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WorksheetsDialysis PREP Exam PCT
Total questions: 133
Worksheet time: 2hrs 52mins
Name
Class
Date
1.
What is the roles and responsibilites of the Dialysis RN?
a)
Oversee and assess the patient and patient’s treatment, develop and implement the patient’s plan of care, direct intereventions, provide patient education
b)
Run the CQI meeting
c)
Delegrate assessments to the LPN
d)
Delegate assessments to the PCT
2.
What is the roles and responsibilites of the Dialysis PCT?
a)
Teach patients about high phosphorous foods
b)
Evaluate patients and reinforce nursing education
c)
Assess EDW and make changes to UF goal
d)
Teach patients how to perform foot checks at home
3.
What are the anatomical structures of the urinary system in order of urine flow?
a)
2 kidneys, a ureter, a bladder and a urethra.
b)
2 kidneys, 2 ureters, a bladder and 2 urethras.
c)
2 kidneys, 2 ureters, a bladder and a urethra.
d)
2 kidneys, 2 ureters, a bladder and a uterus.
4.
What is the functional unit of the kidneys?
a)
Nephrons
b)
Electrons
c)
Protons
d)
Neutrons
5.
What are the functions of healthy kidneys?
a)
Filter fluid, wastes, & extra electrolytes
b)
Filters protein out of blood and eliminates in the urine
c)
Retains carbon dioxide in the blood
d)
Eliminate RBC's from bloodstream
6.
What is the endocrine function of the kidney?
a)
Decrease bone marrow production of RBC's and decrease blood pressure
b)
Secrete erythropoietin and release renin
c)
Regulates blood sugar
d)
Regulates external body temperature
7.
What Glomerular Filtration Rate (GFR) does replacement kidney treatment start?
a)
80
b)
50
c)
25
d)
15
8.
Chronic renal failure is caused by?
a)
Diabetes and Hypertension
b)
Drug Overdose
c)
Car Accident
d)
Dehydration
9.
What are the classic signs and symptoms of Renal Failure or Uremia?
a)
Hypotension
b)
Increase urination
c)
Shortness of breath, loss of appetite, edema and weakness
d)
Lowered BUN/Creatine, Phosphorus and Potassium blood levels
10.
Anemia is?
a)
Decrease of White blood cells
b)
Decrease of Red Blood Cells
c)
Increase of Protein in blood
d)
Increase of Potassium
11.
Why does anemia occur in CKD patients?
a)
Increase iron absorption
b)
Increase in Erythropoietin
c)
Decreased in Erythropoietin
d)
Lengthened RBC lifespan
12.
What are signs and symptoms of anemia?
a)
Increased energy
b)
Increase sense of well being
c)
Increased urination
d)
Shortness or breath and fatigue
13.
How is anemia treated?
a)
Administration of Erythropoieting Stimulating Agents (ESA's) and Iron
b)
Giving a patient platelets pre treatment
c)
IV injection of Hectorol after treatment
d)
Administering Albumin during treatment
14.
Which functions of healthy kidneys are replaced by dialysis?
a)
Removes Protein
b)
Removes waste and fluids
c)
Removes Red Blood cells
d)
Removes Albumin
15.
What are the 3 modalities of treatment for End Stage Renal Disease (ESRD)?
a)
Transference, Osmosis and Diffusion
b)
Hemodialysis, Peritoneal Dialysis and Apheresis
c)
Hemodialysis, Peritoneal Dialysis and Transplant
d)
Plasmaphersis, Transplant and Hemodialysis
16.
What is the difference between Hemodialysis and Peritoneal Dialysis?
a)
Hemodiaysis (HD) uses the blood system and Peritoneal Dialysis (PD)uses the Peritoneal Membrane
b)
HD is 7 days a week and PD is 3 times a week
c)
HD uses Dextrose as the osmotic agent for fluid removal and PD uses ultrafiltration
d)
PD is performed in center and HD only in the hospital setting
17.
Which Blood alarm will NOT stop the blood pump?
a)
Blood Leak
b)
Blood Pressure
c)
Air Detector
d)
Transmembrane Pressure (TMP)
18.
When Conductivity Alarms, what is occuring?
a)
The blood pump is stopped and there is potential for clotting
b)
The RTD and UF clocks both stop
c)
Diffusion is increased so adequacy is improved
d)
The machine is NOT cleaning the blood but Ultrafiltration is still occuring
19.
