CDC Exam Flashcards
An A-V fistula is the preferred access for hemodialysis because?
A. There is a lower incidence of complication
B. Surgeons are more experience and prefer creating A-V fistulas
C. There is a lower incidence of thrombosis
D. Both A and C
D. Both A and C
What is the best way to prepare an access for cannulation?
A. Scrub with a gauze or pad soaked with a germicidal agent in a circular motion from the outside inward
B. Scrub in a circular motion from inside to outside and allow the recommended time for skin contact before cannulation
C. Rub vigorously up and down on the area to be cannulated then insert the needles
D. No further preparation is required if the patient has just washed their access
B. Scrub in a circular motion from inside to outside and allow the recommended time for skin contact before cannulation
Mr. Brown has been diagnosed with dialysis dementia. Symptoms of this condition may include:
A. Confusion and hallucinations
B. Short-term memory loss and personality changes
C. Seizures and speech impairment
D. All of the above
D. All of the above
Mr. Pitt is always joking. He usually requests to be called “Bob.” He presents today very quiet and when you called him “Bob” he did not respond. How would you further investigate this change in behavior?
A. Go get the nurse without further investigation
B. Put him on and worry about it later
C. Ask a few open-ended questions that would indicate whether there is a personal issue occurring or change in mental status
D. Nothing, he simply may not want to talk today
C. Ask a few open-ended questions that would indicate whether there is a personal issue occurring or change in mental status
The pressure difference between the blood side and the dialysate side of the dialyzer is called: A. Urea Reduction Rate B. Transmembrane Pressure C. Dialysate Flow Rate D. Ultrafiltration Factor
B. Transmembrane Pressure
Which of the following statements is not true about renal tubules?
A. Approximately 66% of water from filtrate is reabsorbed in proximal convoluted tubule
B. Loop of Henle reabsorbs sodium chloride which promotes water conservation in times of dehydration
C. Distal convoluted tubule maintains balance in the liver
D. Nephrons are located in the bladder
B. Loop of Henle reabsorbs sodium chloride which promotes water conservation in times of dehydration
Which of the following statements is not true about nephron?
A. Nephron is the functional unit of the kidney
B. Nephrons process about 7500 ml of filtrate per hour
C. A nephron is composed of renal tubules and collecting ducts
D. Nephrons are located in the bladder
D. Nephrons are located in the bladder
Mr. Peterson experiences as episode of hypotension. He is symptomatic. He only has 10 minutes left of his run and the nurse indicates to take him off. The ultrafiltration (UF) goal was 1.4kg and the machine indicated that 1.3kg was removed. After you returned his blood and pulled his needles, he weighs himself. He has reported his weight 0.8kg below his dry weight. What is/are the possible cause(s) for the variance?
A. The pre weight was inaccurate
B. The math calculated for fluid removal was wrong
C. The patient was not wearing the same clothing while weighing both times
D. All of the above
D. All of the above
Hypokalemia is manifested by: A. Muscle weakness and paralysis B. Cardiac arrhythmia C. Tingling of lips and fingers D. Both A and B
D. Both A and B
Elevated Parathyroid Hormone (PTH) can cause which of the following conditions? A. Nephritis B. Renal Osteodystrophy C. Pericarditis D. Uremia
B. Renal Osteodystrophy
Which of the following are symptoms of uremia? A. Fatigue, weakness, mental confusion B. Stomach pains C. Sores in the mouth D. All of the above
D. All of the above
Hypernatremia is defined as a plasma sodium concentration of above 146mEq/L. It is manifested by:
A. Headache, seizure, muscle cramps
B. Intense thirst, flushed skin, dry mucus membrane
C. Agitation, low body temperature
D. Fever
B. Intense thirst, flushed skin, dry mucus membrane
Stage 5 Chronic Kidney Disease (CKD) is defined by a Glomerular Filtration Rate (GFR) of: A. 30-59 mL/min/ 1.73m2 B. 15-29 mL/min/ 1.73m2 C. < 15 mL/min/ 1.73m2 D. ≥ 90 mL/min/ 1.73m2
C. < 15 mL/min/ 1.73m2
Which of the following statement(s) is/are true about transplant?
