Dialysis Tech Practice Test

Dialysis Tech Practice Test

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Section 1

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All of the following conditions are associated with chronic kidney failure EXCEPT: A. Low Hemoglobin B. Hypoparathyroidism C. Hyperkalemia D. Hyperphosphatemia

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Last updated

6 years ago

Date created

Mar 1, 2020

Cards (150)

Section 1

(50 cards)

All of the following conditions are associated with chronic kidney failure EXCEPT: A. Low Hemoglobin B. Hypoparathyroidism C. Hyperkalemia D. Hyperphosphatemia

Front

B. Hypoparathyroidism

Back

Which hemodialysis schedule is likely to be most efficient? A. In-center hemodialysis, 3-4 hours a session, 3 days a week B. Conventional home hemodialysis C. Short daily home hemodialysis, 2-3 hours a session, 5-7 days a week D. Nocturnal home hemodialysis, 8 hours during sleep, 3 days a week

Front

C. Short daily home hemodialysis, 2-3 hours a session, 5-7 days a week

Back

Which of the following statements about extracorporeal circulation is correct? A. Approximately 100-250 mL are outside the patient's body at one time B. The arterial tubing is blue, and the venous tubing is red C. A heparin infusion line is connected to the tubing at the venous exit D. All blood tubing is manufactured to the same national standard

Front

A. Approximately 100-250 mL are outside the patient's body at one time

Back

Blood Flow into the dialyzer usually: A. Controlled by a piston type pump B. Inversely proportional to the pump speed C. Limited to less than 250mL/min D. Done by manual hand cranking

Front

D. Done by manual hand cranking

Back

Which of the following statements about the proportioning system is correct? A. The concentrates are mixed manually B. It relies on a continuous supply of fresh concentrate and treated water C. The concentrates are heated after mixing D. Fixed-ration mixing is the only method used

Front

B. It relies on a continuous supply of fresh concentrate and treated water

Back

The term "sieving coefficient of a membrane" refers to the: A. Fraction of solute that passes through the membrane by convection B. Amount of water required for solute drag through the membrane C. Concentration of pores in the membrane D. Size of the pores in the membrane

Front

A. Fraction of solute that passes through the membrane by convection

Back

What percentage of transplanted kidneys is functional 1 year after transplantation? A. 90% B. 70% C. 50% D. 30%

Front

A. 90%

Back

In the dialyzer, water may be removed from: A. The intracellular compartment B. The intravascular compartment C. The interstitial compartment D. All of the above compartments

Front

C. The interstitial compartment

Back

Which of the following kidney structures connects with and delivers urine directly to the ureter? A. Pelvis B. Calyx C. Glomerulus D. Cortex

Front

A. Pelvis

Back

Sodium Modeling refers to: A. Changing the concentration of the dialysate sodium during the course of dialysis B. Injecting sodium chloride directly into the patient's vein C. Adjusting the sodium concentrate of the dialysate with normal saline D. None of the above

Front

A. Changing the concentration of the dialysate sodium during the course of dialysis

Back

Which site in the hemodialysis pathway has the highest positive pressure? A. Arterial blood in the afferent tubing B. Blood entering the dialyzer fibers C. Blood leaving the dialyzer fibers D. Blood in the venous return

Front

B. Blood entering the dialyzer fibers

Back

The amount of fluid to be taken from the patient during hemodialysis: A. Is independent of the filtration pressure B. Requires the dialysate to have a higher pressure than the blood C. May be calculated by subtracting the patient's estimated dry weight form the pre-dialysis weight and adding any fluid the patient receives during treatment D. May be calculated by adding the patient's pre-dialysis weight and the amount of fluid the patient receives during treatment

Front

C. May be calculated by subtracting the patient's estimated dry weight from the pre-dialysis weight and adding any fluid the patient receives during treatment

Back

Which of the following statements about fluid removal from the blood is correct? A. It is achieved with a higher dialysate pressure than blood pressure (TMP) B. It depends on the Trans-membrane Pressure (TMP) C. It requires that the TMP must be calculated mathematically by the technician D. The manufacturer's ultrafiltration constant is usually lower than the true value

Front

B. It depends on the trans-membrane Pressure (TMP)

Back

Dialysate flow rate has which of the following properties? A. Lower flow rates improve dialysate efficiency B. It is always preset C. It may vary from 0-2000 mL/min D. Low water pressure may set off an alarm

Front

D. Low water pressure may set off an alarm

Back

Drip chambers in the extracorporeal circulation do all the following EXCEPT: A. Monitor arterial and venous pressure by attached gauges B. Trap air C. Prevent blood clots from reaching the patient D. Pump blood into the dialyzer

Front

D. Pump blood into the dialyzer

Back

The main difference between an arteriovenous shunt (AVS) and an arteriovenous fistula (AVF) is an: A. AVS is entirely within the arm B. AVF is entirely within the arm C. AVF is more likely to become clotted or infected D. AVF requires and external tube

Front

B. AVF is entirely within the arm

Back

The most likely cause of post-renal failure is: A. Severe Dehydration B. Nephrotoxic Drug C. Glomerulonephritis D. Benign Prostatic Hypertrophy