Diffusion is?
a)
The movement of solutes across a semi-permeable membrane from higher concentration to lower concentration
b)
The movement of solutes across a semi-permeable membrane from lower concentration to higher concentration
c)
The movement of solutes across a semi-permeable membrane from lower concentration to higher concentration
d)
The movement of water across a semi-permeable membrane from lower concentration to higher concentration
20.
Osmosis is?
a)
The movement of water across a semi-permeable membrane from higher concentration to lower concentration
b)
The movement of solutes across a semi-permeable membrane from higher concentration to lower concentration
c)
The movement of solutes across a semi-permeable membrane from lower concentration to higher concentration
d)
The movement of water across a semi-permeable membrane from lower concentration to higher concentration
21.
What is ultrafiltration?
a)
It is the filtration of electrolytes out of the blood
b)
Uses both negative and positive pressure to remove excessive fluid from the patient
c)
The removal of toxins from the body
d)
The creation of ultrapure water used for dialysate
22.
What is the MAIN reason we treat our water to remove contaminants used for dialysate?
a)
We don't have too, the water is safe already
b)
Because CMS regulates us to do so
c)
It is an OSHA requirement
d)
For patient safety because our patients are exposed to so much water during dialysis treatments
23.
What is a chloramine?
a)
It is the combination of chlorine and amino acids
b)
It is the combination of chloraprep and amonia
c)
It is the combination of chlorine and amonia
d)
It is a bacteria in the water
24.
What is the PRIMARY function of the diasafe filter?
a)
To provide ultrapure dialysate to our patients
b)
To provide removal of chlorine and chloramines
c)
To provide removal of calcium and magnesium
d)
To provide removal of large TDS particles from the dialysate
25.
What factors impact diffusion rates?
a)
Calcium and Magnesium levels of patients bath
b)
Temperature, molecular weight of solutes, surface area
c)
Sodium and Potassium levels of dialysate
d)
Albumin, Total blood cell count and phosphorous levels in the blood
26.
What happens to adequacy levels when a patients dialyzer begins to clot?
a)
Surface area decreases therefore adequacy levels decrease
b)
Surface area increases therefore adequacy levels decrease
c)
Surface area increases therefore adequacy levels increase
d)
Surface area decreases therefore adequacy levels increase
27.
What happens when the dialysate flow is turned off during treatment?
a)
The patients blood is not being cleaning and adequacy will increase
b)
The machine will take a blood pressure more often
c)
The blood pump will stop as well and there is an increased risk of clotting
d)
The patients blood is not being cleaning and adequacy will decrease
28.
Which molecules in the blood are too big to pass through the dialyzers semi-permeable membrane?
a)
Urea and Sodium
b)
Potassium and Water
c)
Protein and Red blood cells
d)
Creatine and BUN
29.
What is counter current flow?
a)
Blood and dialysate flow in opposite direction
b)
Water and dialysate flow in opposite direction
c)
Blood and dialysate flow in the same direction
d)
Acid and bicarbonate flow in same direction
30.
What is the normal pH range of dialysate?
a)
5.0-6.0
b)
6.9-7.6
c)
7.0-8.0
d)
6.1-6.8
31.
What is conductivity?
a)
The ability of a solution to transmit or conduct electricity
b)
The ability of the blood to conduct electricity
c)
An electrical charge
d)
Potassium ions passing through the blood
32.
What makes up dialysate?
a)
Potassium, Calcium and Magnesium
b)
Water and Bicarbonate
c)
Acid, Bicarbonate and Ultrapure Water
d)
Acid, Bicarbonate and Sterile Water
33.
What is the osmotic agent used in peritoneal dialysis?
a)
Sodium
b)
Potassium
c)
Normal Saline
d)
Dextrose
34.
What 2 most common electrolyes found in the patients acid bath does the MD prescribe?
a)
Sodium and Albumin
b)
Calcium and Potassium
c)
Magnesium and iron
d)
Bicarbonate and phosphorous
35.
How does the DPC staff know the dialysate is safe for our patients?
a)
It is checked for pH and conductivity prior to treatment
b)
It is checked for pH and conductivity after treatment
c)
The staff member preparing bicarbonate tells us it's okay to use
d)
There on no final checks on dialysate
36.