A. Transplant patients have fewer dietary limits than in-center hemodialysis patients
B. Kidney transplant is a cure for kidney disease
C. Anti-rejection drugs may cause high blood pressure, increased risk of infection and weight gain
D. Both A and C
D. Both A and C
Factors to be considered is managing nutrition of End Stage Renal Disease (ESRD) patients are: A. Comorbid conditions B. Laboratory conditions C. Medications D. All of the above
D. All of the above
As a member of the health team, a dialysis technician can help improve anemia outcomes by:
A. Rinsing patient’s blood back until the bloodlines are clear
B. Reporting to the nurse if a patient complains of bloody stools
C. Monitoring access sites for bloodline separation or exsanguination (bleeding out)
D. All of the above
D. All of the above
What is the most common cause of transmission of Hepatitis B (HBV) in dialysis centers?
A. Needle stick from a contaminated needle
B. Sharing of contaminated supplies
C. Re-entry of single dose vials
D. Non separation of laboratory from medication preparation areas
B. Sharing of contaminated supplies
About one hour into the treatment, three patients complained of fever, chills, nausea and vomiting.
What conditions you think the patients are experiencing?
A. Bone disease
B. Hemolysis
C. Anemia
D. Pyrogen reaction
D. Pyrogen reaction
You are taking care of Mr. Brown today. His pre-treatment temperature is 100.80F. He complains of weakness and diaphoresis at night. He reports of coughing productively for 2 weeks. Your initial reaction is to:
A. Tell the nurse about his symptoms
B. Put on your mask and continue his treatment
C. Give him acetaminophen to reduce his fever
D. Tell him to see his primary physician
A. Tell the nurse about his symptoms
Methicillin-Resistant Staphylococcus Aureus (MRSA) and Vancomycin-Resistant Enterococcus (VRE) can be nosocomial-acquired infection. Nosocomial is defined as: A. Hospital acquired infection B. Community acquired infection C. Dialysis acquired infection D. None of the above
A. Hospital acquired infection
Which of the following complications can happen when removing too much fluid during dialysis?
A. Chest pain and shortness of breath
B. Bleeding, hematoma, anemia
C. Pruritus, dry and scaly skin
D. Low blood pressure, cramps, nausea and vomiting
D. Low blood pressure, cramps, nausea and vomiting
Your patient is complaining of pain and numbness on the access limb, more so during dialysis treatment. The patient may be experiencing: A. Infection B. Recirculation C. Infiltration D. Steal syndrome
D. Steal syndrome
The following statements are true about Hepatitis C (HCV) except:
A. Hepatitis C is spread by contact with infected blood
B. Patients with Hepatitis C must be dialyzed in Isolation Room
C. Outbreaks of HCV in dialysis centers have been linked to cross-contamination among patients
D. Universal Precautions must be observed in all patients, whether or not they have HCV
B. Patients with Hepatitis C must be dialyzed in Isolation Room
John Adams dialyzes 3 hours on a F180 dialyzer using an A-V fistula in his left forearm. His Urea Reduction Ratio (URR) this month is 62% and Kt/V is 1.0. These lab values indicate:
A. Mr. Adams is being adequately dialyzed
B. The A-V fistula probably has a stenosis and Mr. Adams should be referred back to the vascular surgeon
C. Mr. Adams is not adequately dialyzed and should be evaluated by the Care Team to determine what can be adjusted in his treatment regime
D. Mr. Adams needs a bigger dialyzer
C. Mr. Adams is not adequately dialyzed and should be evaluated by the Care Team to determine what can be adjusted in his treatment regime
You are helping another technician on the floor. To assist that other technician, you volunteer to document the patient’s post dialysis weight. When the patient returns to the station to report his post dialysis scale weight, it is 2kg above his pre-dialysis weight. What action(s) should you take?
A. Go over to the scale with the patient to verify the weight
B. Ask the patient if he is wearing the same clothing during pre-dialysis weight
C. Recalculate the fluid removal calculations on the treatment record for accuracy
D. All the above
D. All the above
Pre-blood pump arterial pressure alarms ate caused by suction on the vascular side by the blood pump.
Increasing negative pressure may indicate all of the following except:
A. Flow problem with the access related to the blood pump speed
B. Hypertension
C. Kinking of the arterial blood tubing between the access and the arterial monitor
D. Increased blood viscosity due to ultra-filtration
C. Kinking of the arterial blood tubing between the access and the arterial monitor
When inserting a hemodialysis fistula needle, insert at what angle until a flashback of blood is observed?