Front

D. Benign Prostatic Hypertrophy

Back

All of the following statements about vitamins in dialysis patients are true EXCEPT: A. Dialysis does not remove water-soluble vitamins B. Supplemental B-complex vitamins should be given C. Vitamin D should be given to most dialysis patients D. Megadose fat- or water-soluble vitamins should not be given

Front

A. Dialysis does not remove water-soluble vitamins

Back

The most common cause of chronic kidney disease in the United States is: A. Diabetes B. Hypertension C. Glomerulonepheritis D. Polycystic Kidney Disease

Front

A. Diabetes

Back

Water moves from one body compartment to another by: A. Ultrafiltration B. Active Transport C. Osmotic Forces D. All of the above

Front

C. Osmotic Forces

Back

The molecular weight cutoff of a dialyzer is 12,000 daltons. Which of the following molecules would not pass through the membrane into the dialysate? A. Phosphate B. Urea C. Albumin D. Sodium

Front

C. Albumin

Back

If a dialyzer has a urea clearance ret (K) of 200mL/min and a blood flow rate (Qb) of 300 mL/min, what volume of the blood will be cleared of urea in 1 minute: A. 100 mL B. 200 mL C. 300 mL D. 500 mL

Front

B. 200mL

Back

Which of the following phosphate binders would best control hyperphosphatemia with the fewest side effects in patients with end stage kidney disease? A. Aluminum hydroxide B. Calcium carbonate C. High dairy product diet D. Lanthanum carbonate

Front

D. Lanthanum carbonate

Back

In most dialysate systems, the temperature: A. Is maintained by a thermistor-controlled heater B. Is maintained between 41 degrees Celsius - 43 degrees Celsius C. Of water is raised only after mixing with concentrate D. Is decreased to increase diffusion

Front

A. Is maintained by a thermistor-controlled heater

Back

Which of the following statements about blood leaks in the dialysis system correct? A. They require more than 10 mL of blood to trigger an alarm B. They are detected by use of a light source and photocell C. The blood can be returned to the patient D. They cannot be differentiated from false alarms

Front

B. They are detected by use of a light source and photocell

Back

All of the following statements regarding home dialysis are true EXCEPT: A. A spouse's or other family member's assistance is desirable B. A visiting dialysis nurse may be employed C. The patient and assistant must train for 6-8 weeks D. It cannot be done during sleep

Front

D. It cannot be done during sleep

Back

A hollow fiber dialyzer has which of the following properties? A. Very fine fiber tubes held in place polyurethane material B. Fibers about 1 cm in width C. A high membrane compliance D. A high resistance in the fibers, enhancing ultrafiltration pressure

Front

A. Very fine fiber tubes held in place by polyurethane material

Back

Peritoneal dialysis (PD) differs from hemodialysis in which of the following ways? A. PD requires both vascular access and abdominal access B. PD cannot be done at home C. PD access is by an intra-abdominal catheter D. Sterile dialysate is not required for PD

Front

C. PD access is by an intra-abdominal catheter

Back

Biocompatibility is best illustrated by: A. Synthetic membranes that do not adsorb blood proteins as well as cellulose membranes B. Independence from protein adsorption of the membrane C. Reprocessed dialyzers that have a lower biocompatibility than new ones D. Reprocessed dialyzers that have better biocompatibility than new ones

Front

D. Reprocessed dialyzers that have a better biocompatibility than new ones

Back

All of the following substances are added to the dialysate EXCEPT: A. Bicarbonate B. Chloride C. Sodium D. Phosphate

Front

D. Phosphate

Back

The fluid restriction for most patients undergoing in-center hemodialysis is equal to urine volume/day plus: A. 0 L. B. 0.5 L. C. 1 L. D. 2 L.

Front

C. 1 L.

Back

All of the following substances are produced by the kidney except: A. Rennin B. Aldosterone C. Erythropoietin D. Calcitriol

Front

B. Aldosterone

Back

Clearance of low-molecular-weight molecules by dialysis is accomplished mostly by: A. Convection B. Diffusion C. Adsorption D. Solvent Drag

Front

B. Diffusion

Back

Osmosis is best defined as: A. Diffusion of solute through a semipermeable membrane from a high to low solute concentration B. Diffusion of solvent through a semipermeable membrane from low to high solute concentration C. A version of hydraulic pressure used in dialysis D. Diffusion of solvent through a semipermeable membrane from high to low solute concentration

Front

B. Diffusion of solvent through a semipermeable membrane form low to high solute concentration

Back

A disadvantage of high-flux dialysis is: A. Acetate must be used instead bicarbonate buffer B. Membrane biocompatibility is reduced C. Pyrogen reactions are common D. Post-dialysis fatigue is common

Front

C. Pyrogen Reactions are common

Back

An advantage of high-flux dialysis is: A. Small pore size B. Fast removal of fluid C. Retention of beta2-microglobulin in the blood D. Slow blood flow, leading to more efficient removal of toxic substances

Front

B. Fast removal of fluid

Back

To determine the most accurate clearance rate of a particular solute, one should: A. Use water instead of blood B. Use a large-molecular-weight-molecule C. Reduce the manufacturer's state rate by 10% D. Measure the solute concentrations of blood going into and out of the dialyzer