How long does the RO need to be on for before testing the water for chlorine and chloramines?
a)
10 minutes
b)
15minutes
c)
2 minutes
d)
60 seconds
37.
Which carbon tank are the DPC staff testing from on their initial chlorine and chloramine test and subseqent less than every 4 hour checks?
a)
After the water softner
b)
After the secondary tank
c)
After the first carbon tank
d)
Before the first carbon tank
38.
What are the acceptable limits for chlorine and chloramines using the RPC strips?
a)
0.00-0.02
b)
0.00-0.9
c)
0.00-1.0
d)
0.00-0.09
39.
How long does the sample port need to run before obtaining the water sample for the chlorine and chloramine test?
a)
2 seconds
b)
2 minutes
c)
30 seconds
d)
30 minutes
40.
How long is the RPC strips gently swished back and forth in the water sample?
a)
15 seconds
b)
30 seconds
c)
60 seconds
d)
20 seconds
41.
After removing the RPC strip from the water sample, how long before you read the results?
a)
20 seconds
b)
30 seconds
c)
15 seconds
d)
5 seconds
42.
If chlorine and chloramine results are above the allowable limits, what is the INITIAL reaction DPC staff members must take?
a)
To repeat the test at tank one to make sure the results were accurate
b)
To repeat the test at tank 2 to make sure the patients aren't getting any chlorine or chloramines in their dialysate
c)
To go out on the treatment floor and put all the machines into bypass
d)
To call Biomed for further instructions
43.
What is the PRIMARY function of the water softner?
a)
To keep treated water from contaminating city water stysem
b)
To remove chlorine and chloramines
c)
For patient safety
d)
To protect the RO membranes
44.
What is the purpose of the UV light?
a)
To remove chlorine and chloramine
b)
To kill bacteria and endotoxins
c)
To remove calcium and magnesium
d)
To filter dead bacteria and endotoxins
45.
When are bloodlines replaced?
a)
When dropped on the floor or placed in prime bucket with ends opened, clotted or defective
b)
When the arterial pressure is above -250
c)
When the machine fails Alarm and Pressure holding tests
d)
When the air detector alarm goes off
46.
If there is a "Blood Leak" alarm, where do we test from?
a)
From the drain line
b)
From the fluid sample port
c)
From the affluent dialysate fluid (blue hose)
d)
From the effluent dialysate fluid (red hose)
47.
If you suspect that a patient has an air embolism, what should you do first?
a)
Put the patient in left side trendelenburg
b)
Call the nurse
c)
Clamp the venous blood line
d)
Clamp the arterial blood line
48.
What should a normal venous pressure be?
a)
No greater than -250
b)
a positive pressure that is 1/2 of the BFR
c)
No greater than 400
d)
a negative pressure that is 1/2 of the BFR
49.
If you have an elevated venous pressure, where should you look for potential problems?
a)
A kink in the venous bloodline, venous needle infiltrate or clotting the venous chamber
b)
From the patient needle lines to the blood pump
c)
A kink in the arterial bloodline, arterial needle infiltrate or clotting the arterial chamber
d)
Only the venous needle site needs to be checked
50.
What would concern you if you saw an arterial pressure of -260?
a)
Nothing, as that is a normal arterial pressure
b)
There is an increased risk of crenation
c)
There will be a decreased clearance
d)
There is an increased risk of hemolysis
51.
What is transmembrane pressure?
a)
The pressure difference across the membrane fibers inside the dialyzer
b)
The difference between the aterial pressure and venous pressure
c)
The pressure difference between the pressure holding tests
d)
The pressure difference between the intracellular and extracellular compartments
52.
When the conductivity alarm is engaged while a patient is dialyzing, what is going on?
a)
The blood pump will stop and the patient will clot off
b)
The machine is in bypass and the patient is not receiving dialysis, but fluid removal is still occuring
c)
The machine is in bypass and the patient is not receiving dialysis, fluid removal is not occuring
d)
it is to alert the staff that an independent conductivity should be checked
53.
Which of the following observations if made during a 30 minute safety check would the DPC staff to intervene?
a)
An uncovered access arm
b)
An arterial pressure of -270
c)
A venous pressure of 200
d)
Arterial chambers 3/4 full
54.
