Module 5

Question 0

Mrs. R. is a 40-year-old woman who does not have diabetes or heart problems. If her blood vessels are healthy, what type of access is best?
A. A femoral catheter
B. A forearm loop graft
C. An arteriovenous fistula
D. A cuffed, tunneled catheter

Answer 0

C. An arteriovenous fistula

Question 1

When assessing a fistula or graft, which of these do you listen for before starting dialysis?
A. Bruit
B. Stenosis
C. Thrill
D. Steal Syndrome

Answer 1

A. Bruit

Question 2

Which of these can happen when the needle is “flipped” during cannulation? (NOTE: Choose as many as apply.)
A. Stenosis
B. Infiltration
C. Steal syndrome
D. Stretch the needle hole
E. Tear the lining of the vessel

Answer 2

B. Infiltration
D. Stretch the needle hole
E. Tear the lining of the vessel

Question 3

Which direction should the venous needle be placed:

a. Antegrade
b. Next to the anastomosis
c. Retrograde
d. Into the flow of blood

Answer 3

a. Antegrade

Question 4

Which of the following is the reason for rotating needle sites on a fistula:

a. Prevent infiltration
b. Prevent stenosis
c. Prevent steal syndrome
d. Prevent aneurysms

Answer 4

d. Prevent aneurysms

Question 5

Infiltration refers to which of the following definitions:

a. A pocket of blood inside the blood vessel
b. A needle tip that punctures a vessel and goes out the other side, so blood escapes into the tissues
c. The colonization of bacteria in a graft anastomosis
d. Mixing of already dialyzed blood with arterial blood in the patient’s access

Answer 5

b. A needle tip that punctures a vessel and goes out the other side, so blood escapes into the tissues

Question 6

Which of the following is a long-term complication of fistulae:

a. Infiltration
b. Thrombosis
c. Bruit
d. Recirculation

Answer 6

b. Thrombosis

Question 7

When assessing a fistula or graft, which of the following need to be felt prior to starting dialysis:

a. Pulse and deep access
b. Bruit and deep access
c. Bruit and pulse
d. Pulse and thrill

Answer 7

d. Pulse and thrill

Question 8

Whichofthefollowingisthecomplication that can happen to grafts if the needle sites are not rotated:

a. Stenosis
b. Pseudo-aneurysm
c. Steal syndrome
d. Infiltration

Answer 8

b. Pseudo-aneurysm

Question 9

Which of the following will help prevent infection in catheters:

a. Wash hands and change gloves prior to touching the catheter
b. Palpate the skin along the catheter from the blood vessel down to the exit site looking for drainage at the exit site
c. Change the catheter dressing
d. Assess the catheter blood flow

Answer 9

a. Wash hands and change gloves prior to touching the catheter

Question 10

Which of the following is a step in the port/catheter predialysis assessment:

a. Cleansing the catheter site
b. Connecting the catheter to the bloodlines
c. Assessing the blood flow rate through the catheter
d. Assessing the ease of heparin removal and saline flushing before connecting the bloodlines

Answer 10

d. Assessing the ease of heparin removal and saline flushing before connecting the bloodlines