Front

D. Measure the solute concentrations of blood going into and out of the dialyzer

Back

Dialysis machines control the rate of fluid removal by: A. Volume Control B. Flow Control C. Both A and B D. Neither A nor B

Front

C. Both A and B

Back

The ultrafiltration coefficient of a dialyzer refers to the: A. Fluid that passes through the membrane in 1 hour B. Pressure in the blood compartment needed to force fluid through the membrane C. Pressure difference across the membrane D. Fluid that passes through the membrane in 1 minute

Front

A. Fluid that passes through the membrane in 1 hour

Back

In hemodialysis, blood and dialysate have which of the following properties? A. They flow in the same direction B. They flow is the opposite direction C. They mix within the dialyzer D. They do not require a semipermeable membrane

Front

B. The flow is in the opposite direction

Back

Blood tests for ferritin are performed in hemodialysis patients: A. To check for iron stores B. To check for magnesium levels C. As an alternative to hemoglobin concentration D. To maintain electrolyte balance

Front

A. To check for iron stores

Back

Hemodialysis patients should be taught to: A. Put in their own needles B. Weigh themselves and record it C. Check their dialyzer settings and dialysate D. Do all of the above

Front

D. Do all of the above

Back

Which of the following statements about transducer protectors is correct? A. They measure arterial pressure only B. They measure venous pressure only C. They use membrane with a pore size of 1.0 micron D. They use hydrophobic membranes to keep fluid from passing through

Front

D. They use hydrophobic membranes to keep fluid from passing through

Back

Failure to excrete beta2-microglobulin in patients with kidney failure predisposes to: A. Pericarditis B. Amyloidosis C. Neuropathy D. Seizures

Front

B. Amyloidosis

Back

Conductivity is best defined as: A. A method of checking electrolyte levels in the dialysate B. The voltage required to maintain the dialysis pump to achieve a given flow rate C. A monitor and alarm system to measure dialysate flow rate D. Something that is measured once to check the final ionic concentrations of the dialysate

Front

A. A method of checking electrolyte levels in the dialysate

Back

Uremia may cause which of the following conditions? A. Itching B. Edema (swelling) of the extremities C. Anemia D. All of the above

Front

D. All of the above

Back

Which of the following dialyzers is used currently? A. Kiil B. Flat Plate C. Coil D. Hollow Tube

Front

D. Hollow Tube

Back

The glomerular filtration rate is an important index of renal function and in the normal adult is approximately: A. 50mL/min/1.73 m2 B. 75 mL/min/1.73 m2 C. 125 mL/min/1.73 m2 D. 200 mL/min/1.73 m2

Front

C. 125mL/min/1.73 m2

Back

Synthetic membranes have which of the following properties? A. They are cellulose membranes in which hydroxyl groups are replaced with acetate B. They have thick fiber walls C. They have poor adsorption D. They remove solute by diffusion only

Front

B. They have thick fiber walls

Back

Dialysate pH is kept in which of the following ranges? A. 7.0-7.4 B. 7.35-7.45 C. 6.0-7.0 D. 8.0-9.0

Front

A. 7.0-7.4

Back

Section 2

(50 cards)

Correct statements concerning the charting of patient data include all of the following EXCEPT: A. Each entry must be followed by the writer's name and title B. Entries must be printed for legibility C. Approved abbreviations may be used D. Errors must have a line through them, marked error, and initialed

Front

B. Entries must be printed for legibility

Back

How is anticoagulant heparin given during the dialysis treatment? A. Intermittently B. As a single bolus C. By continuous infusion D. By all of the above ways

Front

D. By all of the above ways

Back

Using the buttonhole technique for blood access, the technician should: A. Use a sharp followed by a blunt needle B. Only use a sharp needle C. Insert arterial and venous needles in a retrograde direction D. Leave and old scab in place

Front

A. Use a sharp followed by a blunt needle

Back

A dialysis patient has a history of heparin-induced thrombocytopenia (low platelets) and severe bleeding. What would be a good method of performing dialysis safely? A. Skip the bolus dose of heparin, and give the infusion at a lower dose rate B. Increase the time between bolus doses of heparin C. Substitute warfarin for heparin D. Use a regional citrate technique

Front

D. Use a regional citrate technique

Back

Which type of arteriovenous fistula is likely to result in high blood flow with the fewest complications? A. Artery side to vein side B. Artery side to vein end C. Artery end to vein side D. Artery end to vein end

Front

B. Artery side to vein end

Back

To diminish vasovagal reactions and needle phobia in the dialysis patient, the technician should ask the patient to: A. Lie down in a recumbent position B. Tense the muscles in the non-access hand for 10-20 seconds during needle insertion C. Cannulate his or hers own vessels D. Do all of the above

Front

D. Do all the above

Back

A sorbent is best described as a: A. Material that moisturizes the dialysis membrane B. Material that is added to the dialysate to buffer it and keep the pH constant C. Continuous dialysate disinfection system that removes bacteria and endotoxins D. Type of electronic device that measures blood pressure