If a patient appears to be sleeping and the blood pressure on the screen is 90/42, what should the DPC staff do?
a)
Awaken the patient, assess if they are feeling okay, readjust the blood pressure cuff and retake the blood pressure
b)
Nothing, the patient is sleeping and needs their rest
c)
Awaken the patient to see if they feel okay
d)
Document the blood pressure and recheck in 15 minutes
55.
Name 2 questions you should ask a patient prior to treatment?
a)
Did you have a nice evening last night and how are your kids doing?
b)
Did you feel your access today and what are your plans for the weekend?
c)
Have you been hospitalized and have you had any falls since your last treatment?
d)
Any cramping since your last treatment and did you weigh yourself today?
56.
What is the first step you would do if you suspect an access infiltrate?
a)
Obtain supplies to recannulate the venous needle
b)
Get ice for the site and instruct patient to ice for 24 hours and then heat for 24 hours
c)
Turn down the blood pump
d)
Turn off the blood pump and clamp bloodlines
57.
When should pH and conductivity of the dialysate be checked?
a)
Once in the morning
b)
Every 4 hours
c)
Before every patient and bath changes
d)
At the end of the day
58.
What is the preferred dialysis access for a diabetic patient?
a)
Arteriovenous Fistula
b)
Arteriovenous Graft
c)
Central Venous Catheter
d)
HeRO Graft
59.
What is always required when cannulating an ateriovenous fistula?
a)
A blood pressure cuff
b)
A tourniquet
c)
Nothing, it is no different from the AVG
d)
A fistula clamp
60.
What is a disadvange to the arteriovenous graft?
a)
Technically difficult to cannulate
b)
Easy to implant and surgically repair
c)
Decreased bleeding time at end of treatment
d)
Increased rate of stenosis
61.
What is a disadvanange to using the central venous catheter?
a)
Prone to infections and clotting
b)
May be used immediately after verification of placement
c)
No waiting time after hemodiaysis for hemostasis
d)
The is an increased adequacy level during treatment
62.
Which statement would require re-education by the nurse if a AVF/AVG patient stated:
a)
"I just had the best work out at the gym. I just bench pressed 25 lbs"
b)
"I'm really having trouble sleeping, I used to sleep on my left side and now I can't because my access is on that side"
c)
"I wear a bracelet on my left wrist to remind others not to take a blood pressure or lab from my access arm"
d)
"I will always wash my access arm before treatment to prevent a blood infection"
63.
When removing fistula needles, when do you engage the needle safety device?
a)
You don't have to engage the needle safety device unless you think you might get stuck
b)
After removing the needle from the access
c)
While removing the needle from the access
d)
Before removing the needle from the access
64.
What evaluation is performed on the vascular access pretreatment?
a)
Look and feel the access only
b)
Look, Listen and Feel
c)
Listen only
d)
Feeling the access only
65.
When admitting a new patient to dialysis, how will the DPC staff determine which arm to put the blood pressure cuff on?
a)
Examination of both arms to see if there is a permenent access
b)
Ask the patient which arm the access is in
c)
Check the chart to see where the access is placed
d)
Call the patients family
66.
Which direction are the fistula needles placed?
a)
Arterial needles go with the flow and venous needle goes against the flow
b)
Venous needles go with the flow, arterial needles in either direction
c)
Both needles go against the flow
d)
With needle tips facing each other
67.
If a patient infiltrates their arterial needle, where can the patient be re-cannulated?
a)
Only below the infiltrate site
b)
The patient can never be re-cannulated after an infiltrate
c)
Only above the infiltrate site
d)
Either above or below the infiltrate site
68.
If you suspect that a patients access is thrombosed, which should you do?
a)
Nothing, as that is a normal assessment of the fistula or graft
b)
Attempt to cannulate to make sure it's not clotted
c)
Call the nurse for further assessment
d)
Have the nurse attempt to cannulate the access
69.
Which finding would potentially need a referral to the vascular access center?
a)
Bleeding post treatment for 20 minutes or longer
b)
Bleeding post treatment for 10 minutes
c)
AVF surrounding skin that is pink and non-draining
d)
A "whoshing" sound when listening to the access
70.
What happens to the AVF or AVG when dialysis needles are flipped?
a)
Nothing, it is a perfectly safe practice to improve blood flow rates
b)
Damage to the intimal lining of the vessel can occur causing "coreing" of the vessel
c)
Enlarges the opening in the skin
d)
It damages the intercellular spaces
71.
