) hemolysis
b) fever/chills
c) bone disease
d) hypotension
a) Scribner and Quinton
32.Who developed the first permanent blood access, the “Shunt”?
a) Scribner and Quinton
b) Kolff
c) Brescia and Cimino
d) Turner
b) mm/Hg
33.Venous pressure meters are calibrated in:
a) PSI
b) mm/Hg
c) mL/hour
d) mg%
b) mm/Hg
34.TPM is measured as:
a) mL/hr
b) mm/Hg
c) mL/min
d) none of the above
c) pH and conductivity
35.The hemodialysis machine continuously monitors many parameters. Which of these parameters must be verified by an external measuring
device?
a) blood flow
b) dialysate flow
c) pH and conductivity
d) temperature and transmembrane pressure
b) chlorine and chloramine
36.Prior to each patient shift, it would be essential to
perform a water quality check for which of these substances?
a) calcium and magnesium
b) chlorine and chloramine
c) organic contaminants
d) inorganic contaminants
b) hydrogen ions
37.The term pH is a measurement of the
concentration of:
a) all ions in solution
b) hydrogen ions
c) bicarbonate ions
d) acetate ions
c) determine the patient’s learning needs
38.The technician’s role in patient teaching
should be to:
a) assess the patient”s barriers to learning
b) check the patient’s readiness to learn new
information
c) determine the patient’s learning needs
d) Reinforce teaching that the patient has received
from other team members
d) all of the above
39.What can dialysis staff do to reduce the
risk of being infected with a blood borne pathogen?
a) proper hand washing
b) universal precautions
c) proper sharps disposal
d) all of the above
d) all of the above
40.Which of the following are ways to
handle chemicals safely?
a) wash hands before eating or drinking
b) wear protective clothing
c) don’t eat or drink in the work area
d) all of the above
b) 25-35 degrees
41.What is the correct angle in which to cannulate a fistula?
a) 10-15 degrees
b) 25-35 degrees
c) 35-45 degrees
d) it dosen’t matter
d) all of the above
42.Which of the following affects access recirculation?
a) distance between the tips of the needles
b) presence of stenosis
c) direction of needles
d) all of the above
a) salt
43.The technician observes that the hardness reading after the water softener isabove the acceptable
limit. The technician should check the softener tank’s level of:
a) salt
b) chlorine
c) carbon
d) sand
c) about one ounce (30 ml) of fluid is on the floor
- A technician observes all of the following in
the hemodialysis unit. Which one poses an environmental risk?
a) the wheels of the hemodialysis machines are locked
b) charts are lying on bedside tables
c) about one ounce (30 ml) of fluid is on the floor
d) a patient’s family member is present during treatment
a) Material Safety Data Sheet (MSDS)
- When preparing a bleach solution for cleaning
equipment, the technician accidentally spills undiluted
bleach on the floor. Which of these resources will provide the technician with information about how to
properly handle spill of the chemical?
a) Material Safety Data Sheet (MSDS)
b) Centers for Disease Control & Prevention (CDC)
c) Association for the Advancement of Medical Instrumentation (AAMI)
d) State Department of Health (DOH)
d) the dialyzer was bypassed
- A conductivity alarm sounds during a
hemodialysis treatment. The technician should expect which of these events to have occurred?
a) the blood pump has stopped
b) the dialysate flow rate has increased
c) the electrical power source was interrupted
d) the dialyzer was bypassed
c) obtain a sample after the second
- During routine water testing, the technician notes
that the chloramine level after the first carbon tank is 0.2mg/L. Which of these actions should the technician
take next?
a) bypass the carbon tanks
b) descale the reverse osmosis membranes
c) obtain a sample after the second
d) immediately terminate hemodialysis treatments
a) refer the patient to the social worker
- A female technician has been caring for a male patient for several months. The patient tells the technician that he is lonely and depressed. He asks the
technician to go out to dinner with him. In addition to politely declining the patient’s invitation, which of these actions, if any, should be taken:
a) refer the patient to the social worker
b) recommend an over-the-counter mood stimulant, such as St. John’s wort
c) share the patient’s need for socialization with other patients
d) no further action is needed
d) left-sided trendelenberg
- A hemodialysis technician suspects that a patient who is receiving a hemodialysistreatment has an air embolus. After stopping the blood pump, the patient
should be placed in which of these positions?
a) low-fowlers
b) high-fowlers
c) right-sided trendelenberg
d) left-sided trendelenberg
b) call for help
- During hemodialysis a patient goes into
cardiac arrest. Which of these actions shouldbe taken first?
a) apply a precordial thump to the patient
b) call for help
c) return the patient’s blood
d) stop ultrafiltration