Front

C. Continuous dialysate disinfection system that removes bacteria and endotoxins

Back

A heavyset patient arrives for dialysis in a wheelchair. He has difficulty standing without assistance. Which technique would be most appropriate to transfer him to the dialysis chair? A. Portable lift device B. Slide board C. Stand and picot D. Simple three person lift

Front

A. Portable lift device

Back

After a treatment, a patient below dry weight may have: A. Edema B. High blood pressure C. Dyspnea (shortness of breath) D. Muscle cramping

Front

D. Muscle cramping

Back

Care of a new arteriovenous fistula should include all of the following EXCEPT: A. Checking for redness, purulent discharge, or other signs of infection B. Being certain the surgical incision is well healed C. Cannulating the vessel to see of the blood flow is adequate D. Listening for a bruit and feeling for a thrill at the fistula site

Front

C. Cannulating the vessel to see if the blood flow is adequate

Back

When the low-pressure alarm rings, signaling inadequate flow, the technician should be sure to: A. Reset the pressure alarm B. Switch arterial and venous lines C. Flush the catheter with saline D. Give a thrombolytic enzyme through the catheter

Front

C. Flush the catheter with saline

Back

A patient undergoing hemodialysis complains of muscle cramps in the calves and feet. All of the following are likely causes EXCEPT: A. Hypernatremia (high-sodium level) B. Excess fluid removal C. Hypercalcemia (high-calcium level) D. Hypokalemia (low potassium)

Front

C. Hypercalcemia (high-calcium level)

Back

An advantage of catheter and port catheter devices is: A. They are less likely than fistulas to become infected B. They have higher blood flows over time C. Needle entry is not required D. They are less apt to induce clotting

Front

C. Needle entry is not required

Back

Which of the following veins is most suitable for hemodialysis catheter placement? A. Subclavian B. Femoral C. Right internal jugular D. Left internal jugular

Front

C. Right internal jugular

Back

To prevent infection in catheters, hemodialysis technicians should be sure to: A. Wash hands and use sterile gloves B. Wear a mask, and ask the patient to wear a mask C. Remove wet dressing, dry around the site, and replace with fresh dressing D. Do all of the above

Front

D. Do all of the above

Back

Which of the following will set off the pre-pump high-pressure alarm? A. An increase in the blood pump speed B. Kinking of the arterial bloodline C. A decrease in the blood pump speed D. Infiltration of the arterial needle

Front

C. A decrease in the blood pump speed

Back

For which type of dialysis patient is a central venous catheter blood access appropriate? A. A patient waiting for a fistula to mature B. A patient with acute renal failure C. A patient waiting for a peritoneal dialysis catheter D. All of the above patients

Front

D. All of the above patients

Back

The urea reduction ration has which of the following properties? A. It requires measurement of both pre- and post-dialysis blood urea nitrogen B. It accounts for the production of urea during dialysis C. It allows calculation of the time needed for dialysis D. It allows calculation of urea removed by ultrafiltration

Front

A. It requires measurement of the pre- and post- dialysis blood urea nitrogen

Back

Which of he following alarms must be checked before dialysis begins? A. Blood leak detector B. Conductivity alarm C. The pH alarm D. All of the above

Front

D. All of the above

Back

Use of protective equipment and techniques are intended to protect both patient and staff member. Examples of include all of the following EXCEPT: A. Changing gloves between patients B. Wearing a gown to avoid contamination with splash or spray C. Always recapping used needles D. Wearing a face shield when injecting into blood lines

Front

C. Always recapping used needles

Back

For centers that reuse dialyzers, reprocessing includes: A. Cleaning the bloodlines with heparinized saline B. Removing and warming the dialyzer C. Disinfecting the clamps and the outside of the dialysis machines D. Using chemical disinfectant or cold saline to disinfect the dialysate pathway

Front

C. Disinfecting the clamps and the outside of the dialysis machine

Back

Which of the following statements about sorbent dialysis is correct? A. It needs a continuous supply of fresh water to add to new dialysate B. In preparing the dialysate, 6 liters of water are added to premixed chemicals C. The duration of the dialysis procedure cannot be altered D. It requires a six-layered cartridge

Front

B. In preparing the dialysate, 6 liters of water are added to premixed chemicals

Back

A hemodialysis patient suddenly develops trouble breathing, hives itching, and hypotension. The most likely cause is: A. An air embolism B. An anaphylactic reaction C. Angina D. Disequilibrium syndrome

Front

B. An anaphylactic reaction

Back

A dialysis patient develops a purulent discharge at the exit site of a central catheter. Which of the following pathogens is the most likely to be cultured? A. Staphylococcus aureus B. Clostridium difficile C. Enterococcus D. Mycoplasma

Front

A. Staphylococcus aureus

Back

When placing a needle into a graft, a hemodialysis technician may do which of the following? A. Use three sides to cannulate the graft, not just the top B. Cannulate at the junction of the graft with the native vessel C. Keep arterial and venous needles less than 1 inch apart D. Place both arterial and venous needles in a retrograde (against direction of blood flow) manner

Front

A. Use three sides to cannulate the graft, not just the top

Back

To calculate the amount of fluid removal from the patient during dialysis, all of the following values are used EXCEPT: A. Priming saline volume B. Saline rinse back C. Dietary intake D. Volume of urine output