If a patient is ordered 17 gauge needles and the DCP staff has the BFR at 400cc/hr, what could potentially happen to the patient?
a)
Nothing, that is the recommended BFR for 17 gauge needle
b)
There is potential for hemolysis due to increased negative arterial pressure
c)
There is potential crenation due to increased venous pressure
d)
They will get a decreased clearance due to higher BFR
72.
What could negatively impact dialysis adequacy?
a)
Air in the dialyzer, priming at 300, access recirculation
b)
Air in the dialyzer, priming at 150, access recirculation
c)
Higher than ordered BFR and DFR
d)
Adequate heparin dose and waiting for 3-5 minutes after giving
73.
What is Fresenius's goal for adequacy?
a)
A KECN number greater than 400
b)
Difference between pre BUN and post BUN be greater than 10
c)
Maximum for 1.2 spKt/v
d)
Minimum of 1.4 L for spKt/v
74.
How much normal saline is refreshed from the extracorporeal circuit before treatment?
a)
100 from each blood line
b)
There is no need to refresh the prime if you prime at 150cc/hr
c)
50cc from the arterial blood line and 250cc from the venous blood line
d)
250cc from the arterial blood line and 50cc from the venous blood line
75.
At what point during the priming process should the Hanson connectors be connected to the dialyzer?
a)
After the bloodlines are filled with saline and connected together for circulation, testing has been completed both on the machine and independent meter
b)
During the filling of the bloodlines
c)
After the patient is on the machine
d)
Before saline is used to prime the extracorpreal circuit
76.
What does a steady decline in the KECN test signify?
a)
There will be an increased clearance due to increased Sodium adsorbtion
b)
The fibers may be clotting so there is an increased clearance and surface area
c)
The fibers may be clotting so there is an decreased clearance and surface area
d)
There has been a steady increase in the blood flow rate (BFR) and dialysate flow rate (DFR)
77.
Which action by the DPC staff could potentially result in false lab result on the post BUN?
a)
At the end of treatment, turning off both UF and DFR, slow the blood pump to 100 for 15 seconds, wipe arterial sample port with alcohol prep pad, turn off blood pump and clamp needle line to draw the sample from the aterial port
b)
Drawing the sample after 15 seconds after the UF and DFR have been turned off and the blood pump has been slowed to 100.
c)
At the end of treatment, turning off both UF and DFR, slow the blood pump to 100 for 15 seconds, wipe venous sample port with alcohol prep pad, turn off blood pump and clamp needle line to draw the sample from the venous port
d)
Gently inverting gold lab tube 5-10 after sample has been obtained.
78.
The patient arrives to treatment with an undocumented heart rate of 49 beats per minute. As the PCT caring for the patient, what is your first action?
a)
Notify the RN in charge for further evaluation before treatment
b)
Start the patients treatment, then notify the nurse for further evaluation
c)
Call the MD for orders, informing them that you started the treatment
d)
No need to notify anyone as this a a normal heart rate for this patient
79.
What are the signs and symptoms of hypoglycemia that are similar to signs and symptoms of hypotension?
a)
Decrease thirst and hunger
b)
Visual disturbances and sweating
c)
Cramping and increased thirst
d)
Cramping and irritability
80.
Which finding could potenially lead to hemolysis?
a)
A conductivity of 13 indicating a hypotonic dialysate solution
b)
A conductivity of - 0.3 from theoretical dialysate solution
c)
Chlorine and chloramine level of 0.01
d)
A machine temperature setting of 36.5 degrees celsius
81.
What is the first reaction a DPC staff member who suspects the patient is experiencing hemolysis should do?
a)
Turn off the blood pump and clamp bloodlines, then return th e blood when the RN tells you to
b)
Administer oxygen to the patient to improve shortness of breath
c)
Recirculate the blood in case it is not hemolyzed and can be safely returned to the patient
d)
Turn off the blood pump and clamp bloodlines, Do Not return blood
82.
Crenation is caused by what?
a)
A BFR of 400 for a 15 gauge needle size
b)
Increased aterial pressures of greater than -250
c)
A hypertonic dialysate solution of 15 conductivity on the machine
d)
A hypotonic dialysate solution of 13 conductivity on the machine
83.
What are the signs and symptoms of hemolysis?
a)
Bright red cherry blood
b)
Dark or black blood
c)
Increase in patients blood pressure
d)
Increased sense of smell
84.