A. 15o
B. 90o
C. Choose the angle of insertion based on the depth of the vein, in general about 45o
D. 60o
C. Choose the angle of insertion based on the depth of the vein, in general about 45o
During treatment the patient’s needle stars to bleed slowly around the insertion site
You should:
A. Change the blue pad beneath the patient’s arm
B. Flip the needle to stop the bleeding
C. Reposition the arm
D. Place a pressure dressing over the site to control the bleeding
D. Place a pressure dressing over the site to control the bleeding
Documentation that need to be noted at each dialysis include all except: A. Patient weight gain/loss B. Medications given during dialysis C. Transplant status D. Overall patient status
C. Transplant status
The following lab values are monitored at least monthly except: A. Blood Urea Nitrogen (BUN) D. Calcium C. Zinc D. Potassium
C. Zinc
What would not be a sign or symptom to exsanguination (bleeding out)?
A. Pain in the access extremity
B. Hypotension
C. Arterial and/or Venous pressure alarms
D. Visual observation of blood
A. Pain in the access extremity
All of the following make up the extracorporeal circuit except: A. Transducer protectors B. Dialyzer C. Acid and Bicarb concentrate D. Bloodlines
C. Acid and Bicarb concentrate
Mrs. Mantel arrives to dialysis with a complaint of feeling cold. Her temperature pre dialysis is 97.8o and her blood pressure is 160/80. She dialyzes with a tunneled permacath which has been in place for three months.
Shortly after initiation of dialysis she starts having chills and her temperature is now 99o, B/P is 100/60. You
Would suspect:
A. Mrs. Mantel is experiencing a reaction to the dialyzer
B. This is probably Dialysis Disequilibrium Syndrome
C. The permacath may have an underlying infection
D. The temperature on the machine is out of range
A. Mrs. Mantel is experiencing a reaction to the dialyze
All of the following are causes of air in the blood except:
A. Pre-blood pump tubing collapsing related to inadequate blood flow from the arterial needle
B. Kinked venous blood line
C. Low level in the drip chamber
D. Not removing all air during dialysis priming
B. Kinked venous blood line
Which vital sign must be assessed before and after every dialysis treatment? A. Blood pressure B. Temperature, Pulse C. Pain level D. All of the above
D. All of the above
Mr. Rice’s dialyzer has cleared poorly. What may be a factor affecting his dialyzer rinse back?
A. The blood flow rate is reduced
B. He has not dialyzed the prescribed length of treatment on several occasions
C. With a catheter he should receive hourly infusions of heparin via a heparin pump or pushed every hour. The amount of heparin he is getting hourly may need to be increased
D. Both A and C
C. With a catheter he should receive hourly infusions of heparin via a heparin pump or pushed every hour. The amount of heparin he is getting hourly may need to be increased
Prior to returning the patient’s blood, what following things should be done? A. Check pulse B. Check blood pressure C. Check temperature D. All of the above
D. All of the above
What factors need to be considered when setting or adjusting the ultrafiltration (UF) goal?
A. The desired weight loss
B. Fluid given during treatment orally or with IV medications
C. Fluid output during dialysis (urine, emesis)
D. All of the above
D. All of the above
Mr. Simmons is a new dialysis patient. This is the second time you have cannulated him. Your plan of care today includes teaching him to hold his own sites. While you are returning his blood he asks you the following question. “Why does it take so long for the bleeding to stop after I am done? How would you best respond to this questions?
A. “Let me get your nurse and she or he can tell you.”
B. “Part of your dialysis prescription includes an order for heparin, a medication that thins your blood so that your blood can circulate freely outside your body.”
C. “That is for the doctor to explain.”
D. All of the above
B. “Part of your dialysis prescription includes an order for heparin, a medication that thins your blood so that your blood can circulate freely outside your body.”
Mrs. Hit has just completed her treatment. You note the following on her post assessment. Hypotension, light headedness, cramping even after rinse back, and nausea. What are these signs and symptoms of?
A. Patient below their dry weight
B. Patient above their dry weight
C. Hypoglycemia
D. Patient at their prescribed dry weight
A. Patient below their dry weight