Front

D. Volume of urine output

Back

Which pressure in the dialysis circuit is usually negative? A. Arterial pressure B. Pre-dialyzer pressure C. Post-dialyzer pressure D. Venous pressure

Front

A. Arterial pressure

Back

What is the urea kinetic modeling calculation? A. it gives the minimum delivered dose B. It gives the minimum prescribed dose C. It gives both minimum delivered and prescribed doses D. It is independent of dialyzer type

Front

C. It gives both minimum delivered and prescribed doses

Back

For patients in whom the priming solution is to be discarded, what should the hemodialysis technician do next? A. Connect the arterial and venous tubing before beginning dialysis B. Connect the arterial tubing, and allow the priming solution to drain before connecting the venous tubing C. Connect the blood lines only after the primer is discarded D. Do none of the above

Front

B. Connect the arterial tubing, and allow the priming solution to drain before connecting the venous tubing

Back

Which of the following statements about arteriovenous grafts is correct? A. They are more prone to thrombosis than arteriovenous fistulae B. They are less prone to cause stenosis than arteriovenous fistulae C. They are less prone to infection than arteriovenous fistulae D. They have a longer lifespan than arteriovenous fistulae

Front

A. They are more prone to thrombosis than arteriovenous fistulae

Back

Which of the following pathogens is most likely to be spread during dialysis treatment? A. Hepatitis B B. Hepatitis C C. Human Immunodeficiency Virus D. Tuberculosis

Front

A. Hepatitis B

Back

Using a sterile technique, a hemodialysis technician should avoid all the following EXCEPT: A. Touching the needle to the outside of a saline bag before penetrating the port B. Touching the heparin syringe tip or the end of the heparin line C. Getting the sterile packet wet D. Washing hands and using sterile gloves

Front

D. Washing hands and using sterile gloves

Back

A low-pressure alarm in the venous (post-dialyzer) line is likely to be set of by: A. A blockage in the blood tubing between the monitoring site and the venous needle B. An infiltration of the venous needle C. A clot in the venous access D. A blockage in the blood tubing before the monitoring site

Front

D. A blockage in the blood tubing before the monitoring site

Back

Which of the following arteries is most commonly used for an arteriovenous fistula? A. Ulnar artery B. Radial artery C. Brachial artery D. Femoral artery

Front

B. Radial artery

Back

A thrombosis is LEAST likely to develop with which of the following vascular access methods? A. A central venous catheter B. An arteriovenous graft C. An arteriovenous fistula D. All of the above

Front

C. An arteriovenous fistula

Back

Which of the following may cause hemolysis of red blood cells during dialysis? A. Kinked blood lines B. Warm dialysis fluid C. Inadequate water treatment D. All of the above

Front

D. All of the above

Back

Which of the following should be avoided when drawing up medication into a syringe? A. Reading the drug name and concentration before drawing it up and then checking it twice B. Injecting air from the syringe into the vial equal to the amount of planned withdrawal C. Changing needles after half the volume is drawn up D. Expelling air bubbles from the syringe before injecting the contents

Front

C. Changing needles after half the volume is drawn up

Back

Which of the following vital signs is abnormal before dialysis in a 30 year-old male patient? A. Blood pressure: 145/95 mm Hg B. Pulse: 90/min and regular C. Temperature: 98.60 F (37 degrees Celsius) D. Respirations: 16/min

Front

A. Blood pressure: 145/95 mm Hg

Back

Common sites of stenosis in patients with an arteriovenous fistula include all the following EXCEPT: A. The vein next to the anastomosis B. Along the outflow vein C. the large draining vein of the arm near the shoulder D. The artery next to the anastomosis

Front

D. The artery next to the anastomosis

Back

A diabetic patient undergoing dialysis complains of tingling, numbness, and cold in the hand below the access site. The most likely cause is: A. Steal syndrome B. Recirculation C. Infiltration D. An aneurysm

Front

A. Steal syndrome

Back

High-output cardiac failure is a complication of arteriovenous fistula or grafting. All of the following actions are a part of this condition EXCEPT: A. Increased venous return to the heart B. Decreased cardiac workload C. Reduced resistance in the arterial bed D. Activation of the renin-angiotensin system

Front

B. Decreased cardiac workload

Back

The hemodialysis technician who is about to insert a needle into the arteriovenous fistula should first do all of the following EXCEPT: A. Feel for flat spots and check for a thrill B. Listen for a bruit C. Place the needle into a previous cannulation spot D. Check skin temperature

Front

C. Place the needle into a previous cannulation spot

Back

If a small fire breaks out in the dialysis center, which of the following safety sequence is correct? A. Contain the fire, activate the alarm, and rescue the patients B. Disconnect patients from the machines, and first evacuate patients who cannot walk C. When using a fire extinguisher, pull the pin, aim the nozzle at the base of the flames, squeeze the handle, and spray from side to side at the base of the flames D. Give all patients and staff respirator masks, and await the fire department

Front

C. When using a fire extinguisher, pull the pin, aim the nozzle at the base of the flames, squeeze the handle, and spray from side to side at the base of the flames

Back

Recirculation refers to: A. Recycling used dialysate into fresh dialysate B. Mixing dialyzed venous blood with blood entering the arterial needle C. Bypassing the fistula via collateral vessels D. None of the above