What are the signs and symptoms of crenation?
a)
Sudden fall in BP, dark opaque blood, chest pain
b)
Increase in BP, dark blood, anxiety
c)
Thirst, facial flushing and cherry red blood
d)
Anxiety, hunger and chest pain
85.
What causes an air embolism?
a)
Improperly primed blood lines, CVC patients talking during dilaysis
b)
CVC patients talking to staff during dialysis, air detector not armed
c)
Tight blood line connections, 300 N/S in Saline bag, Unclamped IV line
d)
Improperly primed blood lines, empty IV bag, loose blood line connections
86.
What are the signs and symptoms of air embolism?
a)
Anxiety, High blood pressure
b)
Cough, Chest pain, shortness of breath, air/foam in blood lines
c)
Low blood pressure, cherry red blood, hyperventilation
d)
Sneezing, cough and high blood pressure
87.
What is the first intervention if you suspect an air embolism?
a)
Place the patient on their left side
b)
Turn off the blood pump
c)
Clamp the venous bloodline
d)
Place the patient in Trendelburg postion
88.
What are the signs and sypmtoms of a needle infiltration?
a)
Pain and swelling at needle site
b)
AP -240 and VP 200 at a 450 BFR
c)
Anxiety and low BP
d)
Chest pain
89.
If a venous needle infiltrates, where could a new needle be placed?
a)
A new needle should never be placed due to damage of the access
b)
Below the infiltrate
c)
Next to the infiltrate
d)
Above the infiltrate
90.
When an infiltration occurs, what patient education is needed?
a)
Continous ice for 24 hours followed by continous heat for 24 hours
b)
Intermittent heat for 24 hours followed by intermittent ice for 24 hours
c)
Intermittent ice for 24 hours followed by intermittent heat for 24 hours
d)
Do nothing, the body with resolve the bruising with time
91.
What are the causes of hyperkalemia?
a)
Increased dietary intake, hemolysis, GI bleeding
b)
Decreased dietary intake, hemolysis, GI bleeding
c)
Diarrhea and vomiting
d)
Diaphoresis
92.
What are the signs and symptoms of hyperkalemia?
a)
Constipation, itching and tingling of lips
b)
Cardiac arrhythmias, muscle weakness and death
c)
Blue fingertips, pain at needle site
d)
hunger, sweating and thirst
93.
When educating/reinforcing patients of Sodium in the diet, which of the folowing is true?
a)
The best food choices are processed foods because of their convenience
b)
Patients should have a 4 gram sodium diet
c)
Sodium in the diet isn't as important as potassium so they should focus on potassium foods
d)
Avoid salt shaker, canned foods, cold cuts and soy sauce
94.
When educating/reinforcing patients of Potassium in the diet, which of the folowing is true?
a)
Bananas, watermelon, potatoes and tomatoes are high potassium foods
b)
Using salt substitues are okay for the kidney patient because it lowers their sodium content
c)
High levels of potassium regulates the heart muscle
d)
Grapes, apples and lemon
95.
When educating/reinforcing patients of Phosphorous in the diet, which of the folowing is true?
a)
Take binders 30 minutes after they eat their meals
b)
High levels of phosphorous in the blood increase calcium in the blood
c)
Milk, nuts, dairy products and dark colas are high in phosphorous and should be avoided
d)
Take binders 30 minutes before eating a heavy meal to allow time for medication to take effect
96.
What effect does high fluid gains have?
a)
Nothing, some patients can handle the extra weight without difficulty
b)
Increased circulating volume increases workload on the heart and lungs
c)
Decreased circulating volume which decreases cardiac workload
d)
Make a patient feel full so their appetite will increase
97.
Which foods are recommended to increase protein for ESRD patients?
a)
ESRD patients are discouraged from eating more protein
b)
Fresh fruits and vegetables
c)
Hot dogs, gumbo soup and protein shakes
d)
Meat, fish, eggs and chicken
98.
What is EDW?
a)
The weight of the patient if all excessive fluid is removed and blood pressure is normotensive
b)
Essential Dialysis Water test
c)
Never changes once the physician prescribes it
d)
The weight of the patient if some of the excessive fluid is removed and blood pressure is slightly above normal
99.
What are the signs and symptoms of EDW too low?
a)
Shortness of breath, edema and hypertension
b)
Increased energy level, decreased thirst
c)
Dizziness, nausea, vomiting, cramping and hypotension
d)
Feeling of well being, decreased BP trends to normal levels
100.
What are the signs and symptoms of EDW too high?
a)
Shortness of breath, edema and hypertension
b)
Dizziness, nausea, vomiting, cramping and hypotension
c)
Increased energy level, decreased thirst
d)
Feeling of well being, decreased BP trends to normal levels
101.
How many staff members are required to perform independent verification of pH and Conductivity?
a)
The staff setting up the machine is required to perform the test
b)
Two staff members are required to observe the test. If they are unable to observe the test then each should independently verify results
c)
There is no need to independently check pH and conductivity as the machines are calibrated correctly
d)
Three staff members, one who should be the RN in charge
102.
What is the acceptable difference between the actual conducivity and the independent meter?
a)
Plus or minus 0.1
b)
They must be the same number
c)
Plus or minus 0.5
d)
Plus or minus 0.3
103.
When do we test for residual bleach on the dialysis machine?
a)
Once a week before disinfection
b)
Before disinfection and in the morning after SDS has been disinfected
c)
After disinfection and the next morning prior to putting on first shift of patients
d)
Before disinfection and after disinfection
104.
When testing for total chlorine, which sample port is the water obtained?
a)
From the city water flow valve
b)
Post carbon tank #1
c)
Post carbon tank #2
d)
Post water softner
105.
What is the acceptable range for chlorine and chloramines?
a)
1.0 to 2.0
b)
0.00 to 0.1
c)
0.00 to 0.09
d)
1.2 to 1.4
106.
How often do we test from Carbon Tank #2 if we have breakthrough on carbon tank #1
a)
Every two hours with Medical Director approval to run patients
b)
Every 2 hours without Medical Director approval to continue patient treatments
c)
Every 3 hours with Clinical Manager approval
d)
Every 30 minutes with Biomeds approval
107.
What are dialysis precautions?
a)
A set of standard rules that are used in all situations in the dialysis setting when caring for dialysis patients
b)
Rules of PPE use only
c)
An Audit tool used by education and clinical managers
d)
A set of standard infection control pratices that are used in all situations in the dialysis setting when caring for dialysis patients or performing related actvities
108.
When are dialysis precautions used?
a)
Only when putting a patient on or taking a patient off the diaalysis machine
b)
Anytime there is potential or actual exposure to blood, body fluids, sweat, tears, feces, sputum, vomit or urine
c)
Only when drawing up and handling lab specimens
d)
Only when handling biohazard materials
109.
What PPE is needed to hold a patients needle site?
a)
Full PPE including Gown, Gloves and Face shield or mask with protective eye wear
b)
Only a face shield and gloves
c)
Only a gown and gloves
d)
Only gown, gloves and mask
110.
Which bleach solution do we use to clean large blood spills (greater than 10 mls)?
a)
1 part bleach to 10 parts water strength
b)
1 part bleach to 1 part water strength
c)
1 part bleach to 100 parts water strength
d)
10 parts bleach with 1 part water
111.
How do we store prepared bleach solution?
a)
In a bucket labeled with date and time solution was made
b)
In an empty sharps container
c)
In a labeled opaque container with lid on
d)
In an opaque container that is labeled
112.
What is the single most improtant infection control measure?
a)
Wearing a face shield
b)
Proper equipment disinfection
c)
Wearing a gown and show covers
d)
Handwashing
113.
When should you wash your hands with soap and water?
a)
After every glove change
b)
Before eating, after using the bathroom, working with C-diff patients
c)
When entering and leaving treatment floor
d)
Going into Medical Records room
114.
What gets placed in the sharps containers?
a)
Broken glass, ampules, syringes with needles
b)
Any glass medication vial
c)
Slightly bloody used 2x2 gauze pads
d)
Pt lab tubes with labels
115.
When are sharps containers replaced?
a)
25% full
b)
2/3 rds to 3/4 ths full
c)
100% full
d)
1/2 full
116.
What is done with sharps containers in an emergency?
a)
Close the lids and leave them in their holders on the machines
b)
Move them to biohaard room, leaving them open so they can be used after the emergency situation is cleared
c)
Only lock the ones that are close to being full anyway
d)
All sharp containers are removed from the machines and treatment floor, lids are locked and they are placed in the locked biohazard room
117.