Front

B. Mixing dialyzed venous blood with blood entering the arterial needle

Back

An antiseptic that kills bacteria when wet is: A. 70% alcohol B. 10% povidone iodine (Betadine) C. Chlorhexidine gluconate with 70% alcohol (ChloraPrep) D. Sodium hypochlorite (Except Plus)

Front

A. 70% Alcohol

Back

During needle insertion, it is important for the hemodialysis technician to always: A. Keep the bevel facing down B. Rotate the needle 180 degrees after insertion C. Cannulate the venous access in an antegrade manner (with the blood flow) D. Check skin temperature

Front

C. Cannulate the venous access in an antegrade manner (with the blood flow)

Back

In a patient with a fistula in one arm and an intravenous line in the other, manual blood pressure should be taken in the: A. Arm above the intravenous line B. Arm above the fistula C. Leg with the patient supine D. Leg with the patient standing

Front

C. Leg with the patient supine

Back

When drawing blood samples for laboratory testing, the hemodialysis technician should draw samples: A. After giving saline and heparin B. From the arterial blood line injection port C. Into tubes with anticoagulant first D. Keep them on a warm surface

Front

B. From the arterial blood line injection port

Back

Which of the following statements about an air detector is correct? A. It is present in the pre-dialyzer blood tubing B. It uses an ultrasonic device to detect air in the blood path C. It set off and alarm and clamps the pre-dialyzer blood tubing D. All of the statements are correct

Front

B. It uses and ultrasonic device to detect air in the blood path

Back

Which of the following statements about grafts used for arteriovenous shunts for dialysis shunts for dialysis patients is correct? A. They cannot be made from human or animal blood vessels B. They can be made from collagen or expanded polytetrafluoroethylene C. They take longer to mature than fistulas D. They have a lower rate of clotting than fistulas

Front

B. They can be made from collagen or expanded polytetrafluoroethylene

Back

Section 3

(50 cards)

All of the following are part of a standard dialysis prescription EXCEPT: A. Access to cannulate B. Length and frequency of treatment C. Dialysate composition D. Heparin dose

Front

A. Access to cannulate

Back

Taking the Certified Clinical Hemodialysis Technician exam requires all of the following EXCEPT: A. 6-months of full-time (1000 hours) experience and training B. A signature of a preceptor or supervisor to prove training and experience C. Compliance with state requirements for hemodialysis technicians D. A high school diploma or GED

Front

A. 6-months of full-time (1000 hours) experience and training

Back

A recent study published in The New England Journal of Medicine compared hemodialysis three times a week with hemodialysis six times a week. At the end of a 12-month follow-up period, the study showed the six-times-a-week group had: A. A weekly Kt/V that was the same as in the three-times-a-week group B. Fewer deaths C. The same left ventricular mass as in the three-times-a-week group D. No difference with vascular access problems than in the three-times-a-week group

Front

B. Fewer deaths

Back

Federal regulations require a center that reuses dialyzers to have: A. A system of quality assurance B. A system of quality control C. Both a and b D. Neither a nor b

Front

C. Both a and b

Back

Which of the following statements about the nephron, the working unit of the kidney, is correct? A. It makes about 180 liters of glomerular filtrate a day B. Renal tubules deliver urine directly into the ureters C. Nephrons are found only in the renal cortex D. Bowman's capsule separates the collecting ducts from the renal tubules

Front

A. It makes about 180 liters of glomerular filtrate a day

Back

At the end of treatment, which of the following actions should be done first? A. Blood rinse back B. Pre-clean the dialyzer C. Blood leak test D. Measure the dialyzer's total cell volume

Front

A. Blood rinse back

Back

Which of the following statements about new dialyzers is correct: A. They should not be preprocessed B. The total cell volume (TCV) does not need checking until after reprocessing C. They may be preprocessed to reduce noxious chemicals or materials D. The TCV needs to be checked against other dialyzers after reprocessing

Front

C. They may be preprocessed to reduce noxious chemicals or materials

Back

All of the following statements regarding kidney transplantation are correct EXCEPT: A. The risk of death is in the 3%-5% range during the first year B. There are more dietary restrictions in PD C. There is a 10%-15% lower success rate if the first transplant is rejected D. The diseased kidneys are usually removed

Front

D. The diseased kidneys are usually removed

Back

The nephrotic syndrome is characterized by all the following EXCEPT: A. Hematuria B. Proteinuria greater than 3.5 g/d/1.72 m@ body surface area C. Hyperlipidemia D. Hypoalbuminemia

Front

A. Hematuria

Back

Which of the following statements about certification examinations in clinical nephrology technology and in biomedical nephrology technology is correct? A. They are given by different nephrology certification groups B. They require 12 months of work experience to take the examination C. They both require six major areas of knowledge in nephrology and dialysis D. All of the above statements are correct

Front

B. They require 12 months of work experience to take the examination

Back

Water softeners remove calcium and magnesium by: A. Ion exchange B. Adsorption C. Filtration D. Osmosis

Front

A. Ion exchange

Back

Grounds for discarding a dialyzer include which of the following? A. The total cell volume is 85% of the original B. It has been exposed to more than one germicide C. Clearance is only 95% D. A few residual streaks of blood are seen on inspection

Front

B. It has been exposed to more than one germicide

Back

Professionalism for a hemodialysis technician includes: A. Using a patient's first name or nickname to make the dialysis experience less formal B. Discussing personal problems with the patient as a way of sharing misfortune C. Keeping busy at all times to indicate that the technician is a critical member of the team D. Refraining from talking about a patient to a colleague the conversation may be overheard

Front

D. Refraining from talking about a patient to a colleague the conversation may be overheard

Back

A patient with kidney disease has anemia, fatigue, elevated phosphate levels, ankle edema, and elevated blood pressure. What is the most likely range of his glomerular filtration rate? A. 90-100 mL/min B. 60-90 mL/min C. 15-29 mL/min D. 5-15 mL/min

Front

C. 15-29 mL/min

Back

The average hemodialysis patient is exposed to how many liters of water a week? A. 10 L B. 100 L C. 350 L D. 1000 L

Front

C. 350 L

Back

What is a sensitization test for a potential kidney transplant recipient? A. Human leukocyte antigen match B. Blood group test C. Potential recipient serum tested with a multiple donor lymphocyte panel D. Potential donor serum tested with potential recipients' lymphocyte panel

Front

C. Potential recipient serum tested with a multiple donor lymphocyte panel

Back

Public Law 92-603, which originally passed in 1972, is concerned with which of the following? A. It covers dialysis only B. It covers dialysis and kidney transplants C. It requires Medicare to pay 100% of dialysis treatment D. It set clinical requirements for dialysis patients

Front

B. It covers dialysis and kidney transplants

Back

To avoid environmental contamination, it is important to do which of the following? A. Clean all surfaces at the station and the external portion of the dialysis machine B. Avoid storage of food and beverages in the same refrigerator or other container with blood or body fluid samples C. Place all used dialyzers and tubing in leak-proof containers D. Do all of the above

Front

D. Do all of the above

Back

A brother of a dialysis patient has blood type O and is being considered a potential kidney donor. What are the odds that he will be a complete match and suitable donor? A. 25% B. 50% C. 75% D. 100%

Front

B. 50%

Back

Which of the following physicians is credited with inventing dialysis? A. Willem J. Kolff, MD B. Belding H. Scribner, MD C. James A. Cimino, MD D. Gregory House, MD

Front

A. Willem J. Kolff, MD

Back

Which of the following immunosuppressive drugs used in kidney transplant patients has renal toxicity? A. Prednisone B. Cyclosporine C. Azathioprine D. All of the following

Front

B. Cyclosporine

Back

Which of the following action is most important in preventing spread of infection? A. Wearing sterile gloves B. Autoclaving equipment C. Hand washing D. Wearing a sterile gown and mask

Front

C. Hand washing

Back

In a water treatment system, feed water is adjusted to a temperature of: A. 55 degree F, using a heater and cold water B. 95 degree F, using a heater and cold water C. 77 degree F-82 degree F, using hot water and a refrigeration unit D. 77 degree-82 degree F, using hot and cold water and a blending valve

Front

D. 77 degree-82 degree F, using hot and cold water and a blending valve

Back

A diet restricting all of the following is appropriate for a renal failure patient EXCEPT for: A. Potassium B. Calcium C. Phosphate D. Fluids

Front

B. Calcium

Back

The National Kidney Foundation's Kidney Disease: Improving Global outcomes includes treatment guidelines for all the following EXCEPT: A. Vascular access B. Anemia C. Hepatitis D. High blood pressure

Front

C. Hepatits

Back

One difference between peritoneal dialysis (PD) and hemodialysis (HD) is: A. There is a greater incidence of disequilibrium syndrome in PD B. There are more dietary restrictions in PD C. Fluid build-up is less of a problem in HD D. The patient is subjected to constant dialysis in PD rather than intermittent dialysis in HD

Front

D. The patient is subjected to constant dialysis in PD rather than intermittent dialysis in HD

Back

A return loop recycles water through the water treatment system because: A. It reduces the amount of water required B. It prevents stagnant spots C. Of both a and b D. Of neither a nor b

Front

C. Of both a and b

Back

Which of the following statements about biofilm is correct? A. It is easily removed from the water treatment system B. It does not adhere to surfaces C. It does not affect the water treatment system D. It is an aggregate of microorganisms that produce a matrix of extracellular polymeric substance (slime)

Front

D. It is an aggregate of microorganisms that produce a matrix of extracellular polymeric substance (slime)

Back

As part of the job of a dialysis technician, one may be required to lift equipment or assist with patient transfers. Back pain-sparing and injury prevention maneuvers include: A. Twisting the body to gain more power while lifting a heavy object B. Pulling the heavy item; never pushing it C. Lifting with the legs and holding the object close to the body D. Trying to lift the object rapidly to avoid straining the back

Front

C. Lifting with the legs and holding the object close to the body

Back

All of the following are indications to start hemodialysis in a renal failure patient EXCEPT: A. Encephalopathy and seizures B. Serum potassium of 6.5 mEq/dL C. Serum creatinine of 15 mg/dL D. Creatinine clearance of 25 mL/min