What precautions are taken when caring for MRSA/VRE patients?
a)
Contact Precautions
b)
Standard Precautions
c)
Dialysis precautions
d)
Respiratory precautions
118.
Which type of Hepatitis requires isolation of the patient?
a)
Hepatitis A
b)
Hepatitis B
c)
Hepatitis B and C
d)
Hepatitis C
119.
How long can Hepatitis B live on environmental surfaces?
a)
1 day
b)
5 days
c)
10 days
d)
7 days
120.
Which of these show patient immunity to Hepatitis B?
a)
HbsAg positive
b)
HbsAb - (less than 10)
c)
HbsAb + (greater than 10)
d)
HbsAg negative
121.
If you are dialyzing a Hepatitis B positive patient in the isolation room, which patient can not be seated in the "buffer zone"?
a)
HbsAb 150
b)
Hbs Ab <10
c)
HbsAb 25
d)
HbsAb 11
122.
Determine which statement is False (in regards to implementing the buffer zone)~
a)
Patients next to or across from the HBV positive patient must have immunity to the virus to create the buffer zone
b)
Patients who have antibodies greater than 10 can sit in the buffer zone
c)
Staff may silence machines or address alarms of any patient machine due to potential for blood loss
d)
Staff caring for HBV patients may never care for susceptible patients at the same time as the HBV patient
123.
What methods are best used to prevent cross contamination of Hepatitis B patients?
a)
Vaccination of susceptible patients and strict infection control practices
b)
Vaccination of immune patients and strict infection control practices
c)
Good equipment sanitation
d)
Make sure housekeeping uses 1:1000 bleach solution for mopping
124.
Determine which statement is False (in regards to PPE practices/requirments for Hepatitis B isolation room)~
a)
Hand hygiene when entering and exiting the isolation room
b)
Fluid resistant gown must be worn at all times in the isolation room
c)
After disconnecting the patient from treatment, immediate documentation must be performed before changing gloves
d)
If the gown is not soiled it may be hung in the isolation room to be used again
125.
What special precautions do active TB patients need?
a)
They must dialyze in the isolation room with a mask on
b)
They must wear a mask at all times while in the dialysis facility
c)
They must dialyze in an isolation room
d)
They must dialyze in a negative pressure room
126.
What are the signs and symptoms of Tuberculosis?
a)
Night sweats, cough, weight loss, blood tinged sputum
b)
Nausea, vomiting, diarrhea and cough
c)
Chest pain, cough and fever
d)
Scratchy throat, runny nose, cough and fever
127.
QAI tools and records are?
a)
Available to the public
b)
Confidential company records
c)
Available only to CMS surveyors
d)
Shredded after being kept for 2 years
128.
After performing CPR on a patient, what must be done to the machine?
a)
Perform routine pre dialysis testing before another patient used the machine
b)
The machine must be disinfected with 1:10 bleach solution
c)
Pull the machine off the floor for functional testing by biomed
d)
Perform Pressure Holding tests
129.
Who is ultimately responsible for QAI?
a)
The Director of Operations
b)
The Medical Director
c)
The Clinical Manager
d)
The Social Worker
130.
What is a near miss?
a)
A potential hazard or incident that did not result in patient harm yet but had the possibility of doing so
b)
A potential hazard or incident that resulted in patient harm yet but did not result in hospitalization
c)
A potential hazard or incident that resulted in patient harm yet but did not result in death
d)
An incident that was unobserved
131.
What should you do if there is a tornado warning in your area?
a)
Monitor weather channel, call MD for orders
b)
Close all blinds, stop treatment, move patients to designated "safe area"
c)
Close all binds, continue treatment watching weather
d)
Nothing, warning is only for potential for tornado not tornado cited
132.
What should you do first in case of a power failure?
a)
Call electric company to find out when power will be restored
b)
Call to find out where the emergency generator is stored
c)
Notify the clinical manager for further instructions
d)
Remove venous line from pinch clamp, Hand crank blood, 6-10 rotations per minute~ watch for air
133.
If a flood is emminant, what should be completed before leaving the building?
a)
Move supplies and equipment to higher location, secure medical records, turn off power, water and gas
b)
Bag dialysis chairs, secure sharps containers to their machine
c)
You should not leave, stay in the building to protect equipment from rising water
d)
Empty refrigerator to prevent spoiling of food
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