Front

D. Creatinine clearance of 25 mL/min

Back

Which of the following statements about deionization of water is correct? A. It removes only cations B. It removes only anions C. It removes both anions and cations D. It uses on-site regenerated resins

Front

C. It removes both anions and cations

Back

A concurrent flow occurs when blood and dialysate flows in the same direction. This make a dialyzer about ___________% efficient. A. 10% B. 20% C. 15% D. 25%

Front

C. 15%

Back

Which of the following statements about administering erythropoietin to a hemodialysis patient is correct: A. Administer it until the hemoglobin level is normal B. Give supplemental iron if ferritin is low C. Give it subcutaneously only D. Double the dose if the hemoglobin has not increased by 1g/dL in 4 weeks

Front

B. Give supplemental iron if ferritin is low

Back

Which of the following statements best describes dialysis centers today? A. They are mostly owned by large dialysis organizations B. They are mostly hospital based C. They are overseen directly by Medicare D. None of the above described dialysis centers

Front

A. They are mostly owned by large dialysis organizations

Back

What is an endotoxin? A. It is a germicide B. It is not adsorbed by dialysis membranes C. It is a toxin produced by certain bacteria D. It is a substance that is not harmful to the patient

Front

C. It is a toxin produced by certain bacteria

Back

Continuous quality improvement refers to: A. Purifying water to make dialysate B. Improving the blood access surgery C. A method for improving clinical, technical, and organizational procedures D. A checklist of clinical data

Front

C. A method for improving clinical, technical, and organizational procedures

Back

Which of the following is most likely to cause problems for the patient receiving hemodialysis treatments? A. Too lengthy dialysis session B. Inadequate vascular access C. Mistaken dialysis prescription D. Dietary indiscretion

Front

B. Inadequate vascular access

Back

Which of the following statements about preprocessing dialyzers is correct? A. It must be done manually B. It can be done manually or by machine C. It may be done in all commercial dialyzers D. It may be done according to the local center's protocol

Front

B. It can be done manually or by machine

Back

Which of the following statements about "first-use syndrome" is correct? A. It may be reduced by repeated rinsing of the dialyzer B. It is less common in dialyzers treated with ethylene oxide C. Both a and b are true D. Neither a nor b are true

Front

A. It may be reduced by repeated rinsing of the dialyzer

Back

Which of the following germicides is most commonly used to disinfect dialyzers in the United States? A. Formaldehyde B. Glutaraldehyde C. Heat with citric acid D. Peracetic acid

Front

D. Peracetic acid

Back

Which of the following statements about an ultraviolet irradiator is correct? A. It emits light at a wavelength of 254 nanometers B. It has a glass sleeve through which water flows and that admits light C. It uses a hydrogen vapor lamp D. All of the above are true

Front

A. It emits light at a wavelength of 254 nanometers

Back

Which of the following statements about carbon tank removal of chlorine and chloramine from feed water is correct? A. It should use activated powdered charcoal B. It requires two carbon tanks in a series C. It may be done with a continuous flow of water D. It requires backwashing when the charcoal is exhausted

Front

B. It requires two carbon tanks in a series

Back

What does the expression Kt/V signify with regard to hemodialysis? A. Blood flow through the dialyzer B. Dialysate flow through the dialyzer C. Prescribed dose of dialysis D. Formula for mixing water and concentrate

Front

C. Prescribed dose of dialysis

Back

Which of the following substances is the most common impurity in tap water? A. Sodium chloride B. Carbonic acid C. Calcium nitrate D. Calcium carbonate

Front

D. Calcium carbonate

Back

Inspection and standards for dialysis centers may be provided by: A. The Food and Drug Administration B. State health departments C. The Association for Advancement of Medical Instrumentation D. All of the above

Front

D. All of the above

Back

Which of the following statements about multimedia filters is correct? A. They trap successively smaller particles B. They trap successively larger particles C. They are backwashed with added solvent D. They are not necessary if an ultra-filter is present downstream

Front

A. They trap successively smaller particles

Back

Acute tubular necrosis may be caused by: A. Shock and hypotension B. Rhabdomyolysis C. Radiographic contrast material D. All of the above

Front

D. All of the above

Back

Which of the following statements about reverse osmosis is correct? A. There is a movement of water across a semipermeable membrane from a low-solute concentration to a high-solute concentration B. Pre-filtration is not required C. Hydraulic pressure is used to move water through the membrane D. Solute concentration on both sides of the membrane becomes equal

Front

C. Hydraulic pressure is used to move water through the membrane

Back

The pH of feed water is 9.0 at a certain center. Which of the following would be the best water treatment? A. No treatment is required B. Add hydrochloric acid to the feed water, using a mixing chamber C. Add sulfuric acid by direct injection into the water line D. Add sodium hydroxide to the feed water, using a mixing chamber

Front

B. Add hydrochloric acid to the feed water, using a mixing chamber

Back

Adding extra sodium chloride to the dialysate will: A. Draw water out of cells and tissues into the blood B. Decrease urine production during dialysis C. Reduce the amount of fluid that is ultra-filtered D. Have no effect on blood volume or fluid removal

Front

A. Draw water out of cells and tissues into the blood